Sex Addictions And Brain Changes–Which Came First?


Although I have not been able to find any serious research papers on frontal lobe volume loss in sex addicts, there are more than enough ‘professional opinions’ out there that claim that sex addicts exhibit the same changes in their brains as other addicts. So, this article will assume that this is true simply for argument sake and because indications, such as their personality behaviors, lead me to believe that it is probably so.

In 2002, a study on cocaine addiction demonstrated measurable volume loss in several areas of the brain, including the frontal lobes, in cocaine addicts.[1] Another study was published in 2004 on methamphetamine, with very similar findings. [2]

I will try not to be too technical, but a significant segment of the neuro scientific community seem to be in agreement that addictions create, in addition to chemical changes in the brain, anatomical and pathological changes which result in various manifestations of cerebral dysfunction collectively labeled hypofrontal syndromes.

Hypofrontal syndromes cause anatomical and functional changes to the frontal cortex of the brain. These changes are popularly thought to be responsible for certain abnormal behaviors in addicts, as well as in trauma and stroke victims who have suffered brain damage. These behaviors include a lack of empathy, compulsive and impulsive behaviors and an inability to consider the consequences of behaviors.

Similar findings have been seen with the abuse of normal biological behaviors such as eating, leading to addiction and obesity. In 2006, a study was published looking specifically at obesity and the results were very similar to the cocaine and methamphetamine studies. [3] The obesity study demonstrated multiple areas of volume loss, particularly in the frontal lobes, areas associated with judgment and control. This study is significant in demonstrating visible damage in a natural endogenous addiction, as opposed to an exogenous drug addiction.

These obesity studies have been used to explain frontal lobe volume loss and loss of functionality in sex addicts. Anecdotal brain studies of sex addicts claim to have shown these same changes in the brains of sex addicts that occur in drug addicts and in so called food addicts.

The media tends to hype, over simplify and morph these findings into absolutes when it comes to sex addiction. Most want to put the cart before the horse and claim that exposure to porn or compulsive sexual activities cause the changes in the brain. This is somehow supposed to explain why sex addicts can’t help what they do.

My opinion is that the brains of these so called sex addicts were abnormal to begin with.

Here’s just one example of why I believe that addicts of all types are born not made.

Anyone who knows me could say that I am ‘addicted’ to the pleasures of creative projects. Emotions flood my body whenever I engage in something creative, especially if it is a new skill. I love that feeling of success and I seek ways to feel it over and over. I am truly a right brain creative junkie. My self talk is very positive, I say to myself, ‘Wow JoAnn, that is a great picture you just painted’, or ‘what an exquisite curtain panel you have sewn’, or, ‘what a clever article you just wrote’ or ‘wow, that’s a blazing fast computer you just built’.

So, do you think my frontal cortex is shrinking because I hyper stimulate certain pathways or that I habitually create activities to stimulate a dopamine surge?

I bet not. And the reason I think not is because I do not have any issues with impulsivity or compulsivity. I am empathetic and I have no trouble considering consequences before my actions. My creative activities do not supercede normal functioning.

Everyone responds to pleasures with a flood of chemicals to our brains. Our brains are lighting up and firing away constantly. We all like to feel good and we tend to repeat things that make us feel good.

But, not everyone allows these pleasurable activities to get out of control. Not everyone who watches porn winds up a porn junkie. Not everyone who ran wild sexually in college, smoked pot for months straight, drank gallons of scotch or even binged on cocaine becomes addicted.

So, what is the difference? It has been theorized that there are so called ‘addictive personalities’,  and I believe that is true (I just don’t like the word addict). But why? Why do some take the low road to addiction while others simply go on with their lives leaving their wild days behind? Is it really a ‘personality’ thing or is it possible that there is a physical cause?

Recently there have been numerous studies that show that the brains of ADHD children are significantly different from children who do not have ADHD. Because these studies have been done on young children the conclusion is that their brain anomalies are responsible for their behaviors, not the other way around.

