Can be people be addicted to sex and pornography?

Sex and porn addiction are often claimed to be on the increase, with serious public health consequences such as ‘marital discord, divorce, sexually transmitted diseases including HIV infection, substantial financial expenditures, job loss, and unplanned pregnancies[111] . However the idea of sex addiction has been strongly criticized. Sex addiction – or ‘hypersexual disorder’ – is not an official psychiatric disorder[112]. The screening tests used for diagnosing sex addiction have been criticized for including indicators that would apply to many people growing up in Western Europe or America, such as feeling concerned about the normality or strength of one’s desires, and engaging with pornography or BDSM. It has been argued that many of the behaviours classed as indicative of addiction can more appropriately be seen as sexual adventurousness[113]. For those who view themselves as addicted to sex, or who find their levels of desire to be problematic in some way, it may be important to consider wider social messages around sex, their own particular meanings, and what may be lost and gained by embracing the identity of ‘addict’[114].

Probably the commonest manifestation of ‘sex addiction’ reported to sex therapists takes the form of those who are troubled by the extent of their engagement with pornography, and/or the content of the pornography that they engage with. Most definitions view a person’s perception of loss of control, and the continuation of particular behaviours despite significant negative consequences, as the symptoms of this disorder. However, like sex addiction, porn addiction is not recognized as a formal diagnosis[115].

While there are claims that many people are becoming addicted to pornography there is no convincing evidence to support this. In a survey of over 1000 consumers of pornography in Australia only 0.5% felt they had a problem with addiction[116].

The concept of pornography addiction has received much press coverage, but few psychiatrists accept that pornography is ‘addictive’ in the sense that heroin or nicotine, for example, is addictive. Instead pornography appears to be addictive in the same sense that gambling or shopping can be addictive: it is possible for individuals to become addicted, but this tells us little about the use of the object by the majority of the population. Some neuroscientists have recently claimed that consuming pornography changes the structure of the brain, causing, in effect, ‘brain damage’[117]. However, this claim has been refuted in the strongest possible terms by other neuroscientists[118] who point out that everything that we do shapes our neural connections and find no evidence that pornography is a special case.

People are sometimes treated for pornography addiction using a 12-step programme[119] or antidepressants[120]. The effectiveness of this kind of intervention has not been supported by controlled trials, nor have the possible long-term consequences been studied[121].

As with sex addiction, those who are troubled by their engagement with pornography are often well-served by therapeutic approaches which enable them to consider, directly, what they find disturbing about it, without stigma and in the context of wider societal perceptions of pornography and sex. Slowing down and noticing how they engage with pornography can be a useful step towards increased awareness and shifting patterns if these are felt to be problematic by the individual concerned[122].

Are people coming under pressure to modify their bodies because of sexualization?

111. Reay, B., Attwood, N. & Gooder, C. (2013). Inventing Sex: The Short History of Sex Addiction. Sexuality & Culture, 17(1), 1-19.
112. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed). Washington, DC: APA; World Health Organisation. (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation.
113. Klein, M. (2003). Sex Addiction: A Dangerous Clinical Concept. SIECUS, 31(5): 8-11.
114. Barker, M. (2013). Reflections: Towards a Mindful Sexual and Relationship Therapy. Sexual Relationship Therapy, 28(1-2), 148-152.
115. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed). Washington, DC: APA; World Health Organisation. (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva. World Health Organisation
116. McKee, A., Albury, K. & Lumby, C. (2007). The Porn Report. Melbourne: Melbourne University Press.
117. Hilton, D.L. & Watts, C. (2011). Pornography Addiction: a Neuroscience Perspective, Surgical Neurology International, 2(1), 19-22.
118. Reid, RC. Carpenter, B.N. & Fong, T.W. (2011). Neuroscience research fails to support claims that excessive pornography consumption causes brain damage. Surgical Neurology International, 2(1), 64-71.
119. Wright, P.J. (2010). Sexual Compulsivity and 12-Step Peer and Sponsor Supportive Communication: A Cross-Lagged Panel Analysis. Sexual Addiction and Compulsivity, 17, 154-169.
120. Kafka, M. & Hennen, J. (2000). Psychostimulant augmentation during treatment with selective serotonin reuptake inhibitors in men with paraphilias and paraphilia related disorders: a case series. Journal of Clinical Psychiatry, 61, 664-670.
121. Levine, M. & Troiden, R. (1988). The myth of sexual compulsivity. Journal of Sex Research, 25(3), 347-363; Gold, S.N. & Heffner CL. (1998). Sexual addiction: Many conceptions, minimal data. Clinical Psychology Review, 18(3), 367-381.
122. Barker, M. (2013). Mindful Counselling Psychotherapy: Practising Mindfully across Approaches and Issues. London: Sage.

Are people coming under pressure to modify their bodies because of sexualization?

Advertisements