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“Porn” problems unlike any known addiction in largest neuroscience study

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Like I’ve said all along…

When studying addictions, there are known relationships between certain stimuli and reactions in the brain. These reactions have, in some instances, become the benchmark for what constitutes an addiction and addiction-based behaviors.  There has been heated debate over the very existence of porn “addiction” and what that addiction would look like when studied.

porn addiction, no such thing

In the largest neuroscience study of porn addiction to date, research conducted at UCLA found a clear reversal of the brain’s typical addiction response in study participants when they were shown sexual images. With the use of brain wave monitoring, participants who reported major problems controlling their viewing of sex films showed decreased brain reactions when shown the sexual images, rather than heightened activity as having a “porn addiction” would suggest.

The study shows that the brain does not react the way an addict’s brain would react to cues for their drug of choice. In fact, the study shows that the hypothetical “sex addict” brain reacts in the opposite way that a drug addict’s brain reacts, questioning whether sex addiction actually exists.

“This finding is important, because it shows a reversal of a part of the brain response that has been consistently documented in other substance addictions and gambling disorder,” Prause said. She also noted that this was consistent with their previous study, in which participants served as their own control and no relationship existed between the severity of their sex film problems and their brain response.

Many self-identified “hypersexual” people say they have an uncontrollable urge for sexual stimuli, and that it has resulted in negative life consequences such as loss of jobs or loss of relationships. For this reason, many clinicians have suggested that “sex addiction” be diagnosed much like drug addiction.

“While we do not doubt that some people struggle with their sexual behaviors, these data show that the nature of the problem is unlikely to be addictive,” said Prause.

The study involved 122 volunteers, both men and women. Some had problems controlling their viewing of sex films and met suggested criteria for problem use of pornography by three different questionnaire measures. Others denied any problems with their viewing of sex films. The 122 participants viewed images and were monitored using electroencephalography (EEG) that measures brain waves. The images were of sexual and non-sexual scenes. They included photos of people skydiving and of a man and woman engaging in intercourse, among others.

The study measured the late positive potential (LPP). Co-author Greg Hajcak described, “The LPP reflects electrical activity of the brain that is recorded at the scalp and time-locked to the presentation of pictures.” The LPP is a very common measure in studies of emotion. “The size of the LPP reflects the intensity of an emotional response, and reflects brain activity occurring in the visual system and ancient subcortical structures,” explained co-author Dean Sabatinelli.sex-addiction

“Hundreds of studies have found that the LPP is larger for emotional compared to neutral pictures,” described Hajcak, “and previous work from myself and my colleagues have shown that cocaine addicts have an increased LPP to cocaine-related pictures.” To test for correlation with hypersexuality, one would expect the brain to show high rates of activity when shown sexual images. In this study, a reverse effect was shown.

“The extent that individuals struggle with attempts to control urges or other internal states such as thoughts or emotions may change how problematic pornography viewing becomes,” co-author and psychologist Cameron Staley added. “Labeling a person’s attempt to control urges a ‘sexual addiction’ may interfere with therapy approaches such as Acceptance and Commitment Therapy (ACT) that can reduce distressing sexual behaviors.”

The study appears in the current online edition of the scientific journal Biological Psychology (http://www.sciencedirect.com/science/article/pii/S0301051…).

Authors on the study are Dr. Nicole Prause, Liberos LLC (http://www.liberoscenter.com); Dr. Vaughn R. Steele, The Mind Research Network, UNM-Albuquerque; Dr. Cameron Staley, Idaho State University, Pocatello, ID; Dr. Dean Sabatinelli, University of Georgia, Athens, GA; Dr. Greg Hajcak, Stony Brook University, Stony Brook, NY.

This research was conducted in the UCLA Department of Psychiatry and Biobehavioral Sciences (http://www.psychiatry.ucla.edu/), which is the within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The lead author is the founder at Liberos LLC, a company in the UCLA startup program devoted to neuroscience research and the treatment of human sexual problems.
Complete Article HERE!

Sex Addiction, or Too Much of a Good Thing?

This last post of 2010 will start with a declaration. One of my famous “Thus Sayeth Dr. Dick” sorta things, if you please.

Ready?

I categorically reject the concept of sexual addiction that has been floating around in the popular culture for the last 20 years or so.

And yes, I know this will rankle a bunch of you, but you’ll just have to get over it. You see, there is no such thing as a sexual addiction. Period!

Nowadays people bandy about the term addiction as if it can be applied to any and all obsessive behaviors. I have an addiction to chocolate; I’m addicted to shopping; I’m addicted to video games; I’m addicted to porn—or, I’m a sex addict. NONSENSE!

