Pornography: Pleasure or pain?

There are few topics that raise as much debate, controversy and angst in the community than pornography. To gain an understanding of this concern, it is first necessary to define the concept of pornography.

What is pornography?

The term pornography is derived from the Greek adjective pornographos, meaning ‘the writing about prostitutes’ and originally related to any work of art or literature about prostitution. Historically and culturally, the meaning of the term has changed over time. While often being associated with erotica, a term generally bearing positive connotations, it is also associated with obscenity, which carries highly negative connotations. The word, erotica, comes from the Greek Eros (God of Love) and is associated with pleasurable desires and feelings. Obscenity, in contrast, is derived from the Latin, obscenus, meaning filth. So the term pornography can refer to material that is potentially sexually exciting and arousing, without any sense of immorality. However, it can also relate to portrayals of sexual activity that are regarded as offensive, and possibly, criminal.

Clearly, the definition of pornography has a subjective component, and this component can only be understood within a cultural context. Images that are viewed as erotic, or even religious in one culture may be denounced as pornographic in another. Thus, any medium used to depict sexual themes could qualify as pornographic. Literature, paintings, photographs and films could all qualify depending on the content and the context. For example, Michelangelo’s sculpture David could be considered pornographic by some; indeed, at one time the image was subject to censorship on the Internet. For others, the statue is a superb representation of the classical beauty of the male form.

On what basis should the definition of pornography be made?

Should the decision be informed simply by the intention of the artist or the creator? Is it better to define it based on the perception of the viewer? Clearly, an individual’s moral training and values will influence the conclusion drawn. When there are significant differences the potential for conflict is high, and human history is replete with examples of conflict between artists and their audiences across the creativity spectrum. For example, many individuals during the British Empire’s rule of India were alarmed by what they perceived as pornographic images carved on Hindu temples, which today are revered.

The problem of definition is complicated, and pornography and obscenity are areas in which moral and legal issues can clash. In a famous USA Supreme Court case (Jacobellis vs Ohio, 378. U.S. 197, 1964) about whether showing the French Film The Lovers was obscene, Justice Stewart remarked that he could not define pornography, but concluded “I know it when I see it”. Although legal standards differ, presently most countries permit depictions of sexual activity that would have been prosecuted in the criminal Courts just a few decades ago.

However, there remains appropriately a general denunciation of pornography that depicts violence and that degrades women, and a universal condemnation of child pornography. These issues are considered in other articles included in this issue.

The ‘Age of the Internet’ and pornography

The Internet has not created the desire or the intention to produce or view pornographic materials. Indeed, manuals detailing explicit sexual activity were first published in China between 206 BC and 24 AD. However, what is new is the sheer volume and accessibility of pornographic material as well as the increased opportunity for, or risk of, unintended exposure. The key identified factors that drive the search and use of pornography on the Internet are affordability, accessibility and assumed anonymity (see Yan, 2012). There is a plethora of pornographic material available, and, unique to the Internet, the opportunity for interactive ‘real’ time sexual activity via computers with cameras and sound.

Although small in relative terms, the quantum of cyber pornography in relation to all other content on the Internet is about one per cent (Zook, 2007). Nevertheless, this figure still represents a massive repository of pornography. In terms of daily search engine requests, 25 per cent are specifically seeking pornographic material (Young, 2008).

Should this be concerning? The weight of empirical evidence indicates that pornography-viewing behaviour exists on a continuum from healthy, positive and educative to exploitative, detrimental and addictive. In terms of its positive contribution, it is instructive to consider how pornography is used, both generally and in terms of the Internet.

‘Normative’ use of pornography

The use of pornography is both well accepted and highly prevalent in the community. Estimates vary, but the consensual view is that the majority of Western men and many women use pornography in their sexual activity (e.g., Træen & Daneback, 2013) and consider the use of pornography acceptable (Carroll et al., 2008). For example, in a study of 2,381 adult men and women aged 18-59 years, 80 per cent reported using pornography at least once. Half the sample reported using pornographic materials in the last year. When considered by gender, almost all men (96%) and the majority of women (up to 71%) used pornography (Træen & Daneback, 2013) with one third of all visits to adult Internet pornography sites made by women (Family Safe Media, 2015).

