In the alternative reward-reinforcement model of addiction, which uses neuropsychological concepts to characterize addictions, sexual addictions are identifiable and well-characterized.
Specifically, sexual activity is an intrinsic reward that has been shown to act as a positive reinforcer, strongly activate the reward system, and induce the accumulation of ΔFos B in part of the striatum (specifically, the nucleus accumbens).
It's a life of justifications, covering up, pretending. I could hear my husband open our front door as I prepped dinner in the kitchen. The coldness in his words, the preoccupation behind his eyes, the sound of his struggling lungs whistling as I try to sleep next to him.
There was simply a phone call from a receptionist: Dropped from care. It's upholding my promise to love him through sickness — except this particular sickness is one of denial, deception, and manipulation. It's mentally preparing his funeral and how I'll explain his death to our son.
So he went to the streets, which is where so many addicts go when their prescription is yanked from their hands. It's searching the self-help bookshelves for some kind of insight or support, wondering why no one saw the "strong" wife quickly deteriorating. It's finally reaching out to a few close friends, then his family, and feeling a cathartic release.
ΔFos B is the most significant gene transcription factor involved in addiction, since its viral or genetic overexpression in the nucleus accumbens is necessary and sufficient for most of the neural adaptations and plasticity that occur; Research on the interaction between natural and drug rewards suggests that psychostimulants and sexual reward possess cross-sensitization effects and act on common biomolecular mechanisms of addiction-related neuroplasticity which are mediated through ΔFos B.
The American Psychiatric Association (APA) publishes and periodically updates the Diagnostic and Statistical Manual of Mental Disorders (DSM), a widely recognized compendium of mental health diagnostics.
(That age was nine.) Not like my husband would have been honest, of course, because addicts aren't honest with anyone, especially themselves. It's trying to love away the hate he feels toward himself, to ease the self-inflicted shame and guilt he carries around, as if it's my duty.
When signs of my husband's dependence became obvious to the doctor — and to several doctors afterward — there was no acknowledgment, no understanding, no effort to help a man struggling with a coping strategy that turned self-destructive. It's faithfully being there for someone who repeatedly hurts me, even if it's not with his hands or his words.
Because of this experience, I understand forgiveness. As of today, I hope that we make it through, but I just can't be sure.
I know without a shred of doubt that I'll be a better, stronger, smarter woman because I once loved a man who had an addiction, and my life unraveled.
He limps into the room: skinnier, snifflier, dead in the eyes. I actually thought he might be coming back to me after a near-death scare, a promise to get clean, a few sessions on a therapist's couch, but it's all back again.