Male Vulnerability to Out-of-Control Sexual Behavior

men, OCSB, SASH, Michael Crocker
Michael Crocker social worker, researcher and professor.

The majority of individuals who experience out of control sexual behavior are men.  Why?  This question is complex as is the answer.  The ecological model of clinical social work (Pardeck, 1988) provides a frame in which we can understand the contributing factors that have resulted in men’s vulnerability to out-of-control sexual behavior (OCSB).  This model provides a frame that includes social, cultural, familial and intrapsychic factors that result in a phenomenon and it is particularly useful in understanding men and OCSB.

Over 30 years ago, Haviland and Maletesta (1981) looked at the differences between male and female infants and their emotional expressiveness.  In their review of 12 infant studies, they found that male infants often displayed more emotional reactivity, tended to cry and be startled more often, and that their emotions changed more rapidly than did those of female infants.  Olesker (1990) found that male infants show a slower achievement of emotional stability than did females, are more invested in the outside, material world, and show less inner processing.  According to Levant (1997), males are more emotional in infancy; however, there is a reversal by the age of 2, which he believes occurs due to a socialization process that is supported both by parents and by society at large.

Olesker (1990) stated that boys had less awareness of maternal separation and often did not display as much clinging behavior as did girls.  She noted that boys often turn to the object world to cope with their anxiety, whereas girls turn to their caretakers to help assuage their distress.  According to Pollack (1998), this process continues into adulthood and leaves men more apt to cope alone rather than turn to others.  He referred to this as defensive autonomy, which he believed was a result of the early emphatic separation from their maternal caretaker that left men with a continued yearning for closeness that simultaneously threatened their autonomy.  This notion is in keeping with Pleck’s (1981) theory of a gender-role strain that posits that, when men conform to the male role, for which the embracing of feelings is scorned, it results in a disconnection from their feelings and needs.

Fonagy, Gergely, and Target (2008) noted that the infant’s ability to reflect on feelings and cognitions is directly related to the caretaker’s ability to understand his or her own history with his or her own parents.  Further, the ability to mentalize and reflect is directly linked to secure attachment and competence in affect regulation.  Insecure attachment often leads to defensive functioning and affect dysregulation.  These theories all have relevance to an understanding of the etiology of OCSB.  Studies have shown that those with OCSB often present with insecure attachment (Crocker, 2013, Gilliland, 2015, Zaph, 2008).

Goodman (1998) hypothesized that alexithymia is related to OCSB.  The term alexithymia was developed by Sifneos (1967), who observed individuals with psychosomatic complaints and felt that the complaints were related to their difficulties in recognizing, naming, and verbalizing their feeling states.  Sifneos believed that alexithymic individuals with psychosomatic complaints typically experienced their feelings as bodily states rather than as identifiable emotional states and that these individuals lost the benefit of having identifiable emotions that could be used to direct their thinking and actions.  Sifneos observed that this alexithymic condition often was accompanied by impairments in self-care, object relations, empathy, and affect regulation.  Goodman felt that individuals with OCSB also presented with alexithymia.  He believed that these individuals often did not know what they were feeling and often experienced their feeling states in their bodies and, as such, were prone to use bodily action to address them.

Levant (1990, 1997a, 1997b) theorized that there is a normative male alexithymia due to familial and social processes.  He theorized that this male-patterned alexithymia results in an impaired ability to put feelings into words and, instead, an inclination to act out feelings.  He noted that one acting-out strategy is nonrelational sex.  Similar to Goodman (1998), Levant believes that men may use sex to address myriad feeling states, including sadness, fear, and anger.  In support of this ideology, Katehakis (2016) has theorized that OCSB is an affect regulation disorder directly related to early attachment trauma.

More recent research indicates that biological factors, specifically testosterone, may cause male vulnerability to OCSB (Alexander & Saenz, 2010), yet not due to the assumed idea of a high sex drive, but actually increases in affect dysregulation.  Alexander and Saenz found that male infants with high testosterone levels showed lower levels of frustration tolerance as well as externalizing behaviors, which is often seen in OCSB (Goodman, 1998).

Testosterone appears to impact the amygdala, the region of the brain often associated with emotional reactivity.  Both Ledoux (1998) and Goleman (1995) refer to the amygdala activation as “emotional hijacking,” stating that this activation can hijack an individual’s ability to be reasonable and logical.  Hamann, Herman, Nolan, and Wallen (2004) found that, when presented with visual sexual stimuli, men experienced more activity in the amygdala than did women.

All these issues help to explain the speculated higher prevalence of OCSB in men and why men may corner the market on OCSB.  With this in mind we must think creatively about how to treat men that are struggling with these behaviors.  It is essential to take into account that many men may struggle with the typical therapeutic question of “how does that make you feel?”.  Not only may they not be able to answer the question but they could also feel shame about the fact that they have no idea how they feel.  As clinicians we need to take this into account and find ways to help our male clients find their feelings.  As noted men often experience their feelings in their bodies without the necessary process of mentalization and for this reason run the risk of turning to bodily means to address the feeling state.  If we can help these men locate the feeling states in their body and begin to help them describe their experience then we can help them move towards reflective function.  This approach needs to address both somatic and emotional literacy (Linden, 1994, Goleman, 1995).  With men we often have to start with their bodies.  If we help men find words to describe what they are experiencing in their bodies we can move them towards increased emotional intelligence.  As emotional intelligence is improved, our clients start to be able to describe their feeling states in nuanced ways, which includes blends of emotional experience.

As attachment theorists have noted, increase in reflective function provides an additional interpersonal benefit.  In increasing reflective function and mentalization in our male clients we improve their ability to understand another person’s subjectivity.  In the couples we treat it is often a challenge to help our male clients to have empathy and compassion for their partners.  This is directly related to emotional literacy.  The more our clients understand their own emotionality the more they will understand the emotional experience of others.  Helping men understand their feelings also helps them to know and understand the feelings of others.  They are able to identify in themselves and in others hurt, sadness, anger, fear, joy and all the derivatives that come along with these emotional states.  In helping men to know their feeling, we help them to be relational and most importantly we help them to connect both to themselves and others.  Lastly, we help these men to understand that in knowing what they feel they will then begin to know what they need.  Through this process we help men to honor their feelings and to care for themselves and others.  In short, we help them to love.

Michael M. Crocker, DSW, LCSW, MA is the founder and Director of the Sexuality, Attachment & Trauma Project in New York City. He is an expert on sexual addiction, trauma, and attachment disorder.  As an advocate for children Dr. Crocker serves as a State Education Department Approved Trainer on Child Abuse Identification and Reporting. For more information about Dr. Crocker visit or email him at mmcrockercsw{at}


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