The Controversial Psychology Of Porn Addiction, Explained

Pornography addicts were often victims of child abuse. They struggle with intimacy and, even after years of therapy, may struggle to manage their sexual impulses and engage in healthy romantic relationships. But according to the American Psychiatric Association, they don’t exist.

Porn addiction doesn’t appear in the Diagnostic and Statistical Manual of Psychiatric Disorders, the publication managed by the APA that essentially dictates whether or not any given condition is pathological. That’s largely because the DSM cleaned house of all consensual sexual behaviors when it removed homosexuality from its list of mental disorders in 1987. Caught in the collateral damage, however, was porn addiction—a consensual behavior, to be sure, but one that belies deep trauma.

“People in the sexology field were very defensive about the idea that any sex that was consensual could be a problem and that sex addiction is not possible as a result,” Robert Weiss, clinical social worker and author of Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, told Fatherly. “But what they didn’t understand was trauma. I know a lot of men who were sexually abused by their mothers who can’t maintain relationships and watch porn or have sex with prostitutes instead. It’s consensual, but they’d rather have relationships and get married.”

“It isn’t always true that all consensual sex is healthy.”

Fatherly spoke with Weiss about trauma-induced porn addiction as well as a new porn-dependency that is emerging among teens who grew up in the era of easy internet porn. He shares the difference between the two, how both can get help, and how everyone can enjoy a healthier sex life.

Is there a difference between porn and sex addiction? If so, what is the difference?

A few years ago I would’ve said, if sex addiction is like a drug addiction, porn addiction is like cocaine addiction. In other words, whether it’s porn or prostitutes or affairs, like whiskey or wine for an alcoholic, what difference does it make? This traditional patient has been emotionally, physically, sexually abused or neglected in childhood. I work with very smart, successful people who just really screw up around sex and it’s because they have early emotional deficits. They have what we call attachment deficits, to be more specific. Most of my clients, if they had a porn problem and you took away the porn, they’d just start seeing prostitutes. If I took whiskey away from an alcoholic, they’d start drinking wine.

And now?

With everything I’ve seen over the past few years, there seems to be a new patient population. What we’re seeing is young men, a good number of them between the ages of 16 and 30, who are having a compulsive problem with porn that keeps them from pursuing relationships with people. They’re not like the people I’ve traditionally treated in that they’ve missed out on early stages of development, but they seem to have missed out on later stages of development. These people either opted out of or were left out of stages of development that involve being a teenager. Then they find themselves in their twenties having looked at a lot of porn, but when they actually go on a date they’re not aroused by the person they’re with. It seems like these particular men, and likely some women, learn the comfort, distraction, and familiarity of self-stimulation and using porn.

Is this new population also “addicted” to porn?

This new category is the least researched, and I want to keep it separate from what we traditionally call porn and sex addiction. I call it a conditioned response and not an addiction, because when you take it away and give them other opportunities, they don’t continue to pursue the addiction. What we’re seeing with that population, if you take the porn away from them, but then flush them with dopaminergic or pleasurable experiences that involve people — I make them join a team or go to a club, and eventually I have them start dating — amazingly, within a couple of months they’re enjoying life. The deficits they created from 15 to 18, they’re not that hard to surmount when you’re 25. You just get into the social world and start to find your way. They probably don’t need endless therapy and support groups because they just missed out on being a teenager and that’s very, very different than missing out on being a two year old.

How does this compare to people who missed out on being a normal two-year-old?

People who miss out on being two, three, and four because they have alcoholic, addicted, or incestuous parents are going to struggle with intimacy and relationships their entire lives. Someone who was just maybe a little shy in high school and thought that porn was more comfortable, they’re not going to struggle to move on, as much. I suspect if they get under stress later in life they might return to the porn because it’s sort of burned in as being a high level of comfort. But it’s not the same as burning in dissociation and self-stimulation as soothing when you’re two.

What usually prompts porn or sex addicts to seek help?

For the most part, for the traditional sex addict, they always come into treatment in crisis — which means my wife found out, my girlfriend found out, my boyfriend found out. It’s usually the potential loss of a relationship that leads someone into a treatment anyways, that’s what an intervention is all about. So by the time they get into a relationship that serious, they’re probably in their 30s.

What’s the prognosis?

Everyone is different. I know people who have had a little bit of a difficult childhood, they went to some 12-step meetings, they got support, and everything was fine. I know people who’ve been going to meetings and therapy for 30 years and they have a relationship, but it’s not easy. But on average, it typically takes about two to three years of pretty active therapy and twelve-step work, and then maintenance. But if you’re using cocaine and seeing prostitutes and have multiple addictions co-occurring, it could take longer and that probably indicates that you’re more troubled.

Once people are in recovery, can they ever look at porn again?

It’s not a good idea. If something has been a problem for you, why go back to it if you know what it is? Besides, you now know to nurture yourself in other ways, and those other ways should be through connection. Because porn is all about disconnection.

What about masturbation?

Some can and some can’t. And it depends on this — if you’re a person who’s intensely visual and you can keep visualizing your porn in your head, no. But most people don’t. What happens with most people is that you take the porn away and after a while masturbation is kind of boring, in your thirties.

Can people lead healthy, sexually-active lives in recovery? Is it even possible to have a sex-positive lifestyle as a recovering porn addict?

I mean, why get in recovery if you’re not going to have a real life? That’s the whole goal of recovery. People get married, they have kids, they have lives. I’ll give you a metaphor: If life is a track, healthy people run around it no problem. The people I work with, they need crutches and wheelchairs and people to hold their hands, but if they get the right support, they’ll get around the track. So I don’t see a reason for recovery unless you get to have the life that you want and that includes the sexual life you want, as long as it’s not going to lead you back to the problem you started with.