Sex Therapy does not involve any physical contact or sexual activity. Sex Therapy is a professional service providing support, counselling and education for adolescents, couples, and singles that are experiencing issues or distress relating to sexual health.
‘Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled’ (WHO, 2006a)
In its new International Classification of Diseases, WHO defines Sex Addiction as a Compulsive Sexual Health Disorder, characterised by a ‘persistent pattern of failure to control intensive sexual impulses or urges resulting in repetitive sexual behaviour’.
A recently released study on pornography and the brain, led by Dr Valerie Voon, University of Cambridge (UK), confirmed sexual addiction as an identifiable and diagnosable disorder of the brain, and affecting three significant brain regions; the dorsal anterior cingulate (anticipating rewards), the ventral striatum (processing rewards), and the amygdala (processing the significance of emotions and events). The Cambridge study on pornography addiction found that these three brain regions mirror the neuronal excitation as seen in drug addiction.
A study by researchers at the German Max Planck Institute and published in May 2014 in JAMA Psychiatry, found several brain changes associated with the amount of pornography consumed. The study found that higher hours per week, and more years of viewing porn, correlated with reduction in grey matter (brain cells) in sections of the reward circuitry (the striatum). This region of the brain is involved with motivation and decision making. Reduced grey matter in the reward related region means fewer nerve connections. Researchers interpreted the reduction in nerve connections as a result of longer-term pornography consumption.
Lead author Simone Kuhn said – “This could mean that regular consumption of pornography more or less wears out your reward system”.
This is in line with the hypothesis that intense exposure to pornographic stimuli results in down-regulation of natural neuronal responses to sexual stimuli. That could explain why porn addicts are at risk to lose sexual interest in their partners, and why male porn addicts may develop pornography induced erectile dysfunction (PIED).
Researchers confirm that ‘dysfunction of the brain’s reward circuitry is linked to inappropriate behavioural choices, such as compulsive drug/alcohol/gambling/porn/sex seeking, regardless of the potential negative consequences.’ In short, there is evidence of an association between porn consumption and impaired impulse control.
A publication released August 15th 2011 by the American Society of Addiction Medicine (ASAM) is stating that ‘addiction is a primary chronic disease of brain reward, motivation, memory and related circuitry, and not simply a behavioural problem involving too much alcohol, drugs, gambling, and sex.
Addiction is characterised by inability to control such behaviours, inability to persistently abstain from such behaviours, severe cravings and chronic relapse, diminished relationship ability, and impaired ability to recognise the significance of their problem.
The National Council On Sex Addiction And Compulsivity classes sexual addiction as ‘engaging in persistent and escalating sexual behaviours, acted-out despite negative consequences to self and others. Untreated sex addicts continue their behaviour despite their awareness of financial, emotional, relational, or physical health damage.
Acting out compulsive sex is not primarily about feeling more, but about feeling less of underlying conscious or unconscious emotional pain, trauma and distress. During sexual preoccupation and activity, various neurotransmitters including dopamine, noradrenaline, endorphins, oxytocin, and serotonin are secreted in larger quantities, and generate instant feelings of relief, relaxation, and elation.
Continued over-stimulation of the reward-learning system, located in the mid brain, eventually interrupts the pathways to the choice-memory (glutamate) system, located in the prefrontal cortex. This temporary disruption of brain communication is believed to be responsible for the addict’s inability to accurately evaluate their cravings and stop their acting-out behaviours, despite their awareness of negative consequences.
Long-term over-stimulation of the above mentioned neuronal pathways may lead to desensitisation, or in extreme cases, to a total loss of excitement. This state is called Anhedonia. It stems from two Greek words; ‘an’ meaning ‘without’, and ‘hedone’ meaning ‘pleasure’. Researchers suggest that Anhedonia may result from a breakdown in the brain’s pleasure and reward system.
Another psychoactive chemical named phenyl-ethyl amine or PEA is believed to play its role in the biological basis of sexual addiction. PEA is naturally present in states of euphoria and falling in love. Researchers believe that elevated levels of endogenous PEA boost excitement and infatuation, and a sexual addict’s brains may depend on elevated levels of this chemical. PEA functions as a neuromodulator and neurotransmitter in the mammalian central nervous system. Phenethylamine, similar to amphetamine, releases norepinephrine. Abnormally low concentrations of phenethylamine may be found in persons suffering from ADHD, and abnormally high concentrations are believed to have a strong positive relationship with the occurrence of schizophrenia.
In some cases of sexual addiction, underlying disorders, including certain brain tumors, depression, OCD, Bipolar Mood Disorder, ADD/ADHD, Asperger’s Syndrome, epilepsy, or medication such as agonists designed to manage Parkinson’s disease, may influence sexual behaviour.
Sex Addiction Australia recommends clients should seek advice from a qualified medical health professional if characteristics of behaviour suggest underlying mental or physical health conditions.