Huit questions sur l’addiction sexuelle (Dr KARILA) – PSYCHE #11

Hi psychonauts Among the many and wonderful mechanisms that have been forged over millennia to ensure survival many species – including ours – there is pleasure and displeasure Two sensations that accompany a lot of situations and a lot of different behaviors

The general idea is simple: we find pleasure in the activities essential to our survival, that of our peers or that of our species For example, we eat when we are hungry, we drink when we are thirsty and we have sex when well actually

anytime! In the same way we feel displeasure in potentially dangerous situations For example: pain reminds us to pay attention to where we put our feet The fear, that we must be wary of our environment

And disgust, that we must not eat anything A super well-oiled machinery especially at the brain level with, among others the famous "reward system" on which we will return soon A machine that has served us well in the history of our species So our special appetite for sugar and fat helped us a lot because it was probably very rare commodities in the hostile environments we used to survey hundreds of thousands of years ago But today, in our affluent societies, the difference is big

This is what evolutionary psychologists call an "adaptive shift" or "evolutionary mismatch" You probably know that since you just watched the great video of Leo No ? And bin follow the link The That one That one In 2016, in developed countries, sugar and fat are ubiquitous and, above all, very accessible Which probably explains why, in the world today, the number of overweight people is much higher than the number of people malnourished And what about sex then? Just an example In 2009 a team of Montreal researchers attempted to study the effects of pornography on representations of sexuality among young men in their twenties

And they could not do their study Why ? Bah because they failed to create control group They failed to create a group of young men who had never watched pornography! That's it, here it is Overabundance of "stuff" that storms our reward system can turn some people's heads around and this is called addiction

So it may seem a little strange to introduce the subject of addiction with sexual addiction, but we thought that it would please the last subscribers who joined us after watching the last video of Leo And to do this, Chris went to meet one of the specialists of the issue, Laurent Karila The gentleman is a psychiatrist AND addictologist co-chair of the scientific committee of the association SOS addictions, researcher at INSERM but also author, columnist on the Hard Force website uh it's a magazine that talks about music huh! and lyricist of an opera-rock Listen to Metal is good for health !!!! In short, we like it Addiction is a term a little has been We must now focus on "addiction" and "addiction"

But I want to say addiction What is addiction? It's a bit of a special terminology, it's After the addiction it is a clinical entity addiction is a set of symptoms during a certain time of consumption with repeated consumption withdrawal syndrome a phenomenon of tolerance, physiological dependence You have lost time you have consequences on social life etc

Sex addiction is an addiction like with a substance but here the sexual behavior that becomes addictive So you use sex as a drug And if you use sex as a drug it's the same definition Which means you will have repeated sexual behaviors obsessing thoughts at the sexual level you will have an irresistible urge to consume sex You'll have a waste of time, a loss of money and consequences: in the physical consequences the main are related to STIs and STDs At the psychological level, depression, anxiety essentially And the social consequences concern the couple, family life and work You will find beautiful clinical cases of sexual addiction by watching these 3 movies Steve McQueen's Shame Don Jon from and with Joseph Gordon-Levitt and Nymphomaniac by Lars Von Trier But we have a slight preference for Shame, magnificent and melancholy You see in Shame there are two important things You see this loss of control where at one point, – it's unlike paraphilias you do not have sexually centered behavior like voyeurism, exhibitionism all you want – you have a guy who will consume nonstop sex At one point he goes completely into a spin he totally loses control It's incredible ! And there is another thing that we see well too is that he can not make love to a woman when there are feelings in the story You have no pleasure in addictions

You have no pleasure You struggle against suffering It is true that at the beginning when you consume, it's to have fun

