Articles by David H Jacobs Ph.D

What Drives Sex Addiction?

Calling a behavior or activity an addiction connotes an insatiable yearning to engage in the behavior or activity. Sex addicts spend a lot of time and energy (and often money) looking for and engaging in sexual activity of some kind. A desire to have sex presumably needs no explanation; what needs explanation is the insatiable, driving, devil may care, indifferent to consequences character of the role of sex in the lives of some people.

The explanation is no more about sex per se than a seriously obese person’s eating habits are about the enjoyment of food or an anorexic’s eating habits are simply about an interest in being fashionably slim (or a cutter’s interest in cutting is simply about administering relatively superficial wounds). I suggest two clues.

Clue number one is a general suggestion that persistent strange or desperate behavior on the part of an adult points backward to serious and persistent aberrations in the person’s home environment during the course of growing up. I like the slogan: ‘They don’t call the formative years the formative years for nothing.’ Forget just shrugging off the formative years when a person legally becomes an adult. There is a legacy from the formative years that cannot be evaded. This is inherently complicated and likely unresolvable because a person’s behavior is usually neither simplya matter of free choice or predestined by past experience.

Clue number two requires paying attention to the person’s baseline or background feelings. I am referring to how a person characteristically feels when nothing is going on that demands focused attention. I suggest that a person whose formative years were oppressive or neglectful in important ways does not at all enjoy his background feelings. There are lots of possible descriptive terms, but keep in mind that words are frequently inadequate to the task of depicting feelings (think about it) – bored, empty, anxious, afraid, apprehensive, restless, antsy, deprived, hungry for something, lonely, guilty, inadequate, self-loathing. A person who sinks into a dysphoric feeling state when not strongly distracted is motivated to seek strong distraction. There are many possibilities. Sex is one possibility. Technology has literally put pornography at everyone’s fingertips. Sex as a commodity for sale is a gigantic business (if we want to talk about reality, the sheer size of the total illegal goods and services market cannot be ignored or overlooked). And of course there is old fashioned hooking up for those with power and/or charm (but even the rich and powerful may and do avail themselves of fee-for-service opportunities that are only a phone call or email away).

Although there is a spectrum of shades of gray, it is useful to distinguish affairs from simply buying sex and/or watching pornography. People who are driven to have affairs are in effect showing their need to be wanted, desired, affirmed, and so on. Everyone wants that, but not everyone has insatiable needs. Insatiable needs point backwards to deprivation growing up.

I do not offer this as an excuse; I am talking about origins and development of behavior. Understanding and explanation is one thing, moral evaluation is something else. I think all addictions are marked by a certain shallowness in human relations, especially when it comes to what is nominally the person’s most intimate relationship. This too points backward to injuries sustained in the home environment growing up. The ‘ability’ to have affairs without feeling troubled by betraying the trust of one’s spouse indicates a shallowness in connection, meaning a shallowness in being concerned about and caring about the feelings and well-being of the other person (the spouse). I think this is basically due to having learned growing up that it is dangerous to be too vulnerable and too trusting of anyone. I think of addiction as a substitute for deep human relationships. The addict trusts and relies on the addiction, not actual people.

An addiction is two sided: one side is the obvious involvement with the addiction, but the other side is the less conspicuous substitution of relying on the addiction rather than actual people. Deep intimacy with the spouse and deep caring about the spouse is incompatible with affairs. The spouse cannot satisfy the addict’s need for affirmation and so on because the need cannot be satisfied. The addict probably does not really see this, he or she just knows they are not satisfied and is driven to keep trying to feel satisfied. It does not occur to him (probably) that real intimacy with and caring for another person is beyond him. To have an enduring relationship means working through periods of conflict and disappointment. The addict is ill prepared to do this as their needs are too urgent and driving. This once again points backwards. I should add that everything I say is culture-bound. Just today I read a piece about the British upper class in the 50s and 60s. In this context extramarital affairs were taken for granted. My remarks are of course aimed at the marital expectations and understandings of the people I see as clients. It may be unnecessary to include the foregoing caveat, but I do not like psychological writing that gives the impression that culture-free, universal truths are being dispensed. No one is outside of their cultural context.

Continuous involvement with pornography, escorts, massage parlors, strip clubs, etc. indicates an insatiable need for strong distraction and the relief that comes from titillation that masks baseline feelings. Here there is little or no pretense of relating to another person. Comfort, reassurance, strong-enough pleasure derived from companionship and intimacy is not an option for the reason I have already cited, namely actual people cannot compete with porno if what is urgently needed is self-centered distracting titillation. To a lesser degree, the American movie industry is based on a similar need for passive, no-risk titillation, no matter how unrealistic and sensational (the largest movie- going demographic is teenagers, so Hollywood designs movies accordingly; I acknowledge exceptions.). Everyone likes entertainment, titillation, passive zoned-out watching to some degree; I am talking about an insatiable need for it to mask baseline feelings. Since an insatiable need for solitary titillation is hardly compatible with intimacy and companionship, people who are driven to spend a lot of time engaged in such activities come into conflict with their spouse once it becomes apparent what is consuming so much solitary time.

As an adult, sex addicts disappoint, hurt, and infuriate their significant other, especially when the real nature of their unavailability is discovered. There is no gainsaying this. Even if the spouse knows a good deal about the sex addict’s personal history and tormented feeling life, one does not enter into marriage to be betrayed and avoided. The therapist usually sees the sex addict or the spouse post-denouement, in other words once a marital crisis has come about. The spouse is not in a good position to sympathetically grasp the discomfort and drive behind the sex addict’s behavior. This is the therapist’s job. More on the therapist’s job in sex addiction treatment in a companion piece to the present piece.

How Does Change Occur in Psychotherapy?

I think it will be helpful to me and to prospective and beginning clients to try to provide an overview of how I think about …

Make-Believe in the Addiction Treatment Industry

Therapists shouldn’t be in the business of make-believe. There is a great deal of make-believe in the addiction treatment …

Magical Thinking About Drinking

Most of the people I see who have serious drinking problems express the hope that they can over time acquire the ability …