Threat, drive and soothing in compulsive sexual behaviour

Beyond the vulnerabilities that draw men into these behaviours, there is often a mechanism driving them, and it isn't about the behaviour itself. Put simply, sex is something many people learn they can use to escape, fix or avoid a whole range of emotional experiences. In compassion-focused therapy we think in detail about three systems: the threat system, the drive system and the soothing system. What is almost universal in the men I see is that threat and drive are highly active and often intertwined, at the expense of the soothing system. The ability to soothe ourselves, to regulate our own emotions consistently, and particularly to navigate the complex emotions of sex, intimacy and relationships, is massively diminished in this population. There are good reasons for that, but it is important to know, because it is often the starting place. Imagine three circles: two of them huge, threat and drive, and one small circle squashed to the side, which is our soothing system.

Threat, and sex as a fix

The mechanism usually runs in two directions. The easiest to explain is threat leading to sex as a fix. For many men, everyday life raises the activity of the threat system: mental health difficulties, family pressures, work stress, money worries, and also pressures within relationships and around sex itself. Threat is very diffuse, and it differs enormously between men. It can be a pattern of thinking or a set of emotional states, life events, relationships or circumstances. It can be historical, something that happened in the past and was never fully dealt with, or something happening right now, moment to moment. The threat system brings emotions whose job is to alert us to danger: anger, fear, shame, self-criticism, blame, low mood. They feel uncomfortable and dangerous, because they activate the fight or flight response, and they push us into action, to change the situation or to stop feeling this way. The route we would want that to go through is the soothing system: regulating the feeling, making accurate decisions and problem-solving in a way that holds our needs and other people's needs centrally. For many of the men I see, that system is diminished, so they rely on the drive system instead.

The drive system: it works

The drive system is important, and we need it. It helps us set goals, orientate ourselves towards what we want, and get our material needs met. It focuses us on things that bring reward, pleasure and satisfaction. But crucially, it is resource-led. It is about acquiring. Very often the threat system is presenting us with a difficulty that isn't solved by acquiring something. It is an emotional need. Yet we over-rely on drive to fix it, seeking out things or behaviours that, temporarily at least, let us fix, avoid or escape the threatening feelings, whatever their source. And it matters that this works. That is the crucial thing. When we immerse ourselves in something rewarding, it does relieve stress, it distracts us, and it takes us away from the immediacy of our problems.

The problem is that it becomes a self-fulfilling loop, because these behaviours never keep working universally. They work for a while, sometimes very well, then they work less, so we have to do more, invest more, or find another behaviour. It becomes a cat and mouse game between difficult feelings and instant relief, and sometimes we run out of road and feel stuck. The behaviours also have their own consequences. That is obvious with drugs, but it is true of everything. If I'm stressed and spend a day watching Netflix because it helps me relax, I have lost time, procrastinated, and not attended to something else that matters. Even daydreaming has a cost: we haven't harmed anyone, but we have avoided what needed attention. That cost gets magnified depending on the behaviour.

For the men I work with, internal and external threats (feelings and thoughts on one side, life events and relationships on the other) are often poorly managed, and somewhere along the way they have found that sex helps to escape, fix or avoid, or all three. Over time that does two things. First, it stops working as well, so we do more, escalate, push our boundaries, or move into riskier behaviour, which brings fear and shame, real physical health risks, risks to ourselves and others, and sometimes escalation into substance use. Second, because it works initially, we start using sex for a broader range of emotions and situations. It takes up more time and more of our lives than we intended, and it gets used when we aren't actually feeling sexual. We are acting when the original desire wasn't there, and that affects how we see ourselves, our bodies, our ability to hold boundaries, consent and safety, and our physical and mental health.

Sex on a pedestal

There is another way of looking at it. Almost every person has a sexual drive. Part of the drive system is sex: at a very primitive level for procreation, but humans have evolved to want sex for many reasons. It connects us, brings pleasure and is a fulfilling human experience. So the drive system will sometimes switch on in the absence of threat, and we hope it does. Many of the men I see learnt very young that being sexual brings reward. So it isn't only that sex happens in response to threat. Sex happens because of drive. The extra layer, for most men I work with, is a powerful narrative from a young age that sex is the thing that will make you feel best, which gives drive added weight. For many people sexual drive sits within a range of things. I could be sexual right now, or I could have a fulfilling conversation with friends, or go out to a nice restaurant. There is a broader menu. For almost all the men I work with, regardless of sexuality, being sexual is put on a pedestal. It is the A star, the gold standard. The drive system switches on, pulls us towards it, and brings an internal narrative of permission: we should do it, we should do more of it, we deserve it. That is fine initially, except that it keeps pushing, often more than we want, and without the chance to ask whether anything else would meet our needs in that moment.

Because the drive system is focused on acquiring, it also reduces our ability to reflect on consequences. Even when something has already caused problems, we can sidestep thinking about them because we are seeking the feeling, the instant reward. We can find ourselves almost sleepwalking into behaviours, and then the threat system activates afterwards. Drive comes first and threat comes later.

