Why Sex Addiction Isn't Real with Silva Neves | Transcript
Find the episode shownotes here!
CW: Discussion of sexual trauma.
Hannah Witton
Hi everyone, welcome back to Doing It. So you may or may not know, but I am currently working towards becoming a certified sexuality educator through a course at ISEE, which stands for the Institute for Sexuality, Education and Enlightenment. And whilst I have mixed feelings about if you need a qualification, or what kind of qualification you need to become a sex educator, because I already am one without this course, there are still a lot of things that I have been learning from the classes and webinars that I have been taking. And one of those things that came up was about sex addiction, and how it isn't real, which blew my little mind as a person who lives in a society where the narrative is that sex addiction is a real thing. But this is a new thing I've recently come across so I didn't feel like I could do the topic justice myself. So I have roped in an expert.
My guest today is Silva Neves, who is a psychosexual and relationship psychotherapist and author and he's here to dispel all of the myths around sex addiction and give us a better framework to view sexual behaviour through. We talk about the difference between the public idea of sex addiction and the understanding of it in a sex therapy clinic. And Silva gives us a rundown on what the definition of an addiction is and so how things like sex and porn addictions don't fit. We also talk about problems with 12 step sex addiction programmes: how they become about avoidance and seeing all sexuality as bad and trying to fix a problem that doesn't really exist. And so then we get on to compulsive sexual behaviours, which is what someone who might think they are a sex addict could be experiencing. And we talk about the causes of these and the potential distress caused by them, like shame, mental health issues, sexual trauma and chronic stress. And then towards the end, we get onto answering your questions. And so for that section, we talk a lot about sexual trauma. And I give another warning before we start talking about that at the time so you can skip that part if you need to. We don't explicitly talk about sexual violence. But we talk more around coping with sexual trauma, and talking about it with a therapist.
As usual, you can find more info and links to everything we talked about in this episode in the shownotes over at doingitpodcast.co.uk. And please let us know what you think over on our Twitter or Instagram, which is @doingitpodcast And if you liked this episode, please leave us a rating and review over on iTunes. It is really appreciated and really helps us out. And without further ado, here is my conversation with Silva Neves.
Silva, thank you so much for joining me. I'm really excited to kind of get into your brain, and unpick all of the wisdom and knowledge.
Silva Neves
Thank you for inviting me. It's great to be here.
Hannah Witton
Yeah! So basically, like, I wanted to chat with you about sex addiction: what it is, what it maybe isn't. And then compulsive sexual behaviours. And this might be new information to some listeners - and this was new information to me, like, this year - which is that sex addiction is not a thing. It's not real. And I was like, wait, what? Because it's so I guess pervasive in, like, our culture and media messaging and stuff around sex. So where like, where do we begin? Like, why is sex addiction an idea or a framework that we have? And why is it maybe not the most useful thing? And then we can move on to what we should actually be using?
Silva Neves
Sure. When we speak about addiction in general, anyway, there are two different ways that we talk about it: there is the public way, and there is the clinical way. And those two are different. So everybody in the public that don't have, you know, clinical background, of course, they use the term addict in all sorts of different ways. I'm a coffee addict, I'm a Netflix addict, I'm a shopping addict, whatever. And usually when people say that what they mean is that they do something that they love very much and sometimes maybe overdo it. And that's how we talk about.
Hannah Witton
Right so I'm a Pringles addict.
Silva Neves
Right, exactly. I'm a cheese addict. There you go.
Hannah Witton
Nice. I don't think there's anything wrong with being a cheese addict, but.
Silva Neves
No, I don't think so either, but, you know. But of course, on the clinical sense, addiction have a very, very different meaning because to define something an addiction clinically, it has to meet five important criteria that if they are not met, then we can't define it as an addiction. And so those criteria are - very briefly, what they are so that people can understand what a real addiction is - is that first, it has to be something with a problem with impulse control. And so it means people just having urges about something and just not being able to control that and then just launching into the behaviour. The second is risky use. So what that means is that people have to do something that they know is harming themselves and they can't stop doing it. And in the clinical criteria of addiction means that it's something that could be a significant risk of death. Okay, that's the risky use bit. So you know, somebody that is told, if you should drink more, you're going to be dying by the end of this year. Or if you take drugs, you're likely to have an overdose and you're likely to die quite soon. So that kind of risk, we're talking about in terms of addiction.
Hannah Witton
Okay, if the risk factor isn't that high, because there's obviously like a whole spectrum of risk, would it not count as an addiction?
Silva Neves
That's right, that's right.
Hannah Witton
Okay, so it has to be like really serious.
Silva Neves
It has to be a life and death type of risk, or serious, serious physical harm.
Hannah Witton
Right, okay.
Silva Neves
The third one is what we call tolerance. So tolerance is basically, when there is a substance that goes into the brain that the brain is not naturally - cannot process. So usually it will be drugs and alcohol. And so for the brain, for the brain to survive that kind of chemicals, it has to reconfigure itself to sustain the chemical. And that's when the brain is actually changing, because the chemical is an external substance. And then when the brain has reconfigured, then the substance that is taken to produce a high, for example, does not produce a high any longer, because the brain has habituated to it. So then people have to take more of that substance to achieve the same high.
