Sex addiction. Usually, we associate this term with lewd celebrity stories splashed across trashy tabloids. But sex addiction is very real and can have a far-reaching, emotional effect on those afflicted.

We sat down with experienced Gestalt psychotherapist Brian McMinn to lift the lid on this taboo addiction and find out what it really means and who it might affect.

What is sex addiction?

BM: Contrary to what many people think, sex addiction is not a ‘thing’ you can catch or are born with, it’s actually a process that many of us can be affected by. Like many other addictions, sex addiction is a creative adaptation of the brain that emerges from past relationships, including those with our environments and our everyday growing up situations.

In fact, according to some researchers and writers, including Marc Lewis (Biology of Desire), sex addiction reflects the brain’s capacity for advanced learning.

Advanced learning? What’s that?

BM: Advanced learning is when we practice something consciously until it becomes unconscious – we then carry out the skill unconsciously or automatically. Take learning to drive for example, it follows the same stages of:

  • unconscious incompetence;
  • conscious incompetence;
  • conscious competence; and
  • unconscious competence.

Before I can drive I am unconsciously incompetent at doing so – I don’t know that I can’t do it. Then, when I start to learn, I become conscious of my incompetence. I realise: “Hey! I can’t do this!”

But if I persist, as my driving skills develop I become consciously aware of what I’m doing and although it feels a bit clumsy and mechanical, eventually I can competently drive. Then, after continuing to practice, my skills become advanced to such a level that I don’t have to think much about it anymore, my body drives as if I’m unconsciously competent.

So, rather than thinking about what I’m doing, I can now drive while holding a conversation with my passenger or with the radio playing in the background. If a hazard emerges, my conscious brain jumps quickly into action.

In other words, one way of perceiving advanced learning is that we don’t need to use up vital space in cognitive memory to perform a skill. Cognitive or conscious memory is limited in the brain while the unconscious memory is vast.

I believe that if more of those who struggle with addictions understood that these processes or habits showed the ability for advanced learning, there might be less shame, and therefore treatment would be much easier.

Shame is a huge barrier for any addicted person. That’s why facing addiction requires significant courage and support.

Why do people become addicted?

BM: Addictions, sex addiction included, are generally considered to evolve from trauma, or attachment, or opportunity, or any combination of these experiences. This is known as the OAT model.

Some of us are more genetically predisposed to addiction than others. Those of us who experienced addiction within their families as they grew up, learn how to use addiction to avoid emotions and/or the challenging issues in their lives.

So really, sex addiction is a way of coping with something intolerable, that has remained unresolved often from early childhood.

What do you mean by opportunity, attachment, and trauma (OAT Model)?

BM: Opportunity is the availability of the addictive material. For example, porn is very available due to the internet. The availability of smart phone apps, such as Tinder and Grindr, make opportunities for meeting others for sex simple too. The way porn is presented online makes it highly addictive, through its enticing colour and high definition images. Some researchers consider the effect of porn as being similar to this phenomenon which occurs in the natural world, for example, colourful eye-catching peacock displays, and red-bottomed gorillas – this phenomenon is known as ‘supernormal stimuli’.

Attachment relates to our initial bond with our caregivers, usually the mother. If for some reason the mother doesn’t attach well to the baby and developing infant, then that child can develop attachment problems, that can make relating to others complicated. Attachment difficulties can then develop into frustrating patterns of interacting that disrupt our adult relationships.

Trauma might be a birth trauma (a problem with the birthing process), due to abuse, or a serious accident or loss. Sometimes traumas are multiple in peoples’ lives.

Surely the sex-addicted person always has a choice, and could stop if they wanted to, especially if they have a partner and family who are affected by their actions?

BM: In theory this is true, we always have a choice. But, remember the OAT model, and that an addiction is attempting to address something old, often forgotten that has remained unresolved.

Can an abused or traumatised person simply stop their addictive behaviour through choice?

The sex-addicted person, through repeated habitual sexual behavior, changes the structure or neural wiring in their brain. Often extensive therapy is required to help resolve the traumatic experience, so that the impact on day-to-day living, and on unhelpful ways of relating, diminishes.

Addiction intensifies the production of dopamine in the brain – which is a feel good chemical. Those with addictions need increasing levels of dopamine to get that same ‘fix’, which is why sexual behaviour, in those with sex addictions, escalates over time.

Subsequently, our addictive behaviour strengthens the neural wiring in that part of the brain involved in seeking or craving the fix, while the wiring that connects to our conscious control brain centres becomes weaker. Sometimes an actual physical reduction in cognitive brain volume occurs as a result of long established addiction.

Conscious or cognitive control then diminishes as the addiction takes greater hold.

The addicted person often doesn’t understand why they have lost such control, and feels shame, especially when they see the impact on those they care for. This is a stressful situation for all involved.

If the brain is changed as a result of sex addiction, can sex addiction be cured?

BM: Yes, but it first requires commitment from the addicted person and an admission that it is indeed a problem.

Often, because of the shame, an addiction contributes to in the way we see things, simply ‘admitting to the problem’ is difficult. We can often create clever ways of deceiving ourselves, and others, that we don’t have an addiction. Because the addiction origins and unconscious purpose have been around for so long, it can seem impossible to let go of it – in many ways it feels like letting go of something vital, like a ‘friend’ that has been with us for a large part of our lives.

The addiction has ‘helped’ us live through portions of our lives. To stop without addressing the underlying origin of addiction is rarely possible, and then the failure of being able to give up adds to the shame the addicted person already feels.

However, the brain remains flexible, and can be altered even into adulthood and old age. The wiring can be changed and it is possible to live without addiction controlling our lives.

Could an addicted person resolve the addiction themselves?

BM: There are exceptional cases where this has happened but I imagine it is quite rare. We are relational creatures so a particular type of relationship is necessary for addressing and resolving addiction. It is best to have more than one source of support when addressing sex addiction. Such as a sex addiction group, like SLAA – Sex and Love Addictions Anonymous, alongside a commitment to therapy (with preferably a sex addiction trained therapist, or a therapist with a good knowledge of addictions).

Does sex addiction only affect men?

BM: Most people who seek treatment for sex addiction are men. This is interesting as women have similar brain and nervous system biology and developmental histories. As I understand, women are more inclined to seek help for love addiction which may be a more female socially acceptable problem. There is often more shame attached for women who experience sex addiction.

For many men, it can seem like a badge of honour when viewed by other men. How would sex addicted women be viewed by other women? I admire men and women who can admit sex, or any, addiction. I believe that knowing that the problem IS understandable and that HELP IS AVAILABLE can help people admit to having this problem.

Resources

http://www.paulahall.co.uk – there are many resources available from this site including self-assessment questionnaires, books, and other sources of help. Paula’s team also provide excellent training for those who would like to work therapeutically with sex addicted people.

http://www.slaauk.org For those interested in seeking help from this groups, and locating the nearest meeting.

I am a Gestalt psychotherapist, UKCP registered and also listed on the BACP register. I’ve been in private practice in Liverpool since first qualifying as a counsellor over two decades ago, working with individuals, couples and groups.

In addition, I work part-time for University of Liverpool as a student counsellor. I also provide individual and group supervision, and run workshops for qualified counsellors and trainees, and occasionally for the public.

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