Sanctuary for the Abused
Monday, April 11, 2011
Adult ADHD, Sexual Compulsion & Shame
Brian is an investment banker in his early forties who, in graduate business school, first began to visit prostitutes, spend money on phone sex, compulsively masturbate and, finally spend as much as 5-10 hours a day looking at internet porn. When sexually acting out, he would feel that someone had turned on his brain for the first time. On the net, he would suddenly feel alive. He had energy and felt the euphoria that sexual immersion seductively provides. His mind slowed down; he didn’t need to keep moving.
Since his teens, he had masturbated nearly every night before going to sleep and sometimes once or twice during the day as well. He was shy in school and dated infrequently, partly from his feelings of inadequacy from the persistent inability to concentrate, multiple failures, disapproval from parents, teachers and peers and the consequent demoralization that contributed to low self-esteem.
Undergraduate school had been difficult for him. Complex mathematical formulations from his economics courses were tape-recorded while he fantasized about looking under the girl’s shirt who sat next to him. He was chronically late at classes, his dorm was messy and his clothes were disheveled. He seemed to live in another world. Once on the job, he loved the thrill, excitement and risk of being a trader, but when he had to sit in boardrooms to listen to his bosses talk about strategy, his “eyes glazed over” with boredom and he entered into an “erotic haze”. He would fantasize about the escort he had been with the night before and anticipated getting home after a long day to get on the chat rooms and look at pornography on the internet.
His days were the usual business of forgetting assignments and people’s names, of losing things and being chastised by bosses, as he had been by parents, for not being able to sit still or follow directions. At home, he felt empty, depressed and lonely. He was unable to focus on a book or a movie. He often felt different than others. It was as though others were given a chip at birth that allowed them to remember simple things, to process information accurately, to complete tasks in an orderly fashion, to moderate their impulses and calm their bodies and mind when they wanted to. But Brian knew he was “different” from them.
His girlfriend complained that he interrupted their conversations and that he always put his needs first from; He could never finish a task that wasn’t engrossing for him. He would lose his temper over trivial things and he didn’t know why.
On the internet, however, looking at a montage of erotic images, he finally felt not scattered. Moreover, he felt soothed, whole and unafraid. Like a magic elixir, he would immediately feel “not different”. He felt alert, focused and alive. However, he soon found himself in job performance because of the long nights and weekends of compulsive sexing. He went to a 12-step “S” program and learned to stay away from compulsive sex. He married and got a promotion at work. Time passed as he worked his 12-step program and settled in to marriage. However, the impulse to call an escort or make an erotic phone call never went away.
One day, after two years of abstinence, he ran across an escort in a hotel who offered him her services and he could not think of a reason to refrain. Also, he had realized that his fantasies had taken on a distinct sadomasochist flavor and he had been curious about acting them out with this woman. He had been involved in a deal at work that went wrong and he felt “less than” and somewhat ashamed. Memories of shaming and humiliating remarks about his conduct and learning skills from teachers and parents came flooding back, precipitating his masochistic sexual fantasies. His sense of self was completely destabilized. So he did what had always worked for him when he felt psychologically fragmented: he went to an escort to shore up his fragile self esteem. Once again he would miraculously feel like he could live with himself. The non-stop put downs that had taken up permanent residence in his head were quieted, at least for a short period of time. Sex took the edge off like a few martinis do for an alcoholic.
The “quick fix” however, was followed by a crash which made him feel worse than he did before he went to the escort. Knowing he had once again lost control of himself, he would feel extremely remorseful and depressed. His feelings about himself bordered on self-loathing. After the crash, he no longer felt alert, focused, or euphoric. While Brian had been able to walk away from cocaine three years ago, the sex addiction had remained entrenched in his psyche: like an athlete’s foot of the mind -- it called him -- incessantly-- an itch to be scratched but never soothed.
It was at this point that Brian decided that if he didn’t leave the house, he would not frequent escorts, and so he re-discovered the Internet. In no time at all, Brian was spending untold minutes, hours, days totally absorbed in the internet, using chat rooms to set up erotic encounters, and exploring the fetishistic and S&M images and enticements of the cybersex world. Porn surfing became his medium of acting out because the images were flashy, intense, and risky and he could easily go to another web page when the novelty wore off and he would start to be bored.
What happened with Brian’s recovery? He seemed to have managed to avoid compulsive sex for a period of time and to make some positive changes in his life. But when faced with the opportunity, he was easily led to return to sex addiction.
In Brian’s case, he was not able to get a handle on his sex addiction because he had not been diagnosed and treated for Adult Attention Deficit Disorder. A particular constellation of imbalanced neurotransmitters were creating physical and emotional problems for him, including an inability to regulate attention, control impulses, sleeping, and mood and energy levels. His need to self-medicate his impulsivity, restlessness and mental hyperactivity gave way to using sexually compulsive behaviors to try to fix his brain chemistry. Poor impulse control combined with a drive for high-risk, intense, novel experiences contributed to Brian’s addiction to sex.
