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Is Porn Addiction and Sex Addiction the Same Thing?

Dr R. Y. Langham

Jun 26, 2022

Is there really a difference between a person, who has a sexual affair with someone else and a person, who has become “entangled” with porn?

In other words, are sexual behaviors, like prostitution, serial hookups, anonymous sex, or affairs more harmful to your self-esteem and self-confidence, relationships, and livelihood, than porn? Or, is it vice versa with porn being a bigger threat to your happiness and productivity, than sexual behaviors?

Well, the truth is both sex addiction and porn addiction can be damaging on many fronts – i.e., relationships, finances, work opportunities, etc. Unfortunately, society rarely recognizes porn addiction for the threat it is. To many, using porn is “less threatening” than having sex with prostitutes or being a nymphomaniac.

However, the truth is, that “heavy porn use” or porn addiction is one of the most common, sexual compulsions for people who are addicted to sex. And, guess what? Porn addiction does not just affect males, women can also be porn addicts, and “heavy porn use” is often a symptom of sex addiction. So, while sex is addictive, it appears that porn is even more enticing to some people.

But is it really surprising that porn is so addictive?

Porn videos, clips, and images can form neuropathways in the brain, and each neuropathway helps form a habit. This happens when something (i.e., porn) is pleasurable. When something like porn elicits a “feel good” sensation in the body, it causes you to keep returning to it. Because you keep returning to the activity (using porn), your brain links sexual satisfaction and/or general relief to porn. The result? A porn habit – or even worse – a porn addiction.

If you are wondering if sex addiction and porn addiction are the same things, look no more, because this article will help you better understand the relationship between these two behavioral addictions.

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What is Sex Addiction?

In 1983, Patrick Carnes published “Out of the Shadows: Understanding Sexual Addiction,” which highlighted the ins and outs of sex addiction. Since that time, numerous sex addiction clinics and therapeutic interventions have been created to help people deal with sexual obsessions. Although sex addiction is not officially recognized, by the American Psychiatric Association (APA) and the Diagnostic and Statistical Manual of Psychiatric Disorders, Fifth Edition (DSM-5), it is often characterized as a “hypersexual disorder.”

But, to date, there are no universal sex addiction guidelines or criteria for practitioners and sex therapists to use to diagnose it. So, what is a sex addict? Well, it is someone, who has become “fixated” or obsessed with sex. More specifically, a sex addiction resembles obsessive-compulsive disorder (OCD) in some way. People with this type of addiction experience non-stop intrusive thoughts, urges, emotions, and/or mental images about sex, which can and often do lead to compulsions or rituals or routines designed to stop the intrusive thoughts, urges, emotions, and/or mental images.

The never-ending, involuntary obsessions and compulsions often lead to a continuous OCD cycle consisting of stress/anxiety/distress, obsessions, and/or compulsions. A sex addict’s “fixation” on sex can negatively affect his or her quality of life, goals, relationships, job prospects, finances, and even his or her self-esteem and self-confidence. And, although, most people equate sex addiction with men, women can also develop this addiction.

So, what does sex addiction involve?

Well, a sex addict may compulsively view porn, masturbate, pay for sex (i.e., prostitution, phone sex, etc.), secretly watch other people undress and/or have sex – and enjoy it (voyeurism), fantasize about, feel impulses to, and/or exposing your genitals to non-consenting people, especially children and strangers (exhibitionism), repeated sexual encounters with strangers, serial infidelities, etc.

Sex addiction is a progressive addiction, which means it worsens or “progresses” over time. A person with a sex addiction engages in these behaviors as a way to “escape” something or experience sexual pleasure. Still, some people with this addiction engage in it to ease stress, distress, or anxiety, feel the void of social isolation, get “high,” and/or avoid problems or intimacy. However, the stress, shame, guilt, and fear of participating in these sexual activities can exacerbate the addiction.

Note: In contrast to someone with a healthy sex drive, a sex addict will devote a large amount of time to seeking out or engaging in sexual intercourse or sexual activities, while hiding them from others.

What Are the Signs and Symptoms of Sex Addiction?

Listed below are the signs and symptoms of sex addiction:

  • Preferring to have sex takes precedence over everything else – i.e., it is more important than going out with friends, go to work or school, perform household or child-rearing tasks, cook or clean, etc.
  • Engaging inappropriate, taboo, and/or risky sexual activities – i.e., exhibitionism, voyeurism, public sex, sex with prostitutes, extramarital sexual affairs, random sex with multiple partners, “heavy porn use,” phone sex, cybersex, and/or frequenting sex clubs
  • Constantly yearning for sex is, which is followed by intense feelings of regret, anxiety, depression, guilt, embarrassment, and/or shame
  • Excessively masturbating when alone

Note: Understand that sex addiction usually involves an unrelenting cycle of hypersexuality and low self-esteem. Although sex can bring short-term relief, the harm to the person’s psychological well-being will often increase and worsen over time. A person does not have to engage in extreme or “strange” sex to have a sex addiction. All that is required is an inability to stop what he or she is doing.

