A Revealing Look at Sex Addiction: A Patient's Guide

Hi and welcome to Journey to Recovery. Today's topic is on sex addiction. An addiction, for those of you who haven't listened to other presentations, is any person, activity or substance used to escape from negative feeling states, either physical or emotional, despite experiencing negative consequences. So we're going to talk about how this really applies to sex addiction in a little while. But I bet you can figure out, you know, when you think about sex addiction, you think about having sex, masturbation, whatever the case may be, produces a rush. Whether it's helping you escape from the stresses of the day, escape from boredom, escape from loneliness. We're talking about escape. Sex addiction is similar to other addictions because both drug addictions, gambling, sex addiction, the. They produce a dopamine surge or a high. They also produce cravings. This is your body going, I want more of that. Now the that your body wants more of is dopamine and the dopamine rush and the pleasure center. It's not necessarily that individual activity, so your body craves the rush. Triggers and condition stimuli are also common to both. When we talk about recovery from drug abuse, we talk about changing people, places and things. Because when somebody's walking down the street, maybe they pass their old dealer's house, that may trigger a craving. When they're doing something at home, it may trigger a craving. For some people, certain situations, like going to a party or, you know, watching a football game, may trigger a craving. The same thing is true for sex addiction. So you need to be aware of what things in your environment, times of day, people, places, whatever it is, when you have a craving, you need to stop and think back and go, okay, what brought this on? That'll help you identify what some of your triggers are. If you are addicted to Internet porn, I can tell you for certain that being home alone or being able to have privacy and access to a computer or Internet, not necessarily even a computer with all the wonderful mobile devices, those can be huge triggers. So that's one of the things you're going to have to get under control. Brain changes, regardless of what type of addiction, that constant flooding with dopamine, your brain goes, I'm overstimulated. I need a break. So there's a lot of stuff that happens, and I'm not going to get technical here, but basically there are two main things. You run out of dopamine supply and or the receptors, the things that recognize the dopamine and cause the rush. Those start shutting down because too much is getting through. So they've got to shut the pipeline down. The Good thing is it can rewire and you can. You build more dopamine all the time. Part of that is eating a good diet. But we'll get there in a little while. The younger these things start, the less ready the brain is to handle that kind of surge. So the younger these things start, technically, or possibly the worst problems there could be in terms of brain changes that happen in response to this dopamine surge. Do remember that. So if you've got somebody who started using drugs when they were nine or found daddy's hustler collection when they were seven, the level of numbing, of responsiveness and tolerance and all those other kind of things we talk about with addiction is going to be a lot higher than somebody who maybe started experimenting when they were 16, either one. Drug addiction. Gambling. Sex addiction may start as recreational, but then the body goes, oh, I like that. I'll remember that. Because when I don't feel good, I know what I can do to make me feel good. Unfortunately, because of the brain changes at a certain point going through it, what used to make you feel good doesn't do it for you anymore. Think about chocolate cake or no, we'll say brownies. I like brownies better than chocolate cake. That first bite, you're like, oh, my gosh, this is heaven. By the time you get to the second brownie, you're like, yeah, this is pretty good. I think I'll have another. The third brownie. Eh, you know, it's a brownie. That's a very compact way of explaining how our body kind of sensitizes to things over time. Your brain, in response to too much dopamine, starts shutting down. So when you do that same activity, again, not as much dopamine gets through. So it's not as much of a rush. People start experiencing relationship, financial and emotional problems. Drug addiction. Yeah, we know this. This kind of goes without saying. Sex addiction, relationship problems. If you're addicted to Internet porn, you will rapidly probably get to the point where your partner, your spouse, your significant other doesn't make you aroused anymore, this will probably, probably start to cause problems in the relationship. Likewise, when your partner learns of your Internet addiction, that also may cause problems. Financial problems. If you're spending a lot of money on different porn sites or getting your computer fixed because of the malware you got on the porn sites, or paying a divorce attorney because your spouse found out