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Understanding the Neurobiology of Sex Addiction

Originally posted at: https://gentlepathmeadows.wordpress.com/2017/03/22/understanding-the-neurobiology-of-sex-addiction/

Alexandra Katehakis, a Senior Fellow at The Meadows, recently talked with Tami Simon of Sounds True’s Insights at the Edge podcast on a wide range of topics, including…

  • the roots of sexual dysfunction,
  • “grownup sex,” (i.e. sexuality based in honest communication of needs, preferences, and desires for novelty),
  • asexuality,
  • sexuality without intimacy, and
  • why orgasms are overrated.

Alexandra will also be presenting on sexual dysregulation during Sounds True’s Neuroscience Training Summit 2017 on March 23.

Here are a few highlights from the podcast episode:

What’s the difference between having a sex addiction and just being someone who just likes to have a lot of sex?

Alexandra: “One of the differences, main differences, is that people who declare themselves “sex addicts” are in a profound amount of pain as a result of their sexual behaviors. So what may have started out as fun or being used as a way to sort of get out of one’s head—or not deal with psychic pain that some people know or don’t know they have—quickly turns into the proverbial albatross around their neck.

They’ll have a high level of preoccupation with getting into the sexual experience, so sex becomes—there’s a myopia, there’s a shutting down of everything other than getting that experience. It becomes a collapsing of one’s life, and people typically report messes—or what they call “unmanageability” in the 12-Step Program—as a result of having this kind of destructive, painful sex. Which is different from someone who likes to have sex, enjoys it, feels sensual, it feels enlivening to them, and what we think of as life-affirming.” Have you worked with people who aren’t quite sure whether or not they have a sex addiction? How do you help them?

Alexandra: “The term gets thrown around quite a bit now and it doesn’t really fit the bill unless there’s a lot of assessment that’s done appropriately to look at whether there’s a long standing pattern of compulsivity and if this person has in effect created these adaptive strategies that become states over time so if for example you have a child who grows up in a very, very dangerous dysfunctional neglectful household and they start to learn through fantasy whether ti’s comic book fantasy or more commonly we see today kids getting on the internet and looking at internet pornography as early as six and eight years old, and that is there sole way of regulating themselves or feeling good what happens is that the brain starts to form around those patterned behaviors and so what is initially a coping strategy that helps that person manage difficult, lonely, sad, terrorized feelings over time becomes who they are, and they therefore can’t not do what they do. And so that’s the point where is “an addiction.” That these are tenacious neuronal networks that are wired together in the brain because they’ve been firing together for so long.”

“So, just because someone has an affair or looks at internet pornography does not make them a sex addict, it requires a lot of scrupulous assessment to see if that’s really true for each person and then some people like that term, some people don’t. I don’t have bias about what people call it I’m more interested in helping people get out of the snarl they’re in and move towards a healthier, more life affirming sexuality.”

How do you help sex addicts find a way to heal?

Alexandra: “Well, first, I take a very extensive history, because oftentimes these patterns get set not only in childhood, but sometimes really in infancy, depending on the level to which the person is chronically dysregulated, meaning unable to soothe themselves—wherein they’re always reaching for something outside of themselves to make themselves feel better.”

“Sometimes if somebody recalls or knows that their mother had a very difficult pregnancy or she was anxious or depressed at birth, that tells us that she was likely unable to attune to her infant so that she could bring his or her systems to fruition in the way they are meant to be optimally. So, if she’s anxious, her infant’s going to be anxious. If she’s depressed, the infant will be depressed. These are functions that get set up early, early on—some of which can be changed, some of which cannot down the road.”

“Also, if that person suffered any kind of emotional abuse, physical abuse, sexual abuse as a young person, or was grossly neglected, then they’re going to have a lot of trouble with regulating themselves. When a child is left alone or abused, he or she will find ways of coping. It’s sort of a natural adaptive strategy for survival. So, whether it’s fantasy or compulsive masturbation or, as I said before, disappearing into Internet pornography or even making up stories in one’s own head, all of those things are set up to make the pain or the sadness or the loneliness go away.”

