Treating Sex Addiction: The Neuroscience of Integrity
Posted Jun 23 2009 6:54pm
"We are born with two selves, but what we become is the measure of our experiences. We are our experiences. The things we perceive make us who we are. Our perceptions change the size and shape of our brains, they change the architecture of our immune systems, and they change the circuitry of our nervous systems. What hasn't killed us has made us stronger. But it is true, too, that the things we fail to perceive - perhaps inescapably fail to perceive - ensure that there are some things we can never become. If too little is given to us, if we are saved from too much of the filth and pain and din of this world, our paths may so narrow that we are strangled by them. No matter the mettle of the selves we began with, the paucity of our experience, the limits of our sensations can cripple us, can wither us that what remains is barely human."
~ Gerald N. Callahan (2002) ~
According to Heraclitus, "character is destiny". Ok, fine. The problem, the real question, is what begets character? Is it learned? Do you inherit it from your mother? Your father perhaps? If character really is destiny, then is it initially acquired biologically or genetically or like the nature-nurture thing, some combination of both? More importantly, can you get it later in life if you did not have it initially, or sadly, can you lose it if you once had it? But wait a minute. What is character??
The Josephson Institute whose mission statement is "to improve the ethical quality of society by changing personal and organizational decision making and behavior" offers "character education" based upon their definition of 6 character traits that include trustworthiness, respect, responsibility, fairness, caring, and citizenship. Sounds like they are talking about "integrity". Ok, so if that is character then what is integrity? The Stanford Encyclopedia of Philosophy (SEP) (2001) defines integrity as the "quality of a person's character". In other words, integrity is what you have when you have a have an impeccable, morally robust character. I have always thought of integrity as the root cause, the on-going active purposeful process of thinking, feeling, and acting, in an integrous manner, that gives a person their character. The SEP divides integrity into several different interlocking areas four of which are as follows: Self-Integration, referring to a harmonious intact whole; Identity, or being true in their commitment to something; Standing for Something, more of a social virtue, and, Moral Purpose, referring to a moral obligation. Now that we know how to define it, what does it have to do with sexual addiction treatment?
If you have been reading this blog, then you have heard me say in myriad ways, that sexual addiction begins in trauma and without intervention, ends in moral bankruptcy. In psychological parlance, it is an obsessive-compulsive need to medicate pain and anesthetize life. It is about shame and the absence of grace, or said another way, dis-grace. Like any addict, life becomes all about themselves - meeting their needs and in the truest narcissistic sense of the word, finding and hoarding other people as objects, who will constantly and consistently sing their praise or at the very least, confirm their existence. They cannot be alone for any length of time, for they are only seemingly whole or worthwhile when in the presence of others (s.f. my previous blog posts on NPD). Their self-worth is solely derived from others, and their days are filled with shame, despair, despondency, and moral degradation. They are in a nutshell, leading a life devoid of integrity. They are also sensitive, lonely, desperate, fearful, isolated, often kind, often decent, fragile human beings that through no fault of their own, usually secondary to early childhood trauma, find themselves in a world they cannot fully participate in and without the requisite skills to traverse the other side or as it were, to turn the corner. So far, I have said nothing new - nothing I and countless others have not said before. Certainly nothing scientific. But wait, there is more - we have only just begun.
Sexual addiction is a crisis of faith. Not the religious kind however.
Many scientific and neuroscientific studies have investigated the effect of such things as spirituality, meditation, religious experiences such as "callings" and "healing", prayer, and psychosis-induced religious delusions and hallucinations, since the days of Aristotle, Bacon, Galileo and Descartes were credited with using the scientific method. We know, through changes in blood pressure, cerebral blood flow, galvanic skin response, EEG changes, and SPECT scan studies that there are indeed a host of non-random significant changes that occur deep at the cellular level, to substantiate the fact that indeed, what we think, how we feel, and how we act, can and indeed does, change our brain in a noticeable and more often-then-not, profound way.
I have always maintained, for more than two-and-a-half decades now, and my research substantiates it, that sexual addiction is a byproduct of an impaired limbic system and a damaged right prefrontal cortex, specifically the dorsolateral (DLPC) and orbital (OPFC). For more information on this you can read the article in "the reading room" at http://drsarahullman.com . Research tells us that spirituality and religious worship is actually linked to areas of the right prefrontal cortex, specifically the DLPC and the precuneus areas. We also know that meditation and prayer decrease cortisol levels and blood pressure, both of which are implicated in stress and stress reactions. PET scan analysis also revealed increase in dopamine levels in the ventral striatum (Fenwick, 2002). The Newberg et al (2001) SPECT scan study also demonstrated changes in the left frontal lobe and hypoperfusion in the superior parietal lobe, increases in thalamic activity, and in frontal and parietal cortices during meditation.
One of the classic signs, if not the hallmark of depressive symtomatology, is anhedonia. In scientific jargon, "an" means without and you probably know what hedonism is, so anhedonia is the psychiatric term meaning "without pleasure" or more to the point, loss of pleasure in those things that were previously pleasurable. One of the more common complaints that I hear daily, is not just the loss of interest in things they previously found enjoyable, but a loss of joy period. I just finished reading Kathleen Norris's book on Acedia, Acedia & Me: A Marriage, Monks, and a Writer's Life. Norris discusses "acedia" which is akin to anhedonia, but is generally used in a religious context. Norris describes it as "At its Greek root, the word acedia means the absence of care. The person afflicted by acedia refuses to care or is incapable of doing so. When life becomes too challenging and engagement with others too demanding, acedia offers a kind of spiritual morphine: you know the pain is there, yet can't rouse yourself to give a damn" (p.3). I work with quite a lot of clergy from all denominations, the majority of which are Roman Catholic. They understand faith, both lost and found but their struggle is none the easier and their path not necessarily quicker. Olson (2000) wrote on The Relationship Between Moral Integrity, psychological Well-being, and Anxiety that "the Christian's moral integrity is only achieved through God's grace" (p.27). I find that problematic at best and certainly a gigantic obstacle for those with crisis's of faith, of the religious or non-religious variety who happen to subscribe to the Christian faith.
Similar to the SEP definition of integrity, Carter's book (Integrity, 1996) discusses integrity as a three-pronged affair: moral discernment, consistent behavior, and, public justification. I happen to agree. The way to an integrous life begins with the very basic premise that if you are a practicing or sober but non-recovering sex addict, you are not living with integrity, and you may not know what it is or how to get it. After that, it becomes about visualizing a life with it, after which, you will most likely want to have it. The rest is fairly straight-forward. It looks like service, the kind that is described in the 12-step programs about volunteering and "giving back" wherein it says A"However we do service, we receive much more than we give. We break out of the isolation and the self-centeredness of our addiction. We grow as we practice generosity, empathy, and humility. We forge new bonds with others that nourish and sustain us. And we experience the joy and satisfaction of giving something of ourselves to a larger cause" (p.60).
If it is true that sexual addiction is secondary to an impaired frontal lobe, and we know that spirituality (sans religion) changes the frontal lobe in important and positive ways, then part of TREATMENT must include both discussion and direction on how to go about living a life of integrity which is to say, a spiritual life. It will change your frontal lobe and your life.