174 – Misconceptions about Sexual Compulsivity

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Dr. Sandra Morgan and Dave Stachowiak talk to Dr. Sibylle Georgianna about sexual compulsivity and discuss common misconceptions.

Key Points

  • Even if there is a lack of consensus on how to define problematic behaviors, sexual compulsion needs to be taken seriously.
  • Even if free will exists, the complexity of the impact on (drug induced) addiction on women’s’ sexuality cannot be underestimated. The presence of an addiction impairs decision making (including the ability to consent).
  • Even if problematic behaviors stop, a comprehensive treatment and multi-faceted level of support to replace addictive behaviors with long-term, holistic health is needed.
  • Underdeveloped decision making, information processing, and lack of emotional maturity (including trauma bonding) are likely in individuals affected by trauma and addiction.


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Dave: [00:00:00] You’re listening to the Ending Human Trafficking podcast. This is episode number 174. Dr. Sibylle Georgianna Misconceptions About Sexual Compulsivity.

Production Credits: [00:00:11] Produced by Innovate Learning, maximizing human potential.

Dave: [00:00:31] Welcome to the Ending Human Trafficking podcast. My name is Dave Stachowiak.

Sandie: [00:00:37] And my name is Sandie Morgan.

Dave: [00:00:39] And this is the show where we empower you to study the issues, be a voice, and make a difference in ending human trafficking. Sandie, one of the great assets I believe that we have at the Global Center for Women and Justice, is the academic work and research that’s so much a part of us being integrated highly into the higher education institution at Vanguard University. And of course, a big part of our work is studying the issues. And I’m so glad today that we have a guest who’s an expert in studying these issues that will really help us to also get some really new perspective on something I don’t think we’ve talked about much before.

Sandie: [00:01:25] Absolutely. So, I’ll let you take it away and introduce her.

Dave: [00:01:28] I’m pleased to welcome to the show today Dr. Sibylle Georgianna. She is a clinical psychologist and the founder of The Leadership Practice and its affiliates sexual health of Orange County California. As a certified sex therapist, certified sex addiction therapists, certified clinical partner specialist, and certified EMDR therapist, Sibylle is treating teens and adults experiencing sexual difficulties and compulsions. She is also an assistant faculty of Vanguard University of Southern California, where she teaches and oversees the graduate research programs of Vanguard’s masters of organizational psychology students supposed research and publications are focusing on self-regulation and self-leadership. She enjoys her family surfing and Southern California’s weather. We’re so glad to welcome you to the show, Sibylle.

Sibylle: [00:02:09] Thank you for having me. The weather, I had to put that in the description.

Sandie: [00:02:14] Yeah, well and I know you know you come from an area in Europe where it’s much colder, right?

Sibylle: [00:02:20] Yes, I grew up in Germany and went to school there and it was very much like the northern and north-west coasts here in the United States. So, I appreciate any little bit of sunshine that we can get here.

Sandie: [00:02:32] Well, for me it’s been such a delight to get to know you this year and I’m so glad you’re at Vanguard. And you spoke it Ensure Justice where we began a conversation that I hadn’t really studied a lot before. And what I understood was that we in our communities often have a lot of misperceptions about sexual compulsivity and if anybody is listening and you missed Ensure Justice, we’ll put a link to the recordings and you can hear Dr. Georgianna and many others by clicking on that link.

Sandie: [00:03:11] But let’s jump into this, and look at just a few of these perceptions that we have and talk about those. So, the first one is that sexual addiction and compulsivity does not exist. So, talk to us about that. Dr. Georgianna.

Sibylle: [00:03:30] Yes and I appreciate to share on this because we don’t really have guidelines that are fully accepted in the medical community in the psychiatric community. And they are just listed as a condition to explore further and need more research. And at the same time, we know that individuals that are being studied using brain scans for describing sexual compulsivity to the providers coming in, that they have a very similar brain as to cocaine addiction that we see in addicted individual’s brains. So, the complexity, even if we don’t have clear guidelines yet, that are embraced in the treatment community. However, we see that there is physical evidence that nowadays technology can provide. We do hope that this physical evidence will be used to then also supports a clear diagnosis and something that is being embraced as a viable diagnosis in the medical community.

