A while back, I shared a study arguing that porn was not an addiction. I also explained why this matters for treatment. In the months since then, I’ve gotten several emails from people asking questions about that post. Many of these messages cited a response by Matt Fradd that took issue (very respectfully, thank you Matt) with my position. Most recently, I received an email from a pastor who was interested in the debate about the issue. My conversation with this pastor–who, like many pastors, works with a lot of people who confess the sin of pornography and masturbation–led me to believe that an update to my original post was in order.
WHY IS PORN (STILL) NOT AN ADDICTION
To be clear, I have no issue with the phrase “sexual addiction” if it is used casually to refer to inappropriate and destructive sexual behavior. There is no question that pornography is a pervasive, insidious, and terribly destructive problem. It can even seem, superficially, addictive. I and my associates at the Pastoral Solutions Institute’s Tele-counseling practice treat a lot of people who struggle with this issue and we regularly witness, first hand, the havoc it causes.
That said, in treatment, labels do matter because they direct both how we think about the roots of a problem and how we treat it. In light of this, people are often surprised to learn that despite the fact that this phrase has been around since the late 1980’s, “sexual addiction” doesn’t exist as a diagnosis in either the DSM-V or the ICD-10 (which general physicians use). Even the people who argue that pornography use is an addiction are, in fact, obliged to diagnose it either as an “impulse control disorder” or some type of obsessive-compulsive disorder. The psychiatric and medical professions simply do not recognize the pop-psych diagnosis of “sexual addiction” because there is insufficient evidence to suggest it is an addiction rather that a compulsion/impulse control disorder.
Again, here’s why that matters to you.
Addiction VS. Compulsion
There are several important reasons mental health professionals view problem porn use and masturbation as an impulse control disorder or compulsion instead of an addiction. A good rule-of-thumb for determining the difference between a compulsion and an addiction is that addictions are experienced more as a source of pleasure than guilt while compulsions are experienced as more a source of guilt than pleasure.
If sex were an addiction the person…
1) wouldn’t tend to feel guilty about what he did,
2) would experience physiological withdrawal (that jeopardized his health–not just caused psychological discomfort) when the “drug” was removed for a period of time, and
3) once he was “clean” the problem would be largely resolved. (And yes, I’m aware of the “dry drunk” phenomenon, but those behaviors tend to be treated as issues that are co-morbid with the addiction as opposed to the cause of the addiction.)
The compulsive, on the other hand, is simultaneously drawn to the object of his obsession and repulsed by his connection to it. He HATES himself for doing it but he can’t stop. (By contrast the addict will often say he hates himself for indulging, but there’s little emotion behind the claim. In truth, he loves it and lives for it).
Likewise, a sexual compulsion is not driven by a physiological need for either the object (porn)/action (masturbation). While an addict could die from not getting his fix in time, no one is going to die from not being allowed to look at porn or masturbate. Instead, what drives a compulsion–sexual or otherwise– is an underlying, misunderstood, frustrated emotional need. For the sexual compulsive, we are specifically talking about the need for intimacy. Most sexual compulsives are terrible at intimacy and use porn as a substitute. But because, as Mark Shea often says, “you can never get enough of what you don’t really want” the ache of the unsatisfied need for intimacy makes them hate themselves for settling for less. An addict has no such internal struggle, they believe they have found what they need in the bottle or the drug.
Sin versus Disorder
But what about sin? Does everything have to be pathologized? Isn’t there at least SOME time when lust is “just” sinful?
It’s true. For most, otherwise healthy, normal, (sinful) people, porn is attractive simply because we tend to be fascinated by provocative images. This is the sin of lust and, at this level, porn use/masturbation is a bad habit that can be overcome by grace, self-discipline, and accountability. You don’t need therapy for this. Go to confession. Practice virtue. If need be, get some support with an internet filter. You’re good to go.
When Porn Becomes a Pathology
Unfortunately, for more serious porn problems, this approach doesn’t tend to work because the mere fact that porn involves provocative images isn’t what makes porn so hard to resist.
Ultimately, the degree to which a person struggles with porn use is almost directly proportional to his/her struggle to be authentically, genuinely intimate with the people in his or her life. People struggle with compulsive use of porn because they have poor relationship skills, can’t figure out how to be vulnerable in healthy ways, aren’t good at articulating their needs in relationships, and aren’t comfortable dealing with emotions–especially negative emotions. They use porn to self-medicate for all of this. Using filters on your computer or smartphone can be a fine first step, but it can also strengthen the force of the compulsion because now, you don’t even have unhealthy ways to meet these other, very legitimate needs (e.g., needs for healthy intimate connection, emotional expression, personal fulfillment).
Porn is just the tip of the iceberg for these individuals. It’s a symptom, and they’ll continue to struggle with it until the underlying issues are addressed. That’s why an addiction model (which says, in essence, “just avoid it and you’ll be fixed”) doesn’t really work and can even make things worse for these individuals. It leads people to believe that if they could just put their phone away or shut down the computer all would be well but, in fact, these people have much deeper problems expressing their emotional and relational selves in healthy ways; problems that must be addressed if they want to be genuinely free of their sexual compulsions.
Porn isn’t a social problem because people like porn. It is a social problem because, as a society, families have stopped teaching children how to have healthy relationships. This breakdown in the capacity for interpersonal attachment and intimacy is rooted in the breakdown of family life (and even many intact families don’t have an actual family life) which then expresses itself as a compulsion to use porn.
Healing & Hope
We need to think of compulsive porn use, not as the disease itself, but as the fever that accompanies the disease. Yes, sometimes a fever becomes so serious that has to be the focus of treatment. But more often, you watch the fever to judge the progress of healing the underlying infection. The problem with the addiction model is that it tends to ignore both the deeper infection and the responsibility one has to heal this deeper wound. Telling someone “just put a filter on your computer” and “have custody of your eyes” does nothing to encourage them to get the help they need to develop the relational/emotional skills they are lacking; the very problem that drove them to a compulsive relationship with porn in the first place.
Healing from compulsive porn use can be challenging, but it is absolutely possible. If you or a loved one would like more information on what it takes to overcome the struggle against compulsive pornography use, start with both Broken Gods: Hope, Healing, and the Seven Longings of the Human Heart which explores how to stop hating yourself and start healing the hurt, and Holy Sex! which reveals what it takes to experience your sexuality as God intended. For additional assistance, contact the Pastoral Solutions Institute to learn how our tele-counseling practice can help you find healing for yourself and your relationships.