Therapy for Porn Addiction
The TLDR (too long, didn’t read)
We believe that, although porn is powerful and useful, it is deeply unsatisfying. It can inform fantasy and provide stimulation to arousal and orgasm, but it cannot provide a meaningful and lasting relationship. Like cheat codes in a video game, porn provides a way to bypass the game of sex to get to the end.
When used like a hack or to help medicate relational and emotional problems, porn can be a crutch that some learn to rely on. Without it, they often feel horny and dysregulated and/or may be unable to find arousal and orgasm with or without a partner.
We believe that better, more erotic sex and intimacy can be an effective treatment strategy. By helping clients lean into their sexuality and the skills necessary to use it well, we also encourage more fulfilling, less orgasm focused sex that is superior to porn in almost every way.
Strugging with porn addiction?
Our clients often request help with excessive or otherwise problematic pornography (porn) use. We help clients who are struggling to regulate, modify, reduce, and/or eliminate porn use with a sex-positive, anti-shame, intimacy-centered philosophy.
We will explain our beliefs and approach in detail below. Here is a brief overview.
It is natural for you to find porn arousing. It is natural for you to be exceedingly interested in viewing porn. You are not wrong or bad for wanting porn. You may not even need to give up porn. But we can help you find something better.
Ultimately, we help clients answer one crucial question, “Why are you alone with your fantasies?”
Fantasies are a powerful tool. They show us much about ourselves and who/what we want. We should not cast them out, but we should learn from them. The core of problematic porn use is a failure to learn the lessons fantasy can teach.
Porn use is not:
● A moral failure
● A chemical addiction
● A barrier to intimacy
● A result of trauma or another psychological issue
● A result of problematic urges
Porn use is:
● A complex behavior, with multiple contributing factors and multiple possible outcomes
● Effective for arousal, orgasm, and coping, sometimes with unintended side effects
● Often a poor substitute for partnered sex and/or emotional intimacy
● A potential barrier to a satisfying sex life with a partner
● A fantasy shaper
In the language of sex positive, humanistic philosophy, the problem with porn is its power to shape fantasy. Like a drug that creates a biological problem only it can solve, porn has the ability to create fantasies only it can fulfill.
Schedule a free, 15-minute, phone consultation to see if we’re the right fit for you.
In our opinion, it is not wrong to fulfill fantasies through fantasy play, and porn can perform an important role in that healthy function
However, porn can also create a “phantom fantasy,” a picture of a picture of a picture, like a grainy porn video that’s been zipped across the internet too many times and has degraded in quality. Because porn images are often so explicit and specific, they can leave a lasting but vague impression of something that really turns you on but that has no basis in real-life experience.
These phantom fantasies can act as a mark on your mind, like a recovering scratch on the skin, that creates an itch only porn can touch. And scratching it makes it worse. It makes the fantasy more defined, more niche, more detailed, in an ever increasing spiral. This phantom fantasy is often experienced as the favorite handful of images you run to automatically in your mind when you want to cum.
Some of our clients struggle to find arousal and orgasm until they can picture a very specific kind of body part or situation. It’s often an image they have refined in their mind like a piece of art they lovingly crafted over countless forays into the underbellies of online porn. And thus it makes the fantasy more of a phantom, illusive, otherworldly, increasingly unattainable in the real world.
For some, their fantasies are so tied up in what they see in porn, that they will only ever find even the smallest sliver of fulfillment through more use of porn.
Once again, the Internet changes everything.
Ideally, this sort of fantasy cultivation would be accompanied by consensual sexual behavior with real people, based on real, obtainable sexual behavior. But, in the age of the internet, now our fantasies are only contained by the bandwidth of our cell phone data plans.
Despite how powerfully porn has shaped our cultural and sexual landscapes, we still do not believe that the desire to view porn should be confused for an unhealthy thing. And, we believe, many sex addiction professionals get this distinction wrong. The desire to view sexual material is healthy. The behavior of viewing sexual material can be healthy and useful. Using porn to cultivate unrealistic sexual fantasy, to medicate underlying problems, and/or to avoid human connection is often problematic, creating an itch that gets worse by scratching but that feels so good to scratch.
Crucially, rather than ask clients to stop cultivating their fantasies through porn, we ask clients to start cultivating their fantasies through intimacy and real life experience. We believe that when fantasies are exposed to the light of day and shared with another, they can start to develop in ways that are more tied to the real world. Some may need to stop viewing porn altogether, but many will not need porn to continue down a more fulfilling path with all of their favorite fantasies intact.
In therapy, we encourage clients to explore, understand, and accept their fantasies as the primary driver for building sexual competence. And sexual competence helps build mastery over the body and mind.
Our approach
● Emphasizes building sexual competence
● Encourages fantasy building as a form of competence building
● Encourages overall health and wellbeing in mind and body
● Destigmatizes sexual desire
● Encourages acceptance of the sexual self
● Encourages sexual intimacy as the best healer of problematic porn use
Our philosophy Is
● Sex positive
● Porn neutral
● Shame negative
● Intimacy focused
We offer individual and group sessions; some may find sharing in a group setting the most effective. Others will find the privacy of individual sessions essential. Regardless, we are ready to help.
