Both sex addicts and those who add drugs to their sexual acting out rituals utilize sex as a mood changer to mask emotional pain. When used in this way, sex ultimately becomes less about erotic desire and more about avoidance through manipulation of the pain-numbing effects of dopamine and other neurotransmitters that are released through addictive processes.
Because this emotional numbing interferes with interpersonal connection, addiction can be seen as a form of dissociative disorder, where one “disconnects” from traumatic or painful feelings. Drugs, behaviors, and even people are compulsively used to soothe emotional pain, effectively creating a very destructive form of self-medication. Ironically, by trying to escape these uncomfortable feelings, addictive behaviors, in reality, perpetuate them by reinforcing those that are most troublesome, such as shame.
Origins of the Dissociative Process
The act of dissociating from feelings is learned at an early age and can impact emotional regulation across the lifespan unless the person’s history of trauma is addressed. Although such dissociation is, at its most basic, one of the body’s mechanisms for self-preservation, it is ultimately destructive because when one disconnects from feelings, the emotions become frozen and unexpressed. For example, someone can get “triggered” when information or feelings that are currently being experienced activate memories of older, similar situations. At that earlier time, if feelings were avoided by “checking out” or dissociating from them, reminders in the present day will likely trigger dissociation (or the desire for dissociation) again.
In all these cases the mind cleverly disconnects from emotions to protect itself from being overwhelmed, just like an electrical fuse. This disconnecting process is called emotional shock, and it may take several forms. And while it serves to protect us, it can, over time, result in an inability to fully process events and feelings.
I believe that learning how to disconnect from feelings in early childhood sets the stage for the development of addictive disorders later in life. Drugs and behaviors that mimic the “fight, flight, freeze” response of the body can be engaged to detach from unpleasant emotions. Sex and porn addiction, along with sexualized drug use (especially with amphetamines, such as cocaine and methamphetamine), engage the “arousal” side of the limbic system to create intensity that also distracts from these feelings. Amphetamines, sex, pornography, and other stimulating behaviors such as gambling and even shoplifting create an intensity that numbs and distracts from emotional discomfort, effectively becoming an antidote to shame and other unwanted emotions.
Impact on Relationships
These patterns of emotional numbing are learned in childhood and affect the ability to form meaningful relationships (to “attach” in healthy ways). As such, both sex addiction (including porn) and co-occurring sex and drug use can be conceptualized as intimacy disorders.[i] They compensate for the inability of an individual to adequately bond in intimate relationships, and indeed may cause or worsen any intimacy concerns that are present. The ultimate treatment goal for sex addiction, as with sexualized drug use, is “mastering the experience of forming enduring and trusting intimate connections with others,”[ii] and, I would add, an intimate connection with oneself. The most common barriers preventing addicts from achieving these intimate connections include emotions such as shame, the inability to self-regulate feelings, and maintaining sexual boundaries.
Another kind of numbing occurs as a result of tolerance, the body’s attempts to manage disruptions caused by the addiction, and escalation, the addict’s response to tolerance. For example, a porn user may find that the kinds of images that were very stimulating earlier no longer create the desired intensity today. This leads to an escalation, where the user seeks out images that are more extreme or taboo in order to get the desired hit of dopamine.
This habituation also results in numbing the individual to acts of violence, both sexual and non-sexual. While there is a distinct difference between sexual fantasy and sexual acting out that most people clearly recognize, a small minority of individuals, especially under the influence of strong drugs like methamphetamine, will merge fantasy and reality in their behavior. This is further complicated by the psychotic features that sometimes accompany the use of methamphetamine.
Challenges in Recovery
The major challenge of recovery is learning how to experience, in a healthy way, the various emotions that bubble up once the numbing or distracting effects of the addictive drugs and behaviors have worn off. In early recovery, the world seems very intense. As recovery takes root, the numbing effects of the addictive behavior fade away. Emotions, both good and bad, begin to emerge and may feel overwhelming to someone who has not experienced them directly for years. A lifetime of accumulated feelings begins to bubble up into consciousness and must be managed. Many people discover that even activities that should be pleasant are so over-stimulating that they become uncomfortable and threatening. This is particularly true with sex and intimacy, which many people have rarely experienced without the protective insulation of mood-altering chemicals.
It is essential for addicts in early recovery to learn how to effectively manage their emotions. Otherwise, they risk transferring their desire to “self-medicate” to other drugs or behaviors. Such transference plays a significant role in the relapse process simply because there are so many opportunities. As pain or stress in recovery is inevitably encountered, the addict may turn to other compulsive behaviors such as sex, work, and even dysfunctional relationships to soothe emotional discomfort. While this may temporarily relieve unpleasant feelings, the core issue persists, and the stress and emotional pain return. Eventually, the cumulative toll of these stressors and the use of other compulsive behaviors snowballs into a major relapse. As substance abuse relapse expert Terry Gorski says, “relapse always grows from the inside out.”
[i] Schwartz MF and WH Masters. “Integration of Trauma-Based, Cognitive, Behavioral, System and Addiction Approaches for Treatment of Hypersexual Pair-Bonding Disorder.” Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention. (1994), 1:57-76.
[ii] Adams KM and DW Robinson. “Shame Reduction, Affect Regulation, and Sexual Boundary Development: Essential Building Blocks in Sexual Addiction Treatment.” Clinical Management of Sex Addiction. (New York: Brunner-Routledge, 2002).