This Fleshy Hunger

This Fleshy Hunger refers to that craving that consumes a man and takes up all his thoughts and possesses him with one intent, to satisfy those desires.
The title is a term used to describe sex addiction but it could also describe various pathological yearnings.
The man is no longer in his home, or even in his own mind and body. He is elsewhere, in a manic reverie, in another imagined place.
He looks insane, possessed, in his imaginary relish and exquisite torture.



This Fleshy Hunger

In our sister blog Inside the Alcoholic Brain –

I had a comment posted on one of the blogs about the pain and heartache that one person had faced as the result of her partner’s addictive behaviour.

The person who posted mentioned her ex partner who is a sex addict as well as alcoholic/addict. It really moved me what the person, who posted anonymously, said in her comment.

I identified with the breaking of her trust and her heart by the unacceptable behaviour of her ex.

Addicts can leave a wake of destruction, lies and deceit, broken promises and broken hearts. In the Big Book of AA it looks at the effects of the life with an alcoholic as akin to having had a tornado wreck havoc in  your life, with the alcoholic often causing so much wreckage  without fully realising it.

This comes across strongly in this post, which I use below, as it was posted publicly and the person was also anonymous.   I use this post to help me and help others understand more fully the damage addiction, especially sex addiction can cause others.

I failed to mention something in my reply, below, which I will now add.

I know where her ex partner is coming from because I too am a sex addict.

I have never admitted that to anyone other than my wife. I have been in recovery ten years but have only realised in the last 15 months or so that I too suffer from sex addiction, in addition to alcoholism, substance addiction, chronic attachment disorder and PTSD.

sex-addiction-eye (1)

Even now I find it difficult to be honest about my sex addiction. It seems to me much more shameful than saying I am a chronic alcoholic or addict.

Maybe that is irrational but I am just trying to be honest.

If any addiction could embody and illustrate the conditional love I was reared with it is my sex addiction.

As I mention in my reply to the post below, in sex addiction somewhere in one’s personal development the brain gets fused in a manner so profound that close intimate human affection can often be just about the most terrifying experience because we don’t really know what the hell it is.

If one has not experienced unconditional love in their primary attachment relationships to a primary care giver, e.g. one’s mother, then the brain may not develop in the same way as with unconditional love – it will be a brain that has distress and a excess of stress chemicals and a deficit in oxytocin,  the “love/cuddle” chemical of human bonding.

Intimacy can be frightening in the extreme.

The human heart is born to beat a beat of love and to have an automatic approach to the love of other humans. In fact we are not singular – we are born into the world as “I and one other”, as we would die otherwise, we need to be reared as we are helpless alone.

So when the heart is naturally moved towards a love attachment which is inconsistent, ambivalent, alternatively available then dismissive and distant, then the most basic survival instinct is impaired, warped, and love of the most basic fundamental type can be mixed with fear and stress chemicals with distress.

Love is the most  fundamental “glue” in the  brain and human development so when it is not consistently given it can have profound effect on the developing infant brain.

Some would say that being conditional it is  not real love but it is as close as some got. “Love” for some often had love mixed with or outweighed by fear, or oxytocin by stress chemicals in the brain.

While a child is looking to receive their love and “cuddle” chemical, that of oxytocin but it is not always available, in that it is shrunk away in the brain by stress chemicals. This reduces oxytocin and the heightened stress chemicals reduce this oxytocin even more.

I grew up then looking for “love” – this oxytocin but unfortunately it is not straight forward. This search is for a conditional loves as it is all I knew, it is not for a fullsome healthy unconditional love but for a “love” that will alleviate our distress and increase our oxytocin. I searched for this thing, this “love” in  sexual acts.

Sex, and reproduction, are fundamental to the human species so it is another “survival instinct” that gets impaired in the addiction cycle – in fact all addictions involve the usurping of systems essential for survival – eating, sex, money, motivation etc and all addictions take over the reward/motivational region of the brain.

Sex addiction does the same – this is also why we see cross addictions as different addictions all activate this same reward/motivational part of the brain.

Back to sex addiction, I grew up through puberty to adulthood with this  now constant battle in my heart between two chemicals that interact to help us survive via our human relationships and communities. Now they interact in the way most opposite to healthy survival. The compete and fight and are conditional on the behaviour of the other.

