Sex Addiction as a ‘Dysregulation of Appetite’
As a recovering sex addict with years of work in, I have struggled with something that feels emotional on its surface, but at base, may be biological. For almost as many years as I was regularly acting out, I grappled to describe a problem I had in relationships (I did not yet know I had sex addiction). I called this problem one of “attraction versus repulsion.” Again and again, with more people than I cared to count, I was drawn in with incredible and overwhelming attraction, only to quickly and thoroughly turn away from our interactions, both physical and emotional, with a sense of uncontrollable revulsion. No matter what my mind told me was “repellant” about a person or a circumstance, I knew deep down, it didn’t make sense. Only days—or sometimes hours—before, I’d been deeply attracted to the very same traits. Still, I couldn’t reason away my deep desire for avoidance; it was inexplicable. I needed to leave, the same way that I had needed to come—immediately and without hesitation.
What was this undermining device, and why did it occur again and again—sabotaging my happiness and any sense of security I attempted to create?
Recovery taught me something vital: sexual addiction is not really about sex or even attraction; it is an intimacy disorder. The attraction/repulsion split I continued to experience, even after years of recovery, was the manifestation of my disordered intimacy. And I knew very well where it had come from: like many of my fellow recovering sex addicts, I am an adult who experienced trauma as a child—physical, emotional and sexual abuse, as well as prolonged neglect. And, like so many women who experienced the kinds of sexual and emotional abuse that I did, I struggled for decades with disordered eating and other forms of addiction alongside issues of hypersexuality.
Trauma and Appetite Dysregulation
In my 20s, I was diagnosed with complex PTSD (C-PTSD). But I wasn’t satisfied simply to learn that repeated abuse had resulted in a set of detrimental emotional consequences for me. I needed to understand how my sometimes-bizarre emotional responses were a result of primitive survival reflexes (fight/flight/freeze), which had been so consistently provoked in my early years that they no longer held the capacity to react appropriately. (A coworker walking up behind me when I was not expecting it could easily cause me to involuntarily jump and scream, for example.) I could examine the content of my traumatic history as much as I liked, but until I understood what had happened to my brain’s wiring, and how to change it, I was in for more of the same: responding to a mostly benign environment as though I was under persistent threat—advancing and retreating from everything in my world. It was exhausting.
Then I read something interesting in The New York Times.
Dr. Martin Kafka, a world-renowned expert on paraphilia and hypersexuality disorders, discovered something important in his work at McLean Hospital. “I began to see that the sex offenders were just like the bulimics. Both groups were suffering from a dysregulation of appetite. I began to think that paraphilias and the [paraphilia related disorders] are to men what eating disorders are to women. I was so excited by this breakthrough, I didn’t sleep for two nights.” (2000)
Kafka’s realization turned out not to be isolated. Sex addiction treatment clinicians had begun to make an interesting connection. Roughly the number of men who sought treatment for sexual addiction matched the number of women seeking treatment for disordered eating, and with both groups, the outlying percentages were and remain taken up by the other gender. While there are biological and social questions as to why, the connections are interesting. Both groups share a problem of disordered appetite, a function of the hypothalamus in the limbic region of the brain, and both groups are statistically likely to have experienced some kind of trauma.
The hypothalamus not only governs sexual and dietary appetite, but also plays a large role in the body’s stress response—that fight/flight/freeze reaction that becomes so overwhelming in children who experience consistent and ongoing abuse. It’s even more interesting to note that individuals who exhibit C-PTSD experience a range of symptoms such as “ … disordered eating, revictimization, promiscuous attachments and sexual behaviors. Alternatively, there are frequent reports of avoidance of relationships and sexual activity, social withdrawal and feelings of isolation and alienation.” (Cloitre, 2007) Individuals who suffer sexual addiction frequently experience these same symptoms, and they were certainly experienced by me. Do we overlap, or are we one and the same?
Understanding Sexual Addiction and Trauma for Recovery
We need food the same way we need emotional connection; our young cannot thrive with lack of either. While sex addiction may be based in disordered intimacy (an inability to create or sustain connection), it’s important that we examine closely the origins of such a disorder in every individual presenting with hypersexuality. For those who experienced attachment trauma in early childhood, particularly for sustained periods of time, a sense of closeness can become to the disordered brain what the threat of snake venom is to an ordered one—a thing from which we must flee in order to survive. But in the circumstance of personal connection, we need the venom to live just as much; it is our antidote.
How we maneuver through this impasse is critical, and for all the years I’ve been in active recovery, I have not learned exactly how to do it for the long term in order to heal the avoidance side of the sexual addiction equation—how to tame my engrained emotional response to flee, and retrain my brain not to fight what cures it. But I’m still trying, and I’m not giving up. And—better news—neither are the countless clinicians who work with people like me.