Can this be true of people who cannot seem to control their sexual behaviors? Brain scans of sex addicts, in fact, of all addicts, do show significant differences from normal brains. Popular opinion wants to blame the changes on the addiction. It seems strange to me that no one has hypothesized that the brain abnormalities may have always been there and the behaviors are because of the abnormalities.

Another curious finding is that there seems to be a link between sex addiction and adult ADHD. I did a survey on my website asking the partners of sex addicts if the sex addicts had been diagnosed with ADHD. Of the current 2,000+ respondents, 54% said the sex addicts were diagnosed with ADHD, 27% said they thought they were but did not have an official diagnosis and only 19% said no.

This is quite a significant finding and the assumption (and it is only an assumption until proven) would be that every single sex addict who has ADHD also has physical and functional brain abnormalities.

Now, it is true that exposure to what does not occur in nature can become a repeatedly sought after behavior. Millions of potential sex partners (as in porn) and excessive amounts of fat, sugar and salt that are abundant in fast foods do not occur anywhere in nature. It has been proven that these excesses produce certain neurological changes in the brain, causing those who are exposed to these excesses to crave them. Some would call it an addiction. I call it a habit.

But, as far as I know, habitually partaking in porn or big macs or funnel cakes has not been shown to cause the brain abnormalities that have been found in adult addicts. Again, this leads me to believe that addiction does not cause the brain abnormalities, but the abnormal brain can cause the addictive behaviors.

We do not have the luxury of any brain scan research on sex addicts when they were children. Research is conducted after the fact and then the assumption is made that the addiction caused the changes in the brain. But, is it possible that these people we call sex addicts were born with these brain abnormalities? And, could these brain abnormalities be the cause of their behaviors?

I have found studies done with children who are diagnosed with ADHD quite interesting. Brain scans of these children show very similar brain abnormalities that are shown in scans of adult drug addicts. And, people with ADHD do have a much higher incidence of addictive and anti social behaviors as well as co morbid personality disorders

So, my question to the medical community that is researching addictions, and specifically sex addiction is, ‘Which came first’? Do sex addicts show changes in brain anatomy and function because of their sexual activities, or, are their brain abnormalities responsible for their behaviors? Has anyone ever seen a normal brain lose volume in the frontal lobe after a patient has started compulsive sexual or drug use behaviors?

Which really did come first?

Either way the sad part of the story is that these so called sex addicts are not getting the proper treatment for their problems. 12 step programs, soft, non accountable type counseling to improve their self esteem, marriage counseling that assumes complicity, outrageously expensive intensives with no validated outcomes and other treatment modalities that focus on changing a behavior that may be caused by brain abnormalities can never work.

The personality disorders that we see in these individuals (sex addicts) I believe are also a result of these brain abnormalities.

I would love to see researchers conduct brain scans of anyone who is diagnosed with a Personality Disorder or sex addiction. I believe that just that simple, non invasive test just might reveal a clue as to why these men (and women) cannot control their impulses and continue to engage in behaviors that ruin their personal and professional lives.

Unfortunately, even if that were the case, and we discovered that sex addicts are born not made, what do we do with that knowledge? There is no cure, but possibly the problem could be managed in some way in order to allow at least a few of those afflicted to lead a somewhat normal life.


  1. Franklin TR, Acton PD, Maldjian JA, Gray JD, Croft JR, Dackis CA, et al. Decreased gray matter concentration in the insular, orbitofrontal, cingulate, and temporal cortices of cocaine patients. Biol Psychiatry. 2002;51:134–42.[PubMed]
  2. Thompson PM, Hayashi KM, Simon SL, Geaga JA, Hong MS, Sui Y, et al. Structural abnormalities in the brains of human subjects who use methamphetamines. J Neurosci. 2004;24:6028–36. [PubMed]
  3. Pannacciulli N, Del Parigi A, Chen K, Le DS, Reiman EM, Tataranni PA. Brain abnormalities in human obesity: A voxel-based                      morphometrystudy.Neuroimage. 2006;311:1419–25. [PubMed]

9 thoughts on “Sex Addictions And Brain Changes–Which Came First?”