“Oftentimes, children like that are set up to become addicts, whether they’re drug addicts or alcoholics or gamblers or eating—it’s hard to say why people choose which behavior to be compulsive with. But when they do, it’s helpful for clients to understand why what they’re doing makes a lot of sense. So, rather than feeling shameful or like they’re bad or damaged or broken, we look at why it makes good sense that they would be doing what they’re doing today because they adapted this a long, long time ago to survive. But, now it’s keeping them from having a healthy relationship or a healthy sex life, or being able to even be in a relationship, if that’s what they desire. That would be the start of treatment.” Learn More

To listen to the Insights at The Edge podcast with Alexandra Katehakis in its entirety, or to read a transcript, visit the Sounds True website.

To learn more about sex addiction workshops, inpatient programs and outpatient programs offered at The Meadows call 800-244-4949 or go to www.themeadows.com.

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Failing without Falling

You and I are on a great climb. The wall is high, and the stakes are higher. You took your first step the day you confessed Christ as the Son of God. He gave you his harness — the Holy Spirit. In your hands he placed a rope — his Word.

Your first steps were confident and strong, but with the journey came weariness, and with the height came fear. You lost your footing. You lost your focus. You lost your grip, and you fell. For a moment, which seemed like forever, you tumbled wildly. Out of control. Out of self-control. Disoriented. Dislodged. Falling.

But then the rope tightened, and the tumble ceased. You hung in the harness and found it to be strong. You grasped the rope and found it to be true. You looked at your guide and found Jesus securing your soul. With a sheepish confession, you smiled at him and he smiled at you, and the journey resumed.

Now you are wiser. You have learned to go slowly. You are careful. You are cautious, but you are also confident. You trust the rope. You rely on the harness. And though you can’t see your guide, you know him. You know he is strong. You know he is able to keep you from falling.

And you know you are only a few more steps from the top. So whatever you do, don’t quit. Though your falls are great, his strength is greater. You will make it. You will see the summit. You will stand at the top. And when you get there, the first thing you’ll do is join with all the others who have made the climb and sing this verse:

“To him who is able to keep you from falling and to present you before his glorious presence without fault and with great joy — to the only God our Savior be glory, majesty, power and authority, through Jesus Christ our Lord, before all ages, now and forevermore! Amen.” (Jude vv. 24–25 NIV)

Today’s devotional is drawn from Max Lucado’s Next Door Savior.

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Can You Ever Affair-Proof a Relationship?

psychologytoday.com · by Linda and Charlie Bloom

 Can love and good sex “affair-proof” a relationship?

This myth is deeply embedded in our culture and is even held by a fairly large number of marriage counselors. But a lot of people who hold this belief have been deeply disappointed to discover that it’s not necessarily true. While it may seem reasonable to assume that if both partners love each other and have a mutually satisfying sexual relationship, there would simply be no reason for either to stray. Well, that is true: There is no “good reason.” Affairs, however, are generally not motivated by reason or rational thinking, but tend to be matters of the heart, which is the source of passion and desire, and not the mind, which deals with abstraction and logic.

So while it does seem logical to assume that there would be little motivation for partners in a happy relationship to go outside of it to fulfill their most intimate desires, particularly if they’ve made an agreement to be monogamous, it does happen—and more frequently often than most of us realize. A study cited in the Journal of Marital and Family Therapy in 2015 reported that 54 percent of female respondents, and 57 percent of males, stated that they had been unfaithful in their relationship. What may also be surprising: The average length of the affairs was two years.

Still more surprising is that according to relationship and sexuality expert Esther Perel, author of Mating in Captivity, the motivating drive to have an affair is a desire not necessarily for sex, but rather for experiences their relationship is no longer delivering. What they desire, according to Perel, is attention, novelty, adventure, vibrancy, aliveness, and passion. They crave the experience of losing themselves in the intensity, excitement, and stimulation of a new relationship, with the hope of re-invigorating the feelings that occur in the stage of infatuation.

