Welcome to my mythbusting series!
Here I examine and deconstruct the most common issues clients bring into sex therapy. I am a registered clinician counsellor, a registered psychotherapist (qualifying), a certified sex therapist, and a certified holistic sex therapist with several years experience working with various sexual concerns with clients.
Today’s subject: Sex & Porn Addiction.
This is the area I have the most experience working with, and at any given time is the primary issue affecting the majority of my clients within my caseload.
Common Myths
Let's break down some of the ideas these clients come in with that I hear time and time again:
I watched porn a lot when I was younger and that is why I believe I struggle to have/maintain an erection.
Porn is the reason I cannot connect with my partner; I need to save this sexual energy for my partner.
I am addicted to porn or sex; I am a porn or sex addict.
Assessment
Before we start mythbusting these, let's look first at what I am assessing for every client that walks through my door with these ideas: fantasy. What is fantasy? Not the type of porn you watch or what you fantasize about (though that can be helpful to understand, too). No, fantasy is how we escape reality through imagination. Fantasy can be anything. I can fantasize about the chili I am having for lunch; I can fantasize that I am a wayward cowboy when I play video games; I can fantasize I am a jedi when I watch Star Wars. What is the fantasy you are engaging with?
Another way to look at this: what are you trying to escape from?
What is taking place in life that creates a need for escapism to a degree that it feels all-consuming? Perhaps there are a variety of stressors in our life; perhaps our relationship is struggling and it is difficult to look at and think about; perhaps we do not have a good relationship with ourselves. What happens when we put down the screens in our life and are left alone with our thoughts? A skill to consider developing is slowing down in these moments and identifying what it is we are feeling as we face the world: dread, loneliness, insecurity, avoidance, fear? This is important information to understand what we are fleeing from before we can understand what we are running towards.
Mythbusting
Let’s refer back to the common myths I raised earlier and explore the ways we can deconstruct them.
1. I watched porn a lot when I was younger and that is why I struggle to have/maintain an erection.
I hear this all too frequently, especially among younger clients venturing into their first sexual relationships. They come to me telling me that through their time spent trying to understand their difficulty with their erections, they’ve also discovered that they are sexual deviants being punished for having watched porn growing up. This narrative never ceases to break my heart.
First, let's explore what an erection is. In simplest terms, an erection is the result of blood flow into the penis. But a tight pelvic floor can thwart blood flow and we can purposefully or accidently tighten our pelvic floor. Purposeful constriction of the pelvic floor muscle is most associated with keigels (which is an isolated exercise intended to strengthen the pelvic floor), but the pelvic floor can also be activated anytime there is tightness in the stomach/lower body. Therefore, anytime there is tension in our muscular system (neck, shoulders, stomach, back etc), the pelvic floor muscle is usually activated alongside these other muscles and blood flow is constricted. Just as we tend not to notice when our jaw muscles are clenched till awareness is brought to the jaw, we tend not to notice our pelvic muscles are tense until we are mindful of the pelvic muscle group.
Beyond the act of purposefully flexing our muscles, what else tightens the muscles in our body? Emotions! Emotions interact with both our nervous system and muscular skeletal system at the same time. If you are worried, anxious, fearful, or apprehensive, your muscles will reflect that. This creates a chain: emotions tighten the muscles in the body; the tightening of the muscles in the body constricts the pelvic floor; the pelvic floor tightens and blood flow to the penis stops.
With this in mind, how do people come to the conclusion that porn impacts the pelvic floor and blood flow? My understanding, and the understanding of many other sex therapists, is that porn does not interact with this muscular function directly, but rather with our underlying emotions.
For example: I have never had sex before, I have only ever watched porn that has modeled how sex should look. I get into my first sexual relationship and as I go into my first sexual encounter I notice right away that I feel nervous. My brain judges this nervousness and says “Hey, this fear does not belong here; the people I see in porn are confident and strong. If this stays here then I will not be ‘successful’”. Rather than letting this emotion pass I become tense, and with this tension comes a constricted pelvic floor and less blood flow.
Now, from the outside looking in, we can empathise with this example and notice how fear, judgement, and comparison is at the bottom of the erection loss. However, if we do not see the internal experience, we can only see the external contributing factor: porn.
Another example: I struggle with erections and notice that when I watch porn I do not have this struggle. When I am watching porn I am able to focus on something else rather than watching myself struggling to relax, and am distracted enough to be able to masturbate/have sex. When porn is not around my mind does not know where to focus and I find myself distracted, nervous, and notice myself watching and waiting for my penis to become erect.
