Sex & Porn Addiction
Sexual addiction is a relatively new term. Canes’ first described Sexual Addiction in his book Out of the shadows: Understanding sexual addiction in 1983. He postulated that sexual addiction is diagnosable disorder, similar to alcohol or drug addiction, which stems from the inability to adequately control sexual behaviour.
Sexual Addiction: has been described as a subtype of hypersexual behaviour, a behavioural addiction and an impulse control disorders.
In 2019 the World Health Association included Compulsive Sexual Behaviour Disorder in their International Classification of Disease ICD-11. It is described as a subset of impulse control disorders.
People who complain of sexual addiction tend to report:
- A lack of control over sexual behaviour, lack of impulse control or compulsion to engage in sexual behaviour (masturbation; pornography; web sex chat/texting/apps; sexual behaviour).
- Obsessions or preoccupation with sexual behaviour, and or planing and searching how to engage in sexual behaviour.
- Distress associated with sexual behaviour (guilt, depression, anxiety, shame, or low self-esteem due to conflict between public social role and secret behaviour).
- Continuation of sexual behaviour despite adverse consequences and/or attempts to cease behaviour.
- 80% of peolple also describe problematic pornography use. (Kafka, 2010; Reid et al., 2012) (Bőthe et al. 2018)
Sexual compulsivity is seen with other impulse control disorders such as ADHD, Alcoholism, Drug Addiction, Gambling and Internet Addiction.
What is NOT sexual addiction?
- Hypersexuality related to Bipolar disorder
- Promiscuity.
- Interest in sexual behaviour that is outside common practice.
- Watching Internet porn regularly.
- Interest in fetishes/kink.
- Seeking sexual behaviour because you are bored or unsatisfied
Porn addiction
There is increasing evidence that watching too much porn is bad for you. Too much porn has been described as behaviour that interferes with every day activities such as work, sleep, socialising or your relationship. Although men are more likely than women to have problems with porn, women are increasingly showing up in high usage group.
There is increasing evidence that porn rewires the brain so that it is difficult for individuals to enjoy regular sexual activity with their partner. Compulsive users have described decreased sensitivity leading to decreased satisfaction with partnered sex, erectile dysfunction, delayed ejaculation and a preference for masturbating to porn rather than having sex with a human partner. There is no information on sexual impact of excessive pornography on women.
This partner-specific reduction in sexual enjoyment is thought to be related to the Coolridge Effect, i.e. the increase in sexual interest for a novel partner over a regular partner demonstrated in all mammals (particularly strong in male mammals).
Internet pornography provides immediate increased sexual arousal via the delivery of multiple novel partners (specific to your fantasy). Thus porn, with repeated exposure and practice can become more sexually stimulating than a long-term partner.
In addition, there is no judgement from porn, there is less distractions about having to please your partner or worry what a new partner will think of you. Internet pornography is easier than having to think of your own fantasy and deal with a person. Unfortunately with internet pornography if you practice your sexual response repeatedly in one way you become very good at that one thing, sometimes to the detriment of partnered sex. Thus excessive porn use can lead to a narrowing of sexual response and decreased flexibility in sexual response and arousal.
Although pornography has been around for ever, the Internet has provided the pathway for porn to become compulsive. Historically, people tend to watch a Video, CD or DVD only limited amount of times. Now you can access multiple partners doing multiple different sexual activities all at the same time on the same screen.
Further, the reward of pleasure is easily and immediately accessible; there is an abundance of types of porn and avenues to access it (phone, tablet, computer; chatting with a real person via web cam, sexting, virtual realities) you can check in at any time of the day. The speed of access and reward, is a powerful habit builder.
Internet porn also can provide both a sense of intimacy…..(there is some one else who is into the same things as you) and anonymity. There is always someone who is willing to have sex with you, it makes you feel good by boosting your ego and you can live out your fantasies and forget about reality.
Individuals who are watching too much porn tend to display the following signs:
- Continued porn use despite negative consequences and/or promises made to self or others to stop.
- Escalating amounts of time spent on porn use: hours, sometimes days, lost to viewing pornography (sexting, sex chats, checking dating apps, searching back page, crags list etc).
- Viewing progressively more arousing, intense, or bizarre sexual content.
- Lying, keeping secrets and covering up the nature and extent of porn use.
- Anger or irritability if asked to stop.
- Reduced or even non existent interest in sexual, physical, and emotional connections with spouses or partners.
- Loneliness and detachment from other people.
- Drug/alcohol use or addiction relapse in conjunction with porn use.
- Increased objectification of strangers, viewing them as body parts rather than people.
- Escalation from viewing two-dimensional images to using the Internet for anonymous sexual hook-ups and sex workers.
- Change in sexual interest leading to questioning sexual orientation, such as engaging in same-sex or transgender sexual fantasy and or behaviour in context of compulsive porn misuse but remission of this interest when not watching porn.
- Watching at work with possible job loss as a consequence.
- Watching illegal content.
What is the treatment?
There is little data on treatment out comes for sexual addiction. This is due to the lack of consensus on the definition (sexual addiction, hypersexuality or sexual impulsive control disorder).
Personally, I find that it is better to respond to the individual rather than try and fit a person into a category. This is particularly true for sexuality. All of us have unique sexual histories that influence our sexual expression. Sex is a great way to feel better and to process negative feelings. It’s just if that if you rely on sex as a self soothing strategy at the expense of other forms of emotional regulation, then it can become compulsive and unhealthy.
Many cognitive and behavioural strategies that are effective in reducing addiction to alcohol, drugs and food also work for sexual compulsivity. Also DBT strategies that are effective for emotional regulation are effective for sexual compulsions.
Important initial interventions are:
1) Disclosing intent to stop to someone important
2) Deconstruction of secretive sexual behaviour; integrating the self; stopping compartmentalisation
3) Use of firewalls and blocks on technology to stop access to hook ups and sexual content
4) Development of support networks and strategies to reduce or cease behaviour
5) Alternative emotional regulation skills
6) Physical activity to complete the stress response cycle
7) Development of alternative pleasurable activities
8) CBT
9) Partner education and support: intermittent attendance as required
10) Planning for relapse.
Partners may be traumatised by the extent of the compulsive behavioural or infidelity. They may also require support and are instrumental for behavioural change to be long-lasting.
Alternative approaches include
- Medication to treat symptoms or co-existing conditions such as anxiety, depression, ADHD, or hypersexual desire (suppressing sexual desire not recommended unless engaging in criminal activities.)
- Sexaholics Anonymous : a 12 step program for “sex addiction” requiring sexual sobriety or
- Sex and Love Addicts Anonymous: also a 12 step program for sex and love addiction and sexual annorexia
- Sex addiction detox/rehabilitation: South Pacific Private.
- Sex Rehab Thriving Industry article by the Los Angeles Times.
