What is Porn Addiction/Compulsivity?

By: Robert Weiss PhD, LCSW

Although the American Psychiatric Association has willfully ignored our nations ongoing sex and porn addiction/compulsivity epidemic, other organizations, equally if not more prominent, have chosen to recognize the issue and act on it. Most notably, the World Health Organization (WHO) has revised its diagnostic manual, the International Classification of Diseases (ICD-11), to include Compulsive Sexual Behavior Disorder, with a definition that comfortably encompasses both sex and porn addiction and compulsivity. The WHO states:

Compulsive sexual behavior disorder is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior. Symptoms may include repetitive sexual activities becoming a central focus of the persons life to the point of neglecting health and personal care or other interests, activities and responsibilities; numerous unsuccessful efforts to significantly reduce repetitive sexual behavior; and continued repetitive sexual behavior despite adverse consequences or deriving little or no satisfaction from it. The pattern of failure to control intense, sexual impulses or urges and resulting repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors is not sufficient to meet this requirement.

This description meshes nicely with the criteria Certified Sex Addiction Therapists (CSATs) have been using for many years to identify and diagnose sex and porn addiction and compulsivity. The short version of those criteria reads as follows:

1. Preoccupation to the point of obsession with sex/porn.

2. Loss of control over the use of sex/porn, best evidenced by multiple failed attempts to quit or cut back.

3. Directly related negative life consequences troubled relationships, issues at work or in school, declining physical health, depression, anxiety, diminished self-esteem, social and/or emotional isolation, loss of interest in previously enjoyable hobbies and activities, financial woes, legal problems, etc.

Any person who identifies with the WHOs definition of Compulsive Sexual Behavior or the typical CSAT criteria related to his or her porn use is probably has a problem related to his or her heavy usage of pornography, regardless of whether we call that problem an addiction or compulsively.

Research suggests that in todays world most of the people who self-identify as addicted to or compulsive with pornography spend at least 11 or 12 hours per week looking at (and usually masturbating to) porn most often digital imagery accessed via their computer, laptop, tablet, smartphone or some other Internet-enabled device. Magazines, VHS tapes, DVDs, and other traditional forms of pornography are still in use, but the vast majority of heavy porn users prefer the anonymity, affordability, and 24/7 accessibility that digital technologies provide. And this 11 or 12 hours per week number is the low end of the spectrum. Many users spend double or even triple that amount of time with pornography.

Common signs that casual porn use has escalated to a level that is problematic for the user include:

• Continued porn use despite consequences and/or promises made to self or others to stop

• Escalating amounts of time spent on porn use

• Hours, sometimes days, lost to searching for, viewing, and organizing pornography

• Masturbation to the point of abrasions or injury

• Viewing progressively more arousing, intense, or bizarre sexual content

• Lying about, keeping secrets about, and covering up the nature and extent of porn use

• Anger or irritability if asked to stop using porn

• Reduced or even nonexistent interest in real-world sex and intimacy

• Male sexual dysfunction (erectile dysfunction, delayed ejaculation, inability to reach orgasm)

• Deeply rooted feelings of loneliness and/or detachment

• Drug/alcohol abuse in combination with porn use

• Drug/alcohol addiction relapse related to porn use or feelings about porn use

• Increased objectification of strangers, viewing them as body parts rather than people

• Escalation from two-dimensional images to casual/anonymous sexual hookups, paid sex, affairs, etc.

Individuals who are addicted to or compulsive with pornography feel compelled to look at porn. Over time, they organize their lives around pornography. Porn becomes an obsession to the point where important relationships, interests, and responsibilities are partially and sometimes completely ignored. They spend inordinate amounts of time searching for porn, viewing porn, and organizing their porn collection. Very often, feeling shameful or remorseful, they will tell themselves, This is the last time that I am going to use pornography, but in a few days or weeks they're right back at it. Sometimes they delete their entire porn collection and feel great about doing that. But then, when their pink cloud dissipates, as inevitably occurs, they regret the deletion and scramble to reassemble their collection. Many people spin their way through this delete-reassemble cycle over and over and over.

Sadly, individuals who struggle with pornography are often reluctant to seek help because they dont view their solo sexual behaviors as an underlying source of their unhappiness. And when they do seek assistance, they often seek help with related symptoms depression, loneliness, and relationship troubles rather than the porn problem itself. Many are in therapy for extended periods without ever discussing (or even being asked about) pornography and masturbation. Either the subject feels too shameful to talk about, or they just don't see the correlation between their porn use and the problems they're having in life. As such, their core problem remains underground and untreated.