The are two partners in a dance of destruction. Their neuro-chemical offspring is dopamine – the chemical of wanting (needing). The battle between stress and oxytocin results in a pathological wanting (needing), peaks of dopamine when distressed with dopamine increase reflect the need to take action to relive distress. .

Distress is the result of never finding relief in human relationships, in human bonding, in healthy relationships, so healthy human love and bonding is replaced by the need relieve the inherent distress in an activity which guarantees a reduction in stress. In an activity guaranteed to increase in oxytocin. Sex with another human being, a fleeting physical intimacy.

That is a role oxytocin has, to reduce stress/distress (and control dopamine)  via human contact. If that contact was never there fully it never played a role in our survival. Instead we have to find this oxytocin elsewhere, like alchemists, outside healthy human bonding.

I found it via a different  type of “love”. A so-called love making when it was really an approximate transient glimpse of intimacy, or the opposite of intimacy in fact, a refuting of intimacy, instead simply a transient increase in our love making chemical. It feels like a yearning for something always beyond one’s reach but something that feels somehow essential and has to be got.

A fleshy hunger.

But these fleeting “intimacies” didn’t work, it wasn’t enough to still our hearts and reassure us, it was a temporary harbour in a storm of distress.

When it calms, I was left with the receding tides of shame, shame and more shame. It wasn’t enough, I wasn’t enough. And the distress cycle begins again.

Every time I searched for this love I ended with less than before.

Anyway here are the comments.

“I discovered that he had been seeing a secret drinking/ sex partner the entire time, one 5 years older that his daughter who, by cultural standards, was not attractive. The phone I finally looked at showed that, in addition to worshiping him as a senior co-worker, she was a great devotee of 50 Shades and all night activity. I had noted only a lack of interest in me – which I attributed to his passing age 50. The crafty extremes he went to to hide this affair from me while cutting as close as possible the encounters he had with the two of us was completely out of character in terms of the persona he showed me. Still, I have felt stupid for the extent of my trust.

Reading this and Part 1 have offered me great comfort. He was definitely denied affection in his youth, and is definitely a late stage alcoholic, but is tested for drugs frequently by work. Sex does not show up in lab work, I guess. Thanks for this very helpful post.”

Part of my Reply –

“thank you Anonymous for your honest post – can I also suggest this post Looking for love in all the wrong places – – which looks at how lack of attachment in childhood to a primary care giver has dire consequences in terms of later adult relationships – where sex is used instead of intimacy – it is also probably more common than mentioned, the cross addiction of sex and other addictive behaviours like alcoholism – anecdotally I know it to be an issue in recovery for many. There is often a migration from one addiction to another mainly because we generally use and have used external means to regulate negative emotions and negative self schema. We probably have done so one way or the other since childhood. Emotional relationships for some are terrifying, full of angst, conflict etc and have not been straightforward, unconditional love relationships like many people have experienced. In fact relationships with sex addicts often have an element of conditional love about them as this is generally how addicts have grown up to understand relationships, as being conditional, if you do this I will do that, type thinking. I give you this and you give me that etc etc Sex addiction runs very deep as it is linked to an impaired ability to form loving, healthy relationships throughout one’s life and the relationships in a sex addict sense are often abusive, often in a dominant/domineering sense. The sex addict brain can often fuse what should be affection with arousal. Often “good looks” are not that much of an issue, it is often what the person “can do” sexually that is the main consideration. What sort of “fix” that they can offer. Sex does show up in labs in the sense that sex addiction activates the same brain areas as any other addictions and similar neurotransmitters like dopamine. A fascinating thing however is that sex gives one a “shot” of oxytocin which is the “love/cuddle” brain chemical and which is there in major amounts during caring for a child and in human bonding, in attachment to another human being. In sex addicts this might actually be the so-called “hole in the soul” the “love” drug we have all been looking for. So the sex addict brain has been fused to confuse human affection with arousal as oxytocin is activated and prompts the addict to want more of what he/she does not have in great supply namely oxytocin. Sometimes addiction seems like it is a compulsion to “replenish” chemicals one is deficient in, e.g. natural opioids and heroin abuse. I hope you continue to have the compassion you seem to have through your understandable hurt and upset – it sounds like a real rollercoaster you have been through. He is a very very sick (mentally) sick person like all addicts of one hue or the other. The problem also is that we sometimes are the last to see how sick our behaviours can be. Forgiveness is maybe a long way off, but in the end this heals the pain of the past more than anything else. It helps you just as much if not more than the person who has really hurt you. Hope this comment helps you too. Paul

Different addictive behaviours all centre on the same inherent difficulties.

by alcoholicsguide


Commonalities across all addictive disorders. 

