This was his first therapy session and he had no idea what to expect. He was drunk all the time and yelling at my mom, so I would go in my room and lock the door and lose myself in porn for a few hours as a way to not hear or feel what was happening.
But his escapist compulsivity with online pornography needed to be addressed first, as it was clearly and directly linked to his most pressing issues.
Men who engage in online sexual activities for temporary emotional escape are significantly more likely to experience related negative consequences. Sexual dysfunction with real-world partners, in particular erectile dysfunction , can be linked to heavy engagement in online sexual activities. The first finding, that the men use porn, should not surprise anyone— research tells us that 13 percent of all internet searches seek some form of erotic content.
The third finding, that heavy porn use can lead to sexual dysfunction with real world partners, is also no surprise—at least not to clinicians who work with compulsive porn users on a regular basis. Click here for more on that issue. But it is the second conclusion, on the surface is the least "sexy" of the three findings, that is by far the most meaningful from a diagnostic and treatment perspective.
However, a desire to regulate uncomfortable emotions was not far behind, with Obviously, most porn users have multiple motivations, such as feeling stressed out or bored while also wanting sexual satisfaction and orgasm. This information gets really useful, from a clinician's perspective, when the research team links the reasons for going online to other factors, such as time spent online, activities engaged in online, and, most important, negative life consequences.
What they found was a powerful link between escapist motivations and negative consequences. They concluded that men like Roberto who use online porn to escape emotional discomfort are far more likely to experience related problems than men who go online primarily for sexual pleasure.
This indicates that porn use and other online sexual activities are, for some users, a maladaptive coping strategy rather than a pleasure-seeking strategy. This result is very much in line with what we know about other compulsive and addictive behaviors, including substance use disorders and gambling disorder. In short, these individuals use not to feel pleasure but to escape emotional discomfort. In fact, this occurs rather often. When this occurs, all sorts of problems may ensue—damaged relationships, trouble at work or in school, financial woes, declining physical health , anxiety, depression, shame, legal issues, and more.
As this recent study shows, with porn there is a clear link between repeated attempts at mood regulation and problematic usage. As such, the most effective way to treat problematic porn use—usage that results in negative life problems—initially involves not prescription medications and extensive psychodynamic psychotherapy , but a behavioral approach focused, in part, on the development of healthier coping mechanisms.
He is the author of several highly regarded books, including Sex Addiction Understanding Sex Addiction in Gay Men.