Hannah Witton
Got it.
Silva Neves
And so and so that's what we call tolerance. And so it means also that then, the other criteria is withdrawal, and withdrawal, what we talking about withdrawal, we mean that it's an actual body tissue - a body tissue pain, that people have and actually the body can go into shock, and it can be quite dangerous to stop a substance so, so quickly, so soon. So that has to be medically supervised. And the reason why there is a withdrawal in that way is because when the substance is taken away from the brain, and the brain goes into shock, and has to reconfigure itself again back to its original setting, which can take quite some time.
Hannah Witton
Yeah.
Silva Neves
So those are - those are some of like the main kind of criteria for for a clinical addiction.
Hannah Witton
Yeah, that's so interesting as well because like you're saying, like, substances, like drugs, and alcohol is like the obvious ones that we think of? So in that sense, like, can you not be addicted to certain behaviours? Does it have to be a substance? Because when you're saying about tolerance as well, that reminds me of the way that some people talk about porn use? Does that have like a kind of like tolerance effect, but maybe not the other ones so it wouldn't count as an addiction?
SIlva Neves
Even with pornography we've not actually seen tolerance clinically. So when it's very common that people say, "Oh, I've been watching something on porn, and then it stops being pleasurable. So now I'm just clicking on other things to watch something different. And then watch something different."
Hannah Witton
Yeah, we hear a lot of people saying that they become desensitised to certain things. And so then they are looking for like more and more extreme things to like, get that arousal.
Silva Neves
Of course, and people mistake that with tolerance. But it's actually not a tolerance because the brain is not impaired. Point can not impair the brain in the way that drugs can. So what it is, really, is that it's two things. First is boredom. And that comes with novelty seeking. We as human beings we like to have - we seek novelty, because it's exciting. And it's fun, and we all do it. Right. We don't always like to eat the same food every day. We like to sometimes change what we eat. And sometimes we like to eat something we've never eaten before for that extra bit of excitement.
Hannah Witton
Yeah, and how sometimes your favourite meal might eventually like get boring and you need to change it up a bit before you then go back to that meal.
Silva Neves
Yes, absolutely. Exactly. So that's that's one of the things that - and people mistake that they think, "Oh, yes, gosh, it's tolerance and porn is bad." But it's not. It's just novelty seeking. And of course on porn there's always a lot of novelty seeking because there's always something more that you can click on. You will never, you will never expire the whole kind of library of porn available out there. The other thing that that people mistake tolerance for is when people say, "Oh, I don't feel pleasure with sex anymore." And - and often people think, oh, well, that's because then the brain has - is impaired, and so the pleasure of sex is no longer present and you have to do more to get the same kind of pleasure of sex. And again, that's really not been observed clinically. It's people that mistake it for tolerance, but it's not. The the issue with people that report not feeling pleasure with sex is because they are in dissociation, not tolerance, and it's very different.
Hannah Witton
Ah, okay, do you want to briefly explain what disassociation is?
Silva Neves
Yeah, well, I can explain very easily because it happens to all of us. Say, you go to the cinema, and you have a big bucket of popcorn, and you sit down and you watch all the exciting trailers, and then by the time the film starts, you just look down at your bucket, and it's all empty. And you think what the hell happened? I didn't even - I didn't even taste the popcorn! What - you know - that's because you ate the popcorn in dissociation, because you were you were focusing on something else. But if the next time - if the next time you go to the cinema, and you have your bucket of popcorn, and you eat your popcorn mindfully, and you're aware of the popcorn, then you will have the same pleasure of the popcorn that you would have done the time before. So it's not that you're tolerant, it's not that you become tolerant to popcorn, it's not that you're addicted to popcorn, it's just that you were in dissociation. And with sex, that's what happens a lot. People who don't get the pleasure of it, often that's because their mind is somewhere else, they think of something else, and they're not present with the experience of sex, and therefore they're not getting the pleasure of it. But if the next time they decide to be or they learn to be mindful about what they're doing with their body in a sexual situation, then the pleasure - they will then feel the pleasure as they would have in the first time around. It does not mean that they have become tolerant to it.
Hannah Witton
Okay, yeah. And that makes a lot of sense to me as well, because I have seen a lot of people doing work around like mindfulness and sex, and like sensate focus, and things like that. So, yeah, pay attention to your popcorn, people.
Silva Neves
Exactly. And sometimes the confusion between people out there is, you know, when people think they are a sex addict is because they are confusing the popular term, which is the one that we all use, you know, I'm a cheater, you're Pringles addict, and people will say, they're a sex addict. But often what they mean is, "I love sex very, very much and I sometimes overdo it." Or they might say, a lot of the time, they might say, "I've got problems with my sexual behaviours, because I don't understand it, and it feels out of control." And feeling feeling out of control does not mean being out of control. So and that's also an important distinction that a lot of people are confused about. That they use the term sex addict, because the public does not have any other terms. That's the most popular term that everybody uses. And so and it's not challenged, and so people keep using that term.
Hannah Witton
Yeah. And because it's so common, and it's what kind of like people use and understand, like, as far as I'm aware, there are like sex addict anonymous groups that have like a similar kind of, like, 12 step, kind of programmes. And one of the things that I was learning about in my course was just how like, these don't work for sex addiction, because it's not an addiction. And I wondered if that's something that you've come across.