Sandie: [00:29:20] OK. And I think it’s important for some of our listeners with a professional background, to understand that part of that is taken from the DSM4 so that we understand that we’re talking about classifications that are tracked and recognized across the psychological, intellectual community so to speak. And because you are so precise, I made really a lot of notes so that I can be equally as precise. I admire your attention to detail. You’re one of the most accomplished research professors on this subject that I’ve ever met. And so, when you were speaking at Ensure Justice, one of the misconceptions that you addressed is that sex work is a choice that women consent to it and can make a lot of money. And that was really a departure from your normal language, but it captured the attention of so many people who were attending Ensure Justice. Can you speak to that and why that’s not true?

Sibylle: [00:30:16] Thank you for that background. I think what is so difficult in this conversation, is that we do have some medical information, and we have some studies and surveys, and then we have information that for instance, everybody can basically broadcast through social media. And that piece of the misperception, that this is something that people choose. And there are really no strings attached, apart from generating an income source, is really reflected more on what we see in let’s say, YouTube videos, and what is so commonly portrayed in the media or social media. However, if we really would then have a survey assess interview really go in-depth with the person who may have presented themselves in the social media. That way, we may see that in reality, there is a very high risk for post-traumatic stress and that we don’t know the intricate power struggles that the person may face in their set up that let them choose this line of generating any [00:31:09] comment. [0.3]

Sibylle: [00:31:09] We see endless studies that a lot of times it comes as the little bit through the back door. So, it’s very enticing thing maybe to receive a gift, in exchange for being with somebody and then it goes into something that can supplement needed income. You live in an area where there is a lot of basically the cost of living is very high and schooling is very expensive. And so, it’s not necessary. It could be a byproduct of what we’re dealing with in the society. And at the same time how this is being described in the media, is in a very glorified way, that it’s not really representing the reality and the mental health or physical health that a lot of times is associated, unfortunately, with that type of sexual behavior.

Sandie: [00:31:46] It’s really interesting. Our last guest on episode number 173 was Harmony Dust. What she said was that “choice without options isn’t really a choice.”.

Sibylle: [00:31:57] Yes. And I would really highly recommend you look at her testimony. She is really an amazing example of how she turned this situation where she was affected, and that prompted her to go into this type of outlet that she can empower women. And so yes, I think that is like a fantastic example of how you know it’s over-glorifying it. You know we go into this [00:32:19] fear [1.0] thinking that it would be a real solution to the difficulties that are being experienced. And you know in many of these individuals, who are going into this line of financial support, and then, however, there are ways and more resources out of this. But we as consumers of social media are still affected by what we see. And you know how basically it may be a funded advertisement to give a certain message, that this is a choice, that this is something where you know people can find a lucrative way to sustain themselves.

Sandie: [00:32:50] Well in that section when you were at Ensure Justice, you connected substance abuse, drugs with the complexity of this issue.

Sibylle: [00:32:59] Yes. And still, unfortunately, we see and we do not know what comes first. We can understand that if people have people already who are in very hard circumstances, where maybe drugs were introduced in order to really decrease the stress response from the trauma, then the drugs would be something that’s first and then the use of sexuality could be an added piece in order to get to the drugs for consumption. Or to be the other way where we see that, unfortunately again, with individuals with sexual compulsivity they also report higher use of other substances. And then basically those two substances basically activate our brains reward center and can really cause that addictive damage to the brain. They can interact and kind of feed into each other, and therefore makes it a more complex situation to attend to. And even as a service provider to be aware of this type of screening, or even treatment recommendations that need to address multiple of these addiction tracks and need to be part of the aftercare program.

Sandie: [00:34:00] So are we using the word “addiction” and “compulsivity” as synonyms?

Sibylle: [00:34:05] Well, thank you for that. So, the compulsivity is a lot of understood part of like what we would see in OCD, some kind of compulsive pattern. It’s not defined as addiction potential. Now, whether or not we use addiction as a word, it means that there has been this effort that we wanted to stop, that doesn’t work, we need to consume more. There are the typical criteria that can be mapped. Now people use that interchangeably. I usually don’t start talking about addiction really when we see that there is a sudden loss of control and addiction related to [00:34:39] European man. [0.8] But what this animal of what we’re dealing with, with the sexuality and these other outlets, substances, emotions, and even how we use technology and our fast-paced world; they all can have this kind of compulsive nature to it, if we leave it unattended, can then really truly move to the level of an addiction pattern in the brain. Thank you for that.