about the porn sites. Financial problems. And then the one we don't talk about a lot, I don't know why is emotional problems when we start Messing with that pleasure center, that dopamine system. Dopamine is our motivation chemical. Dopamine, among others, helps us feel good when we don't have motivation, when not much does it for us. We're just not motivated to do anything. We don't care about much of anything. That's saying dopamine and maybe serotonin have kind of of gotten out of whack. When people are engaging in sexual activity too much or having too many dopamine rushes because of drugs, gambling, whatever, eventually their brain just kind of says, I'm out of gas, I got nothing else for you. So they start feeling depressed. When they feel depressed, they have a memory of, well, when I did that before, I felt better, so let me do it again. They do it again and it's just like, what happened? That's tolerance. So a lot of times people amp up their use. If they're gambling, they spend more money, they gamble for longer periods of time. If it's Internet porn, they may use more different sites or they may go to more and I, the word escapes me right now. More shocking type material in order to help get them aroused. Eventually that may not work either. And again, the depression is just getting worse as the dopamine system, that reward system becomes more and more broken. Sex addiction differs from other addictions because part of sex is biologically driven urge. We are programmed to procreate, so we are going to have urges to have sex. We're going to have urges to survive, to eat, sleep, those sorts of things. With drugs, cocaine, marijuana, alcohol, we don't need those to survive. So our brain doesn't go, I've got to have that, because we don't have to have it. Once you get through that initial recovery period, the cravings tend to subside to a manageable level. So that's one thing, sex is a biologically driven urge. Secondly, we have this interesting little thing called the Coolidge effect. And they've shown it in rats and they've hypothesized it in humans. They haven't really tested it in humans because that wouldn't be real ethical. But basically you put a rat in with another rat, a male, and a female male rat goes, score, I've got her. And she's got nowhere to go but these four walls. After a while he can't even get aroused by her. He's like, eh, go press the lever and eat some pellets or something. Take female rat number one out, put rat number two in, and all of a sudden he has this energy back he's like, oh, hello, what's your name? I'm Mr. Rat. Sorry, I'm getting off topic. The Coolidge effect sort of applies to humans in the same way your pleasure center craves novelty. So after you do something 20 times, it's not going to have the same effect as the first time you did it. And that applies to our partners as well. The interesting thing with Internet porn is there's never ending novelty. Novelty is just a mouse click away from rats to mice, you know. Anyhow, the other important difference, like I said earlier, is you cannot abstain from sex forever. You can abstain from alcohol, you can abstain from cocaine, you can abstain from gambling. But eating, sleeping, sex, those are kind of primitive biological drives. So most people are going to find that at some point they need to engage in sexual behavior. Sex addiction is also socially sanctioned in our culture, especially for men, and more so for women now than in the past, but especially for men. If you're having multiple partners and engaging in these wild activities, it's like, score, you know, you're the man. Internet porn not as sanctioned. However, sex is not illegal most ways you do it. So if you're engaging in legal sexual behavior, it's socially sanctioned. So it's kind of like the person who is addicted to prescription drugs who comes to you and goes, well, my doctor prescribed it. Well, yeah, just because you have it doesn't mean you have to use it. All symptoms, needing more to get the same high as that dopamine self regulates. You're going to either need to have sex more often, look at different images, increase the novelty, do something in order to get that arousal system going again and again, that Coolidge effect novelty. These are the first couple things we've got to address in sex addiction. Treatment is helping people understand why Internet porn is so addicting. Because once you understand why, then you can make more rational choices. People also use more in response to worsening problems. When they come out of the bedroom or wherever they were and they are finished masturbating, having sex, whatever the case may be, and they realize that their world is falling apart, they may turn around to a beeline and go back into the bedroom, turn the computer back on and go back into their Internet porn world. The same thing is true with drug addiction. So we do need to realize this sometimes or at a certain point. The addiction, the dopamine rush, the activity becomes a way of escape, escape from dealing with whatever, fill in the blank. Using more or for longer periods than intended, especially if