Too often, it seems that couples fail to keep that spark alive after they formalize their commitment, and so they run the risk of weakening the glue that keeps their relationship passionate and healthy. When daily routines and responsibilities dominate their attention, the risk of a violation of their monogamy agreement increases. When either partner feels that they must submerge aspects of themselves to maintain peace or avoid conflict, the risk factor is similarly heightened. The fantasy of being free to be fully authentic, and to experience aspects of oneself with another person that one’s partner disapproves of, is a compelling motivator for anyone who has withheld or concealed aspects of themselves out of fear of judgment, rejection, or punishment.

The expectation that one person can and should meet all of another’s needs, particularly when many of them appear to be at odds with each other—security and adventure, excitement and peace of mind, spirituality and sensuality, tenderness, and strength—can be a setup for disappointment or betrayal. This is not to justify violating anyone’s vows, but rather a warning to be mindful of the dangers of holding a partner responsible for fulfilling a range of needs and desires that may be beyond any one person’s capacity.

The experience of loneliness is also something that can occur even in good relationships. This often comes as a surprise to those who wrongly assume that once they enter into a serious partnership, their lonely days are over. But the experience of loneliness has more to do with our relationship to ourselves than whether we are in relationship, or with whom. It is a function of how comfortable we are in our own skin, whether we relate to ourselves with compassion or criticism, and how much we enjoy our own company. When we mistakenly hold our partner responsible for taking away our loneliness and making us happy, he or she will be likely to feel turned off by our efforts to coerce their attention.

There is a significant difference between desire and neediness: Neediness often feels manipulative and is seen as a turnoff. It can also include a sense of entitlement, or an expectation that one has the right to be taken care of by one’s partner. When we experience a partner’s desire, without their expectation of our reciprocity toward us, it feels pleasurable and attractive.

Sometimes the burden of fulfilling family obligations and responsibilities can feel oppressive, and the desire for relief, even briefly, can be compelling. At these times we are particularly vulnerable to the temptation of affairs. When partners take each other for granted and neglect their relationship, they put it in jeopardy. When unresolved conflicts mount up, resentment, anger, a lack of respect, and even contempt may form conditions that are an accident waiting to happen. Such animosity can become a perfect rationalization to go outside the marriage for intimate contact.

Infidelity can be as brief as a one-night stand, or a secret, years-long affair. Some people try to fulfill their need for attention and validation through sex. Some may rationalize their indiscretions with the justification that there was no intimate physical contact, but like emotional affairs, in which literal sex does not occur, even technical infidelity or virtual affairs can do great damage to one’s primary relationship.

No matter what their cause or nature, every betrayal harms a relationship and requires repair work to restore trust and integrity. Another statistic cited by the Journal of Marital and Family Therapy study was that, of marriages in which an affair was discovered or admitted, 31 percent lasted. The shock of the crisis can expose the source of the unmet needs that the affair was an attempt to fulfill, and in doing so, open the possibility for this breakdown to become a breakthrough, provided both partners do the work that is required to heal the relationship.

Pain can sometimes be a great motivator. It would, of course, be more efficient and less painful to avoid the torturous stages of wounding and healing that accompany unfaithfulness. There are many ways to enhance the quality of your relationship without unnecessary suffering. If you don’t know what they are, ask your partner: It’s likely that he or she will be happy to give you a few ideas. As the saying goes, an ounce of prevention is worth a pound of cure.

Linda and Charlie Bloom are excited to announce the release of their third book, Happily Ever After . . . and 39 Other Myths about Love: Breaking Through to the Relationship of Your Dreams:

“Love experts Linda and Charlie shine a bright light, busting the most common myths about relationships. Using real-life examples, they skillfully, provide effective strategies and tools to create and grow a deeply loving and fulfilling long-term connection.” —Arielle Ford, author of Turn You Mate into Your Soulmate

If you like what you read, click here to visit our website and subscribe to receive our free inspirational newsletters.

psychologytoday.com · by Linda and Charlie Bloom

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Why Is Your Partner’s Smartphone Use an Issue?

Smartphones have now been with us for 10 years, and play a huge part in our lives. We use them to take selfies, connect on social media and dating apps, read the news, and play interactive games. Many people check their smartphones as the last thing they do at night and then first thing in the morning. Train and bus passengers constantly gaze at their phones; people even stare at them when walking down the street, oblivious to others. There is no doubt that phones have changed the ways we behave and live.

