Pornography addiction is the scientifically controversial [1] application of an addiction model to the use of pornography. [2] Pornography use may be part of compulsive behavior, with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's ICD-11 (2022) has recognized compulsive sexual behaviour disorder (CSBD) as an "impulsive control disorder", [3] CSBD is not an addiction, [4] [5] and the American Psychiatric Association's DSM-5 (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a mental disorder or a behavioral addiction. [4] [6] [7]
Problematic Internet pornography viewing is the viewing of Internet pornography that is problematic for an individual due to personal or social reasons, including the excessive time spent viewing pornography instead of interacting with others and the facilitation of procrastination. Individuals may report depression, social isolation, career loss, decreased productivity, or financial consequences as a result of their excessive Internet pornography viewing impeding their social lives. [8]
Universally accepted diagnostic criteria for pornography addiction or problematic pornography viewing do not exist.[ citation needed ] Pornography addiction is often defined operationally by the frequency of pornography viewing and negative consequences. [9] The only diagnostic criteria for a behavioral addiction in the current Diagnostic and Statistical Manual of Mental Disorders are for pathological gambling, and they are similar to those for substance abuse and dependence, such as preoccupation with the behavior, diminished ability to control the behavior, tolerance, withdrawal, and adverse psychosocial consequences. Diagnostic criteria have been proposed for other behavioral addictions, and these are usually also based on established diagnoses for substance abuse and dependence. [10]
Pornography use has also been associated with many issues such as Sexual Satisfaction, Marital Quality, and Gender Violence. These are detailed in Opposition to Pornography.
A proposed diagnosis for hypersexual disorder includes pornography as a subtype of this disorder. It includes criteria such as time consumed by sexual activity interfering with obligations, repetitive engagement in sexual activity in response to stress, repeated failed attempts to reduce these behaviors, and distress or impairment of life functioning. [11] A study on problematic Internet pornography viewing used the criteria of viewing Internet pornography more than three times a week during some weeks, and viewing causing difficulty in general life functioning.[ citation needed ]
According to the American Society of Addiction Medicine, some psychological and behavioral changes characteristic of addiction brain changes include addictive cravings, impulsiveness, weakened executive function, desensitization, and dysphoria. [12] BOLD fMRI results have shown that individuals diagnosed with compulsive sexual behavior (CSB) show enhanced cue reactivity in brain regions associated traditionally with drug-cue reactivity. [13] [14] These regions include the amygdala and the ventral striatum. [13] [14] Men without CSB who had a long history of viewing pornography exhibited a less intense response to pornographic images in the left ventral putamen, possibly suggestive of desensitization. [13]
Neuropsychopharmacological and psychological researches on pornography addiction conducted between 2015 and 2021 have concluded that most studies have been focused entirely or almost exclusively on men in anonymous settings, and the findings are contradictory. [14] Some researchers support the idea that pornography addiction qualifies as a form of behavioral addiction into the umbrella construct of hypersexual behavior and/or a subset of compulsive sexual behavior (CSB), [15] and should be treated as such, whereas others have detected the increased activation of ventral striatal reactivity in men for cues predicting erotic but not monetary rewards and cues signaling erotic pictures, therefore suggesting similarities between pornography addiction and conventional addiction disorders. [14]
Despite the fact that pornography is being spuriously [16] indicted as a public health crisis in the United States and elsewhere, [17] [18] with problematic Internet and online pornography use reported to constitute an increasing burden on public mental health since the 2000s, psychopathological models and diagnostic criteria have lacked consensus, and the body of evidence on the effectiveness of therapeutic approaches is still scarce.[ citation needed ]
The repeated cross-sectional surveys did not find any consistent associations across years between poor mental health and ever having watched pornography or the frequency of watching pornography. [19]
— Svedin et. al. (2023)
Svedin et. al. found that moderate consumption of pornography is associated with good mental health in boys, while both extremes (too much or too few) yielded worse mental health. [19] Watching deviant (non-mainstream) pornography was associated with worse mental health in boys, but girls were unaffected. [19]
