Sexual Addiction: A Multi-Factoral Approach

By Darrell Provinse, MA, LPC, NCC

In order to discuss sexual addiction we must first define our terms.  We can reasonably define an addiction as obsessive or intrusive thoughts or cravings, which produce a compulsion to act in a way that is unwanted, undesirable, or harmful either to the individual or others.  In terms of sexual addiction, I think we can reasonably cast that net broadly enough to include any unwanted, damaging, or maladaptive sexual behaviors that the individual experiences themselves as being powerless to control.  Karnes (1983) defined sexual addiction as pathological relationship with a mood altering experience.  There again in most respects, I think that could apply to almost any type of addiction.

At Agape, we tend to view an individual holistically.  We see them as not merely the product of their environment or learning, but an interaction of the biological, the psychological, the emotional, the spiritual, the social, the relational, etc.  It is supportable to say that there is a biological basis for addictive behaviors; but that doesn’t excuse them, nor is it even sufficient to explain them.  Some could say that it’s the product of faulty thinking, or past experiences.  Again this would be true, but that, in itself, may not be sufficient to produce the acting out behavior.  Similarly, to say that sexual addiction is sin would certainly be correct, but it may not be useful to merely say, “So therefore, stop sinning” or “Just pray more,” because that, in isolation, may feed into the individual’s sense of being misunderstood or their guilt-shame cycle that actually promotes and produces more maladaptive behaviors.  We believe that human experience (e.g., thoughts, feelings, and behaviors) are multi-factoral.  We get the best results by breaking down these thoughts, feelings, behaviors into their component parts, and addressing each factor individually. By doing that we can then formulate a comprehensive and effective approach to treatment and intervention.

In terms of working with someone who is in bondage to sexual addiction, we believe it’s necessary to look at the historical, e.g., early exposure to pornography or other sexually explicit material, early childhood sexual experiences, sexualization in the home, molestation, etc. as one component which necessarily must be addressed.  This is not used to justify or rationalize, but it is to help to understand what things are factoring in to the individual’s choice of behavior, how they see themselves, and how they see the world.

We also look at the cognitive, those things that they tell themselves, their beliefs, and whether or not their beliefs about themselves and their world are accurate, and how those beliefs shape their behavior and their perceptions of self-efficacy.

We look at the behaviors that contribute to the cycle of acting out.  That may include isolating, or getting on the computer when there’s no accountability, or engaging in conversations that begin the process of obsessive, intrusive thoughts.  This would even include the cycle itself of acting out, feeling remorse, the remorse turning to guilt, the guilt turning to shame, the shame turning the hopelessness, and then the hopelessness causing that person to once again act out.

We also look at the physiological.  We find that many people who have ADD, for example, tend to medicate by seeking out highly stimulating behaviors.  Since sexually acting out, whether it’s viewing pornography or engaging in high-risk behaviors, etc. is by its nature highly stimulating, it can actually have a soothing effect or create a sense of well being.  We know that people who are Bipolar, when they are manic, will often seek out, either compulsively or impulsively, highly stimulating behaviors, also.  Again, if there is an underlying issue of mood swings, then that necessarily needs to be addressed as part of the comprehensive approach to dealing with the bondage to sexual addiction.  Often when people are depressed, they will seek to medicate or distract themselves through the use of pornography.  On some level, there is then a biological component or basis when somebody views pornography; it stimulates dopamine in the pleasure center areas of the brain.  When viewed on a brain scan, it looks very much like a cocaine high or a similar euphoric experience.  Once this pattern is engrained in the addict’s brain, it is difficult to change.  Landau, J. et. al. (2008, pg. 4) states, “The neurobiology of sexual arousal parallels that of cocaine in its relationship to dopamine, the brain’s pleasure chemical.  Furthermore, the article states that where this is significant reward, as in sex, gambling, eating, shopping, etc. – there is the potential for compulsion.”

Other factors could be environmental.  When bills stack up, marriages grow cold, jobs get stressful, and/or the sting of singleness gets too hard to bear, an escape may seem necessary.  Some may use drugs, others may use food, while still others may use gambling.  Sex addicts use sex to either escape from too many external stimuli or to bring their internal emotions or passion to a life that either in their experience has too much or too little stimuli.

As alluded to previously, another component to be addressed is the relational.  Sex addicts often use sex to distance themselves from true intimacy which may seem threatening, or to create a false sense of intimacy in which there is a feeling of bonding without the same risk of being rejected or feeling emotionally vulnerable.  Many view sexual addiction as an intimacy disorder (Schwartz and Masters, 1994).  In this view, the concern with the addiction has more to do with intimacy than with sex.  Hypersexuality is seen as a symptomatic problem resulting from the lack of intimacy in one’s life.  Simply put, individuals will often turn to pornography, strip clubs, prostitution, fantasy, compulsory masturbation and other sexual acts to provide a sense of intimacy, even though it’s counterfeit.  The reason, the article presumes, that people settle for a false sense of intimacy, is that true intimacy either seems dangerous or elicit.  People often sexualize when they lack control in their primary relationships.  The sexualizing gives them opportunity to feel as if they are in control.

Another component is the spiritual, which, for some, may seem obvious or self-evident, but upon examination, it can be quite complicated as to how it plays out.  Some may compartmentalize their behavior, and believe that they have a good and strong relationship with God and a well developed spiritual life, and yet their acting out behaviors may stand in stark contrast to that belief.  Others may feel a sense of guilt or worthlessness because of their behaviors, which factors into that aforementioned cycle, of guilt which leads to shame, and that shame, instead of leading them to seek grace from the only One who can grant grace and forgiveness, they instead run out of fear, embarrassment, or hopelessness.

For anyone who believes themselves to be sexually addicted, the answer will not just be yes to one component, but to several if not all components.  The goal of therapy is to intervene at each point in order to achieve the best possible outcome.  It’s hard to have a good and healthy spiritual life, if your belief system is faulty.  It’s hard to foster good relationships, if your sense of self if flawed or if the behaviors that one engages in sabotages and damages those relationships.  Although not excusing the behavior, it is helpful to view even bad and self-damaging behavior as a maladaptive attempt to meet a very real need.  That doesn’t diminish that those behaviors may be objectively wrong, but it does give not only context for that behavior, but hope for how that behavior might be changed by finding adaptive ways to meet them.  For instance, relationally, by finding and developing a healthy emotional intimacy, first with God and then with a spouse, those intimacy needs can be met in a healthy way, and much of the drive and energy for the damaging behaviors can be reduced.

The nature of the addictive personality is to try to minimize, deny, or hide their struggle or not to admit that they are not in control.  Addiction is bondage.  In order to be truly free, one must be truly honest about their inability to manage on their own, and humbly enlist the help of God and others.

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