Last week, a colleague consulted with me on a challenging case in which his client cannot enjoy sex unless he is engaged in smoking. The client, who also struggles with obsessive-compulsive disorder (OCD), specifically cites the feeling of being addicted to nicotine as the most arousing aspect of this behavior. In other words, he is aroused by addiction.

In trying to make sense of this, I think the first thing to understand is the role that this person’s OCD plays in his everyday experience of life. Many would argue that OCD is some sort of inborn disruption of the neurochemicals in the brain, and maybe there’s some truth to that in some cases, but the first things that I look at are the themes of anxiety and control. Specifically, how do this person’s obsessions and compulsions help him to gain a greater sense of control over his anxiety?  In my experience, an individual experiencing either obsessions (incessant thoughts) or compulsions (incessant behaviors) inevitably uses either or both of these as strategies to manage and control anxiety. Unfortunately, they often only serve the purpose of making the anxiety worse.

Often, other people will categorize those who suffer with OCD as “anal” or “control freaks,” but this controlling behavior can best be understood as an antidote to the overwhelming feeling of anxiety that these folks experience on a regular basis. The constant ruminating (obsessional thinking) and ritualized behaviors (compulsions) can come across as overly controlled, but this is the only way that these folks have learned to defend against constant and intense anxiety.

This is where I think the addiction piece comes in. For my colleague’s client, feeling like he was addicted was the only way he could let go enough to experience and enjoy arousal. In many ways, an addict is the opposite of the hyper-vigilant control freak. The addict is out-of-control and helpless, a victim of his addiction. He has given up his self-control, personal agency, and autonomy to the addiction. No more need to hold it all together so that he doesn’t come apart at the seams. No more need for the obsessive thinking. And no more need for those ritualized compulsions. He has relinquished control to the addiction.

I think this aspect of addiction holds the key to understanding why it is so arousing for this individual. He has found the only way in his life that he can just relax and “let go.” And letting go is essential for sexual pleasure. For more on this, feel free to check out my previous article on the psychosexual aspects of letting go.  By combining the out-of-control sense that comes with being an addict to his sexual experience, then and only then is he finally able to relax enough to experience arousal. In this way, this client has actually found an elegant solution to his difficulties, albeit with negative consequences. Helping him to expand his sexual repertoire will require him to drill down deeper to understand the root of his anxieties so that he no longer needs to defend himself with obsessions and compulsive behavior. Then the magic allure of addiction will no longer hold sway on him, as he will no longer depend on it as an antidote to his obsessive and compulsive need for control.