NYC Sex Therapist Talks: Porn Addiction, Sex Addiction – The scientific reality

NYC Sex Therapist Talks: Porn Addiction, Sex Addiction – The scientific reality

In 2008, the Mayo Clinic published a case study of treating compulsive sexual behaviors with pharmaceuticals:

A male patient first presented to a psychiatrist (J.M.B.) at age 24, with the explanation, “I’m here for sexual addiction. It has consumed my entire life.” He feared losing both marriage and job if he could not contain his burgeoning preoccupation with Internet pornography. He was spending many hours each day chatting online, engaging in extended masturbation sessions, and occasionally meeting cyber-contacts in person for spontaneous, typically unprotected, sex.

The story is a familiar one. A young man seeking sexual activities outside of his marriage or relationship experiences guilt because of his compulsive behaviors. He feels he cannot stop and is at a loss for solutions. He wants to be good, by whatever measure his culture dictates, but feels he can’t.

The term “sex addiction” is the new darling of sensational media. The narrative of an addict is a compelling one, their struggle with external forces in the world leaves much room for pity. After all, this isn’t their fault but the fault of the pesky stimulus hijacking their tender neurological reward circuitry. Right?

Not really. The picture of compulsive sexual behaviors is far more complicated than (male) brain + (non-monogamous) sexual stimulation = addiction. Dopamine may indeed play a role in all compulsive behaviors but the narrative of porn as an external factor that takes over your system is a false (and overwhelmingly Christian) explanation that fails to recognize sexual histories and user conceptions of sexuality. (Read Article)

 

This is a pretty common issue as a sex therapist in New York right now.  Not because New Yorkers are hornier than anyone else, but because New Yorkers have the same shame and guilt surrounding sexuality as everyone else.  As a sex therapist,  we would treat this as more of a self-defeating behavior (if it is indeed self-defeating), and would work on challenging the thoughts you have about normal sexuality, relationships, fantasies, etc so we can get a more balanced belief-system resulting in a non-obsessive and self-defeating behavior.  Sex therapists aren't about moralizing you or enabling you to give up your responsibilities to a “higher power” (I’m looking at you, 12 Step Programs).  Modern therapy can involve some education about human sexuality, some challenging of those negative thoughts that keep you stuck, and can do it in a way that doesn’t break you down or switch your obsession to counseling from your original presenting issue.  (Modern therapy doesn’t require you to attend therapy every day for the rest of your life to make sure you’re not watching porn or having sex).

 

Sex is fun.  Some people are more into it than others.  If you have replaced something tense in your life with sex, and are now avoiding dealing with that conflict, maybe let’s talk it out.  If you’re in a monogamous relationship, but find yourself not attracted to your partner, well- let’s try some couples counseling.  There are so many fewer people that are just having sex 24 hours a day and losing their jobs, running around masturbating in the streets than the media types would have you think.  So that’s probably not you.  Enough with the sexual guilt and shame, and let’s work on establishing a balanced sex life that works for you and what you want out of life, and not against you.

 

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