Pornography Addiction

In addition to our society becoming more sexualized, the internet has greatly contributed to the availability of pornography. Both these factors have led to a dramatic increase in pornography addiction. Online pornography is so pervasive that porn sites often appear on computers unsolicited.

In itself, looking at pornography only becomes dysfunctional and addictive when one is compelled to seek it out and then, once the search has begun, is unable to stop. Long unsatisfying hours may go by unnoticed as frustration builds and more time is lost. The object of porn addiction is not necessarily sex itself but rather images of sexual perfection, a perfection that becomes increasingly unattainable as the search progresses. Even with orgasm, the obsessive hunt may continue with satisfaction elusive.

The negative consequences of pornography addiction are insidious and harm one’s capacity for intimacy – particularly when the addiction is played out while the addict is in an intimate relationship. Since pornography deals in fantasy, sexual relationships with real people become dissatisfying. Compulsive pornography viewing desensitizes one’s lust and desire for the sexual partners in one’s life and, hence, leads to the need for more pornography to satisfy sexual desire.

Pornography addiction, much like sex addiction, ruptures one’s intimate relationships. In addition to negatively affecting the sexual desire for one’s partner, the addiction alienates the partner and causes painful feelings of rejection, insecurity, and jealousy. Relationships break down and recriminations abound.

It is vital when dealing with porn addiction to understand that the addiction is not about the partner or about sex. Rather it is a way for the addict to self-medicate unwanted feelings of intolerable pain. While porn addiction is often considered a weakness, the addictive behavior is an uncontrollable disease. A pornography addict needs to avoid even a casual look as this can initiate the addictive behavior.

It is also of primary importance not to demonize pornography or the compulsion to look at it, but rather to recognize that the addiction is beyond the person’s control. Outside support – from the partner, recovery groups, and counseling – is the key to dealing with addictive behavior. Given the difficulty for the partner to understand and not personalize pornography addiction, patience and understanding, for both the addict and the partner, are necessary to support the hard work that recovery will entail. Since addiction results in deception, secrecy and shame, an enormous amount of support is vital to help the person deal honestly with his or her compulsive behavior.

Treating Sexual Addiction

Sexual addiction is not defined by how frequently a person has sex or what kind of sex one prefers, but rather is when one has a compulsive/obsessive relationship to sex that leads to habitually acting out repeated behavior.

Sex addiction is particularly hard to treat because, unlike addictions which are typically treated in a way that encourages abstinence, not all sex is unhealthy or is to be discouraged.  Unless one is asexual and has no interest in sex, completely abstaining from sex is not possible.  Therefore, with sexual addiction, the goal of treatment is not to refrain from sex but to treat the compulsive behavior that feeds the addiction.

How does one know if a person who wants to have frequent sex simply has a high sex drive or if there is a problem with addiction?  Because our society uses a moralistic barometer to define behavior, it’s essential to separate behavior that may be negatively judged by moral standards from that which is genuinely unhealthy and destructive.

Because there is a tendency to judge and blame those with addiction problems, I am careful not to think of addiction based only on the behavior itself.  When I suspect addictive behavior, I start by asking simple questions that allow me to distinguish addiction from non-destructive behavior.

Does the behavior negatively affect one’s functioning, e.g. one’s job/career, health,
family, etc?

Does the behavior negatively affect one’s relationships, involving deception, guilt, secrecy and shame?

Can a person stop the behavior if he/she wants to?

What would the person feel if the behavior was taken away?

These questions establish whether the behavior is an addiction and, if so, to what degree the behavior is self-destructive.

Harder to treat than other addictions, sexual addiction has become more pervasive because of both the availability of internet sites devoted to the seeking of sex and pornography and the increased sexualization of our culture.  While in the past, it was harder to satisfy sexual addiction, today one can feed compulsive behavior without ever leaving home with the click of a mouse on the computer.  Sexual addiction has increased dramatically in segments of the population where it had previously been rare, e.g. women, adolescents and senior citizens. This has created a significant problem and made it difficult for many people to establish healthy intimate sexual relationships.

The Therapist Stance as Self-Disclosure

As an analyst, I wrestle with myself about what stance will be most effective and helpful for my patients.  Being psychoanalytically trained, I was taught that the “blank screen” was a most effective approach.  After exploring and working in this way, I have abandoned the concept of the blank screen as ineffective and unrealistic.

While the theory behind the “blank screen” has merit and can be useful at times, psychotherapy is a two person psychology.  The “blank screen,” while theoretically tempting, is, in fact, illusory.  Inevitably, therapists and the people they treat affect each other in a multitude of ways, both verbal and non-verbal, that cannot be controlled by self-imposing an artificial neutrality.  As much as we may try to remain “blank,” patients pick up things about us, by transference, projection, deduction and/or exposure.

In the psychotherapeutic setting, we are often confronted with dilemmas about the most effective way to respond and meet the needs of our patients.  We continually make decisions about how best to offer empathy to our patients, including when to keep silent.  When listening to patients, how much do we self-disclose what we are thinking and feeling?  When do we keep thoughts and feelings hidden?

While to some analysts unorthodox, I offer my patients those aspects of myself that contribute to a holding environment.  For example, when a fearful and anxious patient chastises him/herself for not being “normal,” I may point out that such feelings or thoughts are common.  On rare occasions when I think that a personal example may ease a patient’s self-judgment, I’ll offer a personal detail that helps my patient feel less isolated.  One patient talked about how together and organized I am and how she suffers so in comparison.  I told her that this self-organization took a lot of time, work, and learning.  She was both grateful and hopeful.  My self-disclosure left her with the feeling that she too could accomplish positive change.

While such self-disclosure is uncommon, I have used it to offer hope to a despairing patient.  There are times as analysts when we can use ourselves as examples and hence ground patients and quiet their self-recriminations.  I once had a patient in his mid 30’s who talked at length about his lack of career achievement and focus.  He felt it was too late to have a satisfying career and furthermore he didn’t even know what he wanted to do.  He used his own expectations and the expectations of society to reinforce his feelings of worthlessness.  I told him that I had changed careers mid-life and went on to establish myself in another profession by going back to school for 12 years, an experience which at first was daunting but to which I had adjusted and succeeded.  My self-disclosure gave him hope and helped him work through the blocks he created by his self-recrimination and found motivation to explore what he might want to accomplish.

Non-verbal self-disclosure of our feelings can help convey empathy and caring.  If I am moved to cry by what I am hearing from my patient, do I hold back and hide my tears or gently let them be known?  Often when I tear up or cry, patients feel that I am empathizing with them and feel psychically held.  I am careful to let them know that it’s okay for me to cry when I am sad and I make sure they know I do not need to be taken care of.  Both my tears and my reassurance that I can still take care of them relieves patients and allows them to go deep into their sadness.

It is of the utmost importance that patients experience me as a human being with thoughts and feelings.  At times, self-disclosure can help create a warm and empathic relationship and provides a safe environment vital to the work.  It’s vital to let patients work though negative transference and rupture.  But to allow that to happen, careful self-disclosure can facilitate the safe holding environment necessary for the patient to freely express all that he/she is thinking and feeling.