you're using Online porn sites or dating apps. You may intend to go in there for 15 minutes and before you know it, five hours has passed because there is so much new. And your brain is just like being flooded with all these images, text messages, those sorts of things. Unsuccessful efforts to cut down. We are biologically driven for procreation. So that whole Coolidge effect we want to spread our genetic material around is at work. Combined with a little part in your brain going, I need to feel okay, I need more dopamine. I need more dopamine. As you try to get more dopamine and there's less to get and there's less getting through, you're kind of fighting a losing battle. So these cravings keep getting worse. Spending significant time and or resources, that is money to thinking about, preparing for acquiring and or recovering from use. Okay, so if you're at work and you're not paying attention to your job because you're thinking about going home and getting on the Internet, that's a problem. That's spending time. If you're trying to figure out how you're going to get time away from your spouse so you can get on the Internet, that qualifies here as a problem. Preparing for making sure everybody's out of the house or everything's set so you don't get caught. Acquiring. Finding the site that you're going to use. Sometimes it takes a while to find whatever's going to work for you that night. Using and recovering from use. Now, recovering is not just that rebound effect where you can get another erection. Recovering means letting those brain chemicals go back up so you can do it again. Unfortunately, like I said, the system's getting broken. So it's going to take a whole lot more than 10 minutes to recover. And the more you do it, the more broken the system becomes, the longer it's going to take for your brain to recover. So you can get that rush feeling again from anything. Not just from sex or masturbation, but from anything. Continued use despite negative consequences in one or more areas of life due to the addiction. Okay, so this Internet porn thing, it's not working for you, as Dr. Phil would say, but you're continuing to do it. Why? Clearly there's a reason, there's a reward, there's a motivation, or you wouldn't be doing it. We don't beat our heads into the wall for a reason because it hurts. So the question is, why are you continuing to use? Your relationship is falling apart. Well, gives you an escape. If you are in Internet la la land with The Internet, porn ladies. You're not having to think about what's going on in real life. Financial problems, work problems, emotional problems. These are all getting worse. And what is the one thing they have in common? Your brain is going, I know when I did that before, it made me feel better. So I'm going to do it again. You do it again, and it doesn't make you feel better. So you're like, hmm, let's try it again. I'm sure that made me feel better. You get enough of a rush, especially if you change things up and add a little bit of novelty, that you can keep this going for quite a while. But before you hit bottom. We are driven by survival mechanisms. We humans, we want to reduce pain, emotional, physical. So if you're in pain, if you're depressed, bored, lonely, got a stress, tension headache, whatever the case may be. Sex may help, masturbation may help sometimes at first, but over time, that doesn't work anymore. We are driven by safety. We want to eliminate threats. Well, okay, so that's fine. That doesn't really apply necessarily to sex addiction. But it's important to understand that we are driven by certain biological urges. We are driven to eat and, and drink. We want to survive. Part of survival is also spreading genetic material, having little carbon copies of us growing up. God help the world. Addiction is maintained by positive and negative reinforcement. Positive reinforcement is that good feeling it provides. It's that rush. Negative reinforcement is eliminating the pain, the threat, the depression, whatever. It makes the stresses of the day go away, even if it's just for 10 minutes or two hours. That's another reason we see people staying in Internet porn sites for longer and longer and longer. Because every time they come out of the room or come out of the Internet porn sites, reality smacks them upside the face and it's not pleasant. So they want to go back in. There are solutions, but they're not easy ones. Reboot. You need to give your brain a rest from the rush. Stop masturbating. If you're going to have sex, it can only be sex with your partner. One partner. Consenting human, you know, shouldn't have to say that, but adding that in there, it needs to be a normal, healthy, monogamous relationship. Important to remember that at first going from this level of stimulation provided by the Internet to your partner, you may not be able to get aroused. It'll come back. But your brain has got to rewire because it's used to this never ending novelty. And now looking at this like going from chocolate to Celery. It's like, eh, really sorry to your partner, but our brain is not tactful. Give your brain a