In the last few years, the discussion around pornography and the effect it has on individuals and relationships has intensified. Groups such as Fight the New Drug have made it their sole mission to prove “porn kills love.” There are a growing number of therapists specializing in pornography addiction, the psychological consequences the addicted bears, and the betrayal trauma the spouse endures. Yet, there are also those, such as clinical psychologist Dr. David Ley, who claim there is no such thing as pornography and sex addiction. So, when well educated people in the same field argue opposite findings, what is the truth?
Though my experience certainly isn’t everyone’s, there is no doubt in my mind pornography addiction is very real and can be catastrophic for marriages. My husband told me about his addiction to porn before we were married. It was something he had battled for over a decade at that point. His honesty and vulnerability just made me fall even deeper in love. The problem was, neither of us understood what porn addiction really was. It wasn’t something my husband could stop on his own, no matter how hard he tried. It wasn’t something getting married and being sexually intimate would fix, no matter how much I “put out.” No, this was bigger than either of us realized that night.
How is addiction diagnosed ?
International experts in all fields of mental health use the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) to diagnose and treat a variety of disorders, including substance-related and addictive disorders. Though sex and pornography addiction is not currently covered in DSM-5, the diagnosis of Hypersexual Disorder (HD), which includes problematic, compulsive pornography use was considered in the last update. (American Psychiatric Association) Ultimately, HD was not added to DSM-5 yet because “current research in the field of hypersexual behavior is in its infancy.” (Reid) In short, the study of sex and pornography addiction is still too new. The criteria psychologists use for assessing a sexual addiction is just barely ten years old. (Skinner) To put things in perspective, Substance Use Disorder, including alcoholism, wasn’t included in DSM until 1980, 24 years after the American Medical Association deemed alcoholism a disease. (Robinson & Adinoff)
How is Pornography and Sex Addiction diagnosed ?
If pornography addiction isn’t currently categorized in DSM-5, how do the professionals make a diagnoses? As found in Dr. Skinner’s book Treating Pornography Addiction, Dr. Patrick Carnes outlines the following widely accepted criteria:
- Recurrent failure to resist impulses to view pornography
- More extensive/longer viewing of pornography than intended
- Ongoing, but unsuccessful, efforts to stop, reduce, or control behavior
- Inordinate amount of time spent obtaining pornography, viewing pornography, and/or being sexual–either through masturbation, or with another person or object
- Feeling preoccupied with fantasy, sexualized thoughts, and/or preparatory activities
- Viewing pornography takes significant time away from obligations: occupational, academic, domestic, or social
- Continuation of behavior despite consequences
- Tolerance — more frequent or intense pornography is needed over time to obtain the desired result
- Deliberately limiting social, occupational, or recreational activities in order to keep time open for finding and viewing pornography
- Distress, restlessness, or irritability if unable to view pornography (withdrawal)
b. body aches
g. mood swings
In order to diagnose a pornography addiction, a minimum of 3/10 criteria must be met. Interestingly, Dr. Carnes has found most sex addicts display five signs, while over 50% display at least seven. (Skinner) It is worth noting, these criteria mimic the criteria found in DSM-5 for diagnosing Alcoholic Use Disorder (AUD). However, to diagnose alcoholism, just 2/11 criteria must be met. (National Institute of Alcohol Abuse and Alcoholism) The severity of both HD and AUD is based on the number of criteria met.
Is Pornography Addiction real?
While pornography and sex addiction is not accepted by some in the mental health fields, many others have found evidence of its reality and have seen first-hand how devastating it can be. The study of Hypersexual Disorder, including compulsive pornography use, is still in its infancy. Research into the effects of pornography on individuals and relationships is continually increasing.
The beautiful, though sometimes frustrating, thing about psychology is: psychology is not a perfect science. After all, our human experiences and responses are not the same. Because of this, the struggle of pornography addicts, and those who love them, cannot be discounted or trivialized. Based on the number of specialized Sex Addiction therapists, there are thousands of marriages on the brink of implosion, weakened by the reverberations of pornography addiction. Thousands of couples who have recognized the issues and are seeking help for overcoming addiction and betrayal trauma. And there are certainly many more who are struggling but don’t understand why, don’t realize there is help for them, or are too afraid to reach out. If you fall in one of those categories, know you are not crazy, you are not alone, and there are an ever growing number of resources for you.
Though we still have a long way to go, the relationship between my husband and I is stronger than ever before. Acknowledging the problems porn was causing and seeking help to work through them has saved us. Individually and together. There’s hope for you, too.
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Alcoholism: A Disease. (n.d.). Retrieved from http://www.gmu.edu/resources/facstaff/facultyfacts/1-1/alcohsm.html
American Psychiatric Association, DSM-5 Development. Retreived from: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=415
National Institute on Alcohol Abuse and Alcoholism. (2020, January 31). Alcohol Use Disorder. Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders
Reid, R. C. (2015, December). How should severity be determined for the DSM-5 proposed classification of Hypersexual Disorder? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712755/
Robinson, S. M., & Adinoff, B. (2016, August 18). The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039518/
Skinner, K. B. (2005). Treating pornography addiction: the essential tools for recovery. GrowthClimate, Inc.