  1. I am very interested in research on the brain.
    I have heard opposing theories on the brain and addiction.
    IN most alcohol focused treatment programs, the theory has always been that the brain was changed by the addiction. There are specific research studies that document such change. I have listened to many presentations by psychiatrists specialized in addiction who even claim that once the addict stops using, it takes TWO YEARS for the brain to repair itself – as well as it will be able to repair itself.
    I have also recently listened to a presentation (I will get this guy’s name) who event stated:
    “Addicts are NOT coming from homes that have any more dysfunction, abuse, addiction, than any other family. The addict, though, chooses a “story” about their life and they fixate on that story, and they turn it into a victim story that proves that they have suffered more than others, and the story is the excuse for using. When they change that story, they change their excuse to use.”

    On the other hand, I have been reading research about early infant, early childhood abuse and neglect that stops normal development of the child’s brain. The child enters a state of “agitation,” a “fight or flight” position with permanently inflated adrenalin, etc., and they are not able to self-soothe, not able to calm. The limbic brain does not develop fully enough to integrate core identity with attachment, attunement, etc.
    These children are likely to begin isolating, and use masturbation to pleasure themselves.

    I have been interested in this topic because I have a daughter with a traumatic brain injury and in order for me to understand some very confusing personality changes, and some of her struggles to understand what may be happening socially around her, I had to study.
    Now, with sex addiction, I am curious. IF addicts were neglected as children, I can tell you that MY CHILDREN WERE NOT NEGLECTED. I was attentive, I did not believe babies should ever be left to cry, I focused on soft, calming attunement, I mirrored, I did everything right. I did NOT KNOW these developmental needs when they were born and young children, but intuitively, I knew that they were content and calm. THEN, I remembered that I had thrown out a dirty blanket once, and became worried that perhaps it was an object replacement for one of my children. I asked a psychiatrist and he laughed and laughed and laughed at me. He said: “YOU did absolutely NOTHING that would ever create any issues stemming from neglect. An occasional mess up just does not count.”
    BUT, I have two sons who struggle with alcohol addiction. They were nurtured, rocked, fed, kept dry, cooed at, mirrored, encouraged to explore, create, I smiled, sang songs, we colored, we went for walks in the park…
    BUT, they are not sex addicts, and perhaps that is the big difference in the neglect/abuse theory for sex addicts. OR, do they confabulate their “sexual abuse” stories as they become more and more entrenched in their addiction? I have not been told many details at this time, but my husband has recently “remembered” being sexually molested as a child, and other horrifying types of abuse, but his brother and sister say “no way,” and his mother is horrified. Are they in denial? A few times I have had the gut feeling that he is now so souped up from so many years of doping sex that he has fantasized all of it.
    Psychologists say that my sons struggle with alcohol because they carry the gene that will trigger alcoholism if you drink. They tell me that about 50% of alcoholics have the genetic link, BUT ONLY ALCOHOLICS carry such a gene–that no other addiction has any genetic link. SO, for my sons, I could have been PERFECT, and still, they are prone to alcoholism.
    I am tending to believe that the sex addict has fucked up his brain. In the 18 years since we married, I have seen profound brain /cognition changes in my husband. In the past 4 years, in particular, and increasingly now, I am often STUNNED by his slowed cognition, his haziness, his distorted logic. I do not know anymore if he keeps repeating lines to manipulate others, OR if he believes them himself, and has actually become delusional, a type of psychosis.
    Right now, I am thinking many generally accepted ideas in psychology.