That being said, I hasten to add that I do believe there are sexual obsessions and compulsive sexual behaviors, plenty of ’em in fact. However, obsessions and compulsions are not addictions, and addictions, while they may involve irresistible impulses, are not the same thing as compulsions. Get it? Got it? Good!

I want to be absolutely clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological.

  • A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld, it will trigger symptoms of withdrawal.
  • Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

Check it out. With the help of my handy-dandy dictionary, a good place to start in discussions of this sort, I discovered these three very distinct definitions:

Addiction: The need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by well-defined physiological symptoms upon withdrawal. Broadly: persistent use of a substance known by the user to be harmful. A state of physiological and psychological dependence on a drug.

Compulsive: Driven by an irresistible inner force to do something; i.e., a compulsive liar.

Obsession: A persistent disturbing preoccupation with an often unreasonable idea or feeling.

See? Different words. Different meanings. Not a particularly complex notion to grasp, right?

And listen, just because a bunch of yahoo afternoon talks show hosts and even a load of my esteemed professional colleagues banter these words about like they were interchangeable doesn’t make it so. In fact, we do ourselves a huge disservice by muddling these very specific concepts into a jumble. My fellow therapists should be the first to recognize this because finding help for an addiction or an intervention for an obsessive/compulsive disorder will be as specific as the problem itself.

One thing is for certain: identifying one of the things, as the other will complicate the problem solving. It’s like going to the doctor with a headache, and when the doc asks where does it hurt, you point to your stomach. It just won’t do.

Hi Dr. Dick,
I recently found out my boyfriend has been cheating on me. He wants me to forgive him, but he keeps on doing the same thing over and over again. He’s like addicted to sex or something. I love him very much, but I feel dirty just by being around him and knowing what he’s doing. It also makes me feel stupid putting up with all of this and at the same time I still love him, please give me some advice. Thank You.
— Darlene

Before we turn our attention to your boyfriend’s behavior, let me make a quick observation about you. You’re a big fat ball of contradictions, huh? How can you say that you love the person that makes you feel dirty and stupid? You’re deceiving yourself about at least one of those feelings. And if I had to guess, I’d say what you’ve got with your man ain’t love—it’s an obsession.

Your boyfriend probably has you figured out by now, and he knows that you will tolerate his misbehavior, which gives him tacit permission to do whatever he feels like doing. From where I sit, you’re the real sap. If you’re really serious about reining in your wayward BF, you’d better come up with a clear, unambiguous message about what you will and will not tolerate. Until you do precisely that, he’ll just think that he can roam wherever he wants and whenever he wants.

If the two of you are supposed to be living in a sexually exclusive relationship, and he’s taking his business elsewhere, then he’s got a problem, too. However, I caution you against thinking that his sexual behaviors are an addiction. Because they’re not.  And thinking they are will not help you find the solution to the problems you folks are having.

There are root causes for his behavior, just like there are root causes for your behavior. To get to the bottom of all of this, each of you will need to invest a good deal of time and energy with a qualified therapist. One can only hope that there’s a big enough bank of goodwill between the two of you to carry the day because overcoming your obsession and his compulsions will demand all of your emotional resources.

Dear Dr. Dick,
I have been in a relationship for five years now and truly love my partner, however I can never seem to get enough sex. I am 30 and he is 29, but I constantly find myself in the chat rooms lookin’ for younger guys to have sex with. It’s more than just a hobby—it’s a habit! I’ve actually lost jobs because he’d be out of town and I’d spend almost every waking hour on the PC with a cocktail looking for sex, not caring about anything else. It’s like I’m addicted to sex. He knows I have played around (I actually have talked him into three-ways a few times), but he has no idea how extreme it’s become. I don’t know what’s wrong with me. I’m not unhappy with him. I just can’t seem to stop wanting sex with younger guys. Any suggestions?
— Brian

It’s interesting that you should tell me about your compulsive sexual behavior in the same breath that you tell me of your love for your partner. As you’ve probably guessed already, there isn’t really much of a connection between the two. Love and sex are two very different things. Sometimes they go together, but not always or even often for that matter.

It appears to me that you’ve really got two problems happening simultaneously: First, your compulsive prowling of the internet for sex (complicated, I might add, by your alcohol consumption). Second, the deception you’re practicing on your partner. Let’s deal with each of these in turn.