Silva Neves
Yes, absolutely. It doesn't work but also - and for me, what's worse - is that it also gives people a mindset, a particular mindset of fearing sex, and and being erotically avoidant, rather than erotically aware. And if you're going to be erotically avoidant, you're not going to be helped because you're going to always be in the dark about what is going on in your erotic mind, and what's going on in your body. And if all you learn is about avoiding sexual cues, or erotic, erotic content in whatever, you know, magazines and TV or whatever, because you're afraid that that's going to "trigger" you and I use trigger in inverted commas here. And it's kind of really, really not helpful.
And the other thing that's not helpful about those 12 step programmes is that people confuse a problem, like a sexual behaviour problem, and an identity. You know, people say, "I'm a sex addict." And when actually that's not true, you are a human person. And you might have some problems with sexual behaviours that might be compulsive. And that's really quite different. And as soon as people identify with a movement, or they identify with a problem like I'm a sex addict, they are the people usually that are becoming very aggressive, or, or reluctant to hear something different. And of course, I know that because I'm usually the one who talks about, "Hey, actually sex addiction is not really clinically endorsed. And it's there's other ways to look at it, there's other ways to manage your sexual behaviours in a different way." And they become very angry that they often tell me, "You're denying who I am. You denying what I feel." And I'm thinking, and I'm thinking, "No, I'm not denying who you are because you're a human being. And, and but I also don't agree that sex addiction is an identity. It's a problem." And so it's really about actually, you know, when I, when I speak against sex addiction, I'm not trying to deny people's problems or deny people's identity, I want to understand it more and better in a deeper way so that I can help better. And often, but often people that feel that their movement is under attack, then will be quite aggressive about it. I understand, you know, if you have certain - if you believe in something so bad, and somebody tells you something different, they will be defensive, I really understand that. I don't, I don't, you know, I'm not angry at them. You know, it's like, you know, people that really, really believe that the Earth was flat. Well, you know, as soon as somebody said, actually, you know what, it's round. What? That did not come down well, very easily, you know, the new knowledge.
Hannah Witton
But a lot of the times because they identify as a flat earther - not because they identify necessarily as a human being who has ideas that can be challenged or changed, depending on what new information they're given, but like, their beliefs are like, a core part of their identity. So by challenging that belief, you're also like challenging, like, like you said, like who they are.
Silva Neves
Yes, that's right. And there are so many research in psychology that shows that if you that your behaviours will naturally follow what you believe about yourself. So if you believe you're a sex addict, you're more likely to act like one. And, and so again, that's another way that's just not really very helpful. And, and one of the one of the things is that people that do go to those programmes, or they follow an addiction oriented therapy, they often complain about relapse, you know, what they call relapse, meaning that the behaviours don't change, or they return to their sexual behaviours that they didn't want to have. And people just struggle so much with relapse after relapse after relapse, and every single time, they then blame themselves, they think, "Oh, that's because I didn't follow the steps properly. That's because I didn't do the programme well, I failed therapy." And in fact, those relapse are induced by the very programmes themselves. So - and so that's also harming them, because they, they hardly ever say, "Maybe the 12 step is not good for me. Maybe I need to look at something else." They say, "I failed the 12 step."
Hannah Witton
Yeah. Yeah. It becomes a personal failure.
Silva Neves
Yeah. Which is, I think, not helpful either.
Hannah Witton
So one of the other things that I came across was just in general, like our - as a society, as a world, our lack of understanding about really the scope of human sexuality, and how we have a very, like, narrow definition of what is normal and what is healthy. And so often, if anyone falls outside of that, which is in fact, like most people, then you might be like, "Oh, my goodness, am I a sex addict?" Because you don't feel like you like fit into this mould. And yeah, someone said to me, they were like, "Yeah, you might get a therapist who thinks that you're a sex addict, because you either have more or different sex to them, because of just the complete lack of understanding that we have about sexuality."
Silva Neves
Yes, that's right. It's absolutely right. In sexuality in general, so many people really not understanding the diversity of sexual practices and sexual behaviours and even sexual turn-ons. That's primarily because sex education is very poor here in the UK, but in most countries, sex education is poor. So nobody, nobody gets to spend enough time exploring their erotic mind and exploring what what kind of sex and sexual behaviour is going to fit, be good for them and fit them. So they only go with what society tells us what sex "should" be like, again, in inverted commas, and that and all those "shoulds" are usually the things that cause a lot of problems in people's sex lives because so many people - there's such a diversity of erotic minds and eroticism and sensuality and turn ons that a lot of people are going to fall outside of that very strict kind of "should" that society tells us. And so many people feel very shamed about the turn-ons, their sexual desire, and their sexual behaviours, because they think it's not normal. And of course as a psychosexual therapist, like me, or any sex educators out there, those words "healthy" or "normal" is really ghastly for us, right?
Hannah Witton
Yeah, like red flags!