Many sexual compulsives with ADHD have had experiences like Brian’s. They struggled in school because they got bored or had a hard time paying attention. Once bored, they would stare out the window, often caught up by sexual fantasies. As adults, relationships are difficult for them. Impulses carry them from project to project, relationship to relationship, job to job. Their minds come screeching to a halt as they try to remember a friend’s name or the location of the escort they visited last night. Most feel the self-loathing of people who are working under capacity, and experience the pain and grief of living a life of lost opportunities and diminished personal potential.
Deregulation and Deprivation
Deregulation and impulsiveness are the hallmarks of ADHD, as well as the hallmark of sex addiction. Unable to set boundaries on their own behavior, ADHDers feel an intense need to continue forever whether it is on a work project or an involvement in a sexual enactment. One definition of compulsion may very well be “a loss of control characterized by an intense desire to continue despite adverse consequences.”
A sense of deprivation then emerges when compulsive sexualizing does not provide the gratification and satisfaction that results from having the experience of natural pleasure as it relates to intimacy with another human being. Rather than sex being a way to bring two people closer, sexual enactments for the ADHDer can stem from intra-psychic conflict, from a narcissistic need for validation not received in his child’s ADHD world, and as a way to medicate the physiological symptoms of brain chemistry deregulation. The result is that sex takes up a disproportionately large place in his psychic equilibrium. His very sense of self depends on his sexuality.
Deprivation is not a feeling that is comfortable for the ADHD/sex addict. He is a bottomless pit of needs, always looking ahead and never feeling satisfied. The simpler pleasures of life are too mild. Risky, novel, intense and mysterious experiences such as those provided by Internet porn match his voracious appetite. Sex with a spouse seems banal. Marriages are ruined. Unfortunately, trying to feed the monster of endless needs makes the need grow larger and more insistent so the ADHD/sex addict sets a vicious cycle in motion. Despite endless hours looking at cybersex, no amount is ever enough. Sex addicts/cybersex addicts are rarely sated and live daily with a sense of unsatisfied longing.
Mood and Emotion
There are problems with mood and emotion regulation and stabilization in ADHD and sex addicts. ADHD/sex addicts often say they live on emotional roller coasters – the need for risk and intensity in life and in sexuality is ever-present. For the ADHDer, feeling states fluctuate with extreme alterations in the highs and lows over hour or even minutes. Maintaining emotions on an even keel is an intricate process involving fine adjustments by different parts of the brain and nervous system. Since setbacks throw ADHDers off balance easily, they may try to adjust their instability with a sex/internet binge to balance mood and brain chemistry. The release of endorphins and dopamine from sex temporarily settles the physical, emotional and biochemical roller-coaster that many ADHDers experience on a daily basis.
The ADHD mind drifts hither and yon. It daydreams, wanders and drifts among loosely and tenuously connected thoughts, often moving to sexual fantasies that quell its restless energy. This is the famous “distractibility” of ADHD. An ADHDer might engage in sexual fantasies when he should be working. The radio in the ADHD brain seems to have a malfunctioning scan button that won’t let him switch channels efficiently. The sex addict’s solution is to stay tuned to one channel only and it is usually sexual fantasy to which the channel is set. Once he’s in his compulsive, rigid focus, it’s hard for him to turn off the scan button to redirect. Hence, distractibility is not the only problem; ADHDers can also have problems with hyper focusing, or over focusing. Once the person’s attention is captured, he can stay engaged with what he’s doing almost endlessly. Some may not be able to pay attention; ADHD/ sexual compulsives usually can’t stop paying attention. Hours and hours go by, chores don’t get done, children and spouse are neglected, books go unread, the glory of the sound of music is muted. This type of erotic hyper attention can also take its toll in exhaustion, fatigue, and sometimes failing health.
The over- persistence of the sexual compulsive can make switching gears out of the “erotic haze” very difficult. Although this type of self-absorption makes productive/creative work and interpersonal relationships impossible, refocusing is painful. Going from one task that involves excitement, risk, mystery, intensity, soothing and escape is excruciating when taking out the garbage or paying the bills is called for.
Another factor that contributes to sexual addiction for ADHDers is that many people with ADHD have defective sensory filters that make them experience the world as a barrage to the senses -- noises, sights and smells rush in without barriers or protection. When you live with ADHD, you may be constantly bombarded with input that others may not even notice. This assault on the senses often creates feelings of intense anxiety and irritation that can trigger sexual acting out. The comfort of the “erotic haze” on the internet or the soothing experience with an escort can ameliorate these incessant barrages of sensory stimuli to the ADHD brain.
