Clinical Insight  —  Compulsive Behaviour In High-Achieving Me

The Invisible Crisis Behind Success:

Eating Disorders, Cocaine, Sex Addiction and the Search for Intensity in High-Achieving Men

By Dr Philippe Jacquet, DProf

Jungian Analytical Psychotherapist · Harley Street, London

 

He is still running the firm. Still billing the hours. Still in the gym at six. Still the man everyone calls when something needs to be fixed. He is also, in ways that no one around him knows, using cocaine most weekends, unable to stop an escalating pattern of sexual encounters that have hollowed out his marriage, restricting everything he eats to a set of rules so rigid they control his entire social life — and feeling, beneath all of it, nothing at all.

 

In over 25 years of clinical practice specialising in male psychology, this is the man I see most often. Not in crisis in any visible sense. Functioning, succeeding, and suffering in a way that those around him cannot see — and that he himself has spent years refusing to name. What he is experiencing is not one problem but several. And they are, at the deepest psychological level, expressions of the same thing: a compulsive search for intensity in a man who has lost contact with his own inner life.

This article examines four presentations that recur together, with striking regularity, in the high-achieving men who seek help at my London practice: eating disorders, cocaine and substance use, compulsive sexual behaviour, and the relentless pursuit of intensity as a means of managing an inner emptiness that achievement alone cannot fill. These are not separate pathologies. They are, in my clinical and Jungian understanding, variations on a single theme — and they require a depth approach that can work beneath the behaviour to address what actually drives it.

 

— One · Eating Disorders —

The Compulsion Hidden as Discipline

The high-achieving man with an eating disorder rarely presents as the clinical stereotype. He does not appear visibly thin or visibly distressed. He appears disciplined. Controlled. Optimised. The rigid rules around food that constitute his disorder are, in the world he inhabits, culturally indistinguishable from healthy masculine self-management — and this is precisely what makes them so difficult to identify, and so persistent.

Between 10 and 25 per cent of all eating disorders occur in males (Sweeting et al., 2015), and binge eating disorder — the most prevalent form overall — affects men in nearly equal numbers to women, with men accounting for 43 per cent of cases. Research consistently shows that men with eating disorders delay seeking help for years, often believing their condition does not apply to them (Raisanen & Hunt, 2014).

 

10–25% of all eating disorder cases occur in males, yet male-specific research and treatment remain severely limited

43% of binge eating disorder cases involve men — the most prevalent eating disorder across all genders

+53% rise in male hospitalisations for eating disorders between 1999 and 2009 (HCUP Statistical Brief, 2011)

 

In my doctoral research, I developed the framework of the Male Eating Disorder Matrix to describe the specific dynamics — unconscious, archetypal, relational — that drive eating disorders in men. Within that framework, I identified the high flyer as a distinct clinical group. The obsessiveness and compulsivity that produce his professional excellence are structurally identical to the obsessiveness and compulsivity of the eating disorder. The only difference is cultural valuation: one earns respect, the other earns shame. Both are driven by the same engine.

 

“High flyers — successful businessmen, lawyers, bankers, or top-level sportspeople — need to be obsessive about achieving success and compulsive about what they are doing to achieve excellence. These are the same symptoms as eating disorders or addiction. The only difference is that instead of leading to shame and self-loathing, they lead to pride, self-respect, and the respect of the community.” Dr Philippe Jacquet, DProf — Doctoral Research, University of Essex (2025)

 

The eating disorder in the high-achieving man takes several forms. Restriction — iron control over food, calories, mealtimes, and body composition — is often dressed as athletic preparation or health optimisation. Binge eating, conducted entirely in private, alternates with punishing restriction in a cycle the man may have maintained for a decade without acknowledging it as pathological. Compensatory exercise — hours of training driven not by pleasure but by the need to undo what was consumed — reads to others as dedication.

My doctoral research introduced the concept of Body Number 2: the body not as a machine of performance and appearance, but as a site of genuine felt experience, of meaning, of the unconscious made tangible. For the man with an eating disorder, the relationship with Body Number 2 has been severed. The body has become entirely functional. Restoring that relationship is one of the central tasks of depth psychotherapy with this group.

 

— Two · Cocaine and Substance Use —

The Drug That Fits the Life

Cocaine is not an arbitrary choice for the high-achieving man. It is, clinically and culturally, the drug that most precisely mirrors the psychological state he already inhabits: heightened alertness, elevated confidence, suppressed need for rest, a temporary but convincing sense of invulnerability. It extends the working day, lubricates the social performance, and delivers — for a period — exactly the intensity and aliveness that the rest of life increasingly fails to provide.

