When I assess a person, it is important to keep an open mind about what is occurring for them. However I have consistently found that these men (and they have all been men) describe problems with compulsive pornography use that closely mirrors most of the symptoms of substance addiction.
Furthermore, interventions that have been developed to work with substance misuse have seemed generally well suited to assisting these men recover from their pornography problem.
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What does pornography addiction look like? There is a lot of variety, but the following imaginary scenario is not unusual.
Tim is 40 years old and has been married to Michelle for 11 years, with two young children. Tim does not have any substance misuse issues but does suffer from recurrent mild depression. He has always liked pornography, starting with a collection of magazines as a teenager. He described his level of pornography use rising to a whole new level when he got his first internet-connected computer almost 20 years ago. Since that time he has never had a break from pornography for more than a week other than when travelling.
Currently he spends one to two hours a day viewing it, most days of the week. He will go to bed after Michelle is asleep or get up early in the morning. Whenever she and the girls are out and he is home alone he will take the opportunity to watch porn. The content he watches is "mainstream" adult heterosexual material. He does not like anything that involves coercion or other "nasty" elements, but admits that what he watches is a pretty distorted view of sexuality. Tim will build up a library of images and clips and will eventually delete it all, fearing discovery and trying to stop using, only to then start another collection.
Michelle recently discovered Tim's use and although she had previously been unaware, found this helped to explain some of the emotional distance in their relationship. She is struggling with mixed feelings. She loves Tim and wants to support him, but is also very uncomfortable about the idea of this material being viewed in their home, and worries about the effect this will be having on Tim's attitudes to women in general and his judgement of her in particular.
Tim has had problems in previous relationships due to his pornography use. He is angry with himself and can't understand why he can't leave it alone. He has never spoken to anyone about this before and is feeling powerless but resolved to finally stop for once and for all when he calls a psychologist asking for help.
My clinical experience tells me that compulsive pornography use can helpfully be understood, and treated, as an addiction. This does not mean all pornography use is problematic.
There is little data on the extent of pornography use in the general population, and a wide range of political, sociological, religious and health perspectives that influence whether pornography use can be seen as normal/abnormal, right/wrong, healthy/unhealthy, but there is no doubt that for some people use can be heavy and problematic and can feel out of the individual's control.
Simon Adamson is an associate professor at the National Addiction Centre, University of Otago, based in Christchurch. Simon also works as a clinical psychologist in private practice specialising in addictions.
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