Again, from the outside, one may notice an internal experience of someone who is more comfortable with distraction and is less comfortable noticing their emotions and body cues. Distraction helps serve a purpose for giving their busy/worried mind something and somewhere to land, and allows them to be less hyperfocused on their emotions.
With this information about biology, muscular systems, and emotions, we can paint a different picture: porn is not the culprit keeping blood away from a penis, it is our relationship to ourselves, our emotions, and our bodies that can thwart our blood flow. A sex therapist will work with a client to help them better understand the link to blood flow and emotions. We help clients create a relationship with their body to greet these emotions while regulating themselves, rather than the usual pattern of tightening and tensing when these emotions arise.
2. Porn is the reason I cannot connect with my partner; I need to save this sexual energy for my partner.
Let's compare porn to fantasy, because it is. We use fantasy all the time in our daily lives: fantasizing about how the big meeting is going to go; fantasizing about how our dinner is going to taste; fantasizing about how our football team will play. Likewise, we use this same imaginative part of our brain to fantasize about our sexual life. Without imagination, our day to day may seem monotonous. Working everyday at your 9-5 towards the goal of a vacation or retirement without any dreams of what that may look like? No thank you.
The point is, fantasy exists in every aspect of our life and is helpful in moving us forward, creating excitement, and even allowing us to escape reality for a little while. So why, when this same function of the brain that exists in so many areas of our life and is considered a positive, when used within our sexual life does it become wrong or immoral?
Sexual fantasies do not have to be a drain against one’s real-life sexual relationship. We can see these fantasies as “deposits”, like saving money or saving for retirement, to garner excitement, anticipation, and even create new ideas that we may want to try with our partner. However, I would also add that it is okay if our sexual fantasies serve no function for us rather than creating a space free of the responsibilities of reality in the same way we consume entertainment (movies, shows, books, etc.)
A sex therapist will work with clients to understand what they have been told it means to have sexual fantasies, and to unpack the ways in which one believes a fantasy is a tangible object that can hurt someone else.
3. I am addicted to porn or sex; I am a porn or sex addict.
A quick Google search is all you need to find endless evidence for why you are an addict. These sites are usually advocating or directing their viewers to a 12-step program for addiction. However, the difference between substances and porn/sex is that we cannot abstain from our sexuality and our body.
The history of sex being labeled under the “addiction” classification comes from long, cultural histories of religious purity. These histories in and of themselves would require their own dissertation, let alone a blog post. Ultimately, as religions developed, so too did the narrative that all humans are innately bad or sinful emerge. If humans are innately bad and destined for damnation, then all of human nature is sinful as well. This includes acts like sex, seeking pleasure, and any connection to our body that is not purely for a sacred, reproductive purpose.
It is important to delineate between “sex therapy” and “sex addiction therapy” and what differentiates their approaches to this issue. Sex therapists move towards the body; we want to create a relationship with the body, learn what is happening in the body that is creating a compulsive pattern, and encourage a more healthy and balanced relationship. Conversely, sex addiction programs may work great in the short term, but “relapse” rates are high. Why? Because we will always “relapse” with our body. Our body is not something to strive to be distant from.
We will always lose when we attempt to dissociate, disconnect, and turn away from our own biology. Take working with an eating disorder: we would not call someone with compulsive eating an “eating addict” and strive for them to abstain from eating. What would we do? We would seek to understand that person's relationship with food, understand the triggers associated with compulsive eating, and deepen the relationship with the body to regulate our emotions and nervous system and partake in eating in a more mindful and embodied way.
As an AASECT sex therapist I likewise align myself with the findings of talented researchers. Below is their statement pertaining to sex addiction.
“AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual behaviors. 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. 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.”
-Source: https://www.aasect.org/position-sex-addiction
A sex therapist can assist someone believing themselves to be an "addict" to consider a label that grants them more autonomy and allows them a different way to think about how they wish to move forward. Do they wish to try to abstain from sex altogether, or is there room to understand themselves on a deeper level and a desire to create more balance within their lives?
Resources:
Understanding and Managing Compulsive
His Porn, Her Pain: Confronting America’s PornPanic with Honest Talk About Sex- Marty Klein
The Role of Pelvic Floor Muscles in Male Sexual Dysfunction and Pelvic Pain