Research identifies executives as having 40 per cent higher rates of drug use than other occupational groups (SAMHSA). Approximately 1 in 4 male lawyers meets criteria for alcohol use disorder. Young white-collar professionals face two to three times the risk of developing a substance use disorder compared to those in lower-pressure occupations (Development and Psychopathology, 2017).

 

40% higher rates of drug use among executives compared to other occupational groups (SAMHSA National Survey)

1 in 4 male lawyers estimated to have alcohol use disorder — likely an underestimate given widespread under-reporting

2–3× higher risk of substance use disorder in young white-collar professionals vs. lower-income occupational groups

 

The defining clinical feature of cocaine use in high-achieving men is the absence of the expected consequences. He is not missing work. He is not losing money. He is not, by any external measure, failing. The addiction is present not despite his success but woven into the fabric of it — a pressure valve that makes his level of performance feel sustainable, at least for a time, at least on the surface.

 

THE PERFORMANCE ILLUSION Research from clinical studies of executive cocaine use shows that the very cognitive skills that enable a man to reach the top of a demanding profession — critical thinking, compartmentalisation, persuasion, problem-solving — are the same skills he deploys to conceal and manage his addiction. Late-night emails read as dedication. The hours spent redoing work completed while impaired are invisible to colleagues. More than 75 per cent of now-sober executives reported having had help from assistants or colleagues in concealing their use. The performance is maintained — but at a compounding internal cost that eventually exceeds the capacity to manage.

 

From a neurobiological perspective, cocaine acts on the brain’s limbic system by triggering a sharp surge of dopamine — the neurochemical of motivation, reward, and drive. Over time, those associations become triggers, and the brain’s response converts from voluntary choice into near compulsion. Addiction researcher David Linden, PhD, describes directly how the same neurological architecture that produces exceptional drive and achievement also produces elevated vulnerability to addictive behaviour: both are expressions of the same reward-seeking system.

For the high-achieving man, the deeper question — which cocaine use reliably defers — is why the intensity it provides is necessary at all. Why ordinary experience has become insufficient. Why the internal quiet of an evening without stimulation has become intolerable. These are not questions about drug use. They are questions about the inner life. And they will not be answered by abstinence alone.

 

— Three · Compulsive Sexual Behaviour —

The Pursuit That Cannot Be Satisfied

Compulsive sexual behaviour — the persistent, escalating, loss-of-control pattern of sexual activity that continues despite significant personal, professional, and relational consequences — is the condition that the men who come to my practice are most reluctant to name. More than the eating disorder, more than the cocaine, this is the one they carry in the deepest privacy, and the one whose shame is most corrosive.

The ICD-11 now recognises Compulsive Sexual Behaviour Disorder (CSBD) as a distinct clinical entity: a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in significant distress or functional impairment. Research suggests that compulsive sexual behaviour affects between 2 and 6 per cent of the general population, with a substantially higher prevalence in men. It co-occurs at high rates with other addictive and compulsive presentations — eating disorders, substance use, compulsive gambling and spending — pointing to a shared underlying architecture of impulse dysregulation and reward-seeking.

For the high-achieving man, compulsive sexual behaviour follows a consistent clinical pattern: it escalates gradually from ordinary sexual appetite into something increasingly driven, increasingly compulsive, increasingly disconnected from genuine desire, intimacy, or pleasure. The encounter — whether with a partner, a pornographic image, or a series of anonymous meetings — delivers a brief, reliable hit of aliveness and intensity in a life that has otherwise become emotionally flat. Then the despair returns. Then the cycle repeats.

 

THE FOUR-PHASE CLINICAL PATTERN American psychiatrists Reed and Blaine described compulsive sexual behaviour as moving through four recognisable phases: first, obsession — the subject becomes completely absorbed by sexual preoccupations in response to existential difficulty; then ritualisation — preparatory behaviours that precede the sexual activity; then the sexual act itself, which provides temporary and provisional relief; and finally despair — a sentiment of incapacity to control one’s own behaviour, followed by shame, secrecy, and the return of obsession. This cycle is not about sexual desire. It is about the management of an inner state that cannot otherwise be tolerated.

 

Research on compulsive sexual behaviour identifies recurring psychological risk factors: anxiety and mood disorders, attachment difficulties, a history of childhood trauma or emotional neglect, and low self-esteem concealed behind a high-performing exterior. Research on attachment theory specifically identifies that individuals with anxious or avoidant attachment use sexual fantasy or compulsive sexual activity as a substitute for genuine intimacy (Zapf, Greiner & Carroll, 2008).