Silva Neves
Yeah, exactly. But so many - so many people live by those because - and they beat themselves up for not being, you know, "normal" as society says, and and then in the, in the - if those behaviours happen to be a kink that's unusual, for example, or somebody who has a high sexual desire and have a lot of sex, or people that have sexual practices that are just a little bit - that they've never heard of before, they might think, "Oh, I have a problem. Oh, that must be I'm a sex addict." You know, as soon as it's something to do with frequency or, or the unusual practice, people start to think they're sex addicts. And then they might read books about it. Or they might go online and do some an online test about it. And then they will show up they sex addicts, because -
Hannah Witton
Oh, my goodness, I so now just like wanna Google like, "Sex Addict quiz" and like, see what comes up. I bet there's so much like, "am I a sex addict quizzes". Don't take them, people, don't do it.
Silva Neves
Don't take them. Because because there's no - you know, sex addiction is not clinically endorsed in the first place so those quizzes, you know, the assessment of these quizzes are done by the moral judgement of the creator of the quizzes. And usually the creator of the quizzes are those selling services about it.
Hannah Witton
Yeah. And I think you just nailed it there with like what you said about it's individuals' moral judgement. And when we're using morality to judge other people's sexual behaviour, like, again, that's just like, red flag.
Silva Neves
Yes, big, big red flags. But a lot of people will, because of that, a lot of people will self diagnose as a sex addict, and then try to find help for that. And, you know, one of the things I do a lot in my consulting rooms is to undiagnose people who say this. Of course, you know, they come in and say, "I'm a sex addict," I'm not gonna say, "No, you're wrong. This is not what we call it." You know, I'm not I'm not I'm not like that of course, you know, I use their language too. But at the same time, I also said, "And, you know, that is something that in the sex addiction is a disease word. And actually, you're not diseased?" And I think that's very important.
Hannah Witton
And it might be like, why do you think that? What, what's your sex life like? And then it might just be having to be like, "Actually, that all sounds really normal to me."
Silva Neves
Yes, well, sometimes normalising some of the things they do and say is good. You have to look at the distress. Now what is so - what bothers them so much, because there are some sexual practices that might be completely normative, but it might be going against their values, or whether it's religious values or any kind of values. And so that's fine, we have to listen to that too, and listen to what the distress is. But if the distress comes from an external sources, like a book that says they're porn addict, or a therapist that says they're sex addict, or quiz that says they're sex addict, those are external stuff, that doesn't know them, really. And so usually, then when people say, "I'm a sex addict," what they're saying is, I feel a lot of shame about my sexuality, that's what they're saying often underneath. Or they saying, "I really don't understand my sexual processes, and I don't understand how, how I react to sexual cues. And I think there's something wrong." That's what they usually saying. So as a therapist, I don't go for the label. I explain to them, you know, what is clinically endorsed, what is not, and given - and with what we know, clinically and scientifically, they definitely don't have an addiction, so they're not diseased, and they may have some compulsivity traits, and definitely sexual behaviours. And we can look at that and look at what is underneath, what is going on for them as the individual.
Hannah Witton
Yes. And that is a great way to segue into compulsive sexual behaviours then. So actually, like, what, what is the antidote to this? And what are compulsive sexual behaviours? And I guess, like clinically, how, I don't know, is that something that you diagnose people with? Or like, how do you, yeah, how does that work in a kind of like a clinical setting?
Silva Neves
in the clinical setting, the only criteria that we have to assess compulsive sexual behaviours is from the World Health Organisation. And they came out with a diagnostic criteria from 2018. So it's quite recent. And - and so if - it's not perfect, obviously, because people are still trying to figure it out. But if you go by those criteria, I think it's very helpful because just like the, the addiction, the clinical definition of addiction, with compulsive sexual behaviour, if you want to diagnose someone, somebody with a disorder, they have to meet a set of criteria. It's quite a lot of them. And actually, most people don't meet those criteria. So most people then will not be labelled with a disorder, which I think is very important, people not to feel they have a disease when they don't. And, but if they meet some of those criteria, not others, then I said to them, "Well, you have - you don't have disorder. That's the good news. And, and, but what you're coming up with is some sexual behaviour problems, you know, there are problems. They're not - it's not a disorder." And so it's very different and that for me, the words are very important because I just don't like to put some disease or pathology, language on to people if if there aren't any. And, and a lot of people, a lot of people are already pathologizing themselves enough when it comes to sex. There's no point adding to it. And especially from a professional, I don't think it's right to do. So the the criteria that we have from the World Health Organisation says that it's not an addiction, it's an impulse control issue. And impulse control means that it's people finding it harder to, to manage their urges, and intense urges, and the urges leads to then repetitive sexual behaviours that are unwanted. So it's not about the frequency of the behaviours, it's about the - it's about how they manage the impulse.
Hannah Witton
And by unwanted is that by the person who is exhibiting those behaviours -
Silva Neves
Yes.
Hannah Witton
- or could it also be like, unwanted for other people as well, like so say if someone like is an exhibitionist, maybe it's unwanted for maybe other people in public who happen to see that? Do you know what I mean? Well, that's illegal, but.
