The internet and its role in the escalation of sexually compulsive behaviour

As increasing numbers of patients present with problems of compulsive use of internet sex and internet pornography, psychotherapists are challenged to develop models that address the powerful, and potentially disturbing effect of this stimulus. Internet sex does not just facilitate access to sexual materials but can act as a catalyst, affecting established defences and ego and superego functioning. Escalation in sexually compulsive behaviour, which affects a small proportion of those accessing online sex, may be thought of as a series of transitions: from casual to compulsive use, from compulsive use to illegal use, and from use of illegal pornography to contact offending. Drawing on clinical experience and the available research evidence, psychodynamic processes associated with movement through these transitions are considered. Internet sex has the potential to fuel manic defences, invites narcissistic and part-object relating, provides a vehicle for the expression and disowning of sadistic impulses and can potentially undermine superego functioning. The combined effect of these processes may lead to a breakdown of ego controls in vulnerable individuals.