Treatment for Pornography Addiction often focusses on the act of watching pornography and assistance to try to reduce the ‘behaviour’. But if such an approach doesn’t work, what are the alternative models of addiction? And why don’t we hear more about them?
I’ve been working with concerns about addiction to pornography for a number of years now. When men started to contact me seeking help it was mostly men who wanted help with porn use. Many of these men them came to me equipped with a glossary of terms from 12-Step programmes like SAA (Sex Addicts Anonymous), SLAA (Sex and Love Addicts Anonymous), SCA (Sexual Compulsives Anonymous) and SA (Sexaholics Anonymous). They spoke of concepts like ‘sobriety’, ‘healthy sexuality‘ and ‘bottom-line behaviours’.
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12 Step and Alternative Treatment for Pornography Addiction
Some of these men had invested quite a lot of time reading about these models of addiction, understanding the concepts and attending groups. At the same time, they were consulting me because the groups and 12-step programmes had not completely worked for them. They were still using pornography. Ironically, most of the men who had turned to the 12-step model seemed to want to continue to use the terms and concepts the programme had taught them. This was despite deciding 12-step hadn’t worked as treatment for pornography addiction.
It is not always possible to continue to view our actions through the same lenses to which we are accustomed. When those lenses fail to provide us with clarity or vision, we need alternatives. The big problem with 12-step models is that they tell the man he is powerless over his addiction. And that does not help him develop self-agency. It is at odds with gaining more influence over his own actions.

The ‘brain chemistry’ model supports a sense of powerlessness as well. If we don’t understand the chemistry of the brain – and perhaps even if we do – we are at its mercy. Studies are suggesting that brain chemistry does not cause depression. But dialogue can create meaning. Do we really need to pretend pornography use is all about complex science only specialist medical doctors understand?
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Brain Chemistry or Sobriety? Both are Disease Models of Treatment for Pornography Addiction
Both of these approaches assume that pornography use is a disease. And many people are surprised to find out that there is no diagnosis of pornography addiction according to the major disease classifications. I realised quite early on that simply accepting that addiction to pornography was a disease would spin off a number of assumptions about a person’s use of pornography that might go unquestioned. Instead of looking at what was the same for these men, I started exploring what might be different.
And I found many differences. In fact, every man who contacted me had a unique story. There were some common threads. But failing to approach their stories as unique narratives of porn use clearly meant I was missing crucial details about what was significant in each man’s history and the way porn had found its way into his life.
I believe it is disrespectful and fundamentally flawed to use a ‘colour-by-numbers’ approach to treatment for pornography use. We need to look beyond the act of a man looking at pornography. We need to consider the ways in which that act might be a response. And to what it might be a response. Focusing on porn use as a problem rather than as a response is like simply focussing on cars as the cause of traffic accidents without ever considering transport needs. People watch porn for many different reasons. What I offer is a chance to explore those reasons and investigate how pornography has taken up space in a man’s life.

I don’t judge a person’s porn use. The medical model suggests we give ourselves up to the doctor or psychotherapist who presumably knows best. The risk is that the patient or client becomes more or less a helpless victim. When men contact me, I’m interested in their concerns and why they are finding their porn use a problem.
I don’t start with an agenda that I know best. So these therapeutic meetings are dialogical: they happen through conversation. They aren’t about instructing men what to do or passing judgement on their actions. Instead we explore the topic brought to the session and develop meaning around it together, in dialogue. That is the way to new understanding around treatment for pornography. This in turn leads to more influence over the choices made in life.
You can contact me if you would like to make an online appointment or meet with me in-person.
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