Sandie: [00:35:01] Oh, that’s so interesting. So, the addiction is a lack of control, and the compulsivity there is some sort of control attempt?

Sibylle: [00:35:11] So let’s say it’s basically as if we talk about it phenomenon from very different perspectives. So, with an addiction, the World Health Organization says a progressive brain disease that may even cause premature death. And then at the same time, some of the pieces that we see in the compulsivity run on the same pathways in the brain. The difficulty is to stop the thing, we think we just do one thing, and if we do this one thing, then we’ll be safe, then we would be good. And I think they can go into an addictive pattern, where there’s a loss of control and the brain wanting more and more to produce the same results. But let’s say how the researchers and sometimes even the medical community looks at it, is that compulsivity sometimes can be looked at more as a thing with impulse control but not necessarily having the severe impact as a progressive brain disease and behaves defined by the World Health Organization. So, the people will have different lenses on the same topic. But the severity of this, whether we call it compulsivity or we let it move into an addiction pattern, the severity of the impact of the brain a lot of times, we underestimate because we may not see it. Or we may see some changes that are very positive, but we are not fully aware that there may be severe brain chemistry that we still need to attend to. And even if we move individuals into a safe housing facility or if we see people decrease their substance use, there may be still other pieces we need to attend to, to really move people into health.

Sandie: [00:36:43] And that’s kind of where you went next. You talked about the absence of old acting out compulsive addictive behaviors that we think mean “OK they’re no longer at risk” but that’s not true, right?

Sibylle: [00:36:58] Yes, unfortunately, the brain wants to be always outsmarting us a little bit by saying “well you know if we don’t get it through the sexuality and maybe the physiological release that comes with that. You know we could just go into something else, maybe something where we move into a different kind of unhealthy relationship. Where the brain doesn’t necessarily give us a ‘feel good’ feeling but the brain gets the same amount of pressure in the reward center.” Or it may move into a withholding pattern. So, the interesting thing is whether we do too much or too little to the brain, it can make the reward center go into a happy mode. And so even by not showing certain behaviors, which would be withheld, we can get a brain [00:37:37] hurt. [0.1] And so the brain is still not healthy, it’s still not in moderation, it’s still maybe under stress or posttraumatic stress. And so, we still want to attend to these residual pieces that we may think “oh they are abstaining now, it’s all done.” When in reality, it may be part of that suppressing component, that would also give the brain that happy feeling in the reward center activation.

Sandie: [00:37:59] So you describe that as a moving target during this lecture. And I was really concerned that I wouldn’t as a normal, everyday advocate and engaging with survivors especially- I wouldn’t be able to recognize and respond appropriately to someone escaping that kind of behavior.

Sibylle: [00:38:21] That is a very good comment because we’re so focused on providing the level of physiological safety and health. And so, I think the awareness that there could be more like having an assessment that may potentially ask these very difficult questions around sexuality. And that doesn’t necessarily mean that the person who assesses needs to be the one then also helping the person with treatment. But they are specialists or they could be even continuing education on this being received. But at the same time, sometimes even in the set of services, if there wasn’t a place to have recommendations and then potentially maybe even considering having some workshops on these different components so that the providers know OK this is something that they could experience with a client coming in and with the victim that they’re supporting. But it could be also something that maybe the caseworker sees, six months down the road, or the person in the safe housing facility notices. So, it’s as if we want to give as much information as possible to our team of support, so that support when it’s needed, that it’s somehow also accessible and that we don’t feel we need to have it all attended to in the first part of the treatment. But maybe that some of this need to be attended to over the course of the work that we do.

Sandie: [00:39:36] So, very clearly this is a complex issue and requires expertise and you have provided some resources to help us figure that out, right?

