"Porn is an easy outlet, a one-way outlet. What a rush! What a release! The Internet puts an endless stream of images at my fingertips. I've conveniently conned myself thinking it's okay, but deep down I know it's wrong. It makes me feel dirty and has hurt my relationship with my wife. I beat myself up afterward, hate myself, and swear that was the last time. But before I know it, I'm back at it again. I'm scared where it's leading. Can you help me?"—Scott, 44 years old.
Scott, a successful lawyer with a wife and two children, showed up at my office for his first session confused and angry about his relationship with pornography. He could see the damage his Internet porn habit was having on his marriage, health, and career, but he couldn't stay away from it. His story is typical of men and women—of all ages, backgrounds, incomes, and lifestyles—who are seeking counseling for serious problems related to pornography.
When I began counseling in the mid-1970s, cases like Scott's were rare and almost inconceivable. Hardcore pornography was difficult to obtain. But in recent decades, new electronic technologies, such as cable television, computers, and iPhones, have transformed it into a product that's available to anyone—anytime, anywhere, and often cheap or free. It's become a substantial part of our economy, boasting annual revenues in excess of $13 billion in the United States and $100 billion worldwide.
The revolution in accessibility has led to record consumption. According to statistics on the Internet Filter Review site, 40 million Americans visit Internet porn sites at least once a month. Some porn users visit sites for only a few minutes at a time. Others, like Scott, visit porn sites daily, spending more than 15 hours per week. One-third of all downloads each month and one-quarter of all online searches each day are for porn. And, according to a 2008 Nielsen Online survey, a record-breaking 25 percent of employees in the United States are accessing porn at work, despite the risks involved.
Not surprisingly, concerns about the effect of porn on individuals and relationships are also on the rise. According to a 2004 survey in Men's Health, more than 70 percent of the men surveyed said they've looked at more porn since the advent of the Internet, and one in two expressed concern about their use of it. The American Academy of Matrimonial Lawyers and the British Nielsen NetRatings organization have identified it as a major cause of divorce and relationship difficulties. An MSNBC study in 2000 revealed that 70 percent of porn users keep their use secret and that from 8 to 15 percent of regular Internet porn users develop compulsive sexual behaviors that significantly impact their lives. In total, up to half of all regular pornography users report some type of negative consequence or concern about their use. No wonder sexual addiction experts, such as Patrick Carnes, have begun calling pornography addiction "our newest and most challenging mental health problem."
Changes in how people access and use pornography have taken the therapeutic community by surprise. The explosion in porn use has happened so fast that many therapists have been caught unprepared; they may not yet comprehend the extent of the problems porn can cause, or how deeply its use can harm individuals and their intimate partners. Despite the increase in the number of people suffering from anxiety, depression, sexual problems, relationship distress, and other serious consequences of habitual porn use, few therapists feel comfortable and confident addressing porn-related concerns.
How We Feel about Porn
Pornography draws strong responses—from the public at large and within the therapeutic community. Many of us have such strong feelings about pornography that we automatically label, condemn, or reject anyone who sees it differently. If we're critical of porn, we might judge people who like it as "excessively permissive," "exploitive," "addicted to sex," or "misogynistic." If we're supportive of porn, we may see those who don't share our view as "sexually uptight," "religiously conservative," "radically feminist," or "against free speech." Unlike other common mental health concerns, such as depression or substance abuse, we have no reasonably coherent and agreed upon clinical perspective for what constitutes a "porn problem" or how to approach it.
Recently, at a professional training, I asked a group of therapists to share their knee-jerk feelings about pornography. The answers came quickly and from all over the emotional map: "disgusted," "excited," "angry," "anxious," "saddened," "afraid," "horny," "repulsed," "ashamed," "shocked," "amused," "curious," and "ambivalent." I wasn't surprised by the range of feelings: I've had all those feelings myself, even though I've been a sex and relationship therapist for 35 years.
In the past, understanding and dealing with our personal reactions to porn may not have been that important to our success as psychotherapists. But today, when clients who develop problems with porn range from 90-year-old men to 9-year-old girls, examining our own attitudes about porn is critical to our success as healers. Without an informed and accurate understanding of porn and its effects, we can easily discount clients' concerns or respond to them in unhelpful, emotionally reactive ways. A study in the January-March 2009 issue of Sexual Addiction and Compulsivity by Michelle Ayres and Shelley Haddock found that therapists' personal attitudes about pornography play the strongest, most significant role of any factor, including training and clinical experience, in influencing their approach to treatment.
The workshop discussion got me thinking about how significantly my attitudes about pornography have changed during the course of my life and counseling career. To a large extent, my personal journey reflects the evolution of pornography from a product that was hard to get to an experience that can be hard to avoid.