Mindfulness is Negatively Related to Compulsive Sexual Behavior in Adults Undergoing Substance Abuse Treatment
By John M. de Castro, Ph.D.
“Stress contributes to many sex problems. Mindfulness helps by reducing stress.” – Michael Castleman
Sexual behavior is a very important aspect of human behavior, especially for reproduction. In fact, Sigmund Freud made it a centerpiece of his psychodynamic theory. At its best, it is the glue that holds families and relationships together. But it is a common source of dysfunction and psychosocial problems. Compulsive sexual behavior “encompasses problems with preoccupation with thoughts surrounding sexual behavior, loss of control over sexual behavior, disturbances in relationships due to sexual behavior, and disturbances in affect (e.g., shame) due to sexual behavior.” It is also called sex addiction and hypersexuality. It is chronic and remarkably common affecting 3% to 17% of the population. In addition, it is associated with substance abuse in around half of people with compulsive sexual behavior.
Compulsive sexual behavior is frequently treated with psychotherapy, cognitive behavioral, therapy, or drugs with mixed success. Since, it is also looked at as an addiction and mindfulness treatment has been found to be effective for both sexual dysfunction and for addictions, mindfulness may be affective for individuals with both substance abuse and compulsive sexual behavior. Indeed, mindfulness has been shown to be related to compulsive sexual behavior in men undergoing treatment for substance abuse. This suggests that further study of the relationship between mindfulness and compulsive sexual behavior with men and women should be investigated.
In today’s Research News article “Exploring Gender Differences in the Relationship between Dispositional Mindfulness and Compulsive Sexual Behavior among Adults in Residential Substance Use Treatment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884324/) Brem and colleagues examined the records for patients admitted into residential substance abuse treatment facilities. The completed measures of alcohol use and problems, drug use and problems, and psychiatric symptomology. Mindfulness was measured over 5 domains: acting with awareness, observation of experience, describing with words, non-judging of inner experience, and non-reactivity to inner experience). Compulsive sexual behavior was measured over five domains: preoccupation, loss of control, affect disturbance, relationship disturbance, and internet problems.
They found that high levels of mindfulness facets were associated with low levels of compulsive sexual behavior. But the relationships differed between men and women. In particular, for men, the mindfulness facets of acting with awareness, nonjudging of inner experience, describing with words, and non-reactivity to inner experience were significantly negatively related to compulsive sexual behavior, while for women for men, the mindfulness facets of acting with awareness, nonjudging of inner experience were significantly negatively related to compulsive sexual behavior. For both men and women alcohol use and problems, drug use and problems, and depression were positively related to compulsive sexual behavior.
These results are interesting but correlational, so caution must be exercised in reaching conclusions regarding causation. But they do suggest that for men describing with words, and non-reactivity to inner experience are more important than for women in being related to compulsive sexual behavior.
This further suggests that compulsive sexual behavior occurs predominantly without real time awareness and hence mindfulness may be an important antidote to compulsive sexual behavior. But what facets of mindfulness are most important differs between the genders. So, in developing therapeutic programs for the treatment of substance abuse disorders, mindfulness training programs might be tailored differently for men and women.
So, mindfulness is negatively related to compulsive sexual behavior in adults undergoing substance abuse treatment.
“findings tentatively support the usefulness of mindfulness in the effective treatment of sex addiction. In addition to helping bring about a reduction in dysfunctional sex-related actions, fantasies and thoughts, mindfulness training may help affected individuals gain improved emotional control, an increased ability to handle stressful situations and improved resistance to any potentially damaging sex-related urges that arise.” – The Ranch
CMCS – Center for Mindfulness and Contemplative Studies
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Brem, M. J., Shorey, R. C., Anderson, S., & Stuart, G. L. (2019). Exploring Gender Differences in the Relationship between Dispositional Mindfulness and Compulsive Sexual Behavior among Adults in Residential Substance Use Treatment. Mindfulness, 10(8), 1592–1602. https://doi.org/10.1007/s12671-019-01117-7
Compulsive sexual behavior (CSB) is overrepresented among adults with substance use disorders (SUD), yet there is no empirically supported CSB treatment for this population. Cross-sectional and single case designs supported dispositional mindfulness as a potential CSB intervention target. However, the relations between CSB and each of the five dispositional mindfulness facets remain unknown.
Extending prior research to inform intervention efforts, we reviewed medical records for 1993 adults (77.6% male) in residential treatment for SUD to examine gender differences in the relations between dispositional mindfulness facets (acting with awareness, observation of experience, describing with words, non-judging of inner experience, and non-reactivity to inner experience) and five CSB indicators (loss of control, relationship disturbance, preoccupation, affect disturbance, and internet problems).
For men, path analyses revealed that acting with awareness, nonjudging of inner experience, describing with words, non-reactivity to inner experience, alcohol/drug use and problems, and depression and anxiety symptoms related to CSB (p range: .00-.04). For women, acting with awareness, non-judging of inner experience, alcohol/drug use and problems, and depression symptoms related to several CSB indicators (p range: .00-.04).
Mindfulness-based CSB interventions should evaluate the benefit of increasing intentional responses towards present-moment experiences among adults with SUD. Targeting alcohol/drug misuse, negative affect, and judgement towards thoughts and emotions may be beneficial.