To speak, to remain silent or to decide when to cross a street, for example, the brain has a type of brakes that help modulate behaviors. It is cognitive control, a brain process that is usually altered in pathologies as diverse as Parkinson’s or addictions. The neuroscientist Ignacio Obeso (Pamplona, 40 years old) investigates this and other basic cognitive processes, such as the automation of processes and habits – how we learn something and it becomes habitual – in healthy brains to unravel what is behind some of the neurological ailments. and more complex psychiatric disorders: “In both Parkinson’s disease and addictions, cognitive control and habits are relevant because they are altered. We try to understand how these mechanisms fail in addictions and new toxic habits are generated,” explains this researcher from the Cajal International Neuroscience Center of the Higher Council for Scientific Research (CINC-CSIC).
Obeso, who works in the Control and Habit Laboratory, has participated in the joint congress held by the Spanish Society of Dual Pathology and the World Association of Dual Pathology a few weeks ago in Palma. In his presentation, he delved into the neurobiology of sex addiction, a health problem on the rise: according to the data he presented in his speech, between 3% and 10% of the world’s population suffers. this painting. And more and more cases are being diagnosed. In the Adcom unit of Madrid where it collaborates, a center of the Community of Madrid located in the Gregorio Marañón Hospital and dedicated to prevention, treatment and research in gambling disorders and other behavioral addictions, has treated 622 people in its first year in operation: The minors treated were, above all, for problematic use of video games or social networks, although 2.8% expressed problems with sex; In adults, sex addiction is the second most common reason for consultation (only behind gambling problems).
Ask. When does the practice of sex go from being a pleasurable habit to something toxic?
Answer. Every human being has active sexual behavior from a certain age, sooner or later, with a greater or lesser intensity depending on the individual and that is conditioned genetically, contextually, by education… Someone who is at a higher intensity than one’s own, can It may seem like an addiction, but maybe it’s healthy. And what is healthy? That can be controllable. If it is lower for me, but I don’t control it, that is going to be, in my case, a problem because I don’t know how to stop and, furthermore, it impacts my mental and physical condition and my work and social environment.
Q. He has said that the incidence is between 3% and 10% of the population. How is that interpreted?
R. Its alot. They are very high values. And it is becoming more and more recognized. Behavioral addictions are recently recognized and people did not know they had this problem. Even if you are a man and are very sexually active, you even receive pats on the back. But now it is clearer that it could be a problem and the numbers are rising because more are being detected.
Q. What are the warning signs to identify that there is a risky practice?
R. A very obvious one is that daily and constantly, during the 16 hours that you are awake, you are thinking about sex, whether with pornography, with your partner, whether shopping, at work… This happens in the most serious cases. If we go to something a little less serious, then it is the frequency: it is not all day, but I do have that desire every day. And then, there are negative effects of the disease, such as being anxious if you don’t get sex or masturbation. These negative effects on mood, such as irritability, can be another marker.
Q. Are there different patterns by age?
R. In the experience at the Adcom unit in Madrid, the patterns are quite varied. They are usually men and the older ones, 40 or 50 years old, have somewhat special paraphilias, very particular for each person. The sensations, although this is not very scientific, is that the older you are, the more radical or far-fetched and serious the situations are. In younger people, what worries us most is the use of pornography so prematurely—there are cases of cases as early as seven years old!—. This has very serious consequences and then they become violent because of the early use of something that is now super accessible.
Q. How exactly does early access to pornography affect the development of these types of behaviors?
R. We don’t know, but a teenager who starts with pornography receives sexual education that is very out of touch with reality. The reality of voluntary partner sex on both sides is not related to pornography. It is known that this early use explains the violence that increases in adolescence. And then it has repercussions on their intimate sexual life as a couple, showing less interest in the usual sexual act, being less successful and intense. There are no longitudinal studies that look at what happens to children who started earlier in the long term. [con la pornografía] and what about sex and the quality of your sex life, but it’s surely going to be creepy. It will have an impact, not towards a sex addiction as such, in person, as a couple or in a group; but an individual addiction to pornography. Perhaps in a few years we will see more incidence of this type of sex addictions on-lineindividual.
Q. What goes wrong in the brain of someone who has a sex addiction?
R. Several things happen. The most common thing is to see sex addicts with other psychiatric disorders. It is rare that there is someone who is just addicted to sex without anxiety, depression or bipolar disorder involved. But at a neurobiological level, sexual stimulation produces a very ancient response from the limbic system of the brain, which happens in all of us. But by repeating it, this already enters a learning system, a system of habits that will make this search for sexual stimulation excessively repeated. And if you don’t achieve it, other limbic systems with negative aspects begin to enter, such as the feeling of anxiety, among others. It is that limbic system that dominates and hijacks all the cognitive control processes that normally act at the moment when you say: “Now I want to stop” or “I wait so many hours before having sex.”
Q. How is this addiction solved?
R. The underlying pathology is treated. Anxiety or depression is treated with drugs and combined with individual or group psychotherapy. And it works well for 70% of patients.
“A teenager who starts with pornography receives sexual education that is very out of touch with reality.”
Q. What is the quality of life of the patients?
R. They are people who suffer a lot. The bass is around 10%, but there are others that more or less manage. Of the treatments that work, then there is the long-term effect and that is that there are relapses, because as we know, sex does not disappear, sex is within us, it is innate to our species.
Q. For many addictions they usually propose abstinence. And in this case?
R. For these you can’t. Sex is in our genetics and that’s where the story ends. There are people who are anhedonic and are apathetic about sex and have no desires, but almost all of us have a desire intrinsic to our species. With sex, you can’t say, “Don’t touch it.” Maybe with pornography yes and that’s why the two types [adicción a la pornografía y adicción al sexo presencial] You have to see them separately. But with in-person hypersexuality we will have to see if there is a temporary window in which we block it for a while and then gradually integrate it into the person’s life.
Q. What are the big gaps in knowledge on the topic of sex addiction?
R. First, know the origin of the pathology. One variable is genetics, which is somewhat known, but could help us determine where it comes from. Second, deciphering the pathophysiology, what the brain bases are, are not so clear: we know that dopamine is related to all these addictions, but in sexuality, is it at the moment in which you think about the sexual stimulus that it is triggered or Is it when they consume it or continuously? We believe that it is more in the anticipatory moment, but which regions and circuits of the brain we are not at all clear about. Knowing this, the next step that opens us up is to see where the circuit is pathological and there we could attack.
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