The man who cannot achieve genuine intimacy — who has built his entire adult identity on not needing — will often find in compulsive sexual behaviour a form of connection that demands nothing and requires no vulnerability. It is intensity without intimacy. Stimulation without exposure. And it is, in the Jungian understanding I bring to clinical work, a displaced hunger: not for sex, but for genuine contact with another human being — and with himself.

 

— Four · The Search for Intensity —

When Ordinary Life Is No Longer Enough

Underlying all three of the presentations above — and unifying them as expressions of a single psychological condition — is the most important and most overlooked dynamic in the psychology of high-achieving men: the compulsive search for intensity.

The high-achieving man has typically spent his entire adult life in pursuit of stimulation at the highest possible level. The stakes of his professional world, the speed at which it moves, the neurochemical rewards of success — these have, over time, recalibrated his nervous system. Ordinary experience — a quiet evening, an unstructured afternoon, a meal eaten without purpose — has become not merely unsatisfying but genuinely intolerable. The absence of intensity is experienced as emptiness. And emptiness, for this man, is the thing he most fears.

 

“It is not that the job is hurting you. It is that you were drawn to a job that hurts you. Successful people are drawn to their careers because their human operating system is built for it. But any time you are built for one thing, you are not built for another — not built for giving yourself permission to find joy in things that are not hyper-productive.” Dr Daniel Hochman — Psychiatrist, Self Recovery

 

Luigi Zoja, whose work I draw on in my doctoral research, understood this as a collective as much as an individual phenomenon. The pervasive misuse of substances and compulsive behaviours in our culture reflects a collective longing for initiation — for something sacred and transformative that our culture’s relentless drive toward productivity and consumption can never provide. The high-achieving man who has been initiated into performance — but never into himself — is particularly susceptible to this dynamic.

In my doctoral research, I introduced the concept of the Kronos Complex — named after the Greek Titan who devoured his own children — to describe the psychological pattern in which unintegrated masculine drive and compulsive control turn inward and consume the self. The man who cannot stop, cannot rest, who requires cocaine to function and sexual compulsion to feel alive, who controls food with the same iron discipline he applies to everything else — he is, in the deepest psychological sense, both the devouring force and the one being devoured.

 

SPIRITUS CONTRA SPIRITUM — JUNG ON ADDICTION AND HUNGER In his extraordinary letter of 30 January 1961 to Bill W., founder of Alcoholics Anonymous, C. G. Jung wrote: Spiritus contra Spiritum — the spirit of alcohol met only by the spirit of transformation. Jung understood addiction not primarily as a neurological failure but as a misdirected spiritual hunger: a longing for transcendence, for meaning, for contact with something larger than the ego’s relentless productivity. For the high-achieving man, this hunger is rarely satisfied by success. The promotion, the deal, the record, the encounter — these provide a brief hit of aliveness, and then the emptiness returns. The treatment, Jung suggested, is not suppression but transformation: turning the intensity that fuels compulsion toward something that can genuinely nourish.

 

— Recognition and the Path Forward —

Recognising the Signs

The presentations below are those most commonly encountered in high-achieving men at my London practice. They are, deliberately, the signs that look like success — because in this population, that is precisely how they appear.

 

• Rigid, unbreakable rules around food and body composition — accompanied by intense anxiety when disrupted, and framed publicly as health, discipline, or training
• Cocaine or stimulant use that began as occasional and social, and has become regular, private, and increasingly necessary to feel present or perform
• A pattern of sexual behaviour — encounters, pornography, compulsive fantasy — that is escalating, secret, and followed consistently by shame and a resolution to stop that does not hold
• An inability to tolerate unstructured time, quiet, or the absence of stimulation — ordinary experience has become flat, and intensity has become a necessity rather than a pleasure
• Alcohol use that has shifted from social to functional — required to decompress, to sleep, or to manage the gap between public performance and private reality
• Compensatory exercise — hours of training experienced not as pleasure but as obligation, punishment, or the only reliable way to feel in control
• Persistent inner emptiness or meaninglessness that achievement does not touch — and that must be suppressed before the next meeting, the next deal, the next encounter
• A sense that one domain of life has remained stubbornly beyond the reach of the intelligence, discipline, and hard work that have succeeded everywhere else
• Shame that cannot be spoken — because speaking it would threaten the identity built entirely on being the man who has everything under control
• A recognition, perhaps for the first time, that what is being managed internally does not match what is visible externally — and that the gap has been growing for years

 

What Depth Psychotherapy Offers

The approach I take with high-achieving men in my London practice is grounded in Jungian analytical psychology, which works not merely with behaviour but with the full depth of the psyche: with the unconscious, with what Jung called the Shadow — the unlived, unacknowledged aspects of the self that accumulate until, if ignored long enough, they erupt in the forms of compulsion, addiction, and collapse.

