What is compulsive sexuality?

Steve is a professional musician. A man in his 50’s, virile yet sensitive, he is sexually
compulsive around fetishistic sex. Since his early teens, Steve had masturbated nearly
every night before going to sleep. As he matured, his need for masturbation increased
until he was masturbated five or six times a day. He found that if he did not act on these
urges, he would remain “horny” all day, which would make him restless, distracted, and
irritable. When asked about his masturbatory fantasies, he related that they centered on
feet, stockings, worshiping at the feet of a dominant woman to whom he would avow
love, and visiting professional sex workers to whom he would also confess love. By his
mid-twenties, he was routinely acting out on these fantasies. Again, if he did not act out
his sexual fantasies, he would become very uncomfortable and would be unable to focus
on anything except playing music during the day. When the Internet became available,
he started spending multiple hours each day surfing the net, looking for fetishistic images
to which he would masturbate. Stating that he was never interested in “fucking real
women”, he was eager to view websites that featured feet, legs, stockings, heels and
dominatrixes.

When he would begin a romantic/sexual relationship with a woman, he would vow to

stop acting out with aberrant sex to devote his attention to the girlfriend. He could,
however, never bring himself to tell the “real girlfriend” he loved her. Within a few
months after he began a relationship, he would lose sexual interest in his partner and the
relationship would fall apart.

At some point, he started using telephone sex services. He would enjoy having elaborate
fantasy relationships with the workers and would often “fall in love” with one of them.
When he had “maxed out” his credit cards, he applied for new ones and then ran them up
their limits. He got behind in the rent, and the power company threatened to cut him off
unless he paid his bill. Socially isolated, deeply in debt, and about to lose his job, Steve
realized his preoccupation with sex was ruining his life, but he felt powerless to change
his behavior. Moreover, he was fighting the urge to visit a dominatrix/transvestite which
he felt was a significant increase in the level of deviance he required to achieve sexual
satisfaction. He also was beginning to sense that pornography and phone sex no longer
excited him as much as they used to. Increased levels of novelty, excitement and risk
were required to achieve orgasm. At the same time he had met a woman whom he
greatly admired, but for whom he had no sexual feelings despite her very real physical
attractiveness. When he lost interest in her sexually and episodes of emotional intimacy
would provoke anxiety, he began to examine his relationship patterns. Fearful that he
was perpetuating his life-long pattern of not being able to be sexual or to have loving
feelings for a real woman, he was concerned that yet another relationship would painfully
fall apart. This, combined with persistent job jeopardy and chronic debt, propelled him
into treatment.

Personal History
Steve was the youngest child in the family, with a sister who was five years his senior.
His sister was a bit sadistic, tormenting him with teasing when he began to develop
sexually. He relayed an incident wherein he had given an ID bracelet to a girlfriend and
his sister confronted him about the missing bracelet at the dinner table which incited fear
in him about his projection of his mother’s enmeshed and hysterical reaction.

His mother, it seemed, was the stereotypical “Jewish mother.” She was adamant that he
not see girls who were not Jewish (and most of his girlfriends were not). When starting
treatment, Steve relayed that he had a very “loving” relationship with his mother. She
would tell him that she loved him “every 10 seconds” and would incur his guilt about
abandoning her whenever he made an effort to explore his interest in girls. As treatment
proceeded, he began to realize that a fear of engulfment was an underlying factor about
his anxiety about true intimacy and was able to connect this to his relationship to a
mother who was too insecure to allow him to become his own person. He spent his
childhood feeling that he could not retain a sense of himself and still maintain his
relationship to mother, whom he put on a pedestal. Unable to risk his mother’s
emotionally abandoning him, he clocked himself in an armor of a “false self”, which was
a people-pleasing self. Constantly seeking validation from the outside, sexual approvable
and acceptance from sex workers made him feel real, vital and alive. It defined his
identity.

His love and need for mother represented a conflict for him. At some point, he began to
realize how emotionally arbitrary his mother was. He could never trust her telling him
that she loved him “every 10 seconds” because she would act differently from one
moment to the next, giving Steve mixed messages. What disturbed him most as a child
were his mother’s rage attacks, which were unpredictable and could be triggered by
almost anything. Inevitably, whenever Steve would make an attempt to appropriately
separate from family, his mother would rage about an unrelated event. He sometimes
would feel “crazy” by his mother’s enmeshment and abandonment patterns.

Steve’s father worked in the hardware store that his father (Steve’s grandfather) had
started and had successfully run until he sold it to cover his gambling debts. Steve’s
father had intended to save his money and eventually either to buy out the hardware
store’s current owner or else to open his own store. After many years, however, he was
still working for little more than minimum wage, while the store’s owner would regularly
rebuke him for not having his father’s knack for hardware. Steve’s father was not ready
to be a father when Steve was born. Steve understood that his father was planning on
leaving his mother but could not bring himself to leave her with two small children.
Steve came to blame himself for being responsible for holding his father in a marriage he
did not want to be in. Later he realized that his father would not have had the guts to
leave. Steve noted that his father never stood up for himself or for his family, and that he
never stood up to Steve’s mother. While his mother held Steve up on a pedestal, she, at
the same time, demoralized his father with her constant belittling about his failure as a
man.

