How Can Problematic Pornography Use (PPU) Present in Therapy?

Series 2 

Problematic Pornography Use (PPU) can present itself in infinite ways. It doesn’t always involve uncontrolled or extreme usage, nor can it be particularly shocking or have an array of deviant themes. What it can do is distract from your sexual wellbeing by skewing your beliefs about how ‘good sex’ should look. PPU can significantly alter your view of your body image, distort your assumption of the intensity of pleasure – that is if there is not constant ecstasy then you are a below-par lover unable to satisfy and, what is seen on screens is what everybody wants.  

Often people present in counselling feeling shame about their PPU because it conflicts with their values and beliefs. It has become such a burden to ‘remember the lies’ to not get caught out and continue to live a secret life of a ‘public self’ and a ‘private self’. For some carrying the shame and the weight of these burdens of who you really are means that watching pornography becomes the go-to inflexible self-soothing strategy. People are caught in a cycle of desperately wanting to stop and desperately can’t stop.   

Typically, PPU presents in therapy due to the partner discovering the pornography and or objecting to it. Often partners are alerted to a change of behaviour, something that ‘feels off’, behaviours ‘don’t quite make sense’. Whenever they ask about those behaviours there are always excuses or responses that are often very damaging to the relationship such as ‘gaslighting’. It becomes a crisis issue in the relationship not only about PPU but moreover the lies and deceit of trying to persuade the partner it’s their imagination.  

 Another common way PPU presents particularly for young men is the inability to form, maintain and sustain a relationship.  Their loneliness is profound. Whether its discovery by a partner or lack of relationships, often there is pornography induced erectile dysfunction (PIED). This term originated within online forums and self-help communities. It is not formally recognised medical condition.   

PIED hold the idea that (over) consumption of pornography can condition some men’s sexual arousal to respond only to the potent on demand stream of constant novelty. That escalation of ‘novelty’ means a searching for more hardcore footage found on more extreme sites (1). Suffers report that the threshold for arousal becomes so warped that sex with a real live person is no longer sufficiently exciting, or the reality of that person- their smell, their sounds and their agency is too far removed from what is being watched on pornographic screens to induce an erection.  Whilst there may be other factors for PIED some studies do suggest a link between ED and PPU (2) 

The PPU partner may not be the only one affected: their partner may feel rejected, lonely, unattractive and angry. Partners can feel betrayed on feeling cheated on. Their home can no-longer feel safe. Their sexual wellbeing is impacted upon on the comparison (wrongly) to the pornography. Pornography videos can be free and paid for such as Only Fans where there are personalised video recordings. Using the joint account to pay a sex worker while distressed over PIED can wreck a relationship. 

Presenting issues of PPU can vary, for example those who have experienced trauma or sexual abuse. Trauma can take the form of complex PTSD where early attachment issues such as domestic abuse, parental rows and separation or abandonment, a parent hospitalised or very ill and bullying by siblings or in school. Pornography can take the form of a violence or degradation allowing the person to re-experience aspects of the trauma in a more controlled way. Past trauma may have left the felling person powerless or helpless, reprocessing their experienced via pornography gives themselves the power to press play -and stop- choose a script without emotional connection. This can be an attempt ‘to fix’, however, using pornography to move from powerlessness to feeling powerful and in control can be highly addictive 

References 

  1. Wilson, G, (2014) Your Brain in Porn. Internet Pornography and the Emerging Science of Addiction. Commonwealth Publishing UK 
  1. Jacobs T et al., Associations between online pornography consumption and sexual dysfunction in young men: multivariate analysis based on an international web-based survey. JMIR Public Health and Surveillance 2021: 7(10): e32542.pmc.ncbi.nim.nih.gov/articles/PMC8569536 

Please see Addiction or Compulsion or Something Else in Problematic Pornography Use (PPU) 

Series 3