Silva Neves
Well, yes, I'm glad you bring that up. Because with the sex addiction field, there's also a lot of confusion between what is legal and what is not legal. And even in a sex addiction, to after programmes, they put everything together: the people that sexually offend with the people that have compulsive sexual behaviours with consensual adults and those to me are very different issues. Very different problems. But in the sex addiction field, people just mix those two up together thinking that one leads to the other. And somehow it's kind of like on the same line, and I disagree with that totally. Most people, most people that have compulsive sexual behaviours, they have behaviours that might be unwanted for them, or it might be against their commitment to their partner, but it is done consensually. And it's all legal. People who sexually offend, it's very, very different. problem, and I don't think that's the same at all.
Hannah Witton
Okay, yeah. That makes sense.
Silva Neves
Yeah. So, you know, for your, your example of exhibitionism people can do that very -in a legal way, if everybody consents too, so obviously not in the street. But some people do have a turn-on of exhibition, and with other people, but you know, as long as it's all it's all talked about before and so on. And if people - and there are some people that even get turned on by that only, or mostly, by exhibitioning themselves, and again, that's not a problem if it doesn't cause distress to them. So that's fine. But of course, there are some people who might be in a relationship with, with somebody who does not like that type of stuff. And they say, you know, "Stop doing that, and just do something more kind of vanilla or more normal." You know, again, inverted commas. And then the person just then trying to meet their needs. And then they realise "Well, I don't get turned on so much unless I do exhibitionism." And then they think "Well, surely I've got a problem because I should be able to do the other stuff." And then that's when people start to think they have a problem. So, so often it's to do with how they think that fits with the rest of their lives, or how their sexuality fits with the rest of their lives.
Hannah Witton
Yeah. Okay, so what's the rest of the World Health Organisation criteria?
Silva Neves
Then, so that's one of them, it's like the distress has to be a distress that comes from them, not an external source. And it has to be a destress that is big enough, that's going to cause problems in the other areas of people's lives. And one of the one of the criteria is to say that it also has to be - sex has to be the central focus of people's lives, to the extent of causing problems and that is an important bit because a lot of people have sex on their mind all the time, it's the central focus of people's lives. But if it doesn't cause problems, then it's not a problem, basically. So you know, for example, for me, you know, I'm a psychosexual therapist, I talk about sex, I work with people sex lives, and I write about sex all day long. It's the central focus of my life. Right, so if that was the only part of the criteria, I could be diagnosed with, with somebody with compulsive sexual behaviours, but I'm not because it doesn't affect looking after myself. I can feed myself, I can sleep well, I can meet all of my other obligations, I can connect with my friends and my colleagues and everything else. So it's if sex trumps everything else, and they ignore other obligations of their life, and they cannot manage their lives, then that's one of the - that can be one of the criteria. And with that, you know, I have to say, though, that certainly with the clients I see, they often say to me, "Oh, yes, I've been doing that behaviour, you know, basically cheating." You know, that's what people say now. "I've been cheating with my partner for years. And so I've got sex addiction." And, and they've been doing that quite successfully unnoticed. And so you know, if they can do - if they can have a double life unnoticed and manage all of their diaries unnoticed, then that means they have pretty high functioning of their lives.
Hannah Witton
Just the scheduling involved!
Silva Neves
It's a big scheduling involved! But, you know, it means that they manage their obligations, and also do their sexual behaviours. So, so clinically, this person would not classify as having a disorder.
Hannah Witton
Okay, but they might have some ethical issues to work out in their relationship.
Silva Neves
Yes, they might have some ethical issues to work out in their relationship. they might have a bit,you know, learning a bit more awareness of the impact that non-consensual non-monogamy does to a relationship. They might also need to be a bit clearer about the erotic - what is the, what is the motivation behind doing that stuff that is not part of their commitment. But that is really kind of quite different from having a disorder.
Hannah Witton
Yeah. Yeah, for sure. Like, we're not going to pathologize like every single person who has cheated on their partner as being like, "There's something like mentally wrong with you."
Silva Neves
Exactly. Yeah. Because if we did that, then there would be over half the population that would have a disorder.
Hannah Witton
It's a lot of people. It is a lot of people. For sure
Silva Neves
One of the other thing that's really important part of the criteria is that the behaviour has to last for at least six months, or more. And that is very important, too, because some people sometimes notice that the sexual behaviour changes quite suddenly, and it changes and so then they feel it becomes out of control, because it's out of character for them. And if they run straight to a therapist and say, "Oh, I've got sex addiction, or compulsive sexual behaviour, because my behaviours just changed." And it's only changed over the last month or two or three months, then we cannot diagnose with anything, because usually it responds to something that's just happening.
Hannah Witton
Yeah, something situational.
Silva Neves
Yeah, the most, the most common thing is if somebody had a very, very important bereavement, it's really, really likely that those people will respond to that with a surge in sexual behaviours. And that feels quite compulsive.
Hannah Witton
That feels like a minor side character plot in the latest series of Sex Education. There was one of the characters, their cat died, and they wouldn't talk about it, but just wanted sex from their partner all of the time. And that was how they were coping with grief. And that was just like this minor little side plot of the show. All right,
Silva Neves
Oh right, well, that's fantastic. And that's exactly how it is. And this is this is a normal coping mechanism faced with a big grief. So it's not - it's not a pathology, it's not bad, it's not wrong. If somebody comes with this, with these issues, and it's just been between one to six months, then we just have to help that person with their grief, you know, and be there and listen and open the space but not do any clinical intervention for compulsive sexual behaviours, because usually, the compulsion then wanes without any active clinical treatment after a while.
