I f I asked you to describe porn addiction or a porn addict, for that matter, what would it look like? Would it be a question of consumption–the number of times per day, week, month that I access erotica? Would it encompass binging: being helplessly glued to a screen or magazine page for such a span that I lose track of time? Perhaps the consumption is merely a trifling detail, dwarfed in importance by the negative consequences it has on my life. Does my accessing porn make me blow off engagements, neglect my own health, or affect my performance at work or school? Contrarily, if I go on marathon sprees of erotic exploration but maintain all other facets of my life with no noticeable drop-off, should I still be counted as an addict? Asking for a friend.
Part and parcel of having such an extensive set of criteria with which to characterize a disorder is an equally vast list of names with which to label it. Porn addiction has come to be either denoted by or clustered with terms such as Hypersexuality, Compulsive Sexual Behavior (CSB), Problematic Pornography Internet Viewing, Internet Porn Addiction, and countless other confounding identifiers.
A hypersexual, for example, can be anyone “preoccupied with sexual fantasy that contributes to the obsessive pursuit of casual sex, pornography, compulsive masturbation,” or any otherwise romantically detached activity, usually for a period of at least six months.
Definitions of problematic internet pornography viewing, on the other hand, detail personal or social consequences that include prioritizing porn over time spent with close friends or family. Those who perceive themselves to be afflicted by this condition report depression, social isolation, job loss, and decreased productivity.
Whether the aforementioned conditions are, in fact, the root cause of such consequences, however, is a matter of some conjecture. About half of the people that identify themselves as ‘hypersexual’ meet criteria for at least one mood, anxiety, substance use, impulse control, or personality disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM V)–the authoritative resource for all psychological disorders.
What’s more, both hypersexuality and problematic porn viewing frequently occur as symptoms of other disorders such as:
- Borderline Personality Disorder;
- Bipolar Disorder; and
- Schizoaffective Disorder
…as well as neurodegenerative diseases like:
- Autism; and
- Parkinson’s Disease
It’s easy to confuse terms and the disorders with which they’re associated, but thinking of porn addiction like a Russian nesting doll might help you keep things straight. The largest doll would be Hypersexuality–often used interchangeably with Compulsive Sexual Behavior. Within that doll would be Problematic Internet Pornography Viewing, or Porn Addiction, a symptom of hypersexuality.
Our hypersexuality might manifest itself in an addiction to porn, but watching a large amount of porn, masturbating, thinking about sex, or reading an erotic novel does not a hypersexual make. In the same way, being hypersexual doesn’t necessarily mean that someone has Alzheimer’s (an even bigger doll) even though hypersexuality is a symptom of that disease.
We’re not just broad-stroking these terms in the interest of better understanding the complexities of purported porn addiction. Providing these terms with some context is helpful in that despite all of these definitions and associated criteria, the American Psychiatric Association (APA) has until now, not acknowledged sexual addiction, compulsive sexual behavior, hypersexuality, or any similarly proposed condition as a disorder that should be added to the DSM-5.
This lack of recognition has largely prevented porn addiction, or any seemingly ‘troublesome’ sex-related behavior, for that matter, from being accepted as a condition within psych circles. And while it’s true that the World Health Organization recently announced its intention to recognize compulsive sexuality as a condition, it’s still not considered a sexual disorder. This brings us to point number one of the porn addiction conundrum:
You technically can’t be addicted to porn.
Not because there’s no way that such a condition could ever possibly exist, but because it really hasn’t been acknowledged as something that can be scientifically accepted, given existing research. Sure, you might self-diagnose yourself as an ‘addict,’ incapable of controlling your urges to access porn online–and people often do–but diagnosing yourself with a disorder, which, in the eyes of large scientific communities doesn’t yet exist, and then trying to get others to accept it is a lot like walking through airport security with an alpaca under the pretenses that it’s your comfort animal. Maybe it’s justified, given your symptoms, and someday your condition will probably gain popular acceptance, but presently, the more skeptical among us will demand empirical proof before legitimizing your need for it.
The bulk of the conditions covered in the DSM-5 are substance, rather than behavioral addictions. Addiction as a concept in and of itself is a lot more technical and requires substantially more time than we have to spend here. But boiled down significantly, it involves the activation of the reward system within your brain and works in tandem with memory, expectation, reinforcement, and other similar components to habituate you into certain actions on the premise that doing them will repeatedly bring you something that you want.
Behavioral addiction is similar to drug addiction except that in the former, the addict isn’t addicted to a substance but the behavior or the feeling brought about by the behavior. Think compulsive liars, kleptomaniacs, hoarders, etc.