This is not an approach that asks the high-achieving man to dismantle his ambition or abandon his drive. It asks him to develop an equal relationship with his interior world — with emotion, with need, with the body as a site of experience rather than performance, with meaning that exists independently of output. For many of the men I work with, this is the most unfamiliar territory they have ever entered. It is also, in my clinical experience, the most genuinely transformative.

The intensity that has fuelled the eating disorder, the cocaine use, the compulsive sexual behaviour is not something to be extinguished. It is something to be redirected. The man who has spent years managing his inner world through compulsion is often, when the therapeutic work begins to take hold, someone of extraordinary capacity. The work is not to reduce him. It is to help him inhabit the full extent of who he actually is.

 

SPECIALIST PSYCHOTHERAPY FOR HIGH-ACHIEVING MEN IN LONDON Dr Philippe Jacquet offers depth psychotherapy for men dealing with eating disorders, addiction, compulsive sexual behaviour, and the hidden psychological costs of high achievement. All consultations are fully confidential. Available in person in central London and online worldwide.  www.meninnersearch.com · Harley Street, London

 

About the Author

Dr Philippe Jacquet, DProf

Jungian Analytical Psychotherapist and Clinical Psychologist with over 25 years of clinical experience. Founder of Men Inner Search. Doctor of Professional Studies, University of Essex (2025). His doctoral thesis, The Devouring Kronos, introduced original clinical frameworks including the Kronos Complex, Father Hunger, Body Number 2, and the Male Eating Disorder Matrix. Practising at Harley Street, London, and online worldwide.

 

References & Further Reading

1. Jacquet, P. (2025). The Devouring Kronos: A Jungian Investigation into Male Eating Disorders and the Father-Son Relationship. Doctoral thesis, University of Essex.
2. Sweeting, H. et al. (2015). Male eating disorders in context. British Journal of Psychiatry.
3. Raisanen, U. & Hunt, K. (2014). The role of gendered constructions of eating disorders in delayed help-seeking in men. BMJ Open.
4. Strother, E., Lemberg, R., Stanford, S.C., & Turberville, D. (2012). Eating disorders in men: Underdiagnosed, undertreated, and misunderstood. Eating Disorders, 20(5), 346–355. PMC3479631.
5. SAMHSA. National Survey on Drug Use and Health — occupational data. US Department of Health and Human Services.
6. Hochman, D. (2025). Work addiction and high achievers. Self Recovery. www.selfrecovery.org.
7. Development and Psychopathology. (2017). White-collar professionals and substance use disorder risk. Cambridge University Press.
8. Linden, D. (2011). The Compass of Pleasure. Viking.
9. Nestler, E.J. (2005). The neurobiology of cocaine addiction. Science & Practice Perspectives, 3(1), 4–10. PMC2851032.
10. World Health Organization. (2018). ICD-11: Compulsive Sexual Behaviour Disorder (6C72). Geneva: WHO.
11. Sahithya, B.R. & Kashyap, R.S. (2022). Sexual addiction disorder — a review with recent updates. SAGE Open Medicine.
12. Zapf, J.L., Greiner, J., & Carroll, J. (2008). Attachment styles and male sex addiction. Sexual Addiction & Compulsivity, 15(2), 158–175.
13. Reid, R.C. et al. (2012). Understanding and managing compulsive sexual behaviors. Psychiatry (Edgmont). PMC2945841.
14. Jung, C.G. (1961). Letter to Bill W., 30 January 1961. In: McCabe, I. (2015). Carl Jung and Alcoholics Anonymous. Karnac.
15. Zoja, L. (1989). Drugs, Addiction and Initiation: The Modern Search for Ritual. Sigo Press.
16. Bennett, L. & Robb, K. et al. (2023). Cultural norms of masculinity and risk in men with eating disorders. Journal of Men’s Studies.

 

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This article is for informational purposes only and does not constitute a clinical consultation. If you are in crisis, please contact your GP or call the Samaritans on 116 123.