Sibylle: [00:39:50] Yes. So, there are first of all that [00:39:53] matures [0.4] through the Ensure Justice conference where there’s just sometimes the information and going there that’s one way to receive it. But I do host, I call them Thrive Workshops, in which individuals can call in. And that’s really more around [00:40:04] socket [0.4] education on what compulsivity looks like. But even for this next year, we would have the show notes where we could put a very simple screening tool that was developed from a substance abuse background. It’s called the PATHOS, where we’re looking at just six to seven questions, but it can be very easily identified if there is a potential for sexual compulsivity present. So that the provider can, and this is something that will be in the show notes as I understand that correctly.

Sandie: [00:40:31] Yes, we’ll do that.

Sibylle: [00:40:32] Get that through the website. So that basically we can right from the get go say “oh you know maybe there is something out that we need to attend to.” Basically, the focus of this is really to build that port for the providers that we know. We can pick up the phone and say OK, or we can go to a workshop and attend, or we can invite somebody in to provide more pyscho-education on this matter. As we are not alone in supporting the people we work with and we work for.

Sandie: [00:46:23] And that was really an important piece for me because I felt a little overwhelmed, but knowing that I have access to a tool that will give me some guidance kind of helps me process some of the other issues that you raised. And in my world, where you remember I’m from a pediatric nursing background, I’ve always been concerned with how our culture helps a young girl or a boy under the age of 18, but when they reach 18 there is this sense that they’re at the age of majority and they can be held accountable for their actions. But you saw that as kind of a misconception, in terms of this area of addiction and compulsivity.

Sibylle: [00:47:00] Yes. And I think the difficult piece is that we all live in a world that is governed by laws and regulations to really protect us and be at our best as a society, and at the same time with that, then comes the responsibility of the two. Then as we are of some age, it is then implied that we have that full capacity to be aware and to operate within the legal boundaries. And I do think that with today’s complex world, and then even the social media side of technology set up, that we don’t really see a consequence necessarily for our actions. It really makes the part of us that grows up, and that is then able to make good choices and be bound to good decisions. It’s as if it’s not yet fully developed. It could stunt the development of this piece.

Sibylle: [00:47:41] And so it has good reasoning that knows that there’s going to be consequences for our actions. And so, we may deal with, apart from individuals affected by horrible circumstances where we know that brain development is not as mature as a healthy individual. We [00:47:56] meet a decent view [1.1] with these parts in our current environment, where we are not trained enough to say, “okay with what I post there is a legal consequence or could be a legal consequence.” So that basically we go into this whole adulthood maybe potentially a little bit underprepared, then when things were all face to face with real tangible consequences.

Sandie: [00:48:16] In more simple terms then, we’re saying that this person’s brain development has not prepared them to make good decisions to process information the same way that you and I do. And they actually are way behind in emotional maturity, right?

Sibylle: [00:48:32] Yes, that could be. And I know that in the [00:48:34] Aimin [0.3] Clinic they do a lot of research on bringing rehabilitation. And that there are strategies we can even give the person with the more developing brain so that this maturity can be nurtured and grown. And it’s as if we put our brain on an exercise task. But also, I think that’s why that community of support is so vital with a person who doesn’t have these resources maybe, to begin with, somebody you know that’s to be the one who sets up a pathway to health. And so, I do think that looking at the individual, it’s not just the biological health and biological age.

Sandie: [00:49:06] I love that new term, I’m going to add it to my vocabulary. Putting myself on a brain pathway, how did you say that?

Sibylle: [00:49:14] Oh, it was more like an exercise.

Sandie: [00:49:16] Yes, oh that’s great.

Sibylle: [00:49:16] If you go and exercise a brain and we don’t really think about it like that.

Sandie: [00:49:19] So I’m really excited because the light just came on because a lot of the terminology talking about social media from the beginning of this conversation it is connected to this, because we make decisions to go on and click. And we have to develop new exercises for our brain to not click because that chronic overstimulation actually works against our healing and restoration. So somehow, I’m thinking there’s a link here especially to pornography. And can you give us a 1-minute answer to that huge question? I know I’m asking the impossible.