Your particular sexual activity, like any compulsive behavior (overeating, excessive shopping, etc.), is more than just a bad habit. It’s a serious psychological dysfunction. Take it from me: breaking this behavior pattern will be nearly impossible without some professional help. If the problem is as serious as you say, then you’d better seek help right away. This sort of thing, if left untreated, will not only destroy your relationship, it will ruin your life. When you seek that professional help, I encourage you to include information about your alcohol consumption. If there is an addiction in all of this, it’s the alcohol, not the sex. And in your case, the addiction may be fueling the compulsion.

Now, regarding your relationship. It’s imperative that you come clean with your partner about your sexual obsessions and compulsions, as well as your probable alcohol addiction. Not only will you feel better about not lying to him anymore, you’re going to need his support in overcoming the difficult obstacles you face. I suggest that you attend to this right away. There’s not a moment to lose.

Good Luck

Slut Shaming

Name: Martin
Gender: Male
Age: 50
Location:
Thanks in advance for your assistance, Dr. Dick.
Here’s my dilemma; I’m so in love with my partner, he’s actually the man of my dreams. We met much later in life, he being 45 and I’m 50.
I was married before w/children, out now as a gay man and all is well with my children’s relationship.
My partner has always known he was gay, has had numerable relationships, and was a sexual addict. He has wanted me to understand his past in relationship to his level of happiness now, stating that he was a bottom slut only because he was never truly in love or satisfied.
He wants me to believe that “I’m the one” that has changed his life-long addiction to strange dick up his ass.
I can’t seem to get past his past slut behavior, and oftentimes get so pissed off because he wants me to meet and develop friendships with many of these past fucks (primarily because they were military buddies also).
Why can’t I accept his slutty past and stop the suspicions?
Why do I get so upset just knowing that he was a total bottom slut??
How can I get him to understand that I have no desire to know any more about his sexual past and just focus on creating our lives???
Thanks,

Martin, Martin, Martin! How you do go on, darling.bullshit

Take a look at your language, why don’t ‘cha? Could you possibly be any more pejorative when speaking of the sexual experiences of someone who has lived a different lifestyle than you? I doubt it. Look at how many times you use the word “slut” to describe the man you say you love. I’m gonna call you out on that. You simply can’t tell me you love someone that you have so little regard for.

Your man wants you to understand his past, but you won’t take it at face value. You belittle his experience, possibly because it doesn’t match your own very limited, sexually exclusive, predominately heterosexual lifestyle.

circle jerkListen, lots of gay men (and some straight men) have loads of sex for lots different reasons. Sometimes just for the fun of it…or, as your man suggests, just to be a big old bottom slut. There’s absolutely nothing wrong with that. One can be happily sexual without loving each and every one of his partners. And the sex can be really good too. Just as one can have very unsatisfying sex with somebody one loves deeply. Sex, intimacy, and love are not necessarily dependent on the one another. No need to make such a tangle of it all, Martin.

I also want to reinforce my belief that there’s no such thing as a sex addict. Compulsive behavior? Sure! Out of control behavior? You betcha! Self-denigrating behavior? Absolutely! Sexual addiction? No way!

Try for just a minute to extricate yourself from your sex-negative mindset by exchanging the notion of eating when you talk about your friend’s sexual exploits. Would you have the same revulsion if your guy said he had shared food with lots of other guys? Some of it was fast food that didn’t satisfy all that much. Sometimes he ate just because he wanted to, not because he was hungry. And now he wants you and he, as a couple, to be friends with some of the men he ate with. Sounds perfectly reasonable to me!fingering his ass

Your man is inviting you to open yourself up and see life and sex as most openly gay men do. This is fundamentally different from how some formerly closeted men see life and sex. If you let him, he just might help heal you of your sex-negativity.

Finally, jealousy is one of the worst human emotions. It’s actually a kind of hatred, you know. Sometimes it’s hatred of another, but it is always self-hatred. You say you love this man; again, I challenge you on that. It’s clear to me that you have a much greater love of your provincial notions about sex then you have for this guy.

Here’s a tip, Martin. Jettison the unhealthy attitudes about sexual expression and give your guy a chance to be himself, not the idealized man you’ve made him out be, or think he should be. You’d be well served by working with a sex-positive therapist to help you get over this. Do it now, because if you hesitate you will surely ruin the very relationship you claim to treasure.

Good luck

Awakening Your Sensual Self Post Cancer

Name: Doug
Gender: Male
Age: 58
Location: San Diego
HI: I need some help. I had my prostate removed due to prostate cancer. I feel I have lost my man-hood. I don’t experience hard-ons anymore. My penis is dead. Can you recommend something to help me?