What Causes Sex Addiction?

To date, the exact cause of sex addiction is unknown. However, there are a variety of theories on why this addiction occurs. One of these theories is that sex addiction stems from a lack of impulse control. Other theories suggest that sex addiction, like porn addiction, is a form of OCD – with a sexual component or a relationship disorder. Yet, another theory is that sex addiction is the result of childhood trauma, especially child sexual abuse.

Studies suggest that a personal or family history of mental illness (i.e., depression, anxiety, bipolar disorder, panic use disorder, etc.), and some neurological conditions (i.e., traumatic brain injuries, epilepsy or seizures, dementia, etc.) may contribute to hypersexual behaviors like sex addiction. Some drugs (especially those that affect dopamine production and release in the body) and alcohol also appear to contribute to sex addiction – in some people.

How is Sex Addiction Treated?

Sex addiction is usually conducted on an outpatient basis, however, in rare circumstances, hospitalization may be required. Sex addiction treatment typically involves therapy and/or medications. However, medications are only prescribed if there is an underlying mental health condition, such as anxiety or mood disorders that could be causing, contributing to, or worsening the sex addiction.

If you suspect that you have a sex addiction, the first step is to talk to your general practitioner or internist, who will likely refer you to a mental health professional – i.e., a sex therapist, counselor, or psychotherapist. You may also be referred to a couples or marital counselor, support group, and/or 12-Step Recovery Program (if you are also dealing with drug and/or alcohol abuse).

Sex Addiction Therapy

Listed below are the two most common sex addiction therapies:

  • Cognitive-Behavioral Therapy (CBT) – CBT is usually the first-line treatment for sex addiction. The goal of CBT is to help you change the way you perceive or “see” sex with the hope that if you can alter your thought processes, your behaviors will follow suit.

    CBT is designed to help you discover what is triggering your thoughts and urges, and behaviors, so you can stop them before they destroy your life. A cognitive-behavioral therapist can also teach you healthy coping skills and strategies so you do not feel compelled to turn to sex when you feel distressed, stressed, anxious, bored, or depressed.

  • Motivational Enhancement Therapy (MET)MET encourages cooperation between you and your therapist to stop your addiction to sex. The goal of this therapy approach is to identify why you keep returning to sex as a “go-to remedy” for your problems. It also helps motivate you to change your inappropriate behaviors (i.e., excessive sex).
Medications

Although there are no medications specifically designed for sex addiction, antidepressants are sometimes used “off-label” to treat it. One specific group of antidepressants, known as selective-serotonin reuptake inhibitors (SSRIs), are prescribed to people suffering from sex addiction and depression or anxiety.

Medications that are sometimes prescribed for sex addiction are:

  • Mood Stabilizers – Although mood stabilizers are usually prescribed for bipolar disorder or OCD, they may also be beneficial for sex addicts. More specifically, mood stabilizers (i.e., Lamictal, Tegretol, etc.) may help reduce compulsive sexual urges.
  • SSRIs – SSRIs are antidepressants designed to treat mood disorders, like depression, and anxiety conditions, like OCD, post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic use disorder and panic attacks, bipolar disorder, etc. SSRIs (I.e., Zoloft, Paxil, Prozac, Luvox, Celexa, etc.) can also be used “off label” to treat sex addictions – i.e., may help control compulsive behaviors.

What is Porn Addiction?

Porn addiction (pornography addiction) is characterized as a compulsive need to use porn, despite unpleasant consequences. Porn addiction, like other behavioral addictions, resembles obsessive-compulsive disorder (OCD) in that people with this addiction are unable to stop their urges to view porn. It takes precedence over everything in their lives.

People with porn addiction may turn to porn as an “escape” from problems, boredom, a fear of intimacy, poor self-esteem and self-confidence, emotional pain, relationship issues, stress, anxiety, depression, etc. To stop these the urges, porn addicts engage in compulsive behaviors (using porn).

Although some researchers, experts, and doctors do not consider porn addiction a “real” addiction, for the people, who struggle with it, it is very much real – and damaging. Porn addiction, like sex addiction, is not officially recognized by the APA or the DSM-5, however, the symptoms of this addiction mimic the symptoms of other behavioral addictions.

The main difference between sex addiction and porn addiction is the consequences of each addiction. For instance, a porn addict may spend large amounts of time viewing porn, instead of socializing with peers, spending time with friends and loved ones, going to work or school, cleaning the house, taking care of their children, etc.

