Chemsex as a Coping Mechanism: What Are We Trying Not to Feel?

A psychosexual and addiction perspective on chemsex, intimacy, shame, loneliness and the ways we learn to cope. When we talk about chemsex, we tend to talk about the drugs.

Which drugs are being used. How often. How much. The risks involved. Whether somebody has become dependent.

These are important questions, of course. But in my work as a psychosexual therapist specialising in addiction, I often find myself interested in a slightly different question:

What is the chemsex doing for you?

Because when chemsex becomes problematic, it is rarely just about drugs. And it is rarely just about sex.

Quite often, it has become a way of coping.

When something that feels good also helps us cope

I don't want to suggest that everybody who engages in chemsex has a problem. They don't.

For some people, chemsex is pleasurable, exciting and occasional. It may be part of sexual exploration and doesn't necessarily interfere with the rest of their life.

But sometimes the relationship with it changes.

Perhaps sex without chems starts to feel rather ordinary. Perhaps it becomes difficult to feel confident or sexually free without them. Perhaps what used to happen occasionally starts happening every weekend.

Or perhaps you find yourself making promises on a Sunday morning that, by Friday evening, are surprisingly difficult to keep.

This is where I become curious about what else might be happening.

Because substances don't only alter how we feel sexually.

They can alter how we feel about ourselves.

They may quieten anxiety. Reduce inhibition. Take away self-consciousness. Make rejection feel less frightening. Make our bodies feel easier to inhabit.

And sometimes they make intimacy possible when intimacy, sober, feels much more complicated.

“I feel more like myself when I'm high”

There is something important contained in this sort of statement.

On the surface, it sounds contradictory. How can taking something that changes you make you feel more like yourself?

Psychologically, however, it can make a great deal of sense.

Perhaps the sober version of you is constantly monitoring yourself during sex.

Do I look attractive?

Am I taking too long?

Am I hard enough?

Am I doing this properly?

Does he actually fancy me?

Am I too much?

Am I not enough?

Then the drugs arrive and, for a while, the noise stops.

You're no longer watching yourself having sex.

You're simply having sex.

For somebody who has lived with sexual anxiety, shame, body-image difficulties or a fear of rejection, that can feel enormously freeing.

And once you've experienced that freedom, returning to sober sex can feel surprisingly exposing.

Sometimes sex is easier than intimacy

One of the things we learn fairly quickly in psychosexual therapy is that being comfortable with sex and being comfortable with intimacy are not necessarily the same thing.

You can be sexually adventurous and still be frightened of closeness.

You can have numerous sexual partners and still feel lonely.

You can be very comfortable being naked and deeply uncomfortable being emotionally seen.

Chemsex can sit somewhere inside this contradiction.

It can create extraordinary feelings of connection and closeness. Yet it can also make certain kinds of vulnerability easier to avoid.

Being desired might feel easier than being known.

Having sex might feel easier than asking someone to stay.

Expressing an intense sexual fantasy might feel easier than saying, “I actually quite like you.”

Sometimes the substances don't simply make sex possible.

They make vulnerability bearable.

Chemsex and loneliness

Loneliness is another part of this conversation that deserves more attention.

And loneliness doesn't necessarily mean sitting at home alone.

You can have hundreds of contacts on an app and feel lonely.

You can have a very active sex life and feel lonely.

You can spend an entire weekend surrounded by people, bodies, conversation and sexual intensity and still feel profoundly alone when everybody leaves.

For some people, chemsex offers temporary relief from that.

There is contact. Touch. Attention. Belonging. Excitement. Perhaps a sense of being wanted.

Then the session ends.

And the contrast can be difficult.

The flat becomes quiet. The phone becomes quieter. The body is exhausted. The intensity has gone.

Whatever was waiting underneath may still be there.

Sometimes it feels louder.

This is one of the ways a coping mechanism can slowly become a cycle. We use something to escape a feeling, but the consequences of using it eventually create more of the very feeling we were trying to escape.

And then there is shame

It is difficult to talk about chemsex without talking about shame.

For some gay, bisexual and other men who have sex with men, sexuality developed in an environment where desire wasn't always straightforward.

Perhaps there was secrecy.

Perhaps bullying.

Perhaps religious or cultural messages about sex.

Perhaps rejection.

Perhaps years spent monitoring how you spoke, moved or behaved before you ever came out.

We can leave those environments and still carry some of them inside us.

You can be completely comfortable identifying as gay and still carry sexual shame.

You can be confident socially and still feel frightened of rejection.

You can have a great deal of sex and still struggle to believe that somebody might genuinely want you.

Chemsex can temporarily turn the volume down on all of this.

The difficulty is that shame often returns afterwards.

And now it has new material.

I can't believe I did that.

Why did I stay so long?

Why can't I control this?

I said I wasn't going to do it again.

And then shame itself becomes something we need relief from.

