Alexandra Katehakis, a Senior Fellow at The Meadows, recently talked with Tami Simon of Sounds True’s Insights at the Edge podcast on a wide range of topics, including:

• The roots of sexual dysfunction
• “Grown-up sex” (i.e. sexuality based on honest communication of needs, preferences, and desires for novelty),
• Asexuality
• Sexuality without intimacy
• Why orgasms are overrated

Alexandra will also present on sexual dysregulation during Sounds True’s Neuroscience Training Summit 2017 on March 23.

Here are a few highlights from the podcast episode:

What’s the difference between having a sex addiction and being someone who enjoys sex a lot?

Alexandra: “One of the differences, main differences is that people who declare themselves “sex addicts” are in a profound amount of pain as a result of their sexual behaviors. So what may have started out as fun or being used as a way to sort of get out of one’s head—or not deal with psychic pain that some people know or don’t know they have—quickly turns into the proverbial albatross around their neck.

They’ll have a high level of preoccupation with getting into the sexual experience, so sex becomes—there’s myopia, there’s a shutting down of everything other than getting that experience. It becomes a collapse of one’s life, and people typically report messes—or what they call “unmanageability” in the 12-Step Program—resulting from this kind of destructive, painful sex. This is different from someone who likes to have sex, enjoys it, feels sensual, feels enlivening to them, and is what we think of as life-affirming.” Have you worked with people who aren’t quite sure whether or not they have a sex addiction? How do you help them?

Alexandra: “The term gets thrown around quite a bit now, and it doesn’t really fit the bill unless there’s a lot of assessment that’s done appropriately to look at whether there’s a long-standing pattern of compulsivity and if this person has in effect created these adaptive strategies that become states over time so if for example you have a child who grows up in a very, very dangerous dysfunctional neglectful household and they start to learn through fantasy whether it’s a comic book fantasy or more commonly we see today kids getting on the internet and looking at internet pornography as early as six and eight years old, and that is there a sole way of regulating themselves or feeling good what happens is that the brain starts to form around those patterned behaviors and so what is initially a coping strategy that helps that person manage difficult, lonely, sad, terrorized feelings over time becomes who they are, and they, therefore, can’t do what they do. And so that’s the point where it is “an addiction.” These are tenacious neuronal networks wired together in the brain because they’ve been firing together for so long.”

“So, just because someone has an affair or looks at internet pornography does not make them a sex addict, it requires a lot of scrupulous assessment to see if that’s really true for each person, and then some people like that term, some people don’t. I don’t have a bias about what people call it I’m more interested in helping people get out of the snarl they’re in and move towards a healthier, more life-affirming sexuality.”

How do you help sex addicts find a way to heal?

Alexandra: “Well, first, I take a very extensive history because oftentimes these patterns get set not only in childhood but sometimes really in infancy, depending on the level to which the person is chronically dysregulated, meaning unable to soothe themselves—wherein they’re always reaching for something outside of themselves to make themselves feel better.”

“Sometimes, if somebody recalls or knows that their mother had a very difficult pregnancy or she was anxious or depressed at birth, that tells us that she was likely unable to attune to her infant so that she could bring his or her systems to fruition in the way they are meant to be optimal. So, if she’s anxious, her infant will be anxious. If she’s depressed, the infant will be depressed. These functions get set up early—some of which can be changed, some of which cannot down the road.”

“Also, if that person suffered any emotional abuse, physical abuse, sexual abuse as a young person, or was grossly neglected, then they’re going to have a lot of trouble with regulating themselves. When a child is left alone or abused, he or she will find ways of coping. It’s sort of a natural adaptive strategy for survival. So, whether it’s fantasy or compulsive masturbation or, as I said before, disappearing into Internet pornography or even making up stories in one’s own head, all of those things are set up to make the pain or the sadness or the loneliness go away.”

“Oftentimes, children like that are set up to become addicts, whether they’re drug addicts or alcoholics or gamblers or eating—it’s hard to say why people choose which behavior to be compulsive with. But when they do, it’s helpful for clients to understand why what they’re doing makes a lot of sense. So, rather than feeling shameful or like they’re bad or damaged or broken, we look at why it makes good sense that they would be doing what they’re doing today because they adopted this a long, long time ago to survive. But, now it’s keeping them from having a healthy relationship or a healthy sex life, or being able to even be in a relationship if that’s what they desire. That would be the start of treatment.”

To listen to the Insights at The Edge podcast with Alexandra Katehakis in its entirety or to read a transcript, visit the Sounds True.

Treatment at The Meadows

To learn more about sex addiction workshops, inpatient programs, and outpatient programs offered at The Meadows, call 800-244-4949 or visit themeadows.com.