Pornography addiction is a controversial concept, since it appears to be "largely morally, ideologically, and politically motivated." [20] Although it is a "nice theory", empirical support for it is largely missing, [21] and the "industry of porn/sex addiction is based on conservative moral values around sexuality that intrude into clinical practice". [21] Julie Sale stated "No-one refutes that clients access therapy for help with sexual behaviours that they feel they have no control over. The issue is how these client experiences are conceptualised and how the clinical formulation informs treatment." [22]
The status of pornography addiction as an addictive disorder, rather than simply a compulsivity, has been hotly contested. [23] [ unreliable medical source? ] [24] [ unreliable medical source? ] Furthermore, research suggests that the use of a pornography addiction label may indicate a socially (as opposed to clinically) driven nosology. [8]
It is worth considering whether the apparent epidemic of self-diagnosed pornography addicts seeking help today perhaps represents the ready uptake of a relatively new way to describe one's problematic behaviour, and not the development of a modern disease entity whose description should dictate its treatment. [8]
— Kris Taylor, Nosology and metaphor: How pornography viewers make sense of pornography addiction
In November 2016, the American Association of Sexuality Educators, Counselors and Therapists (AASECT) issued a position statement on sex/porn addiction which states that AASECT "does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy." [25]
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a new section for behavioral addictions, but includes only one disorder: pathological gambling. [26] One other behavioral addiction, internet gaming disorder, appears in the conditions proposed for further study in DSM-5. [26] Psychiatrists cited a lack of research support for refusing to include other behavioral disorders, such as pornography, at the time. [26]
Porn addiction is not a diagnosis in DSM-5 (or any previous version). [6] [7] [27] "Viewing pornography online" is mentioned verbatim in the DSM-5, [26] but it is not considered a mental disorder either. [6] [7] [27]
When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was being drafted, experts considered a proposed diagnostic addiction called hypersexual disorder, which also included a pornography subtype. But in the end, reviewers determined that there wasn't enough evidence to include hypersexual disorder or its subtypes in the 2013 edition. [6]
— Kirsten Weir, Is pornography addictive?
A number of studies have found neurological markers of addiction in internet porn users, [28] [29] [30] which is consistent with a large body of research finding similar markers in other kinds of problematic internet users. [29] Yet other studies found that critical biomarkers of addiction were missing, [31] and most addiction biomarkers have never been demonstrated for pornography. [32] [ failed verification ]
The International Classification of Disorders 11 (ICD-11) rejected "pornography addiction". [4] [33] [34] Specifically, the World Health Organization (WHO) wrote: "Based on the limited current data, it would therefore seem premature to include [problematic Internet use] in ICD-11." [35]
However, ICD-11 does include the "Compulsive sexual behaviour disorder" (CSBD) [36] in the "impulse control disorders" section. It is defined as "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour." David J. Ley argued that that is not an endorsement of the concept of pornography addiction. [37] ICD also specifically excludes anyone from this diagnosis whose distress is due to moral conflict alone, yet moral incongruence is the strongest predictor of believing one is addicted to porn. [38] Note that two studies now contradict this, finding that narcissism, [34] especially antagonist narcissism, [39] predicts identification as a pornography addict.
Introductory psychology textbook authors Coon, Mitterer and Martini, passingly mentioning NoFap, speak of pornography as a "supernormal stimulus" but use the model of compulsion rather than addiction. [40] Addiction and compulsion are models of mental disorders which cancel each other out, [41] [42] [43] the term "addiction" being deprecated, [44] but ICD-11 does not support the existence of "porn addiction"/"sex addiction". [37] [45]
DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction/compulsion (which would include internet pornography viewing). [4] [46] [47]
ICD-11 has added pornography to CSBD. [48] However, this is categorized as an impulse control disorder, not an addictive disorder. [48] [45] It has been argued that the CSBD diagnosis is not based upon sex research. [49]
Neither DSM-5, nor DSM-5-TR, nor ICD-10, nor ICD-11 recognize sex addiction or porn addiction as a valid diagnosis. [4] [34] [45] Rothman has stated "pornography is not yet clearly established as a risk factor for multiple health outcomes". [50]
However, pornography addiction is not presently considered a diagnosable condition according to the DSM. Alternatives to the DSM, such as the ICD-11, also have not subscribed to the addiction model for pornography, though they recognize that people may become compulsive about its use.