rest from the rush so it can build up dopamine. It can repair all those receptors or rewire whatever is going on. Take care of yourself. Sleep. When children are growing up and going through growth spurts, they need extra sleep. When we start working out and building muscle, we need extra sleep. Our body's response to needing to repair or grow is needing us to sleep so it can focus energy on doing its job. Nutrition. Our body makes dopamine from the amino acids and some of the other foods that we eat. So you need to eat a healthy diet. Exercise. Prior to masturbation. Sex is a state of arousal. We need to take that energy and do something with it because it's still there. Exercise is good. Many people, not all. You know, everybody's different. Many people find that really intense. Like muscle building. Exercise is counterproductive because it gets that testosterone flowing and then they want to have sex even more. A lot of people find 20 to 30 minutes of moderate intensity aerobic exercise to help take the edge off the irritability and restlessness. Identify other things that make you happy. It's not going to be the same kind of rush, but identify other things that make you content, happy, peaceful, calm. Look for those words and find activities to occupy your time. If you're bored, it's more likely that you're going to think about wanting to get on those Internet sites again. Occupy your time. You'll find that as you go through the first few weeks, the cravings and the urges will become somewhat less intense. And rewire. Okay, we're letting our brain recover. That's the rebooting process. Rewiring is taking some of those stimuli, like your computer. You put a computer in a room and most people are going to look at it and go, oh, I need to check my email. You put a computer in a room with Internet porn addicts and there's a whole different response. So you need to recondition that response initially if you can. It's probably best to just not have access to the Internet. For most people that's not even possible. So you need to get some sort of firewall system set up where somebody else has the password, so you can't just say somebody else sets it up and has the password, so you can't reset the password and get into the site anyway. Make sure it controls Internet access for your phone as well as your mobile device, other mobile devices and your PC only Allow yourself to experience sexual pleasure with a single other person in a monogamous relationship. Like I said at first, this may not even be a possibility. Over time, your brain will kick back into gear and go, oh yeah, procreation. Got to do that. Give yourself time. This is time to repair the relationship with your significant other. Anyway, oops, I guess I ran out. So, a few other things that you might want to think about while you are rebooting and rewiring. If you are really depressed, if you don't even have the motivation to do anything anymore, it's going to make repairing that relationship with your significant other, as well as a lot of other areas in your life, more difficult. You might want to talk with your physician about a short course of antidepressants. Bear in mind, some antidepressants have sexual side effects and they're not good ones either. They will decrease your libido. There are some that don't have those side effects. So be aware when you're going in to talk to your doctor and be honest with him or her about what's going on and what your end game is. What is it that you need to get out of any pharmacological interventions? Get social support. Don't try to do this on your own. It's hard enough to do, but if you try to do it on your own, it's going to be that much harder. Initially, when you're feeling those urges, they're going to be almost overwhelming. Figure out how to get through it. Get yourself up and active for 15 minutes. Most urges and cravings only last about 15 minutes. Think about it like if you're surfing and you go out and you ride the wave in, it gets really high, difficult, challenging for a little while. And then as you come in, all of a sudden it dissipates. The wave that is. You can tell I don't surf. Anyway. They call it urge surfing. This is something else that you can do. Find things in your life that make you happy. Engage in those activities, and like I said, stay busy. If you did this, if you started using Internet porn two weeks ago, you probably don't have an addiction. If you started using Internet porn two years ago, don't expect it to be fixed in two weeks. Okay? You need to give your body time to recover. Now, it's not a day for day sort of thing, especially if you're taking good care of yourself, but do take care of yourself. This has just been an introduction to treating and dealing with sex addiction. But I do want people to realize that There are real changes. There are real cravings, and there are real treatments that can be useful to help people deal with Internet addiction or other types of sex addiction. And each type has its own nuances and variations. But. But that's for another presentation. Thank you for joining us today and have a great afternoon.