Impaired Social Skills
Some ADHDers have experienced the negative impact of ADHD on social adjustment. Many are shy and were not particularly popular in school, especially if learning disabilities have been in the picture. Social ostracizetion has been part of the childhood of many ADHDers. As adults, many ADHDers have to work very hard to interact effectively in social and work situations. The development of social skills is more an art than a science because we must learn to read the ever-changing reactions of others. If deficient selective attention interferes with paying attention to social cues in order to listen and respond empathically, the ADHDer may feel extremely ill at ease. How much easier to go to a chat room to enter into an eroticized communication where sexuality can be used as a surrogate for real social interactions.
Many ADHD children grew up in families in which put-downs, disapproval, personal attacks and threats of abandonment were commonplace events. Punishment and frustration from teachers and taunts from peer groups added to a sense of worthlessness.
As an adult, the ADHD child judges himself mercilessly and often tries to be perfect in a desperate attempt to shield his shame. He feels deeply ashamed of being “different” due to ADHD as well as of being a sexual compulsive – a “deviant”, if he becomes one. Chronic, relentless shame is devastating. Mired in feelings of worthlessness, defectiveness and despair, he is full of doubt about his very validity.
Shame and sex addiction are natural partners. The more intense the pain of self-hatred, the stronger the drive to find a sexual behavior that offers relief from internal pain and emptiness. For the sex addict, the answer to his inner problems lay outside himself in the “magic” of sexual desire, for or from, another. He confuses sexual desirability with self-acceptance. He is trying to fill the void that has been at least partially created by shame. He simply cannot bear feeling empty inside.
ADHD temper problems or problems with rage may also stem from this chronic shame. A rageful person is desperate to keep others far enough away so they won’t see his sense of defectiveness. A shamed person can only think to defend himself from real or imagined attacks by cruelly attacking the other person. And rage works. It drives people away and so protects the person from revealing his shame. But this device of using rage to keep people away is very damaging to a person’s self-esteem. Rage breaks the connection between people and so increases the shamed person’s shame. A rage/shame spiral can result. Social isolation lends itself to engrossment in sexual fantasy as a way to ameliorate lonliness.
The person who is shame-based sees himself as deeply and permanently flawed. He “knows” he is not like other persons. He “knows” he is different. He “knows” he is so bad he is beyond repair. He “knows” he will never be able to join others in a world of productivity, balance, self-respect and pride.Shame and Perverse Sexuality
An early-life sense of shame for being “different” and fear of abandonment can influence the sexual development of an ADHD child. Parents who may have been unstable themselves and who had no knowledge of the special needs of an ADHD child, may create a shame-based home environment. The messages that the ADHD child who has chronic behavior problems, hyperactivity, aggressiveness and learning disabilities receives at home may include:
1 .You are not good;
2. You are not good enough;
3. You don’t belong;
4. You are deficient and disappoint us.
5. You are not worthy of love.
Shame and sexuality become closely connected. Children shamed early in life may become sexually compulsive or develop perverse fantasies as a way to feel better about themselves. Fetishism may occur. Sadomasochistic fantasies and enactments may become paramount. Exhibitionism may be developed and acted on.
Exhibitionism can easily be a chosen perversion for the person who is shame-based. The person who is shamed, instead of hiding, calls attention to himself. He may expose himself in public, in an automobile or by standing in a window. The ADHD child may have suffered from a lack of recognition of his real and valid feelings, wants and needs by parents and teaches who expected him to be other than the way he was. He becomes narcissistically driven. The exhibitionist seeks to redress this lack of recognition. He also uses his perversion as a strategy for dealing with shame by displaying what he really wants to hide – himself.
Sadomasochistic fantasies and enactments are common among shame-based people who have difficulty imagining that relationships can include mutual respect, dignity and pride. People who have grown up with shame, like many ADHD people, often believe that fulfilling, exciting relationships must be shame-based. Men pay hundreds of dollars to see dominatrixes who physically humiliate them and repeatedly tell them something is wrong with them. The submissive man, fearing abandonment, tries to please the “mistress” by becoming whoever she wants him to be, no matter how humiliating or de-humanizing her demands may be. The reasoning is such: “If anyone saw the real me, they would be revolted. I must please the mistress by being a person she would be proud of.” Pleasing the dominant parental figure is a way on undoing the pain of having a parent that couldn’t be pleased. The S&M enactment thus turns trauma into triumph because the masochistic man succeeds in pleasing his dominant partner.
Self-abuse is a common result of shame. Here, the person who is deeply shamed engages in masochistic behaviors that damage him. Seeking out the services of a dominatrix who may beat, whip and verbally humiliate him is one such way of self-abuse.
The other side of the S&M coin is the desire to humiliate and administer pain to others. Shame is a threat to a person’s basic sense of being. The shamed person feels small weak, vulnerable and exposed. He may find this self-hatred to be unendurable and in order to survive psychologically, he transfers his hatred on to others, treating them with distain and contempt.