But at one point BAM! it explodes you consume sex as a medicine in fact Because there are many clinical forms You have different clinical forms of sexual addictions The two most common is compulsive masturbation it's a masturbation without control in fact Even if masturbating is great, huh, that's not the problem but compulsively masturbating is NON STOP! This is often associated with cyber pornographic addiction You hang out on X sites streaming all the time! After you have other shapes, like compulsive seduction, you have people who will flirt with you all the time who do not act It's full of prey and it is increased by some internet dating sites in particular And you also have the consumption of sex priced in unlimited I think the internet is a factor – it's a great tool – but it is an aggravating factor for those who are vulnerable to the problem Everything is unlimited! Porn streaming is free You can see everything you want You have dating sites

You have the chats You have the webcams It's non stop, you can stay there without stopping I see patients taped hours and hours on the web The reward system it is a system common to all addictions But it is also the basic system we have in the natural rewards: Eating, drinking and making love are natural rewards

With sexual addictions you turn the circuit of "making love" and in addictions to drugs and bin drugs will borrow this circuit with a final dopaminergic response Depending on the different addictions you have different neuromediators that are activities or not The ratio is five men for a woman but I think it's underestimated The girls start to come in for consultation

It feels like 60 years ago with the alcohol problem in women You see ? There is a lot of shame, guilt in women but we will see him in consultation For me, and I say it in my last book, it is that female sexuality is very little different from male sexuality Yes it is healing

Fortunately !! I started a program in 2008 of sexual addictions It was based on the American model It's a program mainly focused on behavioral therapy basic There is no pharmacological treatment to the AMM for sexual addiction but we note anxious and depressive comorbidities that you have to screen early and treat

Serotoninergic antidepressants can be used off-label to decrease the sexual compulsion It works, it acts a little on the libido And then you have a whole program next It is also a multimodal program A psychologist intervenes for a more thorough work that CBT We also do a physiological assessment Must see also that some men There are stories of desire disorders, erectile dysfunction We still have to evaluate them on the physical plane The program lasts one year

basic with different steps The main goal is not sex abstinence – it's impossible – but find pleasure, to re-acquire new social repertoires It is an equivalent of controlled consumption Some patients do not want but in any case, they experienced pleasure before the problem it is to find that pleasure again! The idea is, yes, patients suffer And the patients too, they suffer So we (the word "normal" I hate this word) So everyone has his repertoire Everyone reacts as he reacts I help them not to suffer anymore like – I'm a psychiatrist – like all psychiatrists In 2008, I released a book with my former boss Michel Reynaud called "We only think about it" And this at the same time that I went up this consultation of sex addicts And I became interested more and more to the sexual life of our patients psy addicts You see it was an integral part of my treatment and care Whatever the problem

I met Brigitte Lahaie I worked a lot with her And then, I leave a book called "Your pleasure belongs to you" It's a guide to sexuality 20 a little 30 with a little all that is recent in sexuality I talk about sexual addiction in women And then some aspects of pleasure, how to boost etc With a very masculine part and a very feminine part I wrote it alone but in collaboration, we will say in proofreading by a Parisian journalist called Christine Mateus

So this is the third album of Satan Jokers that I did with them and that's called Sex Opera with text by Renaud Hantson – Renaud Hantson who is a "neuro-mirror" is called like that in fact we are our "neuro-mirrors" – With Renaud we decided to make concepts and the first concept is substance addictions The second concept was psychiatric illnesses it was a very "zarbitical" thing And the latest album that we released on the 200th anniversary of the death of the Marquis de Sade it's Sex Opera This is the story of a sex addict It's really rock opera "rock" a little metal what That is to say, there are many participants of the Metal scene It's a story of sexual addiction

Many thanks to Laurent Karila for agreeing to answer our questions As you can imagine, this first episode is an introduction to addictions There will be others We'll talk about a lot of other topics related to addictions whether it's the neuroscientific aspects or that it is more specific addictions on certain substances or certain behavioral addictions So stay tuned

Do not hesitate to follow us on the social networks Facebook and Twitter, to subscribe if it's not already done, to share the video to let us know is what helps us the most! And if you feel like it, do not hesitate to financially support the channel Know that in July we will organize a very special event never seen on the French YouTube to our knowledge I do not tell you more for the moment But if you follow us on social networks we will soon put your mouth watering See you soon


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