Smartphones provide a way for people to stay closely connected with family and friends, and the array of options arguably create feelings of connectedness with others, but excessive use means that users forgo face-to-face interactions. Diverting one’s attention to a smartphone while in the company of another is a behavior known as phubbing, a portmanteau of phone and snub, and generally considered to be impolite or inappropriate in the context of social interaction.

If phubbing is impolite and inappropriate, what is the effect of such behavior on romantic relationships? Is it tolerated because of the closeness of romantic partners, or is its impact exacerbated because of it? Further, are there gender differences in emotional reactions and responses to phubbing?

McDaniel and Coyne (2016) suggest that smartphones can be intrusive and interfere with face-to-face interactions, with one partner feeling upset if the other becomes too absorbed in their phone when they are spending time together. Any distraction or intrusion when partners are together might cause upset, but are intrusions caused by smartphone use more of a problem? Does phubbing merely cause one partner to feel upset because they feel ignored? Or does it go further and cause them to be upset due to a feeling of jealousy as their partner is possibly connecting with a third party via their phone? Remember that one aspect of jealousy is the perceived threat to a relationship from another party.

Hanna Krasnova and colleagues investigated jealousy in partner phubbing and relationship outcomes (Krasnova, Abramova, Notter & Baumann, 2016). In their study, they employed participants between the ages 26 and 40, an age group they argue are most likely to use smartphones, while at the same time likely to be seeking sustainable romantic relationships.

The researchers asked participants to think of the last time their partner used their smartphone for too long in their presence. Participants reported that this happened:

  • When they were at home together (33.6 percent).
  • In bed before going to sleep (19.6 percent).
  • When they were home having a meal together (10.8 percent).
  • In the car or on public transport (9.8 percent).
  • When going out (4.5 percent).

(The remainder of the answers were watching TV, walking, and shopping.)

When asked to describe their emotions on these occasions, participants reported the following:

  • Loss of attention (28.6 percent).
  • Anger (19.4 percent).
  • Sadness/suffering (11.1 percent).
  • Boredom (3.2 percent).
  • Indifference (38.1 percent).
  • Happiness (4.4 percent).

The only notable gender difference was in happiness, with males reporting more happiness than females. However, compared to males, females reported more anger, sadness, and indifference.

The researchers then asked about participants’ coping strategies to phubbing. Reactions included:

  • Voicing intervention, such as making a request to stop using the phone (27.1 percent).
  • Showing curiosity by either looking at the other’s screen or voicing suspicion (7.3 percent).
  • Mirroring; for example, doing the same as a partner (6.9 percent).
  • Doing something else (13 percent).
  • Loyalty, such as showing tolerance, waiting, and understanding (22.3 percent).
  • Feeling negative—being annoyed or angry (7.3 percent).
  • No reaction (22.3 percent).

In terms of gender differences, males reported coping more in terms of loyal reactions compared to females. Further, males were twice as likely to exhibit mirroring behavior compared to females. Overall, it seems that males report more positive emotional responses and coping with phubbing behavior compared to females.

Finally, the researchers tested the relationship between partner phubbing, feelings of jealousy, and relational cohesion (the feeling of togetherness or emotional bonding). They found that it was not just annoyance or the feeling of being ignored when their partner used their phone that impacted on cohesion. Rather, it was more likely affected by an individual’s feeling of jealousy at their partner using their smartphone.

While jealousy is often discussed within the context of partner rivalry, jealousy is often experienced in other ways, such as a partner spending time with friends, or time at work; overall, jealousy can be associated with relationship deterioration. Previous research on jealousy revealed that not all interruptions to a social interaction are perceived equally; even from an early age we experience more intense feelings of jealousy towards social objects than inanimate ones (Hart et al, 2004).

The research of Krasnova et al. seems to suggest that we tend to see smartphones more as social objects—not just phones or computers—because they enable connection with others. Overall, it seems that it is not the process of phubbing itself (merely being ignored), but the feeling of jealousy (a partner connecting with another person) that phubbing triggers which ultimately leads to relationship dissatisfaction.