Steve’s father died from a heart attack when he was 13. Steve felt nothing about the loss
and when he went back to school he never told anyone about it. . About a year later, his
mother was hit and killed by a bus after Steve asked her if she could walk the dog as a
favor to him. He had wanted to stay home to look at internet porn and masturbate.

Extremes of parental depravation or indulgence have devastating effects on a child,

and it is not surprising to find this dynamic in the backgrounds of many sexual
compulsives.

In addition, he had a weak connection to a vulnerable father to whom he felt a guilt-

inducing tie for “holding” him to a torturous marriage to a woman who loathed and
belittled his manhood. There was no port in the storm for Steve; no sustaining
environment where Steve could develop an arsenal of task -orienting coping
strategies. Nor did he have any social connections that could have compensated for
the lack of balance and consistency required for the development of a solid, adequate
sense of self. Like many sexual compulsives, he sexualized his family-of-origin
conflicts and developed an internal “split” to abide an unbearable childhood psychic
reality.

As an adult, he felt he lived in two worlds – not unlike a Dr. Jekyll and Mr. Hyde
syndrome. There was a vacillating connection between fetishistic love objects in his
fantasy world where he could express none- threatening love feelings and “real”
women who were his companions and intellectual equals, although he held no erotic
feelings for them. He could remain alive and vital enough to succeed at a competitive
career in the music industry by remaining in a dissociated “erotic haze” which served
to regulate the amount of intimacy he could tolerate. The sexually compulsive person
therefore frequently alternates between the isolated and anxious clinging to both the
“fantasy” love object with whom he feels safe but dehumanized, demoralized and
fraudulent, and the “real” woman with whom he feels emotionally vulnerable,
terrified of engulfment and de-erotized.

In addition to a lack of self care and the repetitive, impulsive choices that result in
damaging consequences to the self, the person enslaved by compulsive sexuality is ill-
equipped to value, comfort, soothe, and care for his authentic self. Indeed, he has no
authentic self because he has never separated from his family-of-origin. The lack of care
and nurturing from a mother who only saw him as a “need-supplying object” for herself
is his basic trauma and is acted out sexually as an adult.

With this case in mind, let us pick out specifically what makes for a description of a
sexually compulsive person.

Compulsive Sexuality
• Solidifies his identity
• Feels shameful
• Is illicit, stolen, or exploitive
• Compromises values
• Draws on fear for excitement
• Reenacts childhood traumas
• Disconnects one from oneself
• Creates a world of unreality and fantasy
• Is self-destructive and dangerous
• Uses conquest or power
• Serves to medicate and kill pain
• Is dishonest
• Requires a double life
• Is grim and joyless
• Demands perfection
• Mistakes intensity for intimacy
• Requires novelty – intensity always has to be more than the last “hit”
• Gives way to self-hatred, loneliness and despair.
• Has no sexual “boundaries”
• Uses false intimacy as a way to avoid relational pain
• Preoccupation and ritualizations
• Is “doing to” someone
• Is devoid of communication
• Has no limits
• Benefits one person
• Is an uncontrollable energy
• Is emotionally distant

Other considerations
• Behavior leads to increasingly negative consequences but addict unable to control
acting out
• Denial of the behavior’s seriousness
• Is the product of intense, unmet needs, coupled with the demand for perfect
fulfillment and control of relational pain
• Demands that life provides an illusion of reassurance and predictability by getting
self-centered physiological relief
• Is always a narcissistic endeavor – people are seen as “need-supplying objects”,
not as real human beings; more interested in getting than giving
• Is ephemeral – physical orgasm provides a welcome rush of adrenaline, but by
itself can only offer the brief illusion of intimacy and belonging
• Sex is a conquest and abates the terrifying sense of not belonging
• Sexual fantasy conjures up a perfect world of nourishment, love, generosity and
tenderness.
• Are trapped in the paradox of being terrified of loneliness even as they act in
ways that create further loneliness
• In fantasy sex, have the freedom to be vulnerable and nurtured without fear. At
it’s core, sexual fantasy is a worship of self
• Carry a sense of parental betrayal; parents unable to provide a positive role model
of healthy intimacy
• Have no ability to regulate their emotions from within
• Risk relationships, financial loss, job jeopardy and physical safety
• Possesses a set of irrational cognitive distortions, including “Sex is my most
important need”; “I am basically a bad, worthless person; no one could love me as
I am;” “My needs are never going to be met if I depend on others;” “I am valuable
only if I am sexualized; being sexually desired makes me feel alive;” (Patrick
Carnes, Out of the Shadows: Understanding Sex Addiction)
• Have deficits in the areas of social skills, interpersonal communication, stress
control, anger management and empathy for others
• Learned in childhood that feelings are dangerous, so learned how to mask their
feelings, even from themselves
• Sexual addiction is not a moral issue; it is a coping mechanism born from
childhood wounding