Getting help for issues related to excessive porn use is a fine idea, but many therapists have no conception of how addictive today’s hyperstimulating Internet porn is. Many were trained when static, softcore Playboy was porn, and before the recent brain science that is helping to explain the close parallels between extremely stimulating substances and behaviors—both of which can produce addictions. Some counselors have even been trained to suggest porn use as a therapeutic tool!
Said a site member:
When I visited a therapist I sent her links to a couple of threads and webpages about porn-related ED, so she could understand that it wasn’t just in my mind but a very real problem. She was quite amazed at the number of guys going through this. Many therapists have been doing their jobs for years, and base their advice on training/experience of success stories prior to a time when streaming porn was easily available. In fact the ‘old skool’ therapists would often PRESCRIBE porn rather than recommend abstinence. I found myself teaching my therapist more than she was teaching me…and she’s the one that got paid. It beggars belief!
Still, she was a nice lady so I didn’t mind too much. Plus, Internet porn’s a relatively new phenomenon. Personally I would suggest you still see one, they can act as a good non-judgemental mentor.
I recommend educating your therapist prior to a visit. As you’re the customer, the therapist should not ignore your request. He or she may be more willing to take the issue seriously when when it is evident that you have researched and related to the issues. I think the links I sent her really helped. It was the shock of how upset a lot of the young guys were that really ‘got’ her.
In my opinion, airing the matter with the therapist via email in advance should also help to erase any initial reluctance/shyness about discussing porn addiction and related symptoms.
A 2008 survey of marriage and family therapists revealed that they have not been trained to deal with porn addiction.
Most respondents reported that their required college courses were not helpful in preparing them to diagnose and treat cybersex-related problems.
Exactly. Instead, they’ve been taught porn is harmless. Such advice is fine for brains that are not already out of balance due to excess. If there were no such thing as Internet porn, most guys would never develop an addiction to masturbation, and the “do as you please when you have an urge” advice would be reasonable.
However, if your therapist is typical, he/she has never learned that Internet porn has the power to override your natural appetites and create addiction. They may still think that addictions can only occur with substances, and that masturbation can never become an addiction “unless someone has religious shame.” Further, they may not be aware of the upcoming diagnosis for “compulsive sexual behavior” in the World Health Organization’s ICD-11.
It used to be assumed that sex and food couldn’t cause addictions because the brain’s natural satiety mechanisms would regulate their consumption. That is, it was assumed that people would stop when they had had “enough.” That’s not the case, though, with today’s superstimulating Internet porn—or junk food. Already 30+% of Americans are obese (addicted to food). Same thing is happening in many of today’s superstimulated videogamers (rates of addiction in Hungary and China among adolescents are 18% and 14%, respectively).
So chances are that your therapist is remembering what his textbooks said, or going by his own experience as a non-addict, and imagining that the biggest risk you face is sexual repression. It’s not. It’s addiction: honest-to-god changes in your brain that can alter your brain’s pleasure response and executive control.
Recent research has made this evident. In fact, in 2011 the American Society of Addiction Medicine (3000 doctors) put out a public statement explaining this and stating specifically that sex can be an addiction. In 2018, the world’s most widely used medical diagnostic manual, The International Classification of Diseases (ICD-11), created a new diagnosis suitable for porn addiction: “Compulsive Sexual Behavior Disorder.”
However, if your therapist has not specifically been trained in the brain science of addiction, you need to be ready to find one who is. Here’s one guy’s experience:
I went to a therapist who claimed she was an expert on internet addiction. So I told her about my problem and she gave this talk on how it’s normal and that we’re all sexual beings. She continued to talk about how it’s conservative values that’s making me feel shameful about looking at porn and tried to convince me that I don’t have an addiction. Worst of all she talked down on me like I was a 12-year old! I told her my problem was that I spent way too much time on porn, and you know what she said? She told me to use an egg timer and set it for an hour! I never saw her after that.
You may also need to educate your doctor:
When I came to my doctor at first regarding my inexplicable ED, extreme sexual anxiety, and complete lack of a libido, he first ordered a testosterone test. When this came back normal, he put me on anti-anxiety medication. “It’s all in your head, you just have to remind yourself of that, and this should help.” While it WAS in fact all in my head, and pills DID in fact help a bit, it never got to the root of the issue. For months it went on with continued ED and failed sex attempts, and that all added up to a much worse mindframe. Anyways, NoFap has been helping so far, and from the success stories I’ve read (and the sheer volume of them), I’m optimistic it’ll continue to get better and actually fix this. So, when I was in for a physical yesterday, I gave my doctor a link to the TEDx talk and talked to him a bit about the concept. He seemed very interested, and I think he’ll actually give it a watch. Hopefully if he does, he can point another struggling dude in the right direction.