Sibylle: [00:49:55] So let’s think about that, how we can make that in one minute. So, in let’s say the use of technology, in that way a lot of times in the sex addiction terminology the intimacy disorder behavior that goes with that potentially addictive sexuality is a lack of intimacy skills. Now the technology, they called it the “big accelerator,” it’s the triple engine because when we are online by how it is set up to porn sites. Or even just in general, how technology interacts with the brain is that it provides to the brain this illusion that anything we are facing, the technology has an answer because we can browse, you could switch, there are more things that pop up. And that is such a silent hold on the brain, that if it answers all of our unrequited wishes it is the solution to all of our problems, our grievance. And so that’s why the technology is such an attractive distraction to the brain. And then with pornography, it also activates our hormones and our physiological arousal response, and that makes that impact even stronger. So, I don’t know where I’m going with this in 60 seconds. So that’s potentially one of these engines that makes it too hard to disengage from.

Sandie: [00:50:58] That’s really helpful for me, so I hope it is for our listeners. And we’re going to put show links in here because everything here is so in-depth. The last thing that you addressed, and I just want to leave people with hope for what this looks like in professional training. The misperception was that helping professionals work individually and what we really need to see is a village or team approach.

Sibylle: [00:51:22] Yes, and I do think that what kept me being in this field is that I noticed that as a specialist, you enter a network of other providers in that field. So, for example, the International Institute for Trauma and Addiction professionals offer the training to help establish recovery tasks if it is at that level of an addiction that we see with individual’s sexuality. Also, there is an association of the partners of sex addicts and they are also having a very trauma-informed approach so that the family as well can be supported. And then with the [00:51:53] you are [0.8] which is the international association that helps systematically decrease the trauma load that many of the clients bring in. And again, it’s this notion that we need each other as a provider because we can’t all be treating everybody ourselves, and we may give them the support system that we can partner. And we could say, “OK we have individuals who do more psycho-education or we see people working specifically with children or with minors.” So, I think that gives me the hope to stay on this topic because I know I am not alone. But also, the more we share between different types of service providers, emergency response teams, and other valuable organizations that we have in the community, the more we can decrease the individual’s overwhelmed or are otherwise facing by doing this important work. And I think that being the best advocate to our own brain activity, is the best gift we can give to the people that we work with, that we are staying as healthy as possible.

[00:52:47] I am going to work on my brain health, Dr. Georgianna for sure. And we’re going to put links to your website. People can reach out to you through your website. We’re going to put a link to the free resource assessment tool that you’ve given us. Wow. I’m going to have to listen to this podcast about three times, to get everything down. This was so rich and you’ve introduced new terms, new ways for us to think about how we’re doing our work in ending the exploitation through human trafficking and in our society. And I just want to thank you so much and we’ll look forward to future conversations.

Sibylle: [00:53:24] Thank you. And I’m so honored that you invited me on. And if there are any other resources and even as you said you could reach out through the website and the main website is theleadershippractice.biz. So, I’m grateful that you put everything in there, so if I can support you further I would be honored.

Sandie: [47750:28:43] Thank you.

Dave: [47750:28:43] Sandie and Sibylle, I mean one of the things that I think is such an opportunity but also a challenge, when folks are coming into this conversation about ending human trafficking is all of the things there are to learn. So, Sandie, I have two calls to action for our listeners today. First of all, to visit the show notes for all of the resources that Sibylle has provided to us so much there specifically on this topic, if you want to really dive in deep. That said, you may be coming to this conversation for the very first time, maybe this is the first or second episode you’ve listened to. And if that is you, I’m also inviting you to take the very first step. If you hop online, you have the opportunity to download a copy of Sandie’s book The Five Things You Must Know, A Quick Start Guide to Ending Human Trafficking. It’s going to teach you the five critical things that Sandie has identified in her research and the research through the center that you should know before you join the fight against human trafficking. You can get access to that guy by visiting endinghumantrafficking.org. If you go there that will give you access right on the front page there. And if you have a question about today’s conversation or maybe you’d like to know a bit more or are seeking some additional resources, send us an e-mail feedback at endinghumantrafficking.org. That’s the best way to reach us. And we’ll see if we can do our best to respond on a future episode. Sandie, always a pleasure and we’ll be back again in two weeks for our next conversation.

Sandie: [47750:30:00] Thanks, Dave.

Dave: [47750:30:00] Thanks, everyone. See you again in two weeks. Take care.

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