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References

Hart, S. L. Carrington, H. A., Tronick, E. Z. and S. R. Carrol (2004).’When infants lose exclusive maternal attention: Is it jealousy?’ Infancy 6 (1), 57-78.

Krasnova, H., Abramova, O., Notter, I.,Baumann, A. (June 2016) ‘Why phubbing is toxic for your relationship: Understanding the role of smartphone jealousy among ‘generation Y’ users’ (Unpublished). In: 24th European Conference on Information Systems (ECIS). Istanbul, Turkey.

McDaniel, B. T. & S. M. Coyne (2016). ‘Technoference: The interference of technology in couple relationships and implications for women’s personal and relational well-being.’ Psychology of PopularMedia Culture, 5(1), 85-98.

 psychologytoday.com · by Martin Graff Ph.D.

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Child Sexual Abuse Prevention Goes to TEDMED

Source: Stephanie Neal

Last year culminated in a once in a lifetime opportunity—the chance to give a TEDMED talk to a curated, attentive and influential audience about child sexual abuse prevention. TEDMED is the independently owned and operated health and medicine edition of the world-famous TED conference. This annual event is dedicated to “ideas worth spreading.”

The theme for 2016 was “What if…?” and speakers were asked to imagine new possibilities for advancement in medicine, public health and biomedical sciences.

I asked the question: what if we stopped treating child sexual abuse as solely a criminal justice problem and instead treated it as the preventable public health problem that it is?

In my talk, I told the story of the fateful day I met with the journalist who would break the story about non-offending pedophiles and my research in finding a public health approach to ending child sexual abuse. Luke Malone brought the idea of child sexual abuse prevention into the living rooms of millions of Americans who listened to his story on This American Life.

I also discussed some important statistics that everyone should know. The peak age for engaging a prepubescent child in harmful or illegal sexual behavior is 14, and about half of all sexual offences against prepubescent children are committed by other children.

Another important statistic is that nearly 98 percent of children convicted of a sexual offense are never reconvicted of a new sexual offence. This shows that adolescent sexual offending is short-lived and it strongly suggests that we can prevent the first offence.

And yet, instead of focusing on prevention, we put most of our efforts on punishment.

Children who are caught engaging in harmful sexual acts might receive treatment instead of prosecution, which acknowledges that children, even those who make serious mistakes, have the potential to be rehabilitated.

For the children who get caught, prosecuted and convicted of sex crimes, they are often treated like adults. They can face incarceration and sex offender registration and public notification, sometimes for life. Registered children can be prohibited from living near schools, parks and playgrounds—the very places where our children thrive.

And what do we make of the people who discover in adolescence that they have an unwanted attraction to prepubescent children? Our interviews with 30 young adults living with an unwanted attraction to children revealed just how hard it is to find help and cope with their attractions. Many reported that they felt isolated, depressed and even contemplated suicide. Many said that what they truly needed (and could not find) was help in dealing with the shame and stigma that can accompany these attractions.

As part of the TEDMED talk, I presented quotes from these interviews to provide the audience with a better understanding of non-offending pedophiles. (Luke Malone also moderated a panel discussion on non-offending pedophiles that was held in 2015). For children dealing with an unwanted attraction to prepubescent children, acting out might not be the only issue. Some will need our help to resist acting on strong urges some of the time.

So what needs to happen now?

We must start thinking about child sexual abuse as a preventable public health problem. This includes providing all children access to effective prevention programs that focus both on avoiding harm and on attaining health and happiness.

Good programs will teach children how to behave responsibly around younger children; they will encourage children to disclose attractions to others when it is safe to do so and they will inspire all of us to respond to those disclosures with understanding and compassion.

I’ve had positive feedback about the talk so far. A reporter from the Huffington Post called it “one of the boldest” TEDMED talks for that year.

I anticipate that TEDMED will release a publicly accessible link to my talk (and others). But for now, I’ll continue to look for opportunities to bring the idea of child sexual abuse prevention to as many diverse audiences as possible.

psychologytoday.com · by Elizabeth Letourneau, Ph D.