A New Perspective on Sex Addiction (Research)

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The American Society of Addiction Medicine has put addiction back in the spotlight by virtue of its new definition of the term. An upcoming conference will hear how sex addiction falls under this ambit.

While most people understand the background to addiction, they tend to think mainly of alcohol or drugs, and might not understand or appreciate the prevalence of behavioural addictions (such as addictions to gambling, sex, shopping, hoarding or eating).

In August this year, the American Society of Addiction Medicine (ASAM) released a new definition of addiction, highlighting that: “Addiction is a chronic brain disorder and not simply a behavioural problem involving too much alcohol, drugs, gambling or sex.” This was the first time that the ASAM has taken an official position that addiction is not solely related to problematic substance use and has included behavioural or process addictions in its definition.

Dr Susan Campling, Director of Gentle Path at Pine Grove Behavioural Health in Mississippi, will be talking about ‘Sex Addiction and Domestic Violence’ at the forthcoming Toranfield House NEAR (Neuroscience and Evidence-based practices for Addiction and Recovery) Conference in the Ritz Carlton, Powerscourt, in Enniskerry from 10-12 November.

Talking about the ASAM definition, and specifically in relation sex addiction, Dr Campling explained: “There has been considerable research done in the past 10 years that supports the dopamine hypothesis of addiction. It’s believed that anything that causes a surge of dopamine into the nucleus accumbens of the brain can become addictive.

“For example, research at the University of Florida by Dr Mark Gold addresses the hypothesis of hedonic eating, or addictive eating. It’s believed that for some individuals, food becomes the drug of choice — especially high-carbohydrate, high-sugar foods. Milkman and Sunderwirth address the neuropathway theory of satiety, in which food, opiates, alcohol and love all target similar experiences of nurturance, acceptance and contentment.”

Forms of sex addiction
So, what is sex addiction and how do people become addicted to sex? Dr Campling said that sex addictions have many forms — the first being having an affair (or serial affairs) where the person suspends reality, has an affair, feels they are falling in love and feels accepted and loved. However, that is over-simplistic; there are “other things at play here”, according to Dr Campling.

Power of the orgasm
“Firstly there’s oxytocin, which makes a person feel good; then there’s the huge ‘power of the orgasm’, which makes people feel that everything is alright in the world.”

The second type of sex addiction is anonymous sex, whether that means looking for sex online or going to a ‘crack house’ to engage in illicit sex. The drivers of this type of sex addiction are high arousal and the excitement of the risks inherent in having sex with a stranger. Risk is inherent in other addictions such as gambling, cocaine, methamphetamine and, to some degree, anorexia. All stimulate sympathetic nervous system arousal and the secretion of excitatory neurotransmitters, such as epinephrine and norepinephrine.

The third type of sex addiction is fantasy: this is mainly associated with pornography and masturbation. People involved in this type of sex addiction become extremely attached to their porn, often spending hours in front of their computer. The fantasy becomes the primary relationship and social isolation is commonly seen. When people become addicted to pornography, there is little chance of rejection. More often than not, the person involved in this type of sex addiction is probably struggling with an underlying feeling of not being accepted.

According to Dr Campling: “There’s quite a common profile of people who indulge in this type of sexual fantasy behaviour. While a large proportion of men indulge in pornography of some sort or other, porn amongst women is undoubtedly increasing and actual addiction to this type of sex is on the increase across the board.”

Interestingly, all addictions access the fantasy pathways in the brain to some degree. Addicted people almost always acknowledge that they begin to ‘get high’ and alter their reality the moment they think about using their drug of choice.

Increasing tolerance
As with all other addictions, the tolerance of the medium increases, ensuring that the person needs to get more and more stimulation as time goes on, in order to achieve the same type of result. For example, porn addiction may start off quite simply as someone looking at Playboy magazine, yet end up entering into much more dangerous types of behaviour.

In the old days, if you wanted to go and get porn, you had to physically go into your local store and buy a magazine — usually from someone you knew quite well. That was a good deterrent! Today, all you have to do is push a button on your computer’

The reasons for that seem obvious on closer inspection, as Dr Campling explained: “In the old days, if you wanted to go and get porn, you had to physically go into your local store and buy a magazine — usually from someone you knew quite well. That was a good deterrent! Today, all you have to do is push a button on your computer.”

Dr Campling went on to explain how the sex industry “then brings people down paths they might not otherwise have gone down”. For example, somebody who looks online to access a certain type of porn will then be inundated with pop-up advertisements, inviting them down different avenues to different types of sexual behaviours and interests. “The human imagination is infinite and highly creative. We’re seeing those qualities in the pornography available on the internet,” she added.

Dr Campling was clear about the difference between someone who perhaps has an over-zealous interest in sex versus someone who is involved in full-on sex addiction. As with other addictions, the principle applies that if the person continues to engage in the behaviour on a continued basis, despite the negative consequences of that behaviour — and if they deny it or lie about it on a consistent basis — they are likely addicted.

That is the case, whether the person is having affairs, indulging in anonymous sex, or over-using porn or masturbation. The addicted person loses their ‘moral compass’ as the addiction becomes of primary importance in their life.

Domestic violence
At the NEAR Conference, Dr Campling will also speak about the phenomenon of domestic violence and the growing body of research that demonstrates domestic violence, too, is an addictive process. Again, while this is clearly not the case for everybody who suffers from/is responsible for domestic violence, in some cases the victim (be that the man or woman) gets used to the abusive behaviour and tries to hide the negative consequences of the behaviour. They may perhaps even lie to their family and stick up for their partner, despite all evidence to the contrary.

The perpetrator often continues to abuse the victim, despite the negative consequences on their lives: by lying to him/herself; by denying things are as bad as they are; or by blaming their victim for driving them to it. As Dr Campling put it, “shame is a lousy re-enforcer”.

“Not only does it keep the cycle going, it actually helps to keep people acting out”.

She accepted that whilst some people used the excuse that they were addicted to sex to account for unacceptable infidelity or other inappropriate behaviour — such as serial affairs — they really were just attempting to use their ‘get-out’ clause.

At the end of the day, for many people in the throes of sex addiction, it is not an excuse; however, they are still responsible for their behaviour and have to face the consequences. Dr Campling pointed out that everyone should bear in mind that “famous people aren’t much different to any of us”.

Dr Campling will be one of the many international speakers at the Toranfield House NEAR Conference, having spent more than 20 years working in the field of mental health and addiction treatment and presenting extensively on the topics of sexual addiction, sexual offending, domestic violence and trauma.


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