It’s truly uncanny; in the past week alone I’ve received similar email from four different people. Each had a very different presenting problem, but all were experiencing very similar sexual issues. Get this, I heard from a woman in Japan who is recovering from a radical mastectomy. I heard from a guy in San Francisco who is recovering from a serious meth addiction. A young wife and mother in North Carolina whose husband, and father of her two kids, has returned from Iraq a basket case…and now you, Doug.prostatecancer_600x450

Its astonishing that, despite the dramatic differences in each of your life stories, all of you report pretty much same thing — you feel less than whole, disconnected from your sexuality and devoid of any real intimacy or meaningful sexual outlet. It is so amazing how, despite our unique individual difficulties, there are often a universal response to life’s troubling complexities.

Regaining a sense of your sexual-self after prostate surgery, or any of the other problems I mentioned above, is an arduous, but rewarding task. With your self-confidence in the toilet and zero libido to boot, I suggest that you begin your rehabilitation by connecting with others similarly challenged as you. In your case, it will probably be other cancer survivors. More likely than not, they will be a whole lot more sympathetic to your issues and attuned to your predicament. Sometimes, people who have yet to experience a life threatening disease or a disfiguring surgery don’t have a clue about how to interact with those that have. It’s not their fault, it’s just the way things are.

I suggest looking into a support group, if you haven’t done so already. Once you make that connection, you will find, that you are not alone. Other people similarly challenged as you are experiencing many of very same things you are. And to my mind, it’s way much easier to face and handle life’s difficulties when surrounded and supported by others.

AGDD_front coverOne word of caution; my experience is that many disease-based programs and support groups shy away from intimacy concerns. This is a real tragedy, because this is the one aspect of healing that consistently remains unaddressed by the medical profession. That is way I included an entire chapter about the intimacy and sexual needs of chronically ill, elder and dying people in my book — The Amateur’s Guide To Death and Dying; Enhancing the End of Life. I encourage you to check out the book; it’s loaded with amazing sex-positive information.

Next I suggest that you first try connecting with people on a sensual level as opposed to a sexual level. I firmly believe in massage as the best say to accomplish this. Think about it. Imagine the good you’ll be able to do for others, as well as yourself with therapeutic touch. And, to my mind, therapeutic touch also includes sensual touch. It will soothe so much more than the jangled nerves and disrupted muscle tissue caused by radical invasive surgery. It gives the one doing the touch a renewed sense of him/herself a pleasure giver, which is totally important to us all. And when you receive the touch, it will begin to reawaken sensory perceptions you thought were lost for good. And your libido as well as your erection will bloom again. I promise. Here’s a tip: to keep that stiffy goin, I encourage you to use a cockring.

Now if you feel your massage skills aren’t up to par, why not take a class or workshop in massage. You might want to look to something like the Body Electric School Of Massage. They have load of training options. And learning is a hands-on experience. What could be more liberating than that?

If a class is a bit too intimidating at first, you might consider purchasing a book on massage. A great primer is: Male Erotic Massage by Ray Stubbs, Ph.D.  This is a holistic approach to bodywork, including the sexual and the spiritual aspects of Male Erotic Massage. There are over 200 photographs in this volume that reveal both massage techniques and the beauty of the male body embracing the male body. The strength, the joy, the gentleness, the ardor, the tenderness, the equanimity, the pleasure — they are all included.

Another title is: Erotic Massage, The Touch of Love also by Ray Stubbs, Ph.D.  This is a more inclusive volume of erotic massage. It describes long, flowing strokes for the whole body, including female and male genitals. By the way, this was the very first massage book to explicitly illustrate genital massage. The techniques described are simple and easy to perform. It’s superbly illustrated, and the text is both tender and playful.Massage

Finally, your gift of massage is the ideal way to connect with another human, be it a friend, a family member, lover, or even a stranger. Your touch can be either seductive or non-seductive, or maybe a little of both. You can count on this purposefully touching to open new doors. You’ll discover new pleasures, both subtle and profound, as you give as well as receive touch.

I encourage you to push beyond the isolation I know you are feeling, Doug. Purposeful touching, like massage, will change your perceptions about sex, sensuality, and intimacy. And like I said, it will also resurrect your boner. I know this can happen. I’ve seen it happen. Doug, now it’s your turn to make it happen!

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

The Naughty & The Nice

Just in time for the holidays, here’s my Naughty and Nice list.

NICE

NAUGHTY

NICELY NAUGHTY

Happy Holidays!

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