Hannah Witton
So when it then comes to people who do tick those boxes and they exhibit compulsive sexual behaviours, what tends to be the kind of like underlying causes like of that? What can we blame?
Silva Neves
Yes, exactly ! Well, there is the one most important is chronic stress, basically. So for true compulsivity to be assessed as compulsivity and to be treated, it has to be chronic stress because if there's no chronic stress, there's no compulsivity. So it's different from somebody having - it's different from somebody having a terrible day at work, and they're going to then go and see a sex worker to soothe that terrible day at work. That is, as you were saying earlier, situational. It's about, you know, one speck of stress and you use sex to manage that. That's not compulsivity. Compulsivity is if people are using sex every day on a regular basis, on a very frequent basis, with super urges of feeling sexual because of managing something that's chronic underneath. A chronic disturbance.
Hannah Witton
Right, so it's almost like using sex to avoid something else that is going on, maybe.
Silva Neves
Exactly. It's to avoid - it's to avoid feeling the chronic stress. So you - so it's - so people use you know, pleasure and and turn-on and excitement to move away from from the unpleasant feelings of chronic stress. And chronic stress can be anything from being in a crappy job, for example. You know, people, people that are in a job that they hate, and they're working all day long, five days a week, and then the weekend they recover and then it's Monday too quickly, and then they do it again. And they feel trapped in that. That is enough chronic stress to - for sexual compulsivity to exist and to survive.
Hannah Witton
And I guess things like, identity stresses as well. Yeah,
Silva Neves
Yeah. Identity stress, minority stress, all sorts of - all sorts of that stuff is really part of chronic stress. You know, really feeling bad in your skin, or feeling bad about yourself on a regular basis, basically. And often, you know, people don't walk around and say, Oh, I feel worthless, you know, that feeling is a feeling that's embedded inside, but they don't necessarily have the intellectual word "I feel worthless." But but they feel it deep inside, and they can't access it with words, but they can feel it. And that's that disturbance underneath that they can't often access logically that is the one pulling the strings and creates chronic stress and therefore then sexual compulsivity. But chronic stress sometimes can be also a result of unresolved post trauma. So it could be anything that's happened in childhood, from an accident to sexual abuse to neglect, difficult parents. And then of course, out of childhood experiences like this, people do also come out of that with core beliefs. Like "I'm not good enough, I'm unlovable, I'm unlikable, I'm worthless." And then there will be then those same things that can create a chronic stress in people's lives. And then they manage it with sexual compulsivity. And they don't even realise that it's all linked back to some events that's happened in childhood.
Hannah Witton
Yeah. And so it's like one of those things where, when it's involves sex, we just kind of like, we all kind of get in a frenzy about it being sex that is the bad thing and like, porn is evil and like, you know, sexuality and eroticism is what's bad, but actually like, what's going on is it it's just like an expression of other mental health stuff that is going on? And it just so happens that sexual related behaviours is like, how that expresses for some people.
Silva Neves
That's right. Yes.
Hannah Witton
But it's not like the bad thing that is causing this is like, sexual images in society and all of that kind of stuff.
Silva Neves
No, absolutely not. No. It's not, you know, nothing's broken, their sexuality is not broken. They don't have a sexualized brain that's bad. It's none of that. It's just one thing that they have learned to use, and they've learned along the way that orgasm feels good. And therefore that's - when they when they are busy with that they're not busy with feeling bad. And so that's a coping coping mechanism. Some people choose other coping mechanisms, like it's very quite common for people to have a very, very bad or busy, stressful work week. And on the weekend, they binge on Netflix all weekend long. They do nothing but watch Netflix all weekend long. On Monday, they go back to their colleagues and they say, "Oh, yes, I spent the whole weekend on bingeing on Netflix." And nobody says anything. It's, "Oh, alright, okay, well, how fun. Okay."
Hannah Witton
Yeah, whereas if you were like, I spent the entire weekend having orgies.
Silva Neves
Yeah, then that's very different.
Hannah Witton
People would be like, "Oh, my goodness."
Silva Neves
Even I even "I spent the whole weekend masturbating to porn". People would be like, "Oh god, that's so bad." But you know, what is the difference between, you know, scrolling on your phone, to move away from unpleasant emotions, watching Netflix, you know, going away to a spa weekend - or watching pornography or having lots of sex with your partner or strangers? You know, it's the same thing. It's using something that is pleasurable to avoid something that's unpleasant or to soothe from, from a bad week or stressful time.
Hannah Witton
Yeah. And like you said about, it needing to be six months or longer. Like, I feel like if a friend of mine said that, basically like every night after work, and every weekend, they just spend all of their spare time watching Netflix, I would - and that was like six months or longer - I would be concerned about them as well.
Silva Neves
Right, exactly. If you say, "Well, you know, I've not turned up to work and avoided friend's birthday parties and I lied to my friends that I couldn't turn up to their party because I just wanted to watch Netflix all day long." Then you think, "Okay, that's a problem."
