SM: Why is there such a strong link between childhood sexual abuse and sex addiction later on in life?
Pinksy: The extraordinary thing about the human being is that experiences that are overwhelming and terrifying in childhood become very attractive and compulsively so after puberty. Freud used to call it repetition compulsion, where people re-enact the traumas of their past. This is why most strippers and prostitutes have a sexual abuse history. They’re really re-enacting the trauma over and over again.

SM: What is the mindset of an addict?
Pinsky: Here’s what they’re thinking: I want to get high. I want to use, I want to have sex. That’s what they’re thinking, period. Literally the brain’s survival systems become tricked in this disease, where the ongoing behavior becomes synonymous with survival and not caving to the behavior is synonymous with suicide. So the brain feels like it’s committing suicide when it tries not to do these things.

SM: What affect has the Internet, and Internet porn, had on sex addiction?
Pinsky: It’s like crack. It’s brought people into it that might not have manifested the disease had it not been [for] this readily available stimulus. It is increasing the incidents. It’s like having a stronger drug more readily available.