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Sexholism is an addiction that, apart from apparent pleasure, brings many problems. In an interview with Medonet, Dr. Daniel Cysarz, a sexologist.
Sexholism is a long-standing problem
The sex addict hasn’t changed, but he has other tools. She still calls the call girl and visits go-go clubs, risking sex with a truck less often. He makes an appointment via the application, and after hours he starts his laptop and turns on the camera. – New therapies for sex addiction, instead of abstinence, propose to return to the partner’s bed and work on emotions. The main motivation for sex is the drive and the need for closeness, not the desire to relieve tension.
Zuzanna Opolska, Medonet: Doctor, more and more sex and pornography addicts come to specialists. Are we coming out of hiding or is there just more of us?
Dr. Daniel Cysarz, sexologist: The scale of the phenomenon is very large. According to research, every second man uses pornographic content several times a week. Assuming that it is accompanied by masturbation, there is a risk that this behavior will become compulsive and become addictive. Whether we are talking about alcoholism, drug addiction or sex addiction, the mechanism is the same. The brain gets used to certain doses of dopamine (called the happiness hormone) which stimulate the pleasure center, which in turn reduces the tension in the body. In this way, alcohol, masturbation or risky sex becomes a tool for dealing with anger, anxiety and difficult emotions. Another way to reduce tension is through regular physical activity and a lifestyle where there is room for work, pleasure and rest. Usually the cause of tension in the body is the lack of the ability to efficiently manage one’s emotions. It is difficult for us to identify, name and express them. Hence, one of the main areas of therapy is learning to recognize and express emotions. The patient learns to “read” his body, which gives him the opportunity to give access to this knowledge also to other people.
Women are less likely to become addicted to sex or pornography. What it comes from?
I have my own theory on this. Women have a greater social consent to express their emotions. A man who cries or talks about feelings is perceived as weak and unmanly. This way of relieving emotional tension in men is more often blocked. Therefore, in the case of sex addiction, as with other addictions, men are the majority. In my office, I meet both women and men. But the percentage of the latter is definitely higher.
Sexholism today and 30 years ago, is it still the same?
Yes, but the sex addict now lives in a completely different environment. First of all, today’s sex addict sooner or later will find out that he is a sex addict, because this topic appears more and more in the media. Thirty years ago in Poland there was a problem with that. There were neither sexologists nor institutions caring for reliable transfer of knowledge in the field of sexual health, such as, for example, the Polish Sexological Society. Additionally, the sources of addiction have changed over the three decades. A whole range of new possibilities for satisfying one’s sexuality has appeared. The sex addict today is addicted to the same thing – dopamine. But he has different ways to please himself. We are talking about cybersex, masturbating while fantasizing, watching photos, videos, using sex cams, sex chat, and apps for finding a partner for sex. Due to the growing number of sources of stimulation and the specific nature of the addiction itself, sex addiction is very difficult to treat. The beginning is often delayed for years, because addiction is usually invisible to the environment, e.g. it does not cause organic changes in the body, as in the case of alcoholism, it is practiced in secret and rarely becomes the subject of conversation. However, sex addiction can completely destroy relationships with loved ones and ruin your professional life, eventually leading to mental breakdowns and even suicide attempts. It often happens that addicts need stronger and stronger stimuli to satisfy them. And this may even lead to the search for materials with content that is threatened by the relevant paragraph of the Penal Code. Hence also patients who came into conflict with the law due to their addiction.
Is it about paraphilias – disorders of sexual preferences, such as pedophilia or sexual sadism?
It happens that in search of stronger sensations, people find materials with content paraphilic (e.g. pedophilia, zoophilia). However, the mere fact that they masturbate to this type of content does not mean that their sexual preferences are disturbed. However, this may indicate a growing need for new stimuli, which is becoming more and more difficult to satisfy, which often becomes a source of enormous frustration and suffering.
Can we say that certain professional groups are more likely to be sexually addicted? Students, corporate employees?
I don’t think we should generalize. Reporting sex addiction are primarily people who lack the time and tools for other stress relief and confrontation with their own sexuality and needs in this regard.
But, we can talk about a certain type of personality ..
Yes, we can talk about certain personality predispositions, e.g. to a certain extent introversion i neuroticismbut it is also related to the model of emotional expression that we bring out of the home. In therapy, I often ask my patients: how did your father deal with his emotions? As a rule, the answer is similar. Either he exploded, or he had it all inside himself and drank from time to time. A similar model is taken over by the man in his adult life. He does not want to abuse alcohol or use aggression because of the consequences, so he is looking for a different way. And then they turn to pornography or risky sex.
The age limit for pornography is constantly falling. How does this affect our sex life?
A new trend that I encounter is the young twenty-year-olds delaying initiation. The content they watch online is unreal and, compared to their sexuality, acts as a blockade. They don’t feel attractive enough, they don’t always do well in bed, and not all intercourse ends with an orgasm. If pornography arrives too early, psychosexual development may be impaired to some extent.
But in this case we are not talking about asexuals?
No, we talk more about immature sexuality. Because from developmental point of view, masturbation comes earlier than full sexuality with a partner. And compulsive, stressful sex is more like masturbating with your partner than building a drive-based closeness between two.
Do women use cybersex or porn for other reasons?
In my opinion, the main determinant is not biological, but psychological. Two years ago, I did research on women, men, and transsexuals, looking at gender differences. To my surprise, the main determinant turned out to be psychological gender, not biological sex. After all, there are women who, for example, are visual learners, are well versed in the field and have a passion for science. And there are also men, who show high sensitivity to beauty and developed emotionality, although each of the attributes mentioned is usually stereotypically assigned to a different gender. I believe that the so-called “Male women” may resort to pornography or masturbate just as often as men whose psychological gender is male.