There are those, and some in treatment centres, who maintain that addiction is addiction is addiction. I have not always been convinced by this, mainly because I see differences in temperament and personality among different types of addicts (i.e alcoholics often appear different to heroin addicts in my mind) but these supposed and perhaps superficial distinctions may be masking inherent similarities or commonalities in the aetiology of all addictive disorders. There seems to be commonalities in particular between alcoholics, sex addicts, gambling addicts and those with eating disorders.  This commonality may also help explain “cross addiction” – the tendency to become addicted to various things, whether substances or behaviours.
I personally have become” addicted” in very short periods of time to chocolate and many other substances and behaviours, such as constantly having to watch my workaholic behaviour. By addicted I mean I have quickly suffered addictive behaviour symptoms such as excessive consumption, pathological craving, physiological withdrawals from the substance or behaviour and the gamut of negative emotions surrounding my shame and despair  at these obsessive compulsive behaviours. I can’t take it or leave in relation to many things in my life. Period!
There seems to a “manic hamster on the treadmill” mechanism in me that gets ignited by my engaging in what appears to be the most innocuous behaviour. Suddenly, whatever it is, leads me to want more, more, MORE of it!
I have an addicted brain and a recovering mind. 
What is this intrinsic mechanism in my brain? What trips the switch towards addictive behaviour? This is the heart of the question.
How does the brain tumble towards unbridled wanting. What leads our brain to suddenly say I NEED THIS! rather than simply wanting it?
Why does the most simple behavioural decision suddenly seem life or death, urgent, most necessary? Why a such a sudden recruitment of this emergency state? For us it is due to the limbic and subcortical areas, the “fight or flight” areas of the brain being recruited to make the most simple decision urgent. Even the most simple decisions seem to involve feeling about our very survival. As we have blogged about before in “Why a “Spiritual Solution” to a Neurobiological Disease?” survival becomes the domain of these emergency parts of the brain so we do everything like there is no tomorrow, It is everything or nothing NOW. We need these things. Our survival regions have become extreme and constantly react, not act.
Our very survival has become habitually and compulsive governed as if our brains are constantly under siege.
These commonalities centre on the fundamental role we believe emotional processing and regulation deficits have in these various types of addictive disorder. It may be these deficits that are present in all addictive behaviours and  it may suggest that they are fundamental mechanisms in driving addictive behaviours forward.
In a previous blog we showed how these areas of emotional dysfunction may even be inherited in many, so it is tempting to conclude that the vulnerability, or some of the major vulnerabilities that addicts and those with addictive behaviours inherit are the impaired ability to process and regulate emotions which leads to fundamental decision making difficulties and distress-based impulslivity (as the lack of processing emotions represents as distress signals act to relief these states not guide reflective decision making) which combine to shape the rest of their lives.
The encouraging aspect is that at an affective-cognitive level it may be possible to target these deficits in children at risk via prevention programs.
It illustrates what addicts of various types have said about their illness, however, that they suffer from an emotional disease.
The solution may be prevention and/or intervention to shore up these difficulties which is primarily what various treatments do without explicitly saying so. We first need to state categorically this is what we think drives addictive behaviours and then use complementary therapeutic strategies to specifically address these vulnerabilities.
We have to relearn emotions, how to identity, label, verbalise, process and subsequently regulate our emotions so that we become less impulsively driven and ultimately make better decisions in our lives.

We have in previous blogs discussed how substance addiction seems to have emotional processing and regulation deficits at the heart of their manifestation and act as pathomechanisms in propelling these disorders to eventual  chronicity.

In the next series of blogs we will be discussing whether fundamental emotional processing and regulation deficits are common to (or intrinsic to the aetiology of) other addictive disorders too).