- Adolescent Brain Meets Highspeed Internet Porn (2013)
- Your Brain On Porn Series (Powerpoint)
- Erectile Dysfunction and Porn (Powerpoint)
- TEDx Talk
- YouTube channel of Noah B.E. Church
- YouTube channel of Gabe Deem: The Reboot Nation
Give your therapist these lists of studies on porn users:
- Porn/sex addiction? This page lists 40 neuroscience-based studies (MRI, fMRI, EEG, neuropsychological, hormonal). They provide strong support for the addiction model as their findings mirror the neurological findings reported in substance addiction studies.
- The real experts’ opinions on porn/sex addiction? This list contains 18 recent literature reviews & commentaries by some of the top neuroscientists in the world. All support the addiction model.
- Signs of addiction and escalation to more extreme material? Over 30 studies reporting findings consistent with escalation of porn use (tolerance), habituation to porn, and even withdrawal symptoms (all signs and symptoms associated with addiction).
- Debunking the unsupported talking point that “high sexual desire” explains away porn or sex addiction: At least 25 studies falsify the claim that sex & porn addicts “just have high sexual desire”
- Porn and sexual problems? This list contains 26+ studies linking porn use/porn addiction to sexual problems and lower arousal to sexual stimuli. The first 5 studies in the list demonstrate causation, as participants eliminated porn use and healed chronic sexual dysfunctions.
- Porn’s effects on relationships? Almost 60 studies link porn use to less sexual and relationship satisfaction. (As far as we know all studies involving males have reported more porn use linked to poorer sexual or relationship satisfaction.)
- Porn use affecting emotional and mental health? Over 55 studies link porn use to poorer mental-emotional health & poorer cognitive outcomes.
- Porn use affecting beliefs, attitudes and behaviors? Check out individual studies – over 25 studies link porn use to “un-egalitarian attitudes” toward women and sexist views – or the summary from this 2016 meta-analysis: Media and Sexualization: State of Empirical Research, 1995–2015.
- What about sexual aggression and porn use? Another meta-analysis: A Meta‐Analysis of Pornography Consumption and Actual Acts of Sexual Aggression in General Population Studies (2015).
- What about the porn use and adolescents? Check out this list of over 200 adolescent studies, or this 2012 review of the research – The Impact of Internet Pornography on Adolescents: A Review of the Research (2012). From the conclusion:
- For a debunking of nearly every naysayer talking point and cherry-picked study see this extensive critique: Debunking “Why Are We Still So Worried About Watching Porn?”, by Marty Klein, Taylor Kohut, and Nicole Prause (2018). How to recognize biased articles: They cite Prause et al., 2015 (falsely claiming it debunks porn addiction), while omitting over 3 dozen neurological studies supporting porn addiction.
The core concepts of how Internet porn is unique and how use can cause addiction is explained this newer series of articles (I suggest reading in sequence):
- Porn, Novelty, and the Coolidge effect
- Porn Then and Now: Welcome to Brain Training
- Why Shouldn’t Johnny Watch Porn If He Likes?
- Can You Trust Your Johnson?
- Porn, Pseudoscience and ΔFosB
- Recent Internet Addiction Studies Include Porn
- Porn Addicts Will Soon Be Diagnosable Using the WHO’s Diagnostic Manual (ICD-11)
- Are You Hooked on Porn? Ask ASAM
- Toss Your Textbooks: Docs Redefine Sexual Behavior Addictions. American Society of Addiction Medicine agrees to disagree with the DSM
- Young Porn Users Need Longer To Recover Their Mojo
- Porn, Masturbation and Mojo: A Neuroscience Perspective
Links with everything in one place
Links to experts in this field
- Experts who recognize porn-induced sexual dysfunctions, including PIED
- Sex on the Brain: What Brain Plasticity Teaches About Internet Porn (2014), Norman Doidge, MD
- Norman Doidge on Pornography and Neuroplasticity (chapter from The Brain That Changes Itself)
- Porn-induced ED presented at the American Urologic Association Conference, May 6-10, 2016: Part 1, Part 2, Part 3, Part 4.
- “The New Naked” by urologist Harry Fisch, MD (2014)
Organizations and “compulsive sexual behaviors”
- An official diagnosis: The world’s most widely used medical diagnostic manual, The International Classification of Diseases (ICD-11), contains a new diagnosis suitable for porn addiction: “Compulsive Sexual Behavior Disorder.” (2018)
- Peer-reviwed paper by DSM-5 sexuality work group member Richard Krueger MD: Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD-10 and DSM-5 despite rejection of this diagnosis by the American Psychiatric Association
- America’s Top Experts (ASAM) Have Just Released a Sweeping New Definition of Addiction (2011)
- American Society for Addiction Medicine: Definition of Addiction – Long Version (2011)
- National Institute of Mental Health (NIMH): DSM is flawed and outdated (2013).
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