Sex and Love and All That Jazz: The Arousal Conundrum
Posted Jun 23 2009 6:54pm
"And the day came when the risk to remain in a bud was more painful than the risk it took to blossom"
- Anais Nin -
Sexual addiction in its simplest terms is a dysregulation of the pleasure, pain, and fear centers of the brains reward circuitry and a continual biochemical cocktail that feeds the pleasure centers of the brain in order to squelch the tide of unremitting pain and unmitigated fear - further fueled by the incessant out-of-control drive to seek that ever-higher dopaminergic rush, in a failed but panic-driven mixed-up effort to self-regulate, with the dream of someday finding that proverbial ever-elusive homeostatic comfort zone. Whew! But hold that thought for just a moment...
In sex addiction parlance, "sex" and "love" are both experientially impaired pathological events which are indistinguishable from one another. They are each a terrific source of unbridled anxiety, the former however, far more pleasurable and acceptable than the later - the former they feverishly approach in varying amounts depending upon the addicts state of tension, and the later they avoid at all costs, period. It would be a fair statement to say that a non-recovering sex addict has no idea what love actually is and likely has never experienced it or would recognize it as anything other than Jessica Lange in her white wedding gown seductively motioning Rory Schieder to deaths door in the movie All That Jazz - which of course, is part and parcel of the whole damn tragedy. Love and death, fear and joy, pleasure and pain. All are states of arousal, and to those sexually addicted individuals, they are all scary places that the body recognizes and reacts to in exactly the same way.
In a sexually addicted brain, there is no distinction between any type of arousal. And for good reason. There is a song by Ani Difranco titled Falling is like this. "like you're choosing between choking and spitting it all out, like you're trying to fight gravity on a planet that insists that love is like falling and falling is like this... one minute there was road beneath us, the next just sky". While many of you might be thinking, "exactly!" with smile and twinkle, to the sexually addicted individual, who on a good day is filled with a barely containable quantity of anxiety, fear, dread, and shame, the possibility, no, make that the very thought of, falling - whether it is in love or from a 22-story building - is pretty much one and the same. Why? They both represent an out-of-control death spiral. More like one moment there was life no matter how painful, and the next moment there was a long drop and the pavement very rapidly coming up to meet you.
Once again (c.f. previous posts in this blog) it all boils down to the limbic system, the prefrontal cortex, the brain stem, and the functions they subserve. To say that one is "in love" is to say that one is HPA-axis impaired - surging with stress-related cortisol, filled with a gush and rush of Phenylethylamine (PEA), raging with Dopamine (DA), and sappy with Oxytocin (OT). Sounds scary as hell just to say it all.
Diagnostically speaking a sexual addiction is another term for a specifically impaired limbic system and right prefrontal cortex. It means (most of the time) that you were dysregulated in your early childhood years when your budding brain systems were myelinating and coalescing and learning what "normal" homeostatic brain function was supposed to look and function like. The limbic system, comprised primarily of the amygdala, hippocampus, and hypothalamus, make up the "emotional" brain, responsible for what my students know as the 4 Fs - feeding, fighting, fleeing, and sex. The predominantly right prefrontal cortex, where most of the dopaminergic neurotransmitters flow in and out of via the limbic system, is considered the seat of our personality, responsible for things like judgment, attention, impulsivity, social skills, planning, goal-directed behaviors, and a host of other functions needed to keep us out of jail, the poor-house, the dog-house, divorce-court, and a sealed wooden box. Finally, the brain stem, which abuts and innervates the limbic system, houses two critically important areas called the Nucleus Accumbens (NAcc) and the Ventral Tegmental (VT). These two areas are responsible for the regulation of emotion, pleasure and pain.
The limbic system is the seat of our emotions, the right prefrontal cortex is the seat of our personality, and portions of the brain stem are the seat of emotional regulation, pleasure and pain, and as such, we have now defined what has become known as the Reward Centers or circuitry of the Brain. These are the areas that are impaired in the addictive disorders. Pleasure, pain, emotions and the ability to regulate an emotion or emotional experience, our ability to have sound judgment, plan our life, stay out of trouble, and give oneself over to the pleasure and pain cycle of addiction - any addiction actually - represents the life of the sex addict whose limbic and right prefrontal areas became dysregulated secondary to early childhood trauma. A double whammy if ever there was one.
The Hypothalamic-pituitary-adrenal axis (HPA-axis for short) is not so much a structureor physical place in the brain, as it is a cascading of neurochemicals synthesized and utilized by various structures like the limbic and endocrine systems. The functions subserved by the HPA-axis and its neurochemical cocktail is to regulate stress (like the production of cortisol and corticosteroids found in abundance in both traumatic states and love!), digestion, energy output, mood, and immunological tasks. This is why so many psychiatric disorders are secondary to, or the cause of an impaired HPA-axis.
Phenylethylamine, or PEA, affectionately known as the "love chemical" is a kissing cousin to amphetamine (or"speed" to those of us that remember Woodstock-the event, Vietnam Nam-the war, or Watkins Glen-having nothing to do with race cars - but because we were there), which is what gives Love that Rush. PEA triggers the flow of adrenaline and noradrenaline to your brain - again, hence the rush of love even when that person is out of sight. It is why those in the early stages of love can't eat, can't sleep, and can't do much of anything but obsess all day and night long about the object of their desire (for more on OT and DA, please see the previous posts in this blog). It is no wonder why non-recovering sex addicts cannot experience love. For the sex addicted, who is ordinarily in a constant state of anxiety and panic, love represents being completely and totally out-of-control!
So what is the answer? The paradox, it probably will not surprise you at this point, is that love is the answer! But like anything else, you must be willing to go there. To somehow find a place where you feel safe enough to go there - to experience it - to be in the thick of it, and know, through nothing more than unmitigated blind faith and a desire to change, that you will not die, but rather, for the first time, come out whole and live.