Sex for Affect Regulation
Temporary Band-Aid or Therapeutic Balm?

by Alexandra Katehakis

For those who struggle with addiction, factors including genetics, epigenetics, and the interuterine environment have contributed to their developing this sorry substitute for mature, independent affect regulation. Yet developmental neurobiology points to early relational trauma as the most decisive disrupter of the growing body/brain/mind’s ability to self-regulate. Constantly dysregulated affect stemming from early infantile, unrepaired assaults and childhood abuse or neglect can generate the habitual neurological patterns inviting the constellation of behaviors called “sexual addiciton,” an isolating, dissociative strategy of autoregulation deployed to quell emotions that were long ago ignored.

Chronically hyperaroused sex addicts (SAs) use sex compulsively in a desperate attempt to extinguish horrendous conscious or unconscious memories and affect and thereby to attain some serenity. Similarly, habitually hypoaroused SAs uncontrollably pursue sexual outlets to activate the mesolimbic dopamine system and thereby to escape the monotone deadness at their very core.

When sex is employed perpetually and solely for regulatory purposes, it usually becomes a destructive force, robbing individuals of treasured familial relationships, jobs, money, and the rightful role of sex as a source of joy and pleasure without shame. The frantic steps for acquiring the sexual experience (cruising the Internet, preoccupation with sexual fantasy, or endless hours viewing pornography) exemplify the addict’s altered state of consciousness as he or she incessantly chases a fleeting sense of well-being, often followed by a profound shame which reignites the hunt. Fueled by the rush of dopamine, opioids, or both, the addict is hyperfocused: No value, however, precious, matters at that moment. The dopaminergic system drives addicts to stalk the next sexual high, maladaptively offering intensity instead of intimacy. SAs’ pre-scripted, even rote, and shame-filled dissociative behaviors entirely lack the spontaneity and delight of genuine play–the hallmark of healthy, relational sexuality.

How different from non-sex-addicted persons, who seek sexual closeness to strenghten rather than sever connection with others and with their own emotional and physical feelings! The non-SA draws comfort and pleasure from a trusted other, reaching out from an already stable sense of self. When shame-free sex enhances our well-being, improves our mood, manages anxiety, or links us to another in our desire to be seen and loved, sex is co-regulatory, playful and wholesome. In contrast, the SA utilizes sex as though in a solitary system to palliate a chronically dysregulated sense of self.

When even healthy persons are upset, hurt or angry, relating sexually becomes difficult, despite the paradoxical fact that doing so is precisely what’s needed to restore co-regulation and to recreate a sense of connection between partners. Resentments make it painful to “find” each other through eye contact; the other’s touch feels repulsive; and even familiar bodily smells become repugnant. Yet using sex as a shortcut instead of intentionally talking about hurts requires, and exacerbates, the disconnect. Thus two people can have sex as parallel one-person systems without any positive emotional connection between them through mild to moderate dissociation, simply moving their bodies together toward orgasm. But taking time to clear psychic pain intentionally will restore the dyad to a two-person, interactively regulated system. When the social engagement system is online, a live communication takes place, with data streaming between the two via eye contact, prosody, touch, gesture, and facial expressions–the unscripted novelty the autonomic nervous system requires to release oxytocin and dopamine, kindling love and igniting the path toward the erotic.

Yet when sex is used to manage chronic affective dysregulation in a vicious shame cycle, sex itself can create more autonomic dysregulation and becomes problematic or “addictive” over time. Conversely, when sex regulates and enhances our feelings of love and empathy, as well as advancing the individual benefits of pleasure and sheer carnal fun, our sexuality does not own us; instead, we take ownership of our sexuality without shame, in healthy and playful ways.


Alexandra Katehakis, Ph.D., LMFT is Founder/Clinical Director of Center for Healthy Sex in Los Angeles.  She is also the author of Sex Addiction As Affect Dysregulation: A Neurobiologically Informed Holistic Treatment, co-author of the multiple award-winning Mirror of Intimacy: Daily Reflections on Emotional and Erotic Intelligence, contributing author to Making Advances: A Comprehensive Guide for Treating Female Sex and Love Addicts  edited by Marnie C. Ferree, and author of Erotic Intelligence: Igniting Hot Healthy Sex While in Recovery From Sex Addiction.


© 2017 CSAR - Center for the Study of Affect Regulation All rights reserved.
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