The addict keeps engaging in this behavior (using porn), even though it is damaging their relationships, self-esteem and self-confidence, and/or job prospects. Sex addicts relish in interacting with others, preferring to spend time with others with the hope that it will lead to something sexual.

What Are the Signs and Symptoms of Porn Addiction?

Listed below are the signs and symptoms of porn addiction:

  • Being consumed porn urges, mental images, and/or urges
  • Viewing porn on your smartphone while at work, school, or in social situations
  • Feeling embarrassed by, ashamed of, and/or anxious or depressed about your porn habit
  • Continuing to use porn, despite any negative consequences – i.e., breakups, divorces, damaged friendships, low self-esteem or self-confidence, job termination, debt, etc.
  • Being unable to experience sexual arousal or satisfaction without porn
  • Self-isolating or hiding your “porn use” from friends, your partner, and family members
  • Becoming upset if or when you asked to reduce or stop using porn
  • Spending most of your time viewing porn or losing track of how much time you spend viewing porn
  • Being unable to quit porn even though you have tried too many times
  • Engaging in inappropriate or risky behaviors to view porn, such as using porn at work or school
  • Ignoring your tasks and responsibilities in favor of using porn
  • Progressively using porn or turning to more “taboo” forms of porn, such as XXX porn, BDSM, violent porn, etc., to get the initial results (i.e., sexual arousal or satisfaction)
  • Continuing to use porn, despite feeling frustrated and/or ashamed after viewing it
  • Wanting to stop using porn, but being unable to do so
  • Spending large quantities of money on porn, despite other financial responsibilities
  • Viewing porn to cope with emotional distress or sadness, anxiety, depression, insomnia, boredom, relationship problems, etc.

Note: A 2020 study found that 57% of the general adult population has used porn at some point during their lives. Researchers also found that “heavy porn use” is linked to high levels of stress, anxiety, and depression.

What Causes Porn Addiction?

Listed below are possible causes of porn addiction:

  • An unfulfilled sex life
  • Relationship issues (i.e., dissatisfaction with your partner, etc.) stemming from your “heavy porn use”
  • Underlying mental health conditions (i.e., emotional distress, anxiety, depression, etc.)
  • Unhealthy societal norms (i.e., unrealistic ideas of how a person should look, dress, think, and/or behave during sex)
  • Genetics/biology (i.e., genes and changes in brain chemistry and functions)
  • Environmental factors (i.e., childhood trauma or sexual abuse)

Note: According to a 2015 study, porn, by itself, is not the problem, rather, it is the belief that you are addicted to it that is the problem. In other words, it is the belief that you have a problem with porn that causes stress, anxiety, depression, and/or emotional distress.

How is Porn Addiction Treated?

Like sex addiction, there are no universal treatment guidelines for porn addiction.

Also, like sex addiction, the preferred porn addiction treatment involves therapy (i.e., cognitive-behavioral therapy (CBT) and/or acceptance and commitment therapy (ACT)), and/or medications, specifically SSRIs.

For porn addicts, who have experienced trauma, which led to porn addiction, other forms of therapy, such as marital or couples therapy, individual therapy, eye movement desensitization and reprocessing (EMDR), grief therapy, porn addiction support groups, substance abuse therapy, etc. A porn addiction therapist can help you cope with relationship and self-esteem and self-confidence issues and feelings of shame, regret, embarrassment, and guilt.

Overall, porn addiction treatment may include the following:

  • Psychotherapy – A psychotherapist can help you better understand the relationship between what is happening in your life (or what happened in your life) and your “fixation” on porn. Moreover, he or she will help you identify any unmet sexual needs, and help you come up with a healthy coping mechanism to help you deal with emotional distress, stress, anxiety, and/or depression.
  • Couples or Marital Counseling – Couples or marital counselors can help you and your partner talk about your intimacy needs and wants. He or she can also teach you how to communicate better and how to find excitement with each other, rather than with porn. The goal of this type of counseling is to help you and your partner develop a deeper trust with and respect for each other – in and out of the bedroom.
  • Medications: Antidepressants, like SSRIs, can help people, who are struggling with depression and/or anxiety and porn addiction.
  • Self-Help Tools & Lifestyle Changes – Some people use porn out of boredom, frustration, anxiety, or exhaustion. A healthier lifestyle consists of spending quality time with friends and loved ones and less time on porn sites, getting proper rest, eating healthy foods, reading books on porn addiction, putting porn blockers on your electronic devices, using your electronic devices in open or public spaces, removing porn from your home, going to porn addiction support groups, or joining porn addiction forums, and/or investing in an online porn recovery program, like Stop Together. Stop Together can help you get to the root of your sex and porn addiction, so you can experience intense sexual satisfaction with your partner – no “actors” on a screen.