Porn has the power to convince you that you know all there is to know about sex, when the reality is that your understanding of sex is only just beginning to develop.
Let us help you move from image based sex to intimacy based sex.
For those who need a more comprehensive review of our approach, keep reading.
What is porn addiction?
“Porn addiction” is a relatively new concept in the field of mental health science. Despite popular, social movements who espouse the dangers and harms of pornography, researchers have not found sufficient evidence to validate the existence of a specific, biological addiction to pornography[1].
A lack of scientific validation for porn-as-addiction doesn’t mean that the problem of porn isn’t real and doesn’t have real impacts on people. It is real, and it does have major impacts. Although scientists are still debating what to call it and how to treat it, problematic porn use can and does cause problems for many[2].
But the clinical (anecdotal) evidence seems to suggest that addiction may not be the best paradigm to understand and treat the problem of porn. After almost 15 years of clinical work with men who have undergone some kind of porn and sex addiction treatment, we believe that the clinical focus on addiction often clouds the core of the issue - the problem of porn is, most likely, best understood as an intimacy problem.
It’s not your fault.
In our opinion, there is nothing inherently wrong with you if you find pornography exciting, very satisfying, unsatisfying, or even repulsive. How you experience pornography is deeply complicated, rooted in many truths about who you are as a sexual human being. The problem with porn goes way beyond you.
We believe porn is a social problem that presents psychological, social, and biological challenges - all at once. Unfortunately, human evolution happens much more slowly than technological advancement, and we’ve not had the chance to evolve our brains enough to keep up with how technology affects us. In other words, we believe that our susceptibility to modern, digital, internet-based pornography is inherent to us as a human species and is not the product of some trauma, moral failure, or other essential element of individual experience.
The Problem with Porn
Porn is too effective.
If VSS is helpful for arousal, why can porn be such a problem? There are many theories about why so many, men in particular, seem harmed by and/or dissatisfied with their porn use.
We believe that modern porn is too effective. It is like a brain hack. It requires no effort. Evolution was so good at solving the problem of stress around sex that it inadvertently created a real, bonafide, problem for human beings who can so easily access internet-based porn at any moment with just a few taps on their phone.
What happens when an effective hack suddenly becomes ubiquitous? The rules, essential barriers, and helpful processes that govern a complex and important system, like sex with aloving partner, are suddenly meaningless. If all it takes to get aroused and orgasm is looking at a screen, then the erotic processes of self-care, self-cultivation, seduction, and intimacy are, suddenly, almost overnight with the dawn of the internet, totally skippable. It’s like playing a video game with cheat codes. Suddenly, the big boss you could never beat can be destroyed with barely a thought. What’s the point of the game, when you don’t need to play it to beat it?
Not only are the all important erotic processes, like seduction, now unnecessary, they are impediments to quick arousal and release. With cheap and easily accessible VSS, the psychological and behavioral processes previously needed for arousal require more investment and time for no guaranteed payoff. Previously we needed to calm down, breathe, relax, seek pleasure, connect, open up vulnerably, discuss and communicate. But those erotic processes are 100 times more difficult than turning on a screen.
VSS is the hack that bypasses the need for more complex, psychological and behavioral processes of vulnerability and relaxation that would actually lead to better sex and better intimacy between partners. Yes, porn is easier. But is it satisfying? That’s another big problem.
Porn is too pleasurable and not satisfying enough on its own.
Many clients come to our offices to talk about the raw power of porn’s ability to create pleasure. They often talk about it in terms of “dopamine” and “dopamine receptors” being overloaded. Our response to them is usually something like - “Don’t you want your sexual activities to be really pleasurable? Like mind blowing, can’t get enough, pleasure?” Most people say, “Yes, please,” to that question.
The problem is not that sex and sexual stimulation can be overwhelmingly, mind-blowingly pleasurable. The problem is not that sex can preoccupy the mind and body until sex or orgasm are achieved. Most would consider an insatiable appetite for partnered, intimate sex to be a welcome one in a long-term relationship. The problem with porn is that it is just pleasurable enough to scratch an itch and not meaningful enough to qualify as erotically satisfying. It provides just enough for pleasure, arousal, and release to keep you coming back for more, but it doesn’t give you enough of what you need to satisfy your hunger.
Porn is a poor substitute for sex education and sexual learning.
Another problem with porn is that, at least in the United States, society has completely consigned sex education to the bellies of the internet and to hardworking, talented, but unqualified porn actors and producers. Unfortunately, porn is a fantastic teacher but it teaches fantasy and story telling rather than the skills and boundaries of sex.
Porn also teaches people to masturbate at home alone rather than how to go out and advocate for partnered sex.
When does porn become a problem?
This is one of the perennial questions of the internet age, one that scientists and therapists will be trying to answer for the next several decades. And it’s not just porn. What about all of our screens? When is screen time a problem? Netflix. Gaming. Online gambling. Doom scrolling. The short answer is many of these things are good in moderation and terrible in excess.
But specifically porn seems to be a problem when porn and masturbation negatively influence the individual’s ability to form sexual connections with others.
