There have been many attempts made over the years to define addiction. In 2019 the American Association of Addiction medicine defined it as:

“a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences”

So, what does this mean, and how does it relate to pornography and associated behaviours? It’s only been in recent years that we are really starting to understand the nature and impact of pornography on those who regularly consume it, their loved ones, and our culture and society. With the advent of the internet came the accessibility, anonymity, and affordability of online pornography no one could have imagined in decades past. Indeed, pornography has become a mainstream pastime; and you would be hard pressed to find a young person who hasn’t or doesn’t consume it at least occasionally.

I’m not saying that all who use pornography are addicts, any more than everyone who drinks alcohol has a substance use disorder. That said; it is a growing concern as more and more turn to it for a number of reasons (emotional regulation, comfort, sexual connection) and their brain gets hijacked.

While there is no formal recognition of, or criteria for sexual or pornography addiction in the Diagnostic and Statistical Manual of mental Disorders, there is growing consensus among professionals regards this addiction, confirming what those of us working with this population have known for quite some time. In the past year the most recent edition of the International Classification of Diseases created criteria for Compulsive Sexual Behaviour Disorder, further legitimizing problematic sexual behaviour.

Often in making a diagnosis of sexual or pornography addiction we draw upon 10 criteria that research suggests are common for those struggling.

Loss of Control – Clear behaviour in which you do more than you intend or want to.
This may be feeling powerless over the behaviour or thinking patterns. Some describe going into “autopilot” or “zoning out” when acting out and feel like they can’t do anything about it.

Compulsivity – Out of control behaviour over time.
An irresistible urge to act out again and again.

Efforts to Stop – Have tried to control or stop the behaviour without success.
Perhaps you’ve told yourself many times that “this is the last time”, but you always go back. Maybe you’ve tried different strategies but can’t maintain the changes.

Loss of Time – Significant amounts of time lost engaging in and/or recovering from a behaviour.
Perhaps intending to look at one video and realizing that hours of past. Maybe you stayed up later than intended watching porn and now are behind on your work etc.

Preoccupation – Obsessing about or because of the behaviour.
This may include replaying images/experiences in one’s mind, fantasizing, objectifying, planning etc.

Inability to Fulfill Obligations.
Perhaps you’ve missed family events, not completed work or school projects, gone into debt etc. due to your use of pornography and related behaviour.

Continuation Despite Consequences
Many have experienced employment, relationship, legal, health, or problems as a result, yet continue to engage in the behaviour.

Escalation
Over time the frequency, duration, and/or the intensity of the pornography or related behaviour increases. Many identify crossing boundaries they never thought they would.

Losses
Individuals often lose, limit, or end up sacrificing valued parts of themselves such as hobbies, spirituality, relationships, or employment.

Withdrawal
Often when addiction is present, and one tries to stop they may experience considerable distress, anxiety, restlessness, irritability, and even physical discomfort and symptoms.

Research suggests that meeting at least 3 of the above criteria often points to addiction. However, as identified by the definition of addiction above, it is often very complex. Addiction includes an interaction between biology, psychology, and experiences, and so too must assessment and appropriate treatment. If you suspect you or someone you care about has a problem, exploring it with an expert such as a Certified Sexual Addiction Therapist (CSAT) can be very helpful.

Jeff Whitehead, MSW, RCSW, CMAT, CSAT
Registered Clinical Social Worker