First up, we discuss emotional (or otherwise known in research as affective) dysregulation in those with Hypersexual Disorder or more commonly know to lay persons as sexual addiction.

Hypersexual Disorder – the proposed diagnostic criteria that were given consideration for the Diagnostic and Statistical Manual of Mental Disorder Fifth Edition (DSM-5) characterize hypersexual disorder (HD) (1) which is commonly known as sexual addiction.

This study (1) states that HD is a phenomenon involving repetitive and intense preoccupation with sexual fantasies, urges, and behaviors, leading to adverse consequences and clinically significant distress or impairment in social, occupational, or other important areas of functioning(Bancroft, 2008; Kafka, 2010; Kaplan & Krueger, 2010; Marshall & Briken, 2010; Reid, Garos, & Fong, 2012).

Patients seeking help for HD typically experience multiple unsuccessful attempts to control or diminish the amount of time spent engaging in sexual fantasies, urges, and behaviors in response to dysphoric mood states or stressful life events (Kafka, 2010).

Personality characteristics such as proneness to boredom (Chaney
& Blalock, 2006), impulsivity and shame (Reid, Garos, & Carpenter, 2011), interpersonal sensitivity, alexithymia, loneliness, and low self-esteem also have been observed in association with hypersexual behavior (Reid, Dhuffar, Parhami, & Fong, 2012; Reid, Stein, et al., 2011; Reid, Carpenter, Spackman, & Willes, 2008). Collectively, these  characteristics create significant challenges for hypersexual patients.

The importance of finding effective treatments for HD cannot be underestimated given the gravity of its consequences (Reid, Garos, et al., 2012): Hypersexual patients are at increased risk for loss of employment, legal problems, social isolation, higher rates of divorce (Reid & Woolley, 2006; Reid, Carpenter, Draper, & Manning, 2010; Zapf, Greiner, & Carroll, 2008), and sexually transmitted infections (Coleman et al., 2010; Dodge, Reece, Cole, & Sandfort, 2004; Rinehart & McCabe, 1997, 1998).

This study found (1) significant associations between unpleasant emotions, impulsivity, stress proneness, and hypersexuality replicating findings
noted in other studies (Reid et al., 2008; Reid, 2010). The findings in this study also offer some support for the DSM-5 proposed classification criteria for HD (Kafka, 2010). Specifically, stress and emotional dysregulation have been hypothesized as precipitating and perpetuating risk factors for hypersexuality, and, accordingly,  correlations to reflect this relationship, were consistent with findings of this study (1).

Another study (2) looked at  investigating alexithymia, emotional instability, and vulnerability to stress proneness among individual seeking help for hypersexual behavior. Findings (2) provide evidence for the hypothesis thatindividuals who manifest symptoms of hypersexual behavior are more likely to experience deficits in affect regulation and negative affect (including
alexithymia,  depression, and vulnerability to stress).


An increasing number of individuals are seeking help for hypersexual behavior related to a constellation of symptoms that reflect difficulties in regulating sexual thoughts, feelings, and behaviors.

This study’s (2) conceptualization of this phenomenon keys onbehavior dysregulation as manifest through exaggerated frequency and focus on sexual behavior (from sexual activity with partners, to use of pornography, sexual fantasy, or other erotic stimuli, to excessive masturbation).

Hypersexual behavior may include a sense of being out of control or a history of failed attempts at increased control, and it encompasses elements common to other psychiatric dysfunctions, such as impaired functioning in aspects of daily living, subjective distress, and deficits in coping strategies for addressing uncomfortable affective experiences (e.g., anxiety reduction), usually because of over reliance on sexual behavior as a means of affective regulation and relief. Many patients presenting with hypersexual behavior also report incongruence between their values and beliefs and their sexual behavior.

This study, used the definition of Reid and Woolley (2006) was used
to operationalize hypersexual behavior as: difficulty in regulating (e.g., diminishing or inhibiting) sexual thoughts, feelings, or behavior to the extent that negative consequences are experienced by self or others. The behavior causes significant levels of personal or interpersonal distress and may include activities that are incongruent with personal values, beliefs, or desired goals.The behavior may function as a maladaptive coping mechanism (e.g., used to avoid emotional pain or used as a tension-reduction activity)…. (p. 220)

“It may be that such persons possess deficits in affective regulation similar to those encompassed by the constructs of alexithymia and neuroticism. . It
is plausible that such deficits would influence exaggerated sexual behavior
in some persons (e.g., in the absence of other coping strategies for successful affective monitoring and regulation, the stress-reduction aspects of sexual behavior as a substitute may be powerfully reinforced).

