Over at
The Good Man Project there is a recent article called, no joke,
"Theoretically a man could worry that he’s addicted to porn and it turns out he’s really not. Is there room in the diagnostic system for that possibility?” Apparently this was a comment someone left on the post "
Why Does Porn Seem Hotter Than My Partner?"
Please be aware, there is no diagnostic category for porn addiction - it's not a recognized mental illness, nor is sex addiction. Which is not to say that porn addiction does not exist - it most certainly does, and most porn addicts are not aware that they are addicts, and most of them certainly would not self-refer.
The Editors, in their article based on this comment, offered their own definition of porn addiction:
Here’s where [the authors of the original post] are on solid ground: there are men who are aware
that they have a problem with porn. These men know they have a problem
because they feel like their porn habits are out of control. Their sense
of being out of control gives them a lot of stress, and a part of each
of them wants to change but is not sure how. I have no doubt the
testimonials are genuine.
This is often how addiction or other psychological disorders are
spotted and treated. Treatment often begins when the subject asks for
help or when the subject identifies to himself that he has a problem. A
diagnosis of porn addiction is literally “subjective” – based in large
part on whether or not the subject thinks he has a problem. If he thinks
he has a problem, then he probably does. This is a common threshold for
a lot of conditions in the DSM-IV: the difference between a personal
quirk and a disorder is how much it bothers the subject. If I have a
problem with reliance on the subject’s own viewpoint, then I have a
problem with psychiatry as a science in the first place.
So, if a man prefers to masturbate to porn instead of his partner and
this bothers him, or if he can only get an erection to porn and this
bothers him, then he has a problem.
My question is: if it doesn’t bother him very much, then can we still
say that he has a porn problem? Maybe in some cases, maybe not. Maybe
he’s addicted and he’s in denial, or maybe he doesn’t have a problem.
That’s the tricky part.
Again, porn addiction is not in the DSM-IV, nor will it be in the DSM-5.
This brings me to my next point - porn addiction exists, for sure, but there are no standardized, agreed upon measures for diagnosing addicts.
Patrick Carnes teaches counselors how to assess for this problem, but he is still an outsider in the mental health industry (this does not make him wrong, only a trailblazer).
There are differences in the brain scans of sex addicts than those of "normal" people. However, the scans of a sex addict are nearly identical to those of a cocaine addict - pretty much all addiction, with the technology we have today, looks alike in the brain. So a brain scan will not clearly identify a porn addict or a sex addict, largely because sexual addictions are very frequently comorbid with other chemical addictions.
So how do we identify a porn addict?
Obviously, if it is getting in the way of daily activities, or it is destroying an intimate relationship, or if you are acting out (viewing porn and/or masturbating) at work, you have a problem.
In my opinion, all addictions share one common element - the chemical or the activity serves to "self-medicate" our painful or disturbing feelings out of awareness. When we feel the need to engage in our addiction of choice, more than likely there is an uncomfortable feeling just beneath that urge, so we engage in our addiction, the feeling goes away (for now), and then if our addiction is sexual or otherwise troublesome (crack, heroin, meth, alcohol, etc.), then we feel shameful.
Here is how Patrick Carnes conceives of the addiction cycle - it would be the same for porn as it is for sex or drugs:
THE ADDICTION CYCLE
For sexual addicts an addictive experience progresses through a four-step cycle that intensifies with each repetition:
1. Preoccupation—the trance or mood wherein the addicts’ minds
are completely engrossed with thoughts of sex. This mental state creates
an obsessive search for sexual stimulation.
2. Ritualization—the addicts’ own special routines that lead up
to the sexual behavior. The ritual intensifies the preoccupation, adding
arousal and excitement.
3. Compulsive sexual behavior—the actual sexual act, which is the
end goal of the preoccupation and ritualization. Sexual addicts are
unable to control or stop this behavior.
4. Despair—the feeling of utter hopelessness addicts have about their behavior and their powerlessness.
The pain the addicts feel at the end of the cycle can be numbed or
obscured by sexual preoccupation that reengages the addiction cycle.
[Carnes, Out of the Shadows: Understanding Sex Addiction, 3rd Edition, 2001, Kindle Location 462-470]
From
an earlier post I did on this topic, here is more from Carnes on the core beliefs of the sex addict (likely true as well for the porn addict).