Behavioral addiction is very scarcely represented in the DSM-5, with pathological gambling–denoted “Gambling Disorder”– as the sole condition for which diagnostic criteria is currently available. It’s not like other behavioral addictions haven’t been proposed for consideration in the Manual of Disorders, it’s just that any proposed behavior generally needs to be based on established diagnoses for substance abuse.
This brings us to a bigger issue: trying to establish a connection between a behavioral addiction and a substance addiction isn’t the easiest of tasks. To even merit consideration, behavioral addictions need to share similar diagnostic criteria with substance abuse and dependence. This might include obsession with a behavior, a subsequent diminished ability to control that behavior, or withdrawals after having ceased that behavior.
Assuming that hurdle is cleared, you’ve then got to contend with the scientific community at large concerned with the implications of attributing the label ‘disorder’ to what may just be an alternative strain of otherwise healthy sexual behavior, thereby needlessly stigmatizing a fairly large swathe of people for whom the behavior is routine.
Beyond this, the Russian Nesting Doll model we discussed earlier highlights the fact that behavioral addiction–specifically, porn consumption–may not actually be its own disorder, but rather an extension of a pre-existing mental health condition.
A recent study that clustered a large sample of Croatian adults into one group representing problematic sexuality (like chronic excessive porn consumption) and another reflecting high sexual desire and frequent sexual activity found that individuals in the problematic cluster reported more psychopathology (mental or behavioral disorders) than individuals in the high-desire/frequent-activity cluster. This suggests a few things:
- A case of troubling sexual behavior may not be a disorder in its own right, but rather a symptom of something larger;
- Compulsive Sexual Behavior may be organized more along a continuum of increasing sexual frequency and preoccupation, wherein clinical cases are more likely to occur at the upper end of the scale; and
- People’s evaluations of their own sexuality–how morally acceptable what they do is–may be getting in the way of an honest assessment of what they really do sexually.
The study concluded that “despite the growing body of research linking CSB to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.”
But it’s the rate at which that “body of research” continues to grow, which has perhaps proven most astounding. A 2015 literary review whose findings were compiled by a team of renowned psych academics cited more than 300 different studies ranging from brain mapping to the ability to carry out mundane tasks, in assessing the neurological basis of porn addiction and defending growing assertions that porn addiction deserves recognition among disorders and addictive conditions.
One study, for example, made use of functional magnetic resonance imaging (fMRI) to show that self-described porn addicts share the same brain activity as substance abusers and alcoholics when triggered by an addictive cue.
That same study also established a distinction between liking and wanting or craving in hypersexual-subjects when watching porn via what’s known as the incentive-salience theory. The theory holds that addicts compulsively behave a certain way because there is some expectation of a reward that they may not particularly like, but strongly crave resulting from the behavior.
Perhaps most damning among findings like these are the parallels drawn between extended consumption in problematic viewers and comparatively less connectivity between the two parts of the brain most crucial to rewards-based planning and suppressing urges. These studies point to shorter reaction times in relevant brain regions when shown addictive cues, and dulled responses when shown non-addictive cues.
The direction of causality in these studies is obviously critical, as you’d need to establish that over-consumption of porn leads to structural changes in the brain, and not the other way around. Assuming the link between porn consumption and inhibition of the part of the brain responsible for impulse control were established, however, you could make the argument that porn does contribute to addiction.
How prevalent is porn addiction self-diagnosis?
By now, you’ve probably fallen prey to a bit of WebMD self-diagnosis. Ticking boxes, reviewing your porn consumption habits over the past week or so, etc. Understandable, but hasty.
With problematic porn consumption prevalence studies putting the number somewhere between 1.5 and 8.2 percent of Americans and Europeans, addiction probably isn’t as rampant as you might think.
Though exact figures are a bit tough to nail down, most other studies mirror these rates. One separate convenience sample of 9,265 people even found that only 1% of Internet users are clearly addicted to cybersex, while 17% of users meet criteria for problematic sexual compulsivity.
And even these figures may be a bit on the high side. The criteria for problematic sexual compulsivity is based almost entirely on a Sexual Compulsivity Scale, which, while having proven itself accurate in its predictive ability with respect to health outcomes, also isn’t without fault.
On one hand, items on the scale were initially derived from self-descriptions of people who identify as having a sexual addiction. Using a scale that’s composed of affirmations generated by people that identify themselves as afflicted by the very condition you’re trying to diagnose probably isn’t the most objective way of going about things.
On the other hand, many of the questions that make up the scale are every bit as subjective as they are vague:
- My desires to have sex have disrupted my daily life
- [I] find myself thinking about sex while at work
- I sometimes get so horny I could lose control
…of what? My life? The bottle of lotion in my hands? A moving vehicle?
For most people, whether we believe ourselves to struggle with hypersexuality or not, these are things that we all identify with to varying degrees.