A 2022 book by McKee, Litsou, Byron, and Ingham casts serious doubts upon the model of "porn addiction", suggesting that sexual shame should be blamed, instead of pornography. [51] They note that much of the research on the effects of pornography often confuses correlation with causation, [52] and that much pornography research has been normative (i.e. moralistic) instead of descriptive. [52]
Even scientists who find a problem with excessive pornography consumption state that moderate pornography consumption is healthy. [53]
Cognitive-behavioral therapy has been suggested as a possible effective treatment for pornography addiction based on its success with internet addicts, though no clinical trials have been performed to assess effectiveness among pornography addicts as of 2012. [54] Acceptance and commitment therapy has also been shown to be a potentially effective treatment for problematic internet pornography viewing.[ citation needed ]
Some clinicians and support organizations recommend voluntary use of Internet content-control software, internet monitoring, or both, to manage online pornography use. [55] [56] [57] Sex researcher Alvin Cooper and colleagues suggested several reasons for using filters as a therapeutic measure, including curbing accessibility that facilitates problematic behavior and encouraging clients to develop coping and relapse prevention strategies. [55] Cognitive therapist Mary Anne Layden suggested that filters may be useful in maintaining environmental control. [57] Internet behavior researcher David Delmonico stated that, despite their limitations, filters may serve as a "frontline of protection." [56]
Studies of those with non-paraphilic expressions of hypersexuality have hypothesized that various mood disorders, as defined in the DSM, may occur more frequently in sexually compulsive men. [58] [59] [60]
Compulsive sexual behavior has been treated with antidepressants including SSRIs and serotonin-norepinephrine reuptake inhibitors, Naltrexone (a medication used to inhibit reward mechanisms in opiate or alcohol addictions), other mood-stabilizers, and anti-androgens.
A 2017 study using a representative sample of Australians researched distress about sex video use. [61] It found that of 10,131 women surveyed, 0.5% of women agreed with the statement that they were "addicted" to pornography; 1.2% (of 4,218 who viewed) when limited to women who say they viewed sex films. The comparable figure limiting to men who view sex films was 4.4%. This was without any clinical screening that should eliminate primary disorders (e.g., depression) or religious-based concerns, so these should be considered high-end estimates for potential disorders, if any exist.
Most studies of rates use a convenience sample. One 2000 study of a convenience sample of 9,265 people found that 1% of Internet users have concerns about their Internet use and 17% of users meet criteria for problematic sexual compulsivity, meaning they score above one standard deviation of the mean on the Kalichman Sexual Compulsivity Scale. [62] A survey of 84 college-age males found that 20–60% of a sample of college-age males who use pornography found it to be problematic. [63] Research on internet addiction disorder indicates rates may range from 1.5 to 8.2% in Europeans and Americans. [64]
A 2019 study found that the average frequency of use for those self-describing as addicted to porn was about ten times per year. [65] The study found this identification correlated with male gender, higher frequency of use, and belief that pornography was morally wrong (whether for religious or other reasons). [66]
A review paper about pornography consumption notes that sex addiction is correlated with narcissism. [67]
Several support groups exist for people who wish to quit pornography use and/or believe themselves to be addicted to pornography. Twelve-step programs such as Sex Addicts Anonymous (SAA), Sexaholics Anonymous (SA), Sex and Love Addicts Anonymous (SLAA), Sexual Recovery Anonymous (SRA), and Sexual Compulsives Anonymous (SCA) are fellowships of men and women who share their experience, strength and hope with each other so they may overcome their common problem and help others recover from addiction or dependency by using the twelve-step program borrowed from Alcoholics Anonymous (AA) and other recovery tools. [68]
NoFap is website and community forum founded in 2011 that serves as a support group for those who wish to give up pornography and masturbation. [69] It serves as a support group for those who wish to avoid the use of pornography, masturbation, and/or sexual intercourse. [69] [70] [71] Recent peer-reviewed data highlighted considerable levels of misogyny along with a poor understanding of human sexuality and relationships within this online community. [72] Sociologist Kelsy Burke, author of The Pornography Wars, believes that this misogyny arises from blaming the female-dominated profession of pornography for men's personal problems. [65] The Daily Dot and Der Spiegel linked NoFap to recent gender-based murders and breeding domestic terrorism. [73] [74]
Fight the New Drug, a Salt Lake City-based non-profit organization founded by members of the Church of Jesus Christ of Latter-day Saints, [75] [76] is a non-legislative organization which claims to seek to inform and educate individuals regarding pornography usage with science and personal stories. It is aimed at the youth demographic. There is also a PornFree reddit group which focuses on giving up porn rather than masturbation. [77] [78]
Celebrate Recovery is a Christian inter-denominational twelve-step program with about 35,000 available groups and is open to any person who is struggling with life's bad habits, hurts, and hang-ups. [79] Celebrate Recovery was started in 1991 at Saddleback Church in California, and their program is based on the Beatitudes from the biblical Sermon on the Plain and the twelve-step program from Alcoholics Anonymous. [80]
