The topic of porn addiction is a controversial one in the sexual healing community. I frequently see clients who believe they are addicted to porn, yet I’ve also heard many therapists and sexual practitioners adamantly maintain that the label “porn addiction” only causes harm, saying there’s no such thing.
Here’s what I think about porn addiction: it’s real in as much as any other diagnosis is real — and that’s only to the degree that it’s useful to the client.
Mental illness diagnoses are a very recent concept in human history. The idea that a person’s emotional struggles can be reduced to an individual problem of brain chemistry has deep roots in colonial capitalism. This system benefits a lot from making productive laborers out of all of us, and from convincing us that any inability to be a productive laborer is a personal failing (and not a failure of the system).
That being said, diagnoses can be incredibly helpful tools. I’ve never been formally diagnosed with ADHD, but when a therapist friend suggested I might have it, my life transformed. Suddenly, my perpetually scattered brain became something I could build around rather than criticize constantly. Where I used to feel self loathing — when I’d accidentally leave a pot burning on the stove because organizing the pantry suddenly became enticing, or I’d see a friend’s confusion at my inability to stay seated as we engaged in a heart-to-heart — I now felt self compassion. Where I used to try to force or will myself to focus (a strategy that rarely worked), I now approached my constant movement as something to be adapted to, learning how to work with my scattered brain rather than against it. Activities I used to hate became fun. Cleaning my room, which had once been a battle, was now an enjoyable flurry of motion; as long as I gave myself enough time and a to-do list, it was no problem to have twelve unfinished cleaning tasks going at once, popping from one to the next whenever it suited my mood.
That being said, although I found the ADHD label to be a helpful tool for befriending my brain, I know many people who feel angry they received that diagnosis — they were forced onto medications at an age when they couldn’t truly consent, they say, and it altered their brain forever.
I think of porn addiction in the same way as any diagnosis; it is useful only if it empowers a client. When a diagnosis is used as a mechanism of control, of forcing someone into a box they did not choose, it causes harm, not healing.
I have many clients who found the porn addiction label profoundly useful; it led them on a path of healing that helped them find joy and connection in a realm that had formerly brought them shame and frustration. They found a therapist they liked, began working with me in surrogate partner therapy, and learned to build meaningful relationships. But I also have clients who have been deeply disempowered by the porn addiction label. They became consumed by their shame, caught in a spiral of failed attempts at self control followed by hours of porn bingeing.
So when I hear sexual healing professionals arguing about whether porn addiction exists or not, I get frustrated. Whether I think it’s real or not doesn’t matter — and arguing about it is not only missing the point, it’s fundamentally decentering the most important part of my work: my clients.
What actually matters is my client’s relationship to the porn addiction diagnosis. If it helped them start healing and they find it empowering, great, let’s work with that! How can we replace their addictive behaviors with helpful ones? How can we support them in moving away from porn and into relationships that support them?
And if the porn addiction diagnosis harmed a client, if it left them feeling broken and inferior and unfixable, then let’s support them in letting go of that label. Let’s guide them toward self compassion and tenderness, and give them the tools they need to start discovering pleasure apart from shame.
No one should be forced to use a diagnosis that makes them feel ashamed, just as no one should be gaslit for using a diagnosis that works for them. Sexual healing professionals’ job is to support our clients, and when it comes to the label of porn addiction, that means following their lead.
Here’s a sensate focus exercise you can do on your own. “Sensate focus” is basically a fancy way of saying touch-based mindfulness, and it’s a skill we practice again and again in surrogate partner therapy. Typically, sensate focus exercises involves two people, but I’ve adapted this one so that you can do it without a partner.
Katherine Yeagel 