In 2008, the Mayo Clinic published a case study of treating compulsive sexual behaviors with pharmaceuticals:
A male patient first presented to a psychiatrist (J.M.B.) at age 24, with the explanation, “I’m here for sexual addiction. It has consumed my entire life.” He feared losing both marriage and job if he could not contain his burgeoning preoccupation with Internet pornography. He was spending many hours each day chatting online, engaging in extended masturbation sessions, and occasionally meeting cyber-contacts in person for spontaneous, typically unprotected, sex.
The story is a familiar one. A young man seeking sexual activities outside of his marriage or relationship experiences guilt because of his compulsive behaviors. He feels he cannot stop and is at a loss for solutions. He wants to be good, by whatever measure his culture dictates, but feels he can’t.
The term “sex addiction” is the new darling of sensational media. The narrative of an addict is a compelling one, their struggle with external forces in the world leaves much room for pity. After all, this isn’t their fault but the fault of the pesky stimulus hijacking their tender neurological reward circuitry. Right?
Not really. The picture of compulsive sexual behaviors is far more complicated than (male) brain + (non-monogamous) sexual stimulation = addiction. Dopamine may indeed play a role in all compulsive behaviors but the narrative of porn as an external factor that takes over your system is a false (and overwhelmingly Christian) explanation that fails to recognize sexual histories and user conceptions of sexuality.