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. Ordinary sex with a girlfriend holds no interest for me.”
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to ward off chronic feelings of loneliness, inadequacy and emptiness born of a childhood trying to get nurturing from a withdrawn, depressed mother.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 perceives to be intolerable as well as a way of stabilizing a crumbling sense of self-worth. It is my belief that sex addiction requires a contemporary psychoanalytic approach. Psychoanalysis changed drastically in the 1970’s with the work of a prominent