According to professor E. T. M. Laan , a sexologist working for the Academic Medical Center, it is usually the American religious right which claims the existence of pornography addiction and such claims are rare (scarce) among sexologists. [81] A 2018 meta-analysis showed a correlation between a person being religious and perceiving themself as having a pornography addiction, possibly due to people using pornography despite their religion prohibiting it. [82] [83] [84]
According to Addicted to Lust: Pornography in the Lives of Conservative Protestants (2019) written by Samuel L. Perry, professor of sociology at the University of Oklahoma, conservative Protestants in the United States are characterized by a "sexual exceptionalism" related to their consumption of pornography due to certain pervasive beliefs within the Conservative Protestant subculture, which entails cognitive dissonance associated with the unfounded conviction to be addicted to pornography, psychological distress, and intense feelings of guilt, shame, self-loathing, depression, and sometimes withdrawal from faith altogether. [85] [86]
Perry's book received widespread media coverage [86] [87] and his findings were criticized by Lyman Stone of the Evangelical magazine Christianity Today , which asserted that both the quantitative and qualitative statistical data collected by Perry demonstrate that the consumption of pornography in the United States is significantly lower among church-attending Protestant Christians compared to other religious groups, and declared that "Protestant men today who attend church regularly are basically the only men in America still resisting the cultural norm of regularized pornography use". [87]
The overwhelming majority of all websites and YouTube channels devoted to anti-masturbation and anti-porn addiction propaganda, channels and websites supporting NoFap included, are, according to various sources, owned by far-right Christian fundamentalists and conservative biblical inerrantists, and also are entirely political in nature. [69] [88] Various psychologists, medical doctors, and social scientists have contended that traditional Christian concerns over combating sexual thoughts, desires, and activities, including masturbation, [89] [90] [91] [92] [93] can be seen as unhealthy and unwholesome. This may also apply to secular advocacy of anti-pornography and anti-masturbation, [17] [18] including 16 U.S. states' legislatures which have declared that pornography is a "public health crisis". [17] [94]
The American Psychiatric Association had by then already dismissed such moral panic ("political stunt") [17] in DSM-5 (published in 2013), [6] and DSM-5-TR, published in March 2022, does not recognize a diagnosis of sexual addiction (which would include internet pornography viewing). [46] [47]
Emily F. Rothman, Professor of Community Health Sciences at the Boston University School of Public Health, stated in 2021 that "the professional public health community is not behind the recent push to declare pornography a public health crisis". [16] The ideas supporting the "crisis" have been described as pseudoscientific. [95]
Sexual violence, partner violence, anxiety, depression, compulsive pornography use, and commercial sexual exploitation are public health problems, and there is a possibility that pornography exacerbates these problems. Given that possibility, we need to know more about whether, how, and why pornography influences social norms as well as individuals’ behavior, and what we can do to address that influence if it is harmful. It is also important to be aware that framing pornography as a public health issue has been used as a rhetorical trick by right-wing groups to promote a conservative social agenda at odds with public health goals. Public health professionals should sponsor rigorous research on the possible negative effects of pornography on society and individuals, counter misinformation, and use evidence to move forward with policy decisions.
In many cases, sexual addiction therapy applied to gay men is akin to conversion therapy. [96]
In 2013, American actor Joseph Gordon-Levitt wrote, directed, and starred in the comedy-drama film Don Jon , in which the protagonist is addicted to pornography. [97] In an interview to promote the film, Gordon-Levitt discussed what he referred to as the "fundamental difference between a human being and an image on a screen". [98]
In 2014, American actor Terry Crews talked about his long-standing pornography addiction, which he said had seriously affected his marriage and life and which he was able to overcome only after entering rehab in 2009. [99] He now takes an active role in speaking out about pornography addiction and its impact. [100] [101] [102]
In 2015, English comedian Russell Brand appeared in videos by American anti-pornography group Fight the New Drug, in which he discussed pornography and its harmful effects. [103]
In 2016, American comedian Chris Rock and his wife, Malaak Compton, divorced after 20 years of marriage, [104] which Rock attributed to his infidelity and pornography addiction. [105] He later discussed the details of his pornography addiction in his 2018 stand-up comedy special Tamborine . [106]
A paraphilia is an experience of recurring or intense sexual arousal to atypical objects, places, situations, fantasies, behaviors, or individuals. It has also been defined as a sexual interest in anything other than a legally consenting human partner. Paraphilias are contrasted with normophilic ("normal") sexual interests, although the definition of what makes a sexual interest normal or atypical remains controversial.
