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|Clinician's Digest - Page 7|
With its 24/7 availability, limited cost, and unlimited variety, IP can grab hold of our biology and psyche, creating its own self-perpetuating craving. Our brains crave novelty, information, and sex, Maltz says, and "If we had cocaine drips as available in our homes as Internet pornography, a lot more people would become addicted to cocaine."
The comparison to other addictions suggests some treatment guidelines for couples therapists to consider. Since addictions are often hidden, therapists should ask about IP as part of their normal assessment, even if couples don't bring it up. "Evaluate the extent, nature, and the impact," advises Maltz. If someone is using IP, find out what kind—consensual lovemaking, child pornography, or other permutations. Determine the arc of the use: whether it's progressing from one type to another or there's an increase in frequency. A solid assessment not only helps determine whether there's a serious addiction, but may increase understanding about the couple's emotional and physical-intimacy problems.
If the assessment suggests that IP has gone beyond occasional recreational use, it needs to be addressed directly, as something that can create its own relationship problems, not just as something that's symptomatic of existing emotional issues. Ayres and Haddock found that many MFTs, perhaps because of their discomfort about addressing pornography, typically subsume IP under the rubric of a communication or intimacy problem. They also tend to have little sympathy for the non-using spouse, who is usually the wife. Responding to a vignette of a couple in the survey, only 12 percent of the MFTs indicated that they'd validate the wife's concerns about IP use, while 34 percent made pathologizing statements about the wife and her concerns.
Maltz recommends that treatment focus on IP use as a primary problem, both for the user and for the relationship. "Everyone wants to wake up in the middle of the night and feel respected and loved," she says. IP can put that beyond reach for both partners.