Adams and Robinson (2001), as well as others (e.g., Schwartz & Masters,
1994; Wilson, 2000), have theoretically postulated thathypersexuality represents a compensatory behavior that attempts to alleviate symptom distress associated with problems of affect regulation. A similar theory among individuals with eating disorders was advanced by Heatherton and Baumeister (1991), who argued that motivation for binge eating emerged as an attempt to escape from negative appraisals associated with self-awareness and unpleasant mood states triggered by stressful events.
It can be reasonably argued that sexual activity provides a mood-altering experience enabling individuals to disassociate from uncomfortable, awkward, or unpleasant emotions (Quayle, Vaughan, & Taylor, 2006).

The power of sexual experience to shield one from negative emotions, then, probably arises from sexual arousal’s inherent ability to create intense focus on the competing state of pleasurable arousal, as well as the release of tension associated with orgasm. Furthermore, some individuals may find that fantasizing about sexual activity provides a greater distraction than partnered activity because it encourages—and maybe even requires— disconnect from relationships with their inherent problems, challenges, and complexities.

One plausible way to understand hypersexuality is seeing behaviors associated with reward, distraction, or soothing—such as overeating, exaggerated focus on somatic complaints, substance abuse, or hypersexuality—as being particularly likely in those for whom emotional distancing has high priority. This need for emotional distance can arise from increased stress proneness, negative affective states, emotional pain associated with unresolved trauma, or the inability to develop and form secure attachment bonds.

Our clinical impressions of patients displaying hypersexuality, as defined above, are consistent with those of other researchers who have suggested that alexithymic individuals seek tension reduction from uncomfortable or unpleasant emotions (Keltikangas-Jarvinen, 1982; Kroner & Forth,
1995; Zimmermann, Rossier, de Stadelhofen, & Gaillard, 2005), thereby contributing to their eating disorders (Corcos et al., 2000; Larsen, van Strien, & Eisinga, 2006), substance abuse (Haviland, Hendryx, Shaw, & Henry, 1994),
and the like. Our rationale for suggesting associations of stress vulnerability, emotional instability, and alexithymia with hypersexual behavior also stems, in part, from our own observations of poor affect regulation and deficits in stress management among these patients.

Research supports some associations between alexithymia and stress. For instance, high, as compared to low, alexithymic individuals show different cardiovascular response to stress (e.g., Linden, Lenz, & Stossel, 1996).

The findings  support our hypothesis that alexithymia, emotional instability,
and vulnerability to stress are associated with the severity of hypersexual
behavior. More specifically, it appears that patients who present with more
profound levels of hypersexual behavior are more depressed, alexithymic,
and prone to stress.

These findings are consistent with our theoretical conceptualization of
emotional instability among individuals with hypersexual behavior. Our clinical impressions suggest this population struggles with uncomfortable, awkward, or unpleasant affective states, and in fact, these data indicate that they also experience the prevalence of such emotions in greater proportions than those found in normal populations.

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Many of the subjects in the present study displayed emotional deficits and a paucity of emotional awareness. Queries about feelings in therapy would often elicit a response such as “I don’t know” or “I’m not feeling anything.” – otherwise know as emotional differentiation and discussed recently in another blog. 

Our clinical impressions of hypersexual patients suggest that many of
these individuals habitually entertain negative self-appraisals that are likely
influenced by attention bias which seeks evidence in daily experiences to
confirm irrational beliefs (I’m unlovable, worthless, etc.). Additionally, many
of these patients devote time to maintaining facades and implementing strategies of impression management that may further disconnect them from their authentic self, including their genuine emotions. Patients desperately desire external validation by others and privilege such adulation while marginalizing subjective positive perceptions about the self. Unable to control and predict the reactions of others, patients vacillate along a continuum of emotional instability. Negative appraisals by others become threats to their sense of self-worth, and such criticisms often result in disavowing aspects of the self. Specifically, the patients disconnect from undesirable emotional states.

