How to Understand Sexual Compulsions

Sexual compulsions, like anything involving the word “sex,” can be controversial. Because it is not often discussed, remains under-researched, and is still not fully understood, a lot of confusion surrounds sexual compulsions. With this article, you can start to understand sexual compulsions. What are they and how do they work? How do you know if you or someone you love has a sexual compulsion? And if so, what can you do about it?

What are sexual compulsions?

First, to understand sexual compulsions, we have to talk about compulsions generally. A compulsion is something most people are familiar with, usually related to substances like alcohol or opioids. Increasingly however, awareness is rising that certain behaviors can become compulsions as well.

Broadly, compulsion can be defined as the continued, out of control use of a substance or behavior despite harm to oneself or others.

It is useful to consider some key words within this definition to fully appreciate it. Continued means that the behavior has been ongoing, often despite repeated attempts to stop. Out of control means that you feel as if you cannot stop the behavior, despite wanting to. This could mean that you engage in the behavior almost automatically, without feeling like you’ve consciously chosen it or an inability to stop once you’ve started. Lastly, and perhaps most importantly, this substance or behavior must cause perceived harm or distress.

Given this definition, can someone have a sexual (or sex-related) compulsion? It seems like the answer would be yes. However, sexual compulsion remains suspiciously absent from the “Diagnostic and Statistical Manual of Mental Disorders” that mental health professionals use to categorize mental illness.

One of the reasons for this is because sex, unlike other compulsion promoting substances and behaviors, is a normal part of being a human. Therefore, diagnosing sexual compulsion requires labeling some sex and sexual behaviors as harmful. This is where critics point out the moral judgments that can go into making such a distinction.

Do we really want to give psychiatrists the power to say whether what we do in our bedroom is a medical disorder or not? Because what we consider “normal” sexual behavior is in many ways culturally determined, the resulting subjectivity leads to murky diagnostic waters.

One possible resolution to this is to rely on an individual’s honest self-assessment, rather than psychiatric diagnosis. This could start by carefully considering the components of our definition of compulsion relative to your behaviors, paying particular attention to the harm component.

How can you tell if behavior qualifies as harmful or not? A harmful or unhealthy behavior is one that causes significant stress in your life. In contrast, if a behavior leads to long term happiness and fulfilment, it’s probably healthy. Healthy sexual behavior looks different for everyone. If you’re feeling good about the choices you are making, and all parties are consenting adults, it’s probably okay.

What are some of the potentially harmful behaviors that could fall under the umbrella of unhealthy? These might include (but are not limited to): excessive pornography use or masturbation, hyperfocus on sex, increasingly risky sexual behavior, extramarital affairs, or cybersex fixations. You might be able to see where moral gray areas can occur in the range of these behaviors.

Any behavior, even if it falls outside what your culture considers is “normal,” is not necessarily a problem unless it’s disrupting your life. For example, is your sexual behavior causing you to miss work? Do you wish you could stop but feel like you can’t? Is it compromising relationships that are important to you? Do you hide it from your significant other because they would be upset if they found out? If you’re answering yes to questions like these, it could be unhealthy behavior that meets the harm criteria of compulsion.

What causes sexual compulsion?

So far, we’ve gone over what sexual compulsions are and some examples of what they might look like. But how does sexual compulsion work? How does someone develop a sexual compulsion?

To understand sexual compulsions, it helps to understand dopamine. Dopamine is a neurotransmitter, a chemical that conveys signals throughout the brain. Dopamine is associated with reward, movement, and anticipation – and ultimately reinforces behaviors the brain decides are “good.”

In this context, our brains get rewarded by doing all sorts of “good” things like eating, socializing, and yes, having sex. The more rewarding the behavior, the more dopamine, the more reinforcement. Because sex is necessary for reproduction and none of us would be here without it, our ancestors evolved to find sex very rewarding.

Drugs “hijack” the wiring in our brains that was built to reinforce these rewarding behaviors. But sex drive is natural, just like getting hungry. It’s not a drug. So why do some people feel compelled to it? The answer is complicated.

Like all compulsions, both genetic and environmental variables contribute to varying degrees. Unfortunately, our modern environment is not friendly to those genetically predisposed to compulsive behaviors.

Historically, the drive to have more sex usually resulted in having more children. This is what survival of the fittest is all about. But back then, sexual opportunities were limited. Our ancestors likely lived in smaller groups with maybe a few dozen eligible partners at most. Nowadays, not only are we connected to more people than ever, we’ve also turned the dial on sex up to 11.

This is where dopamine comes back into the picture. In the modern world, many forms of sex have become more “drug-like” in the way they release dopamine. Over time, humans have found a number of ways to make sex more rewarding, meaning more dopamine.

The potential problem compounded when we combined sex with the internet. Not only did humans make sex more potent, but also easier to access than ever before. Through a variety of apps and websites, we now have access to a nearly endless amount of highly explicit sexual material at our fingertips – and our brains are not ready for it. When highly dopamine producing rewards are a click or a swipe away, people who may have a genetic predisposition to sex compulsion can run into trouble. If you do go online for sexual experiences, do you find them satisfying and fulfilling? Or do you quickly find yourself reaching for your phone again?

Ultimately, it is this mixture of genetic predisposition, including your neurotransmitters like dopamine, combined with environmental factors, like the smart phone, that can lead to sex compulsion in some individuals. It helps to think about all the factors to understand sexual compulsions. It is also important to realize that sex compulsion is not a moral failing, nor is it an issue of willpower. Developing a sexual compulsion is largely outside of conscious control, it is not something that anyone chooses. That doesn’t mean you can’t do anything about it.

What should you do if you suspect having a sexual compulsion?

We have established what sexual compulsion is, how it works, and how to understand sexual compulsions overall. But what is the solution? If someone is experiencing problematic drug use, the goal is often to quit using substances. A significant difference with sexual compulsions is that the goal usually is not complete abstinence. Instead, we return to the difference between healthy and unhealthy or harmful behavior. Stopping harmful sexual behavior is the first part of the equation, but equally important is developing healthy sexual behavior.

It could start with some soul searching or a good look in the mirror. As the adage goes, the first step is admitting to yourself that you might have a problem. Oftentimes the brain goes to great lengths to justify behaviors that deep down we know are causing harm or that we want to stop. If you’re under any suspicion, it’s time to get curious.

Think about your values when it comes to sex. What does healthy sexuality look like to you in your life? Is what you’re doing now in alignment with those values? Does your behavior fulfill you and leave you with a lasting sense of satisfaction, beyond the momentary pleasure? Or do you find yourself just itching for more? What is the relationship with sex that you want to have? If you’re in a relationship, or would like to be in one, what would your partner think about your current behavior? If you’re seeing discrepancies here, it could be time to make some changes.

If you’re finding it hard to change your behavior, you might benefit from some additional help. There are a lot of resources available including websites like sa.org, the website for Sexaholics Anonymous. Looking into individual or couples therapy like we provide at The Center for Growth could also help.

How to Understand Sexual Compulsions

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