MHM Magazine

30 | MENTALHEALTHMATTERS | Issue 4 | 2021 MHM individual is potentially threatened by real or perceived abandonment. Usually there’s a significant fear or profound sense of loss of identity at the core of these sexual practices. It’s likely these rituals become like a drug the individual uses to ‘self- medicate’ in order to restore balance in response to self-disintegration, motivated by underlying fear. The sexual activity is usually enacted and reenacted as a drama designed to present a false impression that excites one – this defense mechanism arises from an inability to tolerate others. This defense is useful to protect themselves from experiencing another person as complex, real and different from oneself. Sex addiction often serves to reassure a person of an illusion of permanence and omnipotence. There is a discrepancy between one’s real-self and ideal-self. The ideal-self rests upon a social identity of who someone wishes to be. The individual engages in the ideal-self as a means to present favorably to others. The ideal-self employs narcissistic defenses such as, preservation of one’s idealised aspects and denial of realistic limitations. These defenses serve as an affirmation of what one isn’t but wishes to be, and often characterised by feelings of emptiness and longing. The real-self however, rests on a personal identity, characterised by full acceptance of who one really is, and feels content presenting oneself authentically. The real-self makes use of more adaptive coping mechanisms necessary for realistic limitations. An individual is able to comfortably achieve affirmation from feeling gratitude, and feeling ‘good enough’. The constant deep-seated fear of abandonment, inhibits someone from ever experiencing healthy development of deep, meaningful and trusting relationships. The person is left constantly feeling inferior, and inferiority results in a feeling of loss of control. The individual over-compensates by trying to control and use others as a means to confirm their sexual omnipotence, but at the same time allowing them to also experience a brief connection to others that isn’t too intimate and threatening to the person’s fragile sense of self. PHASES OF SEX ADDICTION 1. The initial phase of obsession - the individual is totally absorbed by sexual preoccupations 2. Characterised by ritualised behaviours; the individual engages in rituals that proceed sexual behavior 3. Sexual activity acts as a temporary and instant gratification 4. Lastly, this phase results in a feeling of despair that bears an incapacity to control behaviour As is the case with other dependencies (e.g. substance abuse), the stages involve: • Experimentation • Occasional engagements • Regular use However, the above mentioned, doesn’t usually constitute sufficient reason for help. When these engagements become a defense to ward off emotional states, and the sexual activity becomes a substitute for a lack of a secure attachment, this then warrants the need for help. ATTEMPTS AT COPING In order for the individual to cope with the balance of the psychological ‘game’ of keeping intimacy close and at the same time, at arm’s length, the individual usually has noticeable defense mechanisms and processes: 1. Denial This defense involves denying, excluding, or entirely avoiding at all costs, various emotional states that are not in keeping with the ideal self-image, and that are deemed to be painful and uncomfortable. 2. Idealisation, omnipotence, devaluation A process in which the new person is idealised (through an unrealistic wish or fantasy). Deceptions, or frustrations with reality allow for a dismissal of the other person and results in objectifying (devaluing) the person. The omnipotence aspect allows the individual to easier discard the other person. 3. Anxiety Avoidance The conscious avoidance of anxiety is employed as a means to avoid real, deep, meaningful intimacy. It can often be understood as a phobic strategy to avoid the underlying fear of abandonment (“I will throw this person away before they can abandon me”). The individual continues to use this defensive process as a means to further avoid depressive suffering after the potential attachment is lost. 4. Masked Depression Characterised by the loss of belief in deep meaningful relationships, which results in loss of hope in others (existential crisis). Losing sight of meaning in life that may potentially offer long-term fulfillment. The psychological and emotional cost of the above defensive processes results in the individual feeling empty, sad and physically drained, and can be compared to that of a ‘hangover’ experienced with substance use. To avoid the hangover or recovery period, which when faced, requires delayed gratification, the individual opts for instant gratification via sexual activities and so the cycle begins again - to the individual’s inevitable detriment to themselves and others. VARIOUS MANIFESTATIONS OF SEX ADDICTION • Compulsive masturbation • Pornography • Cyber sex • Promiscuity • Dependency on objects (images, clothing and so on) to achieve sexual gratification CRITERIA • Compulsive and unsatisfying pick-ups, which imply a constant and insatiable search for multiple partners • An unsatisfying compulsive sexuality in which the other is reduced to a state of a partial object • Masturbation that is compulsive (5-15 times a day) and sometimes leading to injury, irritation of the skin, an intense feeling of fatigue, and social/professional difficulties • Compulsive fixation on one or several inaccessible partners, in conjunction with idealisation of the love object • Multiple compulsive love relationships (constantly seeking intensity of feelings through new sexual adventures) References available upon request