What is the Relationship Between Sex Addiction and Porn Addiction?

As mentioned above, sex addiction is not listed in the DSM-5, however, it is still a real addiction that afflicts millions of people around the world. Sex addiction and porn addiction are linked in that many people who struggle with sex addiction also struggle with porn. For example, a person, who is a chronic and excessive masturbator may use porn while engaging in this sexual activity. Porn helps him or her become sexually aroused, become erect, and orgasm (sexual release) during masturbation.

Or, a person may need to view porn before engaging in compulsive sexual acts or experiencing sexual release, like having promiscuous sex with strangers, paying for sex with a prostitute, etc. According to researchers, sex therapists, and doctors, sex addiction can manifest in a variety of ways, such as “heavy porn use.” So, ultimately, porn addiction is simply a subtype of sex addiction.

According to the APA and DSM-5, compulsive sexual behavior disorder is an inability to get control over non-stop, involuntary, and intense sexual urges, images, thoughts, fears, etc., that can result in repetitive behaviors like rituals and routines.

Because sex addiction involves uncontrollable, erratic, impulsive, and extreme behaviors, it is common for people with sex or porn addiction to also be grappling with mood disorders like bipolar disorder, clinical depression, post-traumatic disorder (PTSD), social anxiety, panic use disorder or panic attacks, generalized anxiety disorder (GAD), or OCD.

Similar to other behavioral addictions, there are some signs that you or someone you love has a sex addiction, such as an inability to stop thinking about, fantasizing about, or experiencing urges to engage in sexual activities, including voyeurism, exhibitionism, sexual intercourse with random or multiple people, promiscuity, etc.

When you have a sex addiction, you cannot stop engaging his sexual behaviors, even though there may be serious consequences attached to them (i.e., damaged relationships, a failed marriage, health issues, low self-esteem and self-confidence, etc.). So, basically, sex addiction is the misuse, overuse, or abuse of sexual activities or behaviors, which can range from sexual fetishes or “heavy porn use,” to excessive masturbation.

Understand that a sex addict can seek sexual arousal, release, and satisfaction from viewing porn – in this scenario, the addict misuses or abuses porn for sexual pleasure. Similar to drug abuse, porn elicits a “high” in the brain, which causes you to keep returning to it. When the porn use is accompanied by sexual arousal, orgasm, and/or masturbation, your internal reward system is activated and neuropathways form in your brain – neuropathways that form “habits.”

People with sex addiction will do whatever is necessary to fulfill their urges, impulses, fantasies, etc. For some, this may involve having sex with another person or other people or engaging in sex-related activities, for others, it may involve watching porn on their electronic devices.

Because sex or sex-related activities (a direct action that involves people in real-life), while porn involves viewing sexual-explicit images, videos, movies, and clips (an indirect act that does not involve people in real-life), some researchers believe that porn addiction and sex addiction are two distinct or separate conditions. Sex addiction is more interpersonal than porn addiction.

Sex addicts must have sex with someone or engage in sexual activity to receive sexual satisfaction – porn alone is not enough to accomplish this task. While porn addicts can achieve sexual satisfaction simply by viewing sexually-explicit images. Sex addicts tend to be extroverted (social butterflies) who like to interact and mingle with others, while porn addicts tend to be more introverted, preferring to view porn at home alone.

Still, most experts agree that there are some similarities and overlaps between sex addiction and porn addiction. Also, keep in mind that it is possible to struggle with both sex addiction and porn addiction at the same time.

Can Porn Addiction Be Treated with Sex Addiction Therapy?

Absolutely!

Because porn addiction is often viewed as a manifestation of a subtype of sex addiction, it just makes sense that sex addiction therapy could help both sex addicts and porn addicts.

What is Sex Addiction Therapy?

Sex addiction therapy typically involves a certified sex addiction therapist (CSAT), who is trained to identify and treat people struggling with sex addiction and/or porn addiction.

Sex addiction therapy can help you better understand the ins and outs of compulsive sexual behaviors, so you can gain control over your addiction. This sex/porn addiction treatment involves evaluating you for co-morbid conditions or addictions, trauma, personal or familial mental health conditions, sexual dysfunctions, like porn-induced erectile dysfunction, etc. The goal of this therapy is to highlight why you be may be struggling with a hypersexual disorder like sex addiction and/or porn addiction, so you can finally break from them.

A certified sex addiction therapist can help you learn valuable coping strategies that you can use when you become stressed, upset, anxious, or depressed, so you do not feel compelled to turn to porn or sex to “quench” your thirst. This therapist can also help you identify your triggers and provide you with reading materials, support groups, resources, self-help tools, audio videos, mindfulness meditation techniques, etc., so you can fully recover from your addiction.

References

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