Take a guess, how many studies exist examining the effectiveness of addiction programs for unwanted pornography viewing?
The answer: ZERO.
Pretty shocking right? Addiction recovery programs like Alcoholics Anonymous (AA) have been around for decades. These programs have helped countless people over the years overcome drug and alcohol problems. Many have attempted to apply the addiction model to sexual concerns, like unwanted pornography viewing. However, research does not support the idea that classifying pornography as an “addiction” is helpful, in fact, it may even be part of the problem.
Several researchers have found that individuals who are religious are more likely to perceive themselves as “addicted” to pornography even though they are not viewing pornography at higher rates than less religious individuals (Abell et al., 2006; Grubbs et al.,2010; Levert, 2007). Importantly, individuals who perceive themselves as “addicted” may end up viewing pornography at even higher rates (Grubbs et al., 2015). Let that sink in for a moment. Believing you are “addicted” to pornography may actually increase your unwanted pornography viewing!
Additionally, researchers have found that moral disapproval of pornography was related to both religiosity and perceived addiction (Grubbs et al., 2015). Basically, if you think pornography is “bad”, and are religious, you may be more likely to get stuck in the “I’m a porn addict and I can’t stop” trap without being able to find a way out. You feel guilty about your viewing, believe it’s morally wrong, and yet can’t stop because viewing pornography is what helps you cope with the feeling of guilt and shame about, well, viewing pornography (Grubbs, Perry, Wilt, & Reid, 2018).
So what is the answer? If the addiction model does not adequately explain unwanted pornography viewing, what does? The answer: Compulsivity.
This is how compulsive behaviors work, we experience a negative emotion such as stress, anxiety, guilt, loneliness, or shame, then engage in a behavior to reduce the negative feeling by viewing pornography, masturbating, eating, shopping, gaming, etc, which helps us feel better temporarily, but then leads to more feelings of guilt or shame. In order to cope with these new feelings, we return to the behavior that worked in the first place but also caused the problem. We view more pornography, masturbate, shop, eat, game, etc., again and again and again. That’s how compulsive pornography viewing works. Viewing pornography helps you feel better temporarily, but worse in the long run, because you feel ashamed of yourself for viewing porn.
As a researcher and therapist, I have an ethical obligation to offer treatments that work. Acceptance and Commitment Therapy (ACT) has the best research support on its effectiveness in reducing pornography viewing. ACT has been around since the 1980s. Research has supported its effectiveness in treating many disorders including, depression, PTSD, chronic pain, and anxiety. Importantly, ACT had already been found effective in treating other compulsive disorders such as OCD. If unwanted pornography viewing functioned more like a compulsion than an addiction, it made sense that ACT would be effective, and it was!
In 2010, researchers Dr. Michael Twohig and Jesse Crosby, from Utah State University published their first study examining the effectiveness ACT with 6 adult males who reported problems with unwanted pornography viewing. After 8, 90 minute sessions, participants were able to reduce their viewing by 85%! Three months later these men continued to show on average an 83% reduction in their pornography viewing.
In 2016, these same researchers, Dr. Jess Crosby, now at McLean Hospital/Harvard Medical School, and Dr. Michael Twohig, recruited 28 adult males who were randomly assigned to 12 sessions of ACT or a waitlist control condition. The results of their second study were even more convincing. Ninety-three percent reduction in pornography viewing in the ACT condition compared to only 21% reduction in viewing in the waitlist condition. After three months, participants continued to demonstrate an 86% reduction in pornography viewing. Over half of the participants reported no longer viewing pornography at all. At three month follow-up, over a third of participants no longer viewed pornography.
Acceptance and Commitment Therapy has the best research evidence regarding its effectiveness in reducing pornography viewing. This is exciting news! If you’ve tried other addiction recovery programs, and found they didn’t work, don’t give up! The reason these programs didn’t work for you may say a lot more about the “addiction” model being a poor fit for treating unwanted pornography viewing than your ability to overcome a “compulsive” behavior.
To make these ACT principles and skills more accessible, I have developed an online self-directed program called Life After Pornography and the Life After Pornography Coach app that you can use from the comfort of your own home. You can also check out my free resources including my TEDx talk on ACT as an effective treatment for compulsive sexual behaviors
I also offer online counseling services in over 35 states! To learn more or to schedule an appointment, visit my website.
References
Abell, J. W., Steenbergh, T. A., & Boivin, M. J. (2006). Cyberporn use in the context of religiosity. Journal of Psychology and Theology, 34,165–171.
Crosby, J., & Twohig, M. P. (2016). Acceptance and commitment therapy for problematic internet pornography use: A randomized trial. Behavior Therapy, 47, 355-366.
Grubbs, J.B., Perry. S. L., Wilt. J. A., & Reid, R. C. (2018). Pornography problems due to moral incongruence: An integrative model with a systematic review and meta-analysis. Archives of Sexual Behavior, https://doi.org/10.1007/s10508-018-1248-x
Grubbs, J. B., Sessoms, J., Wheeler, D. M., & Volk, F. (2010). The CyberPornography Use Inventory: The development of a new assessment instrument. Sexual Addiction & Compulsivity, 17, 106–126.
Grubbs, J. B., & et. al. (2015). Transgression as addiction: Religiosity and moral disapproval as predictors of perceived addiction to pornography. Archives of Sexual Behavior, 44: 125-136.
Levert, N. P. (2007). A comparison of Christian and non-Christian males, authoritarianism, and their relationship to Internet pornography addiction/compulsion. Sexual Addiction & Compulsivity, 14, 145–166.
Twohig, M. P., & Crosby, J. M. (2010). Acceptance and commitment therapy as a treatment for problematic Internet pornography viewing. Behavior Therapy, 41(3), 285-295.