    Today, in fact, I thought that the idea of “codependent” has always deeply annoyed me. I have read some studies on domestic violence that show that women who are being abused has the same ratio of defined codependents than the general population. I told my therapist that the idea of “codpendent” was absurd to me. I said that a codependent is a woman whose husband did something to fuck up. BUT, the woman next door, who is MORE codependent, is NOT codependent, but a “great wife” because her husband is a good guy – he didn’t fuck up. IF he fucks up now, THEN she will be told to stop doing his laundry.
    Abusers, in fact, tend to prefer seeking strong women, and being in relationships with strong women, because they like to usurp her identity, and then slowly diminish hers.
    Strong women tend to be MORE damaged in abusive relationships, some studies show, BECAUSE they believe they can “handle it,” and they stay longer.

    Today I wondered about why psychologist assume that women who are relationships with abusive men (sex addicts ARE abusive men), are “codependent,” have issues, etc. Why are they so traumatized? So damaged? So sad? Hurt?

    I began to wonder if they haven’t gotten it all entirely backwards.
    For example, I end up feeling really pissed and hurt because I KNOW I DESERVE TO BE LOVED, A LOT. I am pissed that a many “acted” as if he loved me! Many other men would have given me love. I gave my husband lots of love! His deceit deprived me of love and the opportunity for a good relationship.
    Instead of the theory that “like attracts like,” perhaps it’s really the opposite.
    OR it’s simply random. But when women are abused, when they wake up and discover one day that they have been betrayed, PERHAPS it is because they are HEALTHY, have healthy attachment and healthy attunement – and it never occurred to them that others do not have such human traits. So, they are devastated. Angry. Sad.

    Women who were abused, women who were neglected, women who felt unloved, would perhaps not expect to be treated well.
    EVEN the idea about women fantasizing about the “prince” husband who will rescue them. Really?
    IF I am angry because now I lose my home, was I expecting a magical, fairy tale life and prince/husband? My neighbor is not losing her house, her marriage is intact, did she have realistic expectations for marriage?

    NO. These are all just random ideas that some person thinks about – perhaps it applied to that person, and some others. Suddenly, it becomes a model. It becomes a theory. It becomes the program the partner of a sex addict is supposed to work!

    I have been asked, for example, ten times (THREE by the sexist treatment center), if I am doing my “family of origin” work.
    WHY? I am not a sex addict. My father was not a sex addict? I was never sexually molested. No incest. It’s very easy to begin assigning “types” when one does “family of origin” work, and soon everything is squeezed into the model. And then, that’s your story.
    I tell those who ask, YES, I did my “family of origin” work THIRTY YEARS AGO. Do you think that my family of origin changed since then?
    I don’t need “family of origin” work! I NEED truth. And sending partners off to do “family of origin” work is akin to the entire idea that codependents were told they had problems: “to get them out of the way.”

    So, brain research may not show us ultimately anything more than these theories show us. What was the sex addict’s brain like before he was a sex addict? Who has THAT research?

  2. Although I definitely understand the brain changes and dopamine ( getting high from the behavior) effect, I am struggling with the willfulness aspect of this so called addiction. In other words I think there is a truly deliberate,willful side to this addiction. and that is why I feel so betrayed and traumatized.

  3. Of course it is a choice Laura, they are not raving loonies or crazed, out of control maniacs.

    Yes, they may be influenced by their brain chemistry, but so are all of us. I get an overwhelmingly ecstatic feeling looking at a sunrise, but I don’t ruin my life by running all over the world seeking the absolute perfect sunrise (although that does sound like fun). Some people are able to control their impulses and some choose not to. I think it’s a complex alphabet soup of genetics, environment, immaturity, lousy coping skills and learned behaviors that have allowed them to get away with bad behaviors all of their lives.

    No matter what causes it or what we call it, it is unacceptable in my life and should be in anyone’s life.

    As for the research, there is none. Brain imaging technology was not around when most of our husbands were young. The closest we have are some new studies on autistic children. They are finding that the brain anomolies found in these children have been there since birth.