The function of sexual activity in these instances is stress reduction and escape from or avoidance of uncomfortable and unpleasant affective experiences attributable to difficulties in their interpersonal relationships and other challenges in daily living.



1.  Reid, R. C., Bramen, J. E., Anderson, A., & Cohen, M. S. (2014). Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients. Journal of clinical psychology, 70(4), 313-321.

2.  Reid, R. C., Carpenter, B. N., Spackman, M., & Willes, D. L. (2008). Alexithymia, emotional instability, and vulnerability to stress proneness in patients seeking help for hypersexual behavior. Journal of Sex & Marital Therapy, 34(2), 133-149.

Is Sex Addiction really an addiction?



Pornography triggers brain activity in people with compulsive sexual behaviour – known commonly as sex addiction – similar to that triggered by drugs in the brains of drug addicts, according to a University of Cambridge study published in the journal PLOS ONE.

Although precise estimates are unknown, previous studies have suggested that as many as one in 25 adults is affected by compulsive sexual behaviour, an obsession with sexual thoughts, feelings or behaviour which they are unable to control. This can have an impact on a person’s personal life and work, leading to significant distress and feelings of shame. Excessive use of pornography is one of the main features identified in many people with compulsive sexual behaviour. However, there is currently no formally accepted definition of diagnosing the condition.

Researchers from the Department of Psychiatry at the University of Cambridge looked at brain activity in nineteen male patients affected by compulsive sexual behaviour and compared them to the same number of healthy volunteers. The patients started watching pornography at earlier ages and in higher proportions relative to the healthy volunteers.

“The patients in our trial were all people who had substantial difficulties controlling their sexual behaviour and this was having significant consequences for them, affecting their lives and relationships,” explains Dr Valerie Voon, a Wellcome Trust Intermediate Clinical Fellow at the University of Cambridge. “In many ways, they show similarities in their behaviour to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too.”

The study participants were shown a series of short videos featuring either sexually explicit content or sports whilst their brain activity was monitored using functional magnetic resonance imaging (fMRI), which uses a blood oxygen level dependent (BOLD) signal to measure brain activity.

The researchers found that three regions in particular were more active in the brains of the people with compulsive sexual behaviour compared with the healthy volunteers. Significantly, these regions – the ventral striatum, dorsal anterior cingulate and amygdala – were regions that are also particularly activated in when shown drug stimuli. The ventral striatum is involved in processing reward and motivation, whilst the dorsal anterior cingulate is implicated in anticipating rewards and drug craving. The amygdala is involved in processing the significance of events and emotions.

The researchers also asked the participants to rate the level of sexual desire that they felt whilst watching the videos, and how much they liked the videos. Drug addicts are thought to be driven to seek their drug because they want – rather than enjoy – it. This abnormal process is known as incentive motivation, a compelling theory in addiction disorders.

As anticipated, patients with compulsive sexual behaviour showed higher levels of desire towards the sexually explicit videos, but did not necessarily rate them higher on liking scores. In the patients, desire was also correlated with higher interactions between regions within the network identified – with greater cross-talk between the dorsal cingulate, ventral striatum and amygdala – for explicit compared to sports videos.

Dr Voon and colleagues also found a correlation between brain activity and age – the younger the patient, the greater the level of activity in the ventral striatum in response to pornography. Importantly, this association was strongest in individuals with compulsive sexual behaviour. The frontal control regions of the brain – essentially, the ‘brakes’ on our compulsivity – continue to develop into the mid-twenties and this imbalance may account for greater impulsivity and risk taking behaviours in younger people. The age-related findings in individuals with compulsive sexual behaviours suggest that the may be important in developmental aspects of compulsive sexual behaviours in a similar fashion as it is in drug addictions.

“There are clear differences in between patients who have compulsive sexual behaviour and . These differences mirror those of drug addicts,” adds Dr Voon.

Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, says: “Compulsive behaviours, including watching porn to excess, over-eating and gambling, are increasingly common. This study takes us a step further to finding out why we carry on repeating behaviours that we know are potentially damaging to us. Whether we are tackling sex addiction, substance abuse or eating disorders, knowing how best, and when, to intervene in order to break the cycle is an important goal of this research.”


Voon, V et al. Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. PLOS ONE; 11 July 2014