Consequences of sexual behaviors

What happens in sex is not simply sex. The consequences are numerous, positive and negative, and occur in all areas of life: health, relationships, occupation, and sense of self. It is central to any behavioral understanding of sexual activity, therefore, to enumerate the multiple consequences of sexual behaviors, especially those that have developed into a problematic pattern. Some of the consequences reinforce the behavior, exerting an influence that predisposes the individual to repeat the behavior. Increased sense of self-worth and gender identity, sensual and orgasmic pleasure, and the experience of creating the same results for one’s partner are examples of consequences that become the antecedents of subsequent sexual experiences. The sexual behavior will probably be repeated based on the positive or reinforcing consequences that the individual attributes to the behavior.

Other possible consequences—sexually transmitted disease, loss of spouse and family, loss of job, incarceration—if the individuals is made conscious of them, will serve to inhibit the sexual behavior.

The “consequential antecedents” of future sexual behaviors—those consequences that become the antecedents of subsequent behaviors— may be based in reality, such as intimate love between two caring partners, or they may be the embellished product of fantasy. For example, the sense of self and mastery that is experienced by a man who hires a prostitute and then sadistically terrorizes her during sex is not based in reality. The terror and the sadism are real, but the ego inflation that is gratifying to him is not the product of developmental maturity in interpersonal relationships. It is the fruit of paraphilic and antisocial deception— deception of the tragic prostitute and ultimately deception of himself.

In a lighter vein, the New Yorker cartoon that shows a dog working at a computer keyboard, with the caption, “On the Internet, nobody knows you’re a dog,” captures the deception of self and others that occurs in sexual chat rooms on the Internet. In chat rooms, participants become sexually aroused by the sexual fantasy their activity fosters, rather than by a real-life encounter with another human being with all his or her physical and emotional limitations.

It would be a mistake, however, to think of sexual fantasy as “not real” and therefore not a powerful consequence and antecedent of sexual behavior. Sexual fantasy is as real as imagination and cognition are real. As such, it is very much a determinant of future sexual behavior. The distinction between reality-based and fantasy-based consequences is that the former occur in the interpersonal life of the individual while the latter occur primarily in the head of the individual. It is the task of therapy to repeatedly delineate this distinction. The individual who is blurring the distinction will resist mightily, because to admit the difference is to “lose” the ego-gratifying consequences of the fantasy-informed behavior.

The more an individual judges his or her sexual behavior to be an isolated activity, without consequences other than the sex itself, the more it can become a major player in the shaping of the person’s way of living. Typically such an individual judges the sexual activity to be neatly compartmentalized from the rest of life. The sexual behavior is “here” and the rest of life is “there.” When the “there” becomes “here,” as happens in discovery by spouse or arrest by police, the individual is often retrospectively amazed at his or her own ability to deny the potential consequences of the behavior. The cognitive dissonance between what the person has done and what he or she espouses to value has been mitigated by the attempt at compartmentalizing the behavior. It is the work of therapy to break down the walls of erotic compartmentalization. The therapist and group therapy members work to integrate the split-off eroticism by helping the patient see both the power of the behavior in his or her life and the full range of consequences—reinforcing and inhibiting—of the sexual behavior. As the consequences become more conscious, the individual has more resources to choose whether or not to engage in those antecedent behaviors that will lead to a repeat of the problematic sexual behavior.