Hannah Witton
Yeah, because that's when it's like interfering in other parts of your life. For sure.
Silva Neves
Exactly, but doesn't mean they're addicted to Netflix, it just means that they're using it and they're overusing it because there's a disturbance underneath that they are not resolving.
Hannah Witton
Yeah, that makes a lot of sense.
Okay, so, got some questions from Instagram. And it kind of relates to what you were saying about some of it could be due to like sexual trauma. And so we do have questions about that. So listeners, please take care of yourselves if you don't want to hear about this basically.
Somebody asked how to have healthy sexual relationships after going through sex related trauma. Big question.
Silva Neves
So it's a big question and I won't be able to answer in the time that we have on this podcast. But one of the main thing to be really conscious of is, is to be absolutely sure of what feels right and what does not feel right for you. And so for example, people that have had sexual trauma in the past, there might be parts of their body that they just do not want to be touched. Or there might be some words that they do not want to be spoken. Or there might be some things in the sexual space, say, for example, the sexual space in the bedroom, there might be some things that they just can't, that cannot be there, for example, certain scents, or certain colours or certain texture, or there might be some sexual positions, that just is a no-no for them. So they have to absolutely know what that is for them, that the things that remind them of trauma compared to the things that don't, and then to be absolutely super clear, to tell their partners about, the sexual partners about it, to say, you know, for example, "You cannot have aftershave when we have sex. And it is not possible to say words like - to say dirty words and and missionary position is a no no for me. You can't touch me on my breast, but you can touch me on a buttock." You know, these kind of things are going to be important because then you have a map and you recruit your partner, as a team, as a team player. And together, together, you can work out how you can have sex that doesn't - that is not a reminder of the sexual trauma. And I think that would be like that's like the number one - the number one suggestion, really, I would have.
Hannah Witton
Yeah. If, if the person wants to, is there a way to approach - like with a sexual partner - expanding their comfort zone? Or is that something best worked on like with a therapist?
Silva Neves
Of course with a therapist it's always better because there's plenty more time to slow down the process. Often people rush into wanting to experiment, and sometimes it's important to not rush in, to take more time. But if they want to expand the sexual horizen, or different, different behaviours, they can. They have to make sure that they're super, super, super safe with a partner, that they feel that their partner will be able to respond immediately, if they say, "Oh, actually, no, that's not working out for me," or "Oh, actually, no, you need to stop right now." And the partner has to be responsive immediately, without any questions or without any trying more. And so that's another bit of safety.
Hannah Witton
And this is where things like safe words, but also being really tuned in with your partner's body language is super useful, even in like a vanilla context.
Silva Neves
That's right. And if there is something that goes wrong, because sometimes we're not always aware of all the kind of trauma triggers that we might have, if something goes wrong, and the person has to absolutely say, "Okay, let's stop now." And then they have to figure out what could be the soothing - the soothing ritual that needs to happen afterwards, after something's gone wrong. For some people, they just want to be by themselves with their partners not around. And other people would prefer to have a hug from their partner or to talk to them about it. So they have to really know in advance what will be the soothing, the soothing thing?
Hannah Witton
Yeah, that makes sense. Somebody asked how to approach sexual trauma with my therapist? I'm not really comfy talking about it yet.
Silva Neves
Yes, that's a very good question. I think that there are some therapists that are not trained in trauma, actually. So before you speak about sexual trauma to your therapist, you might want to ask them questions about their training and their experience. And as a client, you have the right, you have the absolute right to be asking your therapist for their qualifications. And if the therapist says, "I'm not trauma trained, and I don't have very much experience with sexual trauma," then don't talk to your that therapist about it, but you might want to find a specialist in that area to address that in a bit of your life.
Hannah Witton
Yeah, that makes a lot of sense. And then even just approaching it then if your therapist is trauma trained - what's kind of like the best way for someone who's may be feeling a bit apprehensive in like bringing that up?
Silva Neves
Very small step at a time just to make sure that you can also feel that it's okay and safe enough for you to do it. Because even if your therapist is trauma trained, there might be something about your therapist that reminds you of your abuser. It could be the gender, or it could be the same eye colour, it could be the same tone of voice, it could be the shirt they're wearing that day, right? So so if you don't feel quite comfortable at a time figure out what might not be comfortable about the therapist. Iif it's just the shirt, you might think maybe next time, there wear a different shirt, that might be fine. If it's that they're a man and your abuser was a man, you don't feel comfortable talking about it to another man, even if it's a therapist that is trauma trained, then then don't, you know. If you feel like you can talk to your therapist about it, but you don't want to launch into it, just go very slow, just one little bit at a time, only the little bit that you feel okay to say. And as you speak it out loud one bit at a time, keep checking with yourself. And and stop and take plenty of breaths. Because even if you're really comfortable your therapist anyway, this is the best way to talk about the trauma without retraumatising yourself is by very small little bits and pieces. Not the whole thing at once.
Hannah Witton
Yeah, okay. Yeah, that makes a lot of sense. Because I guess just kind of being like, "And this is what happened." and just kind of like laying it all out might be a bit intense of a first session.
Silva Neves
Yes, and sometimes it's too intense. And then people can start to relive it, relive the trauma rather than explaining it. So it's really important to really again, take plenty of time. And just one little bit at a time.
