can porn really be an addiction?

As we all know, the concept of addiction was coined with regard to the abuse of drugs and alcohol. And as you may or may not know, it continues to be used ONLY in this way in the technical/official literature of the American Psychiatric Association. For better or for worse, this is the institution that we as a society have authorized to legally define terms related to mental and behavioral health.

That said, it’s simply a matter of time (in my opinion) before the APA expands its technical definition of addiction to include other behavioral patterns which, when engaged in excessively, wreak havoc in people’s lives (i.e. gambling, porn, video games, spending, sex, etc.). Psychotherapists can attest to this because we see on a daily basis that the patterns surrounding drug/alcohol addiction are the exact ones associated with other problematic habits. Some of the key patterns include:

1. Use of the substance, or engagement in the activity, begins as fun, adventure and novelty seeking.
2. The substance/activity comes to be relied on for normal/everyday stress-relief, decompressing & anxiety reduction.
3. The substance/activity comes to have secretive elements and shame associated with it.
4. Promises made to self and/or others to stop using the substance, or engaging in the activity, are broken again and again.
5. While continued use of the substance or engagement in the activity has a progressively negative impact on relationships, self-esteem and social functioning, the behaviors continue. And continue.

wait, so can porn be an addiction or not?

In a practical sense, absolutely and unequivocally yes. In a bureaucratic/legalistic sense (meaning, do insurance companies have to pay for treatment under the diagnosis of “pornography addiction”), the answer, at this point in history, is no. For most people, this debate is beside the point anyway. They are not asking this question for insurance purposes, nor are they asking out of intellectual curiosity. Real people experiencing real confusion/despair are craving ways to understand and more importantly, handle, the porn-related situations they find themselves in.

Think about it like this: drug and alcohol addiction are often likened to cancer in that they develop in stages, with stage 4 literally being deadly. Addiction to porn develops in stages as well, and while no one will die from using porn, there are many, many people who are experiencing the potential or actual “death” of their healthy sex drives, self-esteem and important relationships. Yet they continue to use porn anyway. Life can get very small as you progress through these stages of destruction, a dark and dead-end road to be sure.

who seeks help in NYC re pornography use?

In my psychotherapy practice (in Midtown Manhattan), it is only men (of a wide range of ages) who have reached out seeking help around this issue. Wait, let me correct that. Sometimes women reach out, but it is not because of their own porn use. It is because they have recently (and upsettingly) discovered that their boyfriend/husband has had a secretive and problematic relationship to porn, and these women are shocked, angry, confused and unsure about what to do.

Perhaps there are women also who are suffering from their own porn addictions. Probably so, but certainly far, far fewer in number. Over the past several years, it has become abundantly clear that there are many, many guys who are in a ton of pain in their lives with ongoing anxiety, depression, loneliness, fear, shame and hopelessness, and porn use is at the center of their ongoing thinking and behavior. In such situations, porn is a core feature of what is preventing them from finding a healthy relationship, or it is threatening the very existence of the romantic relationship they are in.

when do men seek help for their problematic relationship to pornography?

We humans seek help mostly when we “hit bottom” of some sort. With regard to porn, here are common scenarios:

• The girlfriend/wife discovered porn on the laptop or smart phone, or walked in and saw porn on the screen before the guy hurriedly shut it down.
• The girlfriend/wife asked “how often do you watch porn,” and the guy was just so sick and tired of lying and decided to come clean.
• Porn use led to markedly decreased appetite for (and/or performance problems in) real-life sex with the girlfriend/wife.
• Due to one or more of the above issues, the girlfriend/wife has threatened to end the relationship if the guy doesn’t get help.

– OR –

• The guy has been single and alone for years, unable (in part due to porn addiction) to form and maintain a healthy relationship with a woman and he has finally hit a breaking point.

what is the cure for porn addiction?

The American Psychiatric Association characterizes addiction as a “chronic brain disease.” This characterization is misguided and unhelpful. Obviously the brain is inextricably involved in all addictive processes, including porn addiction (see www.yourbrainonporn.com), but that is because the brain is deeply involved in EVERYTHING we do. Characterizing addictive processes as brain diseases is painfully reductive, and actually backwards: addictions HARM the brain, they don’t emanate from it. Human behavior flows from a complex combination of biological, psychological and social influences which includes the brain but is surely not limited to it. Anyway, I get it, we live in the “age of the brain” when it comes to health organizations getting financial support and cultural legitimacy, and they need both to survive. I understand completely, but it’s still unfortunate.

But aside from the politics of institutional funding, the truth is that all the most competent NYC psychotherapists that I know see addiction as a lifestyle disease. Thus, if we want to truly neutralize and eliminate the unhealthy addictive processes in our lives, a whole new set of healthy understandings, attitudes, behaviors, routines and relationships must be cultivated—not overnight, but over time. Another way to say it is that with serious commitment, social support and the right kinds of consistent effort, you can grow out of an addictive lifestyle and grow into a healthy/sober one.