Treatment for the Two Categories of Porn Addicts

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In a post last week, we discussed the fact that over the last several years therapists have begun to see not one but two categories of porn addicts. First, there are traditional trauma-driven porn addicts. Then we have a new group of digital-age/conditioned porn addicts. The most obvious difference between the two groups is that traditional porn addicts report significant childhood trauma (as we tend to see with addicts in general) while digital-age/conditioned porn addicts do not. Treatment for the two categories is in many respects the same. But in a few important ways it is significantly different.

Treating Traditional, Trauma-Driven Porn Addicts

Traditional porn addicts are people who experienced significant early-life trauma such as physical abuse, sexual abuse, neglect, enmeshment, etc. Over time, usually starting in adolescence, they’ve learned to use sexual fantasies and behavior as a coping mechanism – as a way to escape from and numb feelings of stress, anxiety, depression, loneliness, boredom, etc.

These individuals generally respond to treatment that mirrors the techniques and strategies that work with substance abuse, eating disorders, and most other addictions (compulsive spending, gambling, video gaming, and the like). First and foremost, this treatment focuses on stopping the problematic behavior. After that, therapeutic work focuses on breaking through denial, managing the crisis or crises the precipitated treatment, and implementing tactics to prevent relapse.

Later in the treatment process, after the addict has developed a modicum of sobriety and ego strength, the underlying abuse and neglect that drives the addiction can be addressed with trauma resolution techniques. Though trauma work is typically necessary for these addicts from a long-term sobriety and healing perspective, it should not be undertaken too soon, as trauma work is extremely stressful, both emotionally and psychologically, and can easily trigger a freshly sober addict toward relapse.

Treating Digital-Age/Conditioned Porn Addicts

Digital-age/conditioned addicts, because their behavior is not driven by early-life trauma, require a modified treatment approach. As stated in last week’s post, these individuals tend to start using porn early, often before adolescence. Over time, porn becomes their primary source of both sexual education and sexual fulfillment. As a result, their ability to form meaningful real-world romantic attachments does not fully develop. Instead, they become “conditioned to” and “stuck with” porn. Eventually, they find that they are unable to break free and move forward into real-world romantic and sexual relationships, no matter how much they desire that.

So how does treatment differ with this new category? In the early stages of healing, it doesn’t. At the start, we use the same approach as with traditional (trauma-driven) porn addicts, focusing on stopping the use of porn, breaking through denial, and creating and implementing countermeasures to prevent relapse. After that, however, the treatment path diverges.

One reason for this is digital-age/conditioned porn addicts nearly always find it easier than traditional porn addicts to quit and stay quit. They just find it easier to walk away from porn. And when they do quit, many of their porn-related problems (most notably porn-induced erectile dysfunction) will dissipate relatively quickly – usually within a few months. Basically, their brains are able to reboot, returning to a pre-porn baseline with a relatively modest amount of intervention. With traditional trauma-based addicts, the rebooting process takes much longer – typically a year or more.

Because of this, treatment of digital-age/conditioned porn addicts can move from initial interventions to secondary issues far more quickly. And those secondary issues are not the same as with traditional addicts. Rather than working to resolve early-life trauma, as with do with most other addicts, treatment transitions toward social development – learning how to develop and maintain real-world romantic and sexual connections.

Remember, for these individuals, porn has been the primary source of sexual and romantic information. As a result of this, they typically don’t have a clue about how to successfully navigate the waters of dating and sexual exploration. The compulsive use of porn stunts their growth in these areas, so they just don’t learn these skills. Then, suddenly, they wake up in the 20s or 30s feeling alone and desirous of a real-world relationship with no idea how to make that happen.

Admittedly, not all digital-age/conditioned porn addicts are entirely bereft when it comes to real-world relationships. In fact, some are quite adept socially. But the majority need to be walked through the adolescent and early adult stages of social development to some degree, and that, rather than trauma, should generally be the secondary focus when working with this population. For more information about porn addiction and treatment, please visit the SeekingIntegrity.com website.