Pornography Problem…. Erotic Conflict or Addiction?

Computer Key - Porn

When I started in this field, sex addiction was not a common place term.  Therapists who treated sex addiction were not that prevalent and you never heard about sex addiction on the news.  Today, it is a different story.  You hear the term sex addiction all the time, bandied about in the news every time you hear about a celebrity sex scandal.  Therapists who treat sex addiction, whether specifically trained to do so or not, are much more common now as well.

The same goes for pornography addiction.  For some reason, this feels less stigmatizing to many.  Again, there are now large numbers of therapists who treat pornography addiction (whether trained to or not) and there are also many new programs popping up to help men deal with their pornography addictions.  These are often programs not run by a therapist or affiliated with a 12-step program but instead created and run by independent agents or religious institutions.

As the visibility of pornography addiction grows, the type of clients we have coming to the office have changed.  In the beginning, over 8 years ago, the (predominantly) men who were coming in to address problems with pornography were men who had struggled for most of their lives with pornography use.  They were watching more than they wanted to. They couldn’t stop.  They were experiencing serious consequences in their work and relationships or even with the law as a consequence of their pornography use.  These were men who were what I would diagnose as pornography (or sex as a broad moniker) addicts.

Today, many of the men who are coming in with self-diagnosed pornography or sex addictions are men who look at some pornography.  They don’t look at it necessarily a lot (maybe one or two times a week or less).  They don’t look at it for hours and hours on end.  They don’t look at anything illegal.  They often don’t look at any pornography that is more “hard core.”  Often their pornography use is causing a conflict in their relationship.  These are not men that I would diagnose with a pornography addiction, but they call themselves pornography addicts.

This brings me to the title of this writing.  Are these men who come in pornography addicts?  Or are they men who are experiencing an erotic conflict?

An erotic conflict is experienced by a person who is engaging in (or even fantasizing about) a sexual behavior that conflicts with his or her moral values or religious values.  For example, a person who is attracted to sex with the same sex might experience an erotic conflict because their religious beliefs tell them that same sex attraction is wrong.  Their behavior conflicts with their religious beliefs.  A person who is using escorts might be experiencing an erotic conflict because breaking the law is against their personal moral values.  A man who is watching pornography occasionally, a few times a month, might feel as though he has a sexual addiction or pornography addiction because his religious beliefs tell him that lust and pornography are bad.  Therefore, he equates any use of pornography with addiction.

Though there is no DSM-V definition of sexual addiction or pornography addiction, we can extrapolate the criteria from drug and alcohol and gambling addictions (Use disorders in the DSM-V).  This means that someone who is a pornography addict would experience at least two of the following issues:  watching pornography more often than they intended and for longer periods of time than intended; an inability to stop watching pornography; spending a lot of time creating opportunities to watch pornography, crave pornography use; fail to fulfil obligations at work, home or school due to using pornography; continuing to use pornography even after interpersonal problems resulting from use; social isolation due to pornography use; the need for more pornography or more intense pornography to get the same feeling and difficulties when they try to stop using pornography or can’t access it.

Here is my plea to clinicians and to society as well:

CAN WE PLEASE BE MORE DISCERNING IN DIAGNOSING SEXUAL AND PORNOGRAPHY ADDICTION?

What happens when we over diagnose pornography addiction?

  1. We never get to the underlying issue.  If someone is not actually a pornography addict and is experiencing an erotic conflict, often they never get to the root of the issue.  Often, they work a 12-step abstinence model and condemn any experiences of lust as bad or problematic.  This can place moral good or bad judgements on sexual behavior that can cause more psychological harm if the client continues to engage in the behavior.  It can shame the normal biological process of attraction by naming it lust to be removed from the person’s being.  It can also prevent the client from learning about healthy sexuality and what truly arouses and attracts them.  Ultimately, they often never work through the conflict between their body and their beliefs to any healthy resolution.
  2. We cause more shame. Though being a pornography addict is less shameful perhaps than it used to be, being named a sex addict or pornography addict is often a very shameful experience for a person.  This shame must be worked through when the person truly does have an addiction.  When the person does not, the label is often causing more shame and possibly isolation than is necessary.  Often this adds to the “I’m a bad person” thoughts the pornography consumer might have, simply for looking at some pornography.
  3. We trivialize sexual addiction. The therapeutic community and often the public press hotly debate whether sexual or pornography addiction are “real.”  The con side often uses the argument that those who support the idea of sexual addiction are religious conservatives who are condemning normal sexual practices.  When someone with an erotic conflict (often based on religious beliefs) is diagnosed with an addiction, this reinforces the argument that we are trying to morally dictate sexual practices and label them addictions.

My goal here is not to condemn or judge someone’s religious or moral beliefs.  We all have our own set of values that we would like to live by.  My plea is that we, both clinicians and consumers, really look at the behavior.  Is the client presenting in your office who uses pornography an addict or someone with an erotic conflict?  The treatment is different. If they have an erotic conflict the work is to process through the beliefs, sexuality and the conflict to come to a resolution that fits the client’s moral and personal compass.  If the client is an addict, the treatment will likely follow a more traditional addiction model with 12 step attendance, abstinence from certain behaviors and recovery work.

I leave you with my plea again:  CAN WE PLEASE BE MORE DISCERNING IN DIAGNOSING SEXUAL AND PORNOGRAPHY ADDICTION?

 

Dr. Weeks is the owner of Sexual Addiction Treatment Services.

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