    If you want to jump to conclusions, that would probably mean that most Sex Addicts are born, not made. But, it could also be that there must be an environmental trigger to cause the behaviors.

    As I have said many times, no matter what you call it it these guys just do not make good relationship material.

  4. My husband comes from a home that was morbidly emotionally repressed. I believe that he was severely deprived of emotional support….. I am certain he needed to self sooth as an infant. I cried once in front of his mother and she literally just stared at me in silence. She had no idea how to respond at all. My husband does not trust me and came to me unable to trust any one under any circumstance and he knew how to hide this reality. He has since admitted that this is something he is trying to come to terms with, though he still does not know why he doesn’t trust and he swears there was zero abuse in his childhood.

  5. i found this to be extremely interesting!! My husband is a sex addict that has 6 children with 3 different women. He has twin 15 year old boys that have had many issues growing up. I initially thought they were both autistic but recently 1 twin was diagnosed with Asperger’s & borderline intellectual functioning (mental retardation). Their uncle (moms brother) is mentally retarded as well. When they were both 12-13 years old, 1 twin started stealing my underwear (dad is a cross dresser) & I caught the other twin masturbating on my couch trying to entice my dog into helping him (Dad also has a disturbing history of beastiality). The twins live with their mom & we only see them on weekends that hubby is home (he works 2 weeks on & 2 weeks off). Sounds genetic to me!! At the same time it scares me to death for the 2 boys that we have together.

  6. I know, now after researching and finding out as much as is available, as well as history of his childhood behavior and now tested, without a doubt that it was the dopamine deficit in my husband’s undiagnosed Adult CD ADHD (Conduct Disorder). The brain was the primary problem. NOT the excuse. He had symptoms all his life. His family of origin up bringing and covert emotional abuse, as well as getting beat for poor performance affected him deeply psychologically. The macho male objectification of women was encouraged & the example he grew up with. Finding his father’s porn at a young age. He inherited ADD from his father, who displays symptoms. I asked him to test for ADHD through the years. He didn’t have the attention enough to finish it. It used to be a joke. But we never knew how serious and devistating this is. It is reported to worsen with age and get out of control without treatment. Lack of impulse control, cumpulsive behavior, risk seeking, pleasure seeking, the (lack of) dopamine in his brain, inability to empathize, not considering consequences, low attention span, etc. Yet highly educated, intelligent, kind hearted, driven and a visionary entrepreneur. His CD ADHD personality disorders spiraled out of control. Yes, he knew what his morals were, and he chose to act out. Defiantly. Simply never an excuse. But I guess that made it that much easier to become addicted to sex, gambling, and then abusing alcohol to drowned his guilt. That being said, still not an excuse for the lies and scheming, the betrayal and the trauma this put me through. He lost his mind! Lost control! Sad really. So much to struggle with and so much devastation. The healing is consuming. What we must do now is be sure to help and warn our (adult) children. I think it is a lethal combustible combination of nature and nurture.

  7. Amazing stuff! Absolutely amazing! It reminds of the “super-male” information I learned at university. Biologically, men are XY and women XX, but a very tiny group are born XXY or XYY. Little biological misprints termed Super-Female or Super-Male. The way the story went in class many years ago is that a legal case had been taken on behalf of a guy in prison for some kind of violent/sexually aggressive crime with the caveat that the client was an XYY –a super male– and therefore could not be held accountable for his socially abnormal behaviour. The case-stopper was the fact other ‘super-males;’ were NOT similarly involved in violent/sexually aggressive crimes.
    If anyone is going to travel the world to look for the best sunsets and/or sunrises, can I go too?

  8. The biggest sign of addiction, whether drugs, alcohol, sex, gambling, whatever, is that you do run around destroying your life to get your next fix. That’s the difference between addict brain and non addict brain. We don’t destroy.

  9. Fabulous article, JoAnn. I am a scientist and researcher by nature and in all of my own research on the subject I have to say I agree with you completely.

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