Why it keeps going

All the while, the soothing system is less active. It isn't only there to make us feel better when we are threatened, although that matters. It also helps us think. It keeps us level enough to process information, weigh things up, make decisions and reflect on what we need. When we over-rely on drive, or on threat, that capacity is diminished. Threat and drive get intertwined, and they stop us not only from soothing ourselves but from thinking. That is the crucial bit.

So I see three reasons this keeps going. First, the behaviours worked in the past and provided a solution, so we keep seeking them in the hope they will work again. Second, sex is rewarding, and drive keeps pulling us towards something we have learnt is the gold standard, both for feeling good and for escaping and avoiding. Third, the interaction between threat and drive shuts down the soothing system, so we can't think. We can't process enough to consider alternatives or hold consequences in mind, even when we really want to. Either threat is so high that we need a behaviour to fix it, or drive is so high that we need to acquire the thing, and every other consideration gets swept away.

On the ground: an argument on Thursday

On the ground, it might look like this, using chemsex as one example. I know rationally that using drugs this weekend is a bad idea. I won't be able to function at work next week, I'll have to miss the family dinner on Sunday, I'll feel awful in my body, and I already have physical health problems building up. Then on Thursday there is an argument at work and someone is critical of me. I feel highly activated, with a lot of self-criticism and shame, and there is no obvious short-term solution. Sitting with those feelings is deeply uncomfortable. On Friday a friend texts that they are going for drinks, and I know there will be drugs. Because my threat level is so high, I am drawn towards it, consciously or not, because I know it will let me switch off from these horrible feelings. It is a way to turn the dial down when I have no other way. Or I want the reward of being sexual, and part of me is in the mood, alongside a lot of complicated feelings, and knowing that sex is one of the things that most lets me escape drives me towards it. Despite the consequences I am aware of, I push towards it. This loop happens in a split second. It becomes quite hardwired, and we can't stop and reflect, usually because the threat is so high, combined with a felt sense of horniness that becomes a big motivating factor.

When sex itself is the threat

Many of the drivers aren't about sex at all. But one thing that is very rarely taught to anyone, and particularly to men in this situation, is how to cope with the emotions of sex itself. Being sexual with another person isn't just a physical act, although that is how we are usually taught to think about it. All sorts of feelings come up before, during and after. Over any length of sexual relationship there are negotiations of emotion, things feel different at different times, our partners have their own experiences, and there is a lot of unspoken, non-verbal communication to navigate. There is an awful lot happening emotionally, and almost never any modelling of what to do about it. So for many of the men I work with, the threats aren't only outside sex. The threat is also sex itself: the feelings that come up, the expectations we place on ourselves, the responsibility to perform, take the lead, initiate or hold a partner's emotional needs, not knowing what to do when something unexpected happens. How do we sit with it, tolerate it, cope with it? All of that is threatening. Yet the sexual drive persists, along with the learning that the right stimulation and release bring a big reward. So we seek out sex that strips out the emotional complexity, which maintains the pattern. That isn't because there is anything wrong with us. It is because we have never been given the skills to navigate the emotional landscape of sex consistently.

Compassion is not niceness

The work, then, is designed to increase our capacity to self-soothe. That does several things. It lets us have emotions, experience them and sit with them without having to react, reach for a behaviour or escape into something. That usually dials down the threat. And it lets us think: once the soothing system is more active, we can make decisions and be more attuned to what is in our interest in any given moment.

We use compassion in this work, and the word is thrown around generically. Compassion isn't just being nice. In this context it means genuinely holding our own interests and the interests of others in a consistent, safe and loving way. Think about what someone who genuinely had your best interests at heart would say. It often wouldn't simply be "don't do this". They would help you think about the range of factors contributing to what is going on, about what would on balance fulfil you, meet your needs and bring you the most pleasure, and guide you to make accurate decisions. Being compassionate sometimes means facing really difficult decisions: being honest about the costs and benefits of what we are doing, truthful about what is pulling us towards something and what the consequences might be. When do I do this, when don't I, is there a place for it sometimes, or never? What does kindness to me actually look like?

Compassion also involves strength. It takes strength to sit with competing and uncomfortable feelings long enough, instead of escaping immediately, to make sense of the ones that stay around and seem to signify something important. Then to hold a line, and choose the behaviours that best meet those needs, even if they aren't the ones we instinctively move towards or the ones that bring the quickest relief. It involves resilience, boundaries, safety, holding a line and persisting while distress continues. The skills of compassion are integral to the soothing system. As we strengthen our ability to respond compassionately to internal and external threats, it helps us soothe, and when we soothe in that way we no longer need a behaviour. We can tolerate the ups and downs of feelings in our lives, our sex and our bodies, stay where we are, reflect, and work with our partners on solutions, rather than escaping or distracting ourselves in ways that usually create more problems. Increasing our capacity to soothe often makes sex itself more tolerable, and it lets us learn how we actually want to respond to the complex feelings that come up in sex, how to talk about them and negotiate them with partners, and often how to use them to connect and be more fulfilled. Compassion is the vehicle that gets us there. It takes a lot to be compassionate consistently, but it is often the key to unwinding habitual patterns that keep repeating and can feel almost impossible to get out of.