Sex addiction, like all other addictions (sex, like gambling, is often
considered a process addiction rather than a substance addiction), is
generally a response to developmental damage in the child, who is
neglected, abused, molested, raped, or otherwise exposed to violence
and/or sexuality at a young age. The result is a brain that is wired
differently, a brain prone to seeking ways to escape, to numb the
psychological pain.
Carnes identifies four primary areas in development that get hijacked
and become unhealthy core beliefs, leading to addictive behavior.
There are four factors in a child’s development that ultimately become part of the sexual addiction:
1. self-image—how children perceive themselves
2. relationships—how children perceive their relationships with others
3. needs—how children perceive their own needs
4. sexuality—how children perceive their own sexual feelings and needs
These perceptions ultimately become “core beliefs” central to the
addictive system. They are conclusions that can govern choices and
behaviors during the child’s adult life.
[Carnes, 2009, Out of the Shadows, Kindle Locations 1432-1437]
In the addict, each of these areas develops into an unhealthy core
belief. In examining how these beliefs comes about, Carnes offers a
series of examples, including a man named Morris. Here is a brief
summary of this man's childhood:
First, there is alcoholism in the family. Second, physical and emotional
abuse accompany sexual abuse. Third, sexual experience is both
humiliating and comforting. And fourth, the reality of the child is
denied when the child’s accounts of abuse are not taken seriously. All
of these are potent contributors to the addiction, as we shall see.
By far the most important factor, however, is
a sense of having been abandoned. From a child’s point of view, “you
can abuse me, humiliate me, exploit me, and even not believe me, but by
far the worst is if you don’t even want me.” Fear of abandonment is a
constant theme in all addictions, including alcoholism. Within the
sexual addiction, it is especially powerful.
[Carnes, 1454-1459]
Abandonment, in some form or another, whether literal, emotional,
physical, or otherwise, is a foundational wound for addicts, but
especially for sex addicts.
The sexual addiction receives its power from a fundamental concern for survival.
The first core belief of the addict is “I am basically a bad, unworthy person.” Abandonment means being unwanted. The child can only conclude that being unwanted means being unworthy and bad.
[Carnes, 1467-1469]
Abandonment does take many forms, and aside from the versions mentioned
above, attachment psychology recognizes poor attachment as a form of
abandonment, especially the absence of "mirroring" for the infant as a
way to develop affect regulation (see Allan Schore).
Schore refers to this as relational trauma, and the results includes
inability to regulate affect (thus the 4th core belief in some form
another as shown below), a sense of worthlessness, feeling fundamentally
flawed, and a variety of other issues, mostly stemming from the right
brain's emotional centers.
Here are the other three core beliefs and how they play out:
A second core belief comes from the first core belief about the child
being a bad person. Because of personal unworthiness, the child
believes, “No one would love me as I am.” Relationships
with others become more tenuous the deeper this belief is. Children grow
up believing that no one will accept them unconditionally. People will
not be there; they cannot be trusted or depended on. If they do want a
relationship, it is because they want something—not because they care.
There will always be a price to pay. Minimally, there will be something
that must be overlooked, ignored, or denied. To be close will mean to
lose reality or integrity somehow. So intimacy is avoided.
[Carnes, 1483-1488]
***
[I]n the lonely search for something or someone to depend on—which has
already excluded parents—a child can start to find those things which
always comfort, which always feel good, which always are there, and
which always do what they promise. For some, alcohol and drugs are the
answer. For others it is food. And there is always sex, which usually
costs nothing and nobody else can regulate.
This choice stems from the addict’s third core belief that is about needs: “My needs are never going to be met if I have to depend upon others.” In healthy families, children have a deep sense that their parents care for them as opposed to abandoning them.
Healthy parenting includes touching, loving, affirming, and guiding. The
child feels cared for even when struggling with rules and limits. Trust
in one’s self, as well as trust of others, emerges in that
relationship.
When a child’s exploration of sexuality goes beyond discovery to routine
self-comforting because of the lack of human care, there is potential
for addiction. Sex becomes confused with comforting and nurturing.
Moreover, the assumption is made that everyone else feels and acts the
same. Therefore, to feel secure means to be sexual.