Men and women often come into our offices in Boston feeling deeply ashamed and deeply hurt that men seem to have this ability to just look at some porn and get hard but can’t seem to do it any other way. When we look at these men we understand much better - of course they can’t. Looking at porn accesses a natural/instinct-based hack to fast and sustained arousal. There are no hacks to deep sexual intimacy and satisfaction with a partner.
How does the problem differ between men and women?
Yes, women can have a problematic relationship with pornography[3]. In our view, women are just as susceptible to the “phantom fantasy” problem described above; it’s just that their fantasies are often very different. Some women are just as turned on by VSS as men, experiencing the hack of VSS just as powerfully and are susceptible to the same pitfalls. But other women express that their fantasies of an ideal lover - for example, a man who is strong, competent, and also emotionally accessible - build resentment for their chosen partner. Women who wish to kick porn often describe a total lack of desire to have sex with a partner they perceive to be inferior to the fantasies they hold. In these cases, we often recommend couples sex therapy to help women and their partners explore an attainable and satisfying mutual sex life.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246896/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10374865/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044607/
Our Approach
We help develop sexual competence.
Sexual competence is the ability to ethically and effectively meet one’s sexual needs and the needs of their partner. The degree of competence needed increases as the length and emotional investment of the relationship increases, because sexual problems also increase with the length and emotional investment of the relationship.
Sexual competence is our primary objective, because it is achievable, measurable, life affirming, sex-positive, porn neutral, and intimacy focused. We believe sexual competence is effective, because it encourages and rewards sexual satisfaction that is ethical and in line with the client’s sexual desires and chosen values.
We explore fantasies.
If pornograpy creates “phantom fantasies,” clear and honest examination of those fantasies can be helpful. Are they realistic? Are they ethical and in adherence with the client’s values? What are the client’s sexual values? Are the fantasies in service to the client’s larger sexual and relational goals, or are the fantasies running the show?
These are the kinds of questions we explore with our clients. There is never any sexual contact in the room. We are professional psychotherapists. But we believe that the explicit and honest sharing of porn and masturbation habits and the underlying urges and needs they mask is the standard of treatment.
Intimacy is the treatment and the goal.
What happens when fantasy is put into words for someone else to understand? When the fantasy is private and secret, full of shame, it may create more tension and induce more excitement and a stronger release of tension (orgasm) due to these factors. When it is put into words and expressed, this intense feeling of release and impulse may be diminished and replaced with something more sustainable.
We do not utilize abstinence-based intervention.
We take a “harm-reduction” approach, meaning we do not believe that abstinence is the best policy for porn and masturbation problems.
We believe the desire to look and the response from looking at porn are hard-wired into our brains. It is a feature not a bug. We do not believe that shaming clients around their desire to and maybe even compulsion toward porn is productive or ethical. Modern porn takes advantage of this “hack,” probably more so than anything that has come before it. But because we are so naturally drawn to it, porn has been around for millenia, in some form or another.
Researchers may eventually convince us that addiction and abstinence based treatment is the right paradigm for porn use problems. However, given the available evidence today, we think pornography differs in at least one crucial way from addiction to a foreign chemical that is introduced to the body through drug use.
For drug users, the way to freedom from addiction is by separating oneself, slowly, from a foreign chemical that has hijacked the body and mind to create a desire for the chemical that is mostly biological and did not exist before the chemical was introduced. By seeing the chemical for the poison it actually is, drug users can return to a normal biological state.
We do not believe this kind of separation from sexual material can be achieved in a healthy way. In our experience, people who attempt to abstain from masturbation find themselves repressing healthy sexual feelings as well as unhealthy impulses. While temporary abstinence may be a helpful reset, it is not a long term solution, and it may accidentally encourage dissociative, repressive, and shame-based strategies instead of healthy integration.
For freedom from problematic porn use, we help clients see how they can integrate healthy sexuality into their day to day. We encourage clients to go deeper into the pleasure, to give themselves over more to their desires, to help them find true fulfillment solo and/or with a partner. We do not encourage separation from the natural, life affirming power of the erotic. We encourage clients to move closer to it.
We do not advocate for abstinence for this reason. We want our clients to have the capacity for sexual pleasure, and we want to support the things that help them reach pinnacles of sexual fulfillment, including through VSS, even porn (if porn use does not contradict the client’s value system).
We do not see VSS as an enemy.
We believe that seeing VSS as an enemy leads to poor sexual outcomes.
Evidence suggests that humans naturally respond to VSS, and that it can be helpful if used well. The evidence is mixed, however. Some studies show that men who use porn and masturbate (at reasonable levels) are more likely to want and be aroused by sex[1][2]. Women, in particular, seem to benefit from pornography use[3]. But, as discussed above, young people may be particularly vulnerable to its negative effects[4]. And most of the studies show that there are clear pathways to harm through problematic porn use.
But, in our opinion, researchers have not done a good job distinguishing between pornography use as stimulation for sex and pornography use as medication, leading to confounding findings.
What are you medicating/avoiding?
For most of the clients we talk to about porn, there is an element of grief involved in their use.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6679165/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246896/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235646/
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569536/