Hannah Witton
Okay, yeah. So this question is a bit different. Someone asked how to deal with disturbing, gross, distressing, intrusive thoughts during sex?
Silva Neves
Well, that's a good - that's, that's a good one. If it's intrusive, as in it's really stopping that person from having sex, then it's just to look at what are those thoughts there for? What are they trying to - what is the function of those thoughts, what they are trying to say, because sometimes it could be linked to, to link to a belief about sex, for example, some people think semen is gross. And so then they might just have that gross thought in their mind. And the other times, it could be that it's something to do with thinking that they think it's gross, but actually, it might be a turn on. Like, for example, they might just think, I don't know, "Feet are gross in normal life. But in the sexual context, I kind of quite like it." But the brain hasn't really quite managed to think of, "Oh, I'm not in a not in a living room context, I'm in the bedroom context, I'm in a erotic context and something can be different." So sometimes it could be something like this. A lot of the time it could be about shame about thinking sex is gross because that's what they were raised to be to be like that.
But other times some people have intrusive thoughts that can be really quite distressing, for example. So it's like, "I'm a paedophile" or so it's like," I'm a rapist", or "I'm doing - I'm harming my partner." And those thoughts can sometimes come in the sexual area, and it can be really, really distressing because of course, nobody wants to think of themselves as a rapist while have sex with their partner, or as a paedophile. And those thoughts are usually something to do with what we call extreme fear or acute fear, because sometimes our brain takes us to the worst possible scenario that you can think of yourself. And of course, if people think of themselves as paedophiles and rapists, that will be like the worst that can possibly be. And sometimes it reflects that there is an anxiety but it does not mean at all that you have tendencies to be a rapist or paedophile. It is just an acute fear as the worst thing that could be. So that is best to address with a therapist that is specialised in OCD, actually, because those thoughts are classified as as compulsive-obsessive part of this. It's not just behaviour, sometimes you can have obsessive compulsive thoughts.
Hannah Witton
Thoughts. Yeah, okay. Yeah, that makes sense. And actually, I had a kind of, like, final question, which is about how - because not everyone can access therapy or like a really specialised sex therapist. And so what is something that you would want to kind of like, impart to our listeners as a therapist, in terms of like this? I don't know. There's a lot of pressure on this question, I'm now realising. But like probably the vast majority of people listening probably aren't in any kind of sex therapy. But what advice would you want to give to people?
Silva Neves
I think my best advice would be to continue to expose themselves to sex-positive content, like your podcast, for example, is, is fantastic. And there are lots of other people like sex educators and sex therapist that do their own podcast as well. They put some fantastic content on Instagram, or on other social media platforms. There are some people that have published some sex positive books that are really, really good. Look at them, expose yourself to them, keep learning about it, because the more you learn about the right and accurate information about sex positivity, and what sexuality is, and the diversity of sexual behaviours, and turn-on, and all of that, the more you will be able to understand a bit more your erotic mind and the less you're likely to feel shame about your own turn-ons, or your own behaviours. So that will be my first advice if you can't afford therapy, or if you don't want to go to therapy.
Hannah Witton
Yeah. And you also, like, have Instagram as well and post a lot of stuff on there too. And I guess, by kind of like exposing yourself to a lot of that kind of information either through like, social media content, or books, or podcasts or whatever it is. It like helps to normalise things, but it's also like equipping you with, like you said, the correct information, because there is so much misinformation out there about sex and relationships, and even just kind of like we were saying about sex addiction, just in terms of like the pervasive messages that are culturally dominant in our society, and how we just kind of we hear them and we just accept that that is how sexuality works. And that's how, how people are. But yeah, by exposing yourself to, to more of like, the current understandings of these things can definitely just really help because I feel like so much of it is just kind of like telling people that they're normal.
Silva Neves
Yeah, absolutely. It is, isn't it? And earlier you used the term red flags. And I think that's important too. And that will be my second advice actually, is, if you hear anybody, whether it's a therapist, or a professional, people with long letters after their names, or anybody on social media, or any books that you read, that sounds really black and white, like, healthy, unhealthy, good, bad, wrong, whatever, you know, be, you know, learn to put a red flag on that. Because sexuality is never right, wrong, good, bad. It's not binary like that. It's not black and white. Because everybody is so different. So if you hear anyone that says "Porn is bad, sex is wrong, sex work is bad," you know, all that that kind of stuff that is really quite prevalent, put a red flag and to say, "That's somebody's opinion. It's not facts."
Hannah Witton
That's so true. Well, Silva, thank you so much for joining me and explaining all of this stuff and answering our questions. Where can people find more of your work online, and also your book?
Silva Neves
Yes, I've got a website that's silvaneves.co.uk. That's my website for my clinical services. But I also have another website called sexpositivityuk.com. And that has some information and some resources for sex positivity, and for the good sex education information out there. So those are the works that you can follow. If you want to contact me directly you can find my details on my website. And I also have a book on compulsive sexual behaviour that's been published by Routledge and you can find that on Amazon.
Hannah Witton
Amazing. Well, thank you so much. And thank you all for listening. Bye.
Silva Neves
Thank you!