Hypersexuality is a medical condition that causes unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomaniac and sex maniac were terms previously used for the condition in women and men, respectively.
Hebephilia is the strong, persistent sexual interest by adults in pubescent children who are in early adolescence, typically ages 11–14 and showing Tanner stages 2 to 3 of physical development. It differs from pedophilia, and from ephebophilia. While individuals with a sexual preference for adults may have some sexual interest in pubescent-aged individuals, researchers and clinical diagnoses have proposed that hebephilia is characterized by a sexual preference for pubescent rather than adult partners.
Reasons for opposition to pornography include religious objections, feminist concerns, moral reasons as well as alleged harmful effects, such as pornography addiction and erectile dysfunction. Pornography addiction is not a condition recognized by the DSM-5, the ICD-11, or the DSM-5-TR. Anti-pornography movements have allied disparate social activists in opposition to pornography, from social conservatives to harm reduction advocates. The definition of "pornography" varies between countries and movements, and many make distinctions between pornography, which they oppose, and erotica, which they consider acceptable. Sometimes opposition will deem certain forms of pornography more or less harmful, while others draw no such distinctions.
Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, autism spectrum disorder, fetal alcohol spectrum disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.
Sexual addiction is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The concept is contentious; as of 2023, sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders, which instead categorize such behaviors under labels such as compulsive sexual behavior.
Video game addiction (VGA), also known as gaming disorder or internet gaming disorder, is generally defined as a psychological addiction that is problematic, compulsive use of video games that results in significant impairment to an individual's ability to function in various life domains over a prolonged period of time. This and associated concepts have been the subject of considerable research, debate, and discussion among experts in several disciplines and has generated controversy within the medical, scientific, and gaming communities. Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests without regard for the negative consequences. As defined by the ICD-11, the main criterion for this disorder is a lack of self control over gaming.
Patrick Carnes is an American proponent of the viewpoint that some sexual behavior is an addiction. According to CBS News, he popularized the term sex addiction. He created the International Institute for Trauma and Addiction Professionals (IITAP), as well as numerous addiction treatment facilities, and created the CSAT certification.
Pedophilia is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty at age 10 or 11, and boys at age 11 or 12, psychiatric diagnostic criteria for pedophilia extend the cut-off point for prepubescence to age 13. People with the disorder are often referred to as pedophiles.
Internet sex addiction, also known as cybersex addiction, has been proposed as a sexual addiction characterized by virtual Internet sexual activity that causes serious negative consequences to one's physical, mental, social, and/or financial well-being. It may also be considered a subset of the theorized Internet addiction disorder. Internet sex addiction manifests various behaviours: reading erotic stories; viewing, downloading or trading online pornography; online activity in adult fantasy chat rooms; cybersex relationships; masturbation while engaged in online activity that contributes to one's sexual arousal; the search for offline sexual partners and information about sexual activity.
Pornography has been defined as any material in varying forms, including texts, video, photos or audio that is consumed for sexual satisfaction and arousal of an individual or partnership. The effects of pornography on individuals or their intimate relationships have been a subject of research.
Internet addiction disorder (IAD), also known as problematic internet use, or pathological internet use, is a problematic compulsive use of the internet, particularly on social media, that impairs an individual's function over a prolonged period of time. Young people are at particular risk of developing internet addiction disorder, with case studies highlighting students whose academic performance declines as they spend more time online. Some experience health consequences from loss of sleep as they stay up to continue scrolling, chatting, and gaming.
Behavioral addiction, process addiction, or non-substance-related disorder is a form of addiction that involves a compulsion to engage in a rewarding non-substance-related behavior – sometimes called a natural reward – despite any negative consequences to the person's physical, mental, social or financial well-being. In the brain's reward system, a gene transcription factor known as ΔFosB has been identified as a necessary common factor involved in both behavioral and drug addictions, which are associated with the same set of neural adaptations.