In the first stage, the addicted person uses rationalization, i.e. “we all watch porn” …
Yes, we are underestimating the problem. The man with sex addiction keeps telling himself that it’s natural, everyone does it, I don’t hurt anyone. Rationalization protects us from negative self-esteem. Very often, the first impulse comes from a partner who sends such a person for a consultation. Sexholism causes patients to report on the basis of their own motivation, often only when important relationships fall apart, discomfort and suffering arise due to the increasing costs associated with the addiction. We are talking about situations where sex becomes risky and masturbation lasts for hours and devastates life.
Are most of the people who come to therapy for treatment of sex addiction in relationships or singles?
I work with both patients who are in permanent relationships and those whose relationships have broken up or who have never formed one. In the early stages therapy it is very important to systematize the motivations leading to sex and masturbation. There are two main sources. We are driven by two forces, the first is drive and the second is emotional tension. Compulsive behaviors are related primarily to the desire to relieve tension (e.g. anxietyanger sorrow). With this in mind, over time the patient can decide for himself whether he prefers to masturbate for one or the other. Sexual masturbation is less frequent and gives more comfort and satisfaction. Sex or tension masturbation occurs more often, but leaves us feeling unsatisfied, emptied or broken. If we go to bed with the voltage model, we treat our partner objectively. And this certainly does not bring you closer and does not build closeness.
In one of the interviews you said that the triangle often stabilizes the relationship. If the third is the Internet, is it so?
It all depends on how we treat masturbation. Contrary to appearances, it can also be an element that stabilizes the relationship. For example – I have a great partner with whom I regularly have sex and the fact that he masturbates occasionally to relieve tension is not necessarily a hindrance. However, if over time his activity becomes more time-consuming or the materials he uses become more drastic, a problem may arise. Remember that any triangle (even with pornography) can only “stabilize” the original relationship temporarily! By “stabilizing” I mean: temporarily compensate for deficiencies in meeting some important needs that were not satisfied in the original relationship (eg the need to be attractive, sexual needs, the need to relieve tensions).
Do women perceive their partner’s cybersex in terms of physical or emotional infidelity?
There are several scenarios, the Internet offers many possibilities. If there is no specific person to whom we masturbate, it is easier for the partner to accept it. But if it’s still the same woman, actress, or call girl, then there’s a problem. In this situation, it may not only be about physical betrayal and relieving tension, but also about some emotional commitment to another woman.
How does this affect women’s self-esteem and their sex life?
No sex in a relationship, a woman may perceive as a simple message: I’m not attractive. I often work with couples who come up with the idea: let’s fix the sex and you’ll be fine. Unfortunately, it turns out that it’s not about sex at all, but about a relationship. If there is room for different emotions, conversation, doubts and weakness in a relationship, then less often there is also room for addiction. Again, sexuality happens between the ears, not the thighs.
Yes, but if your wife has thought all her life that she is the husband’s type, and she finds out during therapy that she’s been dating women who are her physical opposite, she may feel confused …
I believe that in such a situation, dealing with attractiveness could only be a substitute topic that would distract from more important topics such as: trust, closeness and loyalty.
Let’s talk about new treatments. Return to bed instead of abstinence?
Yes, the abstinence model has been abandoned in recent years in world literature. We do not hold the patient accountable for his sexuality. On the contrary, we tell him – please have sex or masturbate, of course if it is within the beliefs or value system of the person. We are working on this choice to be made consciously, i.e. sex it is just sex or a tool for something. After some time, it turns out that patients choose sex or masturbation themselves because of their libido. This is the first step to change.
Do couples start and end therapy together?
It can be different. If sexholism has been engaging in a relationship for years, paradoxically, removing the difficulty and resolving the problem may result in the partners no longer being needed by each other. Assuming they had unconsciously “contracted” before, that one party is a guardian and the other is in need of care. If they are able to cast themselves in new roles, such a relationship has a good chance of surviving. However, if the partners are unable to part with their current roles, unfortunately the prognosis is much worse.
And if they have children, do they fight for each other more?
They feel more compelled to fight. However, working on a relationship for children is not the best motivation to be together, because someday these children will fly out of the house. And then what? A similar motivation is the joint loan, which seems to bind similarly tightly, because it is also possible to pay it back sooner or later.
Are there situations when a woman gives up her partner right away and ruthlessly? For example, when he finds out that he chose women much younger or there were men?
However, by definition, couples who want to work on the relationship come to my office. If one of the parties makes a decision to leave, then if it is not a kind of manipulation or blackmail, then such a couple will probably not go to therapy. Although it sometimes happens that the decision to break up was made in the mind of one of the partners before the first visit, and coming to the therapy is only to serve as a basis for the fact that they have already tried all the methods.
After the first meeting with the patient, is it possible to say how long his therapy will take?
Some patients think they can solve the problem in ten sessions. But therapy doesn’t work that way. It all depends on how long the patient has suffered from sex addiction. If a 40-year-old comes to me, who has been relieving his tension in this way almost forever, the therapy may take up to several years. It is up to us to free ourselves from the disorder. Sometimes, however, we are so attached to our problem that we cannot live without it. Unfortunately, the most effective motivation for change is easier to find in depression than at the top.
Dr. Daniel Cysarz is a sexologist and supervisor of the Polish Sexological Society