Consequently, the child’s relationships with people have the potential
for being replaced with an addictive relationship with sexuality.
Addiction is a relationship—a pathological relationship in which sexual
obsession replaces people. And it can start very early. The final core
belief of the addict emerges clearly: “Sex is my most important need.”
The kinds of childhood situations described here are further complicated
when the children are surrounded by negative rules, messages, and
judgments about sex. When addicts and their spouses study their families
of origin, they are flooded with memories of events where they were
told that being sexual was bad or, worse, that they were bad for being
sexual.
When children’s primary source of comfort is sex and yet they are told
by those whose judgments count the most that to be sexual is perverse,
the conclusions they make about themselves are clear. They are
unlikable. They need to hide that central part of themselves, which
others will despise. Rather than repressing the sexual behaviors, they
hide them or keep them secret. Needing to keep that central part of
themselves secret adds to the pain and loneliness—which, in turn,
creates a need for comfort, making the sexual fix that much more
necessary.
[Carnes, 1494-1512]
In summary, here are the four core beliefs held by most sex addicts in
one form or another (and if you substitute something else for sex in the
fourth one, like cocaine, heroin, or food, these may apply to all
addicts).
- I am basically a bad, unworthy person
- No one would love me as I am
- My needs are never going to be met if I have to depend upon others
- Sex is my most important need
These core beliefs were the foundation of the child's life as s/he grew up
(can also be a she) become the axis of the addict's adult life - with
each belief adding to the disconnect between the addict's interiority
(the "world the addict experiences, with its pain and shame") and the
addict's exterior persona or image that is projected to protect his
secret and keep his inner life hidden. To cope with this
disconnect, to cope with the belief that "I am a bad, unworthy person,"
some addicts feel that any degradation or humiliation that comes their
way is justified - it reinforces their sense of failure and inadequacy.
Other addicts develop a grandiose or detached persona (mask) that
they show to the world hide their foundational guilt and shame.
Addicts create a front of “normalcy” to
hide their sense of inadequacy. They may even appear grandiose and full
of exaggerated self-importance. The front contrasts with actions that
appear degrading or self-defeating or both. Others see decisions or
behaviors as irrational, unfathomable, or even self-destructive, but not
“normal.”
Close friends and family members become angry and frustrated with the
addict’s egocentric quality, especially when there is insensitivity to
others. They are troubled at what looks like destructive or curious
behavior that does not fit the image the addict projects.
The belief “No one would love me as I am” also sustains the secret
world. Addicts continue to believe that everyone would abandon them if
the truth were known. Consequently, they have a constant fear of being
vulnerable or dependent on others.
[Carnes, 1568-1574]
A lot of sexual addicts proclaim extreme sexual propriety, or in some
circles, "postconventional moral development" - the results of this can
be moral self-righteousness around sexual activity, with those who call
them on their behavior being dismissed as morally underdeveloped or
morally rigid.
Cover-ups, lies, and deceptions are made to
conceal personal sexual behavior. The addict’s protestations of high
sexual morality are like a smoke screen, obscuring the impact of sexual
obsession. Friends and family tend to reject suspicions of sexual
compulsivity because of the addict’s “values.” However, as evidence of
powerless behavior and unmanageability mounts, these persons are
confused because they do not know what to believe. In addition, they do
not wish to intervene in something so personal.
[Carnes, 1604-1607]
As this quote shows, people around the addict often dismiss accusations
around the addict because they do not match their experience of the
addict's professed morality in the sexual realm. Those who are closest
to the addict risk becoming co-addicts, according to Carnes:
By definition, the addict replaces normal
human relationships with sexual compulsiveness. Loved ones feel the
loss, try to deny it, and become angry, feeling despair and sometimes
hope. The coaddicts’ efforts to restore the relationship are not only
ineffective, they can intensify and deepen the addictive system for the
addict. To compound the tragedy, coaddicts will take actions which are
self-destructive, degrading, or even profound violations of their own
values. Family members, as coaddicts, become part of the problem. Hence,
the prefix co-.
[Carnes, 1640-1644]
I highly recommend Carnes' books as a good foundation for understanding this addiction - he is a recovering sex addict so he knows the terrain. More importantly, however, we can learn a LOT by talking with porn addicts and sex addicts who are will to share their stories so that others might understand their experience.