Allowing respondents the liberty of self-assessing behaviors that do or don’t seem to jive with their personalities with evaluatory measuring sticks like ‘Slightly Like Me,’ and ‘Mainly Like Me,’ as pictured above in an excerpt from the scale is emblematic of concept creep in its purest form.
Leaving dirty dishes in the sink sounds slightly like me–if you ask me. It sounds ‘very much like me’ if you ask anyone that lives with me.
Even if we were to ignore the potential hang-ups in data collection methodology, other factors exist that challenge the integrity of porn addiction self-assessment.
A 2014 study conducted by doctoral psychology students at Case Western identified a connection between a subject’s religious beliefs and their self-perception of porn addiction, with results strongly indicating an inclination in religious people to believe themselves to be addicted to erotica regardless of how much they watch or whether it negatively impacts their lives.
That’s a different can of worms entirely, but it bears mention that it’s not completely out of the realm of possibilities for a self-described porn addict to have other factors at play that contribute to their self-perceptions.
What if porn addiction is real?
Let’s say that we play devil’s advocate and accept more liberal estimates about the prevalence of porn addiction. If porn addiction as a diagnosis ultimately slides into the DSMs–an assumption which, given the mounting evidence from aforementioned findings, seems to be more of a ‘when’ than an ‘if’–what would it mean?
The dangers of existing addiction diagnoses are clear. A gambling addiction is, in most cases, a one-way ticket to the poor house; and the psychological, physical, and social impacts of a substance addiction have been well-documented for some time now. But what of the implications of a porn addiction? What are the adverse consequences associated with problematic consumption that society would want to avert by getting help for the diagnosed?
Like the issue of porn addiction itself, this is a question whose answer really depends on who you ask. Many studies have looked into correlations between problematic porn consumption and our ability to effectively carry out mundane tasks, but so far there’s been nothing conclusive in the way of findings.
Social impacts are a different story entirely, particularly for those that are in a relationship while simultaneously running through caches of porn like a season of Stranger Things on Netflix.
Surveys of female college students indicate that those who perceive their boyfriends’ porn use to be problematic experienced lower self-esteem, poorer relationship quality, and lower sexual satisfaction. Subsequent studies have mirrored these findings, while also revealing– interestingly enough– that female use of porn was associated with improved quality of sex for women. Take notes, ladies.
There are two explanations for this:
1) The type of porn that men report watching usually isn’t as intimate as that which women watch; and
2) Women report consuming porn as a tool to aid sexual intimacy with their partners.
The study went on to note that when one partner uses porn at a high frequency—typically the men in heterosexual couples—there was a tendency to withdraw emotionally from the relationship, with men reporting “increased secrecy, less intimacy and also more depression.”
This all begs the question: Is pornography the chicken or the egg? Does a person turn to pornography because they’re already in an unsatisfying relationship, or does the significant other pull away and lose interest in sex when they discover their partner prefers porn over intimacy?
In all likelihood, it’s a combination of the two, with one feeding off of the other.
If a heterosexual couple goes through a dry spell, the man may watch more porn to fill the void. Some women may feel threatened or confused by that response–many women from the study reported feeling less attractive–as though they could never measure up to the X-rated actresses. The result: even less sex, even more porn, and a relationship that winds up unraveling faster than a dysfunctional boy band.
Porn addiction has become such a fixture in modern health parlance that it’s begun to take on a life of its own–perhaps a bit prematurely. To be sure, the sheer glut of evidence that has emerged in recent years that defends the existence and, in some cases, the problematic implications of this particular brand of compulsive behavior is nothing to sniff at.
We know that when seeking out rewards, the brain often goes unchecked. If we consider sexual arousal or climax as one of those rewards, and porn as the stimuli we crave in order to get that reward, considering porn as an acknowledged addiction becomes a lot more sensible.
On the other hand, anecdotal evidence from those close to us, self-reporting, self-diagnosis, or whatever you may choose to call it is about as flimsy a diagnostic foundation as you’ll find. What we perceive in ourselves–or others perceive in us–is almost certain to be influenced by some form of bias, and even if no bias exists, the subjective nature of that kind of an assessment makes it tough to establish a standardized concept of what that addiction would entail.
What does a porn addiction look like? What are the tell-tale signs of a slave to ‘screen smut’? Whatever they are, it’s important to be mindful of how we ultimately label these things. Calling Compulsive Sexual Behavior a ‘problematic and diagnosable’ condition opens up the door for an industry that could easily exploit millions of people that may need psychological attention for reasons completely unrelated to porn. We’re still likely years off from a definitive ruling, but for now, as just about all of the research in its totality seems to conclude: insufficient data exists; more research is needed.