The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World Health Organization (WHO). Development of the ICD-11 started in 2007 and spanned over a decade of work, involving over 300 specialists from 55 countries divided into 30 work groups, with an additional 10,000 proposals from people all over the world. Following an alpha version in May 2011 and a beta draft in May 2012, a stable version of the ICD-11 was released on 18 June 2018, and officially endorsed by all WHO members during the 72nd World Health Assembly on 25 May 2019.
Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behavior that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use can alter brain function in synapses similar to natural rewards like food or falling in love in ways that perpetuate craving and weakens self-control for people with pre-existing vulnerabilities. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in the development of addiction. While mice given cocaine showed the compulsive and involuntary nature of addiction, for humans this is more complex, related to behavior or personality traits.
Robert Weiss is an American author, educator, and clinical expert in the treatment of Sexual Addiction and Related intimacy disorders. Weiss currently serves as Founder Seeking Integrity Treatment Programs.
Compulsive sexual behaviour disorder (CSBD), is an impulse control disorder. CSBD manifests as a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause significant levels of psychological distress, are inappropriately used to cope with psychological stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational, personal, or other important functions. CSBD is not an addiction, and is typically used to describe behavior, rather than "sexual addiction".
Wendy Maltz is an American sex therapist, psychotherapist, author, educator, and clinical social worker. She is an expert on the sexual repercussions of sexual abuse, understanding women's sexual fantasies, treating pornography-related problems, and promoting healthy sexuality. She has taught at the University of Oregon and, up until her retirement in 2016 from providing counseling services, was co-director with her husband, Larry Maltz, of Maltz Counseling Associates therapy practice in Eugene, Oregon.
NoFap is a website and community forum that serves as a support group for those who wish to give up pornography and masturbation. Its name comes from the slang term fap, referring to male masturbation. While reasons for this abstinence vary by individual, the main motivation cited is attempting to overcome addiction to pornography, or other compulsive sexual behaviours. Other reasons for abstinence include religious and moral reasons, self-improvement, and physical beliefs that are not supported by medical science.
'Sex addiction' is also referred to as a diagnosis or presenting problem. Sex addiction is not a diagnosis in the DSM-5-TR and identified as Compulsive Sexual Behavior in the ICD-11 rather than an issue of addiction.
Proposals for two constructs related to compulsive sexual behaviors , sexual addiction and hypersexual disorder, have been repeatedly rejected from inclusion in recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for lack of empirical support and lack of consensus as to definition. [...] (CSBD), has been included in the International Classification of Diseases, 11th edition (ICD-11), under impulse control disorders rather than as an addiction disorder. CSBD has significant differences from substance use disorders (SUD) [...]
Given that we do not yet have definitive information on whether the processes involved in the onset and maintenance of the disorder are equivalent to substance abuse disorders, gambling, and gaming (Kraus et al. 2016), CSBD is not included in the grouping of disorders due to substance and addictive behaviors, but rather in that of impulse control disorders (Kraus et al. 2018).
... materials in ICD-11 make very clear that CSBD is not intended to be interchangeable with sex addiction, but rather is a substantially different diagnostic framework
spoke with David Ley
AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.
In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming, have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, which some term behavioral addictions, with such subcategories as "sex addiction," "exercise addiction," or "shopping addiction," are not included because at this time there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders. ... Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.
Note that the word addiction is not applied as a diagnostic term in this classification, although it is in common usage in many countries to describe severe problems related to compulsive and habitual use of substances.
Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.
In addition to the substance-related disorders, this chapter also includes gambling disorder, reflecting evidence that gambling behaviors activate reward systems similar to those activated by drugs of abuse and that produce some behavioral symptoms that appear comparable to those produced by the substance use disorders. Other excessive behavioral patterns, such as Internet gaming (see "Conditions for Further Study"), have also been described, but the research on these and other behavioral syndromes is less clear. Thus, groups of repetitive behaviors, sometimes termed behavioral addictions (with subcategories such as "sex addiction," "exercise addiction," and "shopping addiction"), are not included because there is insufficient peer-reviewed evidence to establish the diagnostic criteria and course descriptions needed to identify these behaviors as mental disorders.
While excessive use can have negative effects, moderate use can be a natural and healthy part of life.
When those aversion techniques are applied to MSM, they can be particularly harmful as they are akin to what I would consider conversion practices.
can be at high risk of crossing into "conversion therapy" because of their lack of robust knowledge in contemporary sexology, mistaking normative sexual behaviours for a pathology.
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