Is Porn Addictive?

I remember in my high school sex ed class we were told that porn was addictive and to reframe from watching it, so it didn't become a problem... That was the most I was told about porn in 2014. Granted, most teens weren't ever told anything about porn, and still aren't today. So, it's no wonder that by adulthood we still have a lot of questions and concerns.

Let's start by talking about why people even ask this question! Some might have heard in passing that porn is addictive, others have seen websites, blogs, news headlines and more touting science and studies. Others have experiences with porn themselves, or watched a loved one struggle in some way, that led them to believe that maybe addiction is a part of the equation. Perhaps they felt out of control, wanted to stop but didn't feel like they could, or worried that any amount of porn use was dangerous.

But the American Society of Addiction Medicine, the DSM or ICD haven't labeled porn as addictive or recognized porn 'addiction'. So, what's going on? For many, many years now there has been a fight to get porn and sex addiction into the DSM to no avail. The reason? A lack of empirical evidence.

Valerie Voon did a study back in 2013 that is sited the most often when it comes to the supposed porn addiction. She conducted a study where she showed drug addicts pictures of drug paraphernalia and took scans of their brains. She also took scans of 'compulsive porn users' while they viewed erotic images. What she found was that the brain scans of addicts, and porn enjoyers were very similar. But science doesn't allow us to find two similar things and call them the exact same. Even Voon herself admits that this doesn't mean that porn is addiction, it's far too early to tell [1]. What we have found with further research is that even the brains of mothers smelling their babies look "similar" to an addict [2].

But I want to clarify what it means to have a brain scan that 'looks similar to an addict'. In this context it means that for just a moment in time all of these brains released dopamine in similar ways. None of these studies are referring to any kind of brain atrophy that happens with long term, intense drug use. It's confusing to a lot of people what exactly is meant by "the brain scans looked similar to drug addicts" because that sentence doesn't tell us what or why or how. Unfortunately, I think this is done intentionally because it paints a picture that some organizations want us to believe; that porn is in fact the same thing as a drug. Addiction is a model that follows a particular pattern. That pattern includes increased use, dependency, usage to feel a sense of normalcy, a cease in enjoyment of the use, severe negative side effects, withdrawal and much more. We haven't yet seen porn follow the pattern of addiction in studies.

I want to be very clear though. Just because porn addiction isn't a recognized diagnosis, and we have no current data to show that porn can be addictive, doesn't mean that people aren't struggling with porn use. Marriages end over porn use, people lose their jobs, money gets wasted, and on and on. Addiction feels like a big enough, and close enough, word to use to describe the suffering that can take place. When we take that word away, people might feel like they have nothing to use to describe their pain. No label, no diagnosis. If people are struggling this much, and it isn't addiction, then what is going on?

There's a handful of options. The two things we see most often are moral incongruence and underlying conditions. Moral incongruence refers to the folks who are participating in an activity that goes against their morals. In this case, it's watching porn. These folks are actually the most likely to identify as addicts, while simultaneously watching the least amount of porn. They tend to be religious or conservative. The second group is people with underlying conditions which include ADHD, autism, OCD, borderline personality disorder, anxiety, depression, among others. Porn is a function of coping within this group. What we see in both of these groups is that working with a sex therapist or sex positive therapist shows good results. When people can normalize their desire to watch porn (even if that means that they ultimately stop watching) or find coping skills or medications for their mental health conditions, we see the issue with porn melt away.

The last two groups we see are a bit more complicated. Compulsive sexual behavior is a diagnosis in the ICD, though it is debated. Luckily the requirements to be diagnosed are high. There must be no other underlying condition present, no medications that cause sexual behavior side effects, you must be in high distress for over 6 months and no moral incongruence among other things. Very few people will meet these standards and for good reason. This sort of condition, if misdiagnosed, could lead someone to believe there is no getting better, no feeling more in control. Similar to OCD where you expect the struggles to be lifelong, though symptoms can be reduced through therapy, coping skills, medication and lifestyle changes. So, we don't want to see a lot of people get diagnosed with this when there are other possible options! The last group is another common one.

It's more of a dynamic. Usually, it's comprised of a heterosexual couple where the man is watching porn, and the woman heavily disapproves of his behavior. She may see his porn use as problematic, or equate it to cheating, he may agree to stop but doesn't. The lying, lack of communication and more might lead this couple to use the label of addiction because the man continues to agree to stop but doesn't. What is at the root of this common dynamic is that he doesn't want to stop consuming porn, but he also doesn't want to lose his wife or partner.

In all of these scenarios I highly recommend sex education, sex therapy or seeking out a sex positive therapist. Did you know that most therapists receive no education on healthy sexuality? They only receive guidance on how to diagnose someone with unhealthy sexuality! If you don't understand the vast realm of healthy sexuality, how will you know it when you see it? This leads traditional therapists to using their own personal sense of what healthy sexuality is as the barometer, which may be lined with religious ideas, conservative ethics, or vanilla ideals. People struggling with sexual wellness need practitioners that understand how vast, strange and exciting healthy sexuality can be to avoid over diagnosis and pathologizing normal behavior.

Sources

[1] Is pornography addictive? (apa.org)

[2] Frontiers | Maternal status regulates cortical responses to the body odor of newborns (frontiersin.org)

The Pornography Wars by Kelsy Burke

The Myth of Sex Addiction by David Ley

His Porn, Her Pain by Marty Klein