Case Studies

A client of mine, a 48-year-old attractive gay man, is in the process of the breaking up of yet another relationship. After spending years of living a noxious childhood household, he went into his own world of fantasizing and masturbation as a way to soothe and protect himself.

"When I was a kid, I was obsessed with beautiful men in the magazines. When I was able to have sex, I went through one man after another. In adulthood, I knew there was sadness and anger I didn't want to face. To evade them, I had a steady stream of men who worshipped me, soothed me, paid attention to my needs. I went to peep shows, to the clubs, to the baths. Many a night I would spend hours in my car circling the block looking for a call boy to give me oral sex in my car. Often, after these encounters, I'd cry all the way home.

He met a man whom he designated as "perfect - my redemption, my salvation." He moved in but soon lost interest in the sex, which he described as "boring". While still living with his lover, he started picking up men in bars, going to the baths and the pubic toilets. He felt most comfortable with strangers who didn't make demands on him.

Another client of mine, a 38-year-old married man, has a compulsion to visit prostitutes. Three years into the treatment, he was finally able to talk about his anger towards his mother for depriving him emotionally through neglect and for never touching or caressing him. He can now make a connection between visits to the prostitutes and his hostility against mother for depriving him of sensual pleasure. As a child, he got lost in the mire of his parents' constant feuding.

"When I was very young I would put a blanket on my genitals as a kind of soothing which I wasn't getting from my parents. The rest of my life was a struggle to find other ways to soothe myself. When I discovered prostitutes, I thought I was in heaven. I can get sex now and be in total control. I can have it immediately, any way I want it, whenever I want it. I don't have to concern myself with the girl, as long as I pay her. I don't have to concern myself with vulnerability and rejection. This is my controlled pleasure world. This is the ultimate antithesis of the deprivation of my childhood."

The use of sexualization as a defense is a common theme that runs through the psychoanalytic literature. A defense is a mechanism the young child devises to psychologically survive a noxious family environment. While this way of protecting himself works well for a period of time, the continuous use of it as an adult is destructive to the person's ongoing functioning and sense of well being. By losing himself in sexual fantasies and constantly seeing others as potential sex partners, or by erotic internet enactments, the sex addict is able to significantly reduce and control a wide variety of threatening and uncomfortable emotional states. Diminution of depression, anxiety and rage are some of the pay-offs that operate to facilitate and maintain life in the erotic cocoon.

I quote another patient which illustrates a case of narcissistic personality together with the use of sexualization (internet fetishes) as a defense and the search for perfection. He is a 52-year old attractive, successful single man.

"I went on a date the other night. She wanted sex. I didn't. It's predictable. I don't think I can even maintain an erection anymore. While a spend untold hours compulsively websurfing to live in my erotic fantasies, when it becomes real, when you find someone who seems to be the embodiment of your sexual pre-occupation, interest soon wanes as her wants and needs come into the picture. Sometimes, I don't even bother with the pursuit of real women, because I know the inevitable result is disillusionment. I'm simply not prepared to meet somebody else's needs.

Oddly enough, my life is still dominated by sex. It becomes the lens through which I view everything. I go to a family gathering and get lost in sexual fantasies about my teenage nieces. I live in constant fear of being found out to be a "pervert". I see a woman on the train dressed in a way that triggers me, and I'm ruined for the day. Regular sex just doesn't do it for me anymore. It's got to be bizarre or forbidden or "out of the box". I arrive at work in an erotic haze. Women around me are all objects of sexual fantasy. I'm distracted; not focused. If something requires my attention, when real life intrudes and yanks me out of my sexual preoccupation, I get angry. Real life is so boring."

This patient uses sexualization as a defense. He uses his sexual pre-occupation as a way to ward off chronic feelings of loneliness, inadequacy and emptiness born of a childhood deprived of nurturing from a withdrawn, depressed mother. When stress or anxiety begins to overwhelm the regulation of his emotions, he is beset by intense urges to indulge in his fantasies and enactments. Sexualization thus becomes his standard way of managing feelings that he feels are intolerable as well as a way of stabilizing a crumbling sense of self-worth.

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Last reviewed: By John M. Grohol, Psy.D. on 7 Sep 2004