That's how these cycles can become remarkably difficult to break.

When a coping mechanism becomes something we rely upon

We all have coping mechanisms.

Some are healthier than others, but none of us moves through life without finding ways to regulate uncomfortable feelings.

The problem isn't that we cope.

The problem comes when one particular way of coping becomes so effective that we gradually lose access to the alternatives.

This is particularly relevant with chemsex.

If chems repeatedly become the route to sexual confidence, connection, excitement or escape, the brain learns something:

This is how we do sex.

This is how we feel confident.

This is how we connect.

This is how we stop thinking.

Eventually, sober sex can feel strangely muted by comparison.

Some people worry that they have damaged their sexuality permanently.

Usually, I think there is a more helpful way of understanding what has happened.

Your sexuality hasn't necessarily disappeared.

It may simply have become accustomed to experiencing arousal under a very particular set of conditions.

And what has been learnt can, with time and the right support, begin to change.

Why “just stop” isn't particularly helpful

If somebody is using chemsex to cope, simply removing the chemsex doesn't automatically solve the problem.

Sometimes it reveals it.

Take away the drugs and perhaps the sexual anxiety returns.

The loneliness returns.

The difficulty with intimacy returns.

The critical voice returns.

The body suddenly feels uncomfortable again.

Sober sex feels awkward.

Rejection hurts more.

And if we haven't understood any of that, returning to chemsex begins to make quite a lot of sense.

This is why I don't find it particularly useful to think about relapse simply as failure.

A return to chemsex can also tell us something:

Something became difficult to manage.

The therapeutic work is partly about discovering what that something was.

What are the chems helping you cope with?

This is a question worth spending some time with.

Not necessarily answering immediately.

Just noticing what comes up.

Are the chems helping you cope with loneliness?

Sexual anxiety?

Boredom?

Stress?

Rejection?

Shame?

The end of a relationship?

Feeling unattractive?

Getting older?

Difficulty accepting your body?

A fear of intimacy?

Trauma?

Or perhaps the relentless pressure of having to be yourself all the time?

Sometimes the answer is much simpler:

I don't want to think for a while.

That matters too.

Recovery isn't only about stopping

From a psychosexual perspective, one of the limitations of thinking only in terms of abstinence is that we can forget to ask what sort of sexual life somebody is moving towards.

Stopping something is one thing.

Building something you actually want is another.

If chemsex has been part of your sexual life for some time, recovery may involve becoming curious about sex again.

What actually turns me on when I'm sober?

What happens if sex is slower?

Can I tolerate awkwardness?

Can I tell somebody what I want without chemical confidence?

Can I stay present when I feel vulnerable?

Can I cope if somebody doesn't fancy me?

Can I experience pleasure without constantly needing more stimulation?

Can I let somebody get close?

These aren't small questions.

And they aren't simply addiction questions.

They are questions about sexuality, attachment, self-worth and intimacy.

Perhaps the question isn't “Why can't I stop?”

People struggling with chemsex can become incredibly frustrated with themselves.

Why do I keep doing this?

Why can't I just stop?

Why do I make the same mistake again?

I understand the frustration.

But therapeutically, I am often more interested in another question:

What becomes possible when you're high that feels difficult when you're sober?

Maybe you can feel desirable.

Maybe you can stop thinking.

Maybe you can ask for the sex you actually want.

Maybe you can tolerate your body.

Maybe you can be close to another person.

Maybe you can feel wanted.

Maybe, for a few hours, you don't feel lonely.

When we begin to understand that, the behaviour starts to make more sense.

That doesn't mean ignoring its consequences. Nor does understanding something mean endorsing it.

It simply means we stop treating the behaviour as the whole problem and start listening to what it might be telling us.

Because sometimes chemsex isn't only about pursuing pleasure.

Sometimes it is about escaping discomfort.

And meaningful change may begin when we become curious about what has felt so difficult to experience sober.

Psychosexual Therapy for Chemsex and Addiction

If chemsex has started to feel less like something you choose and more like something you rely upon, you don't have to wait until things have reached crisis point before seeking support.

I work psychotherapeutically with the relationship between sex, addiction, intimacy and compulsive behaviours.

I don't approach chemsex simply as a drug problem, nor do I believe that useful therapy begins with judgement.

Instead, I am interested in understanding the person behind the behaviour and the function that chemsex may have come to serve.

For some people, our work may involve addiction, cravings and a sense of losing control. For others, it may lead us towards sexual confidence, shame, loneliness, attachment, relationships, trauma, intimacy or difficulty experiencing satisfying sex without chems.

Quite often, these things overlap.

Therapy offers somewhere to talk honestly about sex and substance use without having to sanitise your experiences or present a more acceptable version of yourself.

The aim isn't simply to ask:

“How do I stop?”

We can also begin asking:

“What have I been using this to cope with — and what might I need instead?”

Understanding that can be an important part of creating lasting change.