In terms of the context and motivation for using pornography, most often it is consumed alone, but it is also used by couples and within groups. Frequently reported motivations include sexual education and curiosity, and enhancement of arousal within both individual and partner contexts. Interestingly, many studies report a gender difference in terms of the primary motivation for pornography use, with men typically citing increased arousal during masturbation and women reporting it as an adjunct to lovemaking (Bridges & Morokoff, 2011). Given the explosion in online access via mobile technologies it is not surprising that the demographic pattern of pornography use is changing, with 90 per cent of 8-16 year olds reporting having viewed pornography online (Family Safe Media, 2015). For adolescents, self-produced erotica is increasingly part of their courtship behaviour. For example, in the recent Australian Sexual Health Survey (Mitchell, 2014), ‘sexting’ and exchanging sexually explicit photos was found to be a common part of teenage sexual behaviour and courtship.

Problematic pornography use

While there is unequivocal evidence for the normative use of pornography, pornography has been condemned and legally proscribed in the belief that it corrupts children and adults and leads to sex crimes. However, there is little unequivocal evidence for a direct causal link between pornography use and sexual offending, and not surprisingly, the relationship is complex and variable across the lifespan (Seto, Maric, Barbaree, 2001; Mancinia, Reckdenwald, & Beauregard, 2012). Nevertheless, there is convergent evidence that pornography use can have detrimental effects for some vulnerable individuals, relationships and families.

At an individual level, pornography addiction, including ‘cyber porn addiction’ is one of the most notorious problems associated with pornography use, with approximately 10 per cent of adults accessing Internet pornography admitting to Internet sex addiction (Family Safe Media, 2015; Ross , Mansson, & Daneback, 2012). While the condition is not formally recognised in the DSM‑5 and ICD-10, cyber pornography addiction possesses characteristics of both a substance abuse disorder and an impulse control disorder and should be treated accordingly. Individuals so ‘addicted’ continue to engage with pornography despite the use causing functional impairment. In the extreme, for some individuals sexual arousal and performance becomes dependent on the use of pornography, and a preference for cyber sex over partnered sex develops. Similarly, in the workplace, if the urge or drive to view pornography becomes overwhelming and the individual accesses or engages with it at work despite workplace rules to the contrary, this is likely to impact on work performance and have potential negative consequences if discovered.

There are also other potential areas of harm for the individual. Research suggests that about 25 per cent of adolescents have unintentionally been exposed to online pornography in the previous 12 months. Of these, about 25 per cent were very distressed by the experience (Mitchell, Finkelhor, & Wolak, 2003). For other individuals, particularly those with social anxieties, heavy reliance on Internet pornography is associated with a disconnection between sexual and social behaviour. For these individuals, using Internet pornography provides the opportunity to avoid facing the anxieties associated with socialising and dating or engaging in intimacy with a partner.

Internet pornography also poses major challenges for families. These relate particularly to the need to establish and maintain ‘appropriate’ boundaries and values. For example, unauthorised access by children (or other children visiting the household) to the Internet and possibly without appropriate guidance/supervision by parents may expose them to Internet pornography, which is developmentally inappropriate.

For relationships, another potential negative is that sexual behaviour in pornography is depicted as disconnected from the domain of a loving relationship, leading to unrealistic expectations and beliefs about sexual encounters and sexual intimacy. Differences between partners in terms of expectation and meaning about the use of pornography and cyber sex sites, in the absence of effective communication regarding sexual needs, increases the risk of relationship dissatisfaction. One partner’s use of pornography may be viewed as evidence of rejection and personal inadequacy, the conclusion being that their partner does not find them sufficiently attractive or valuable. For couples presenting with these issues, therapeutic attention needs to be focussed on their communication of attributions, beliefs, needs and values within the context of the relationship itself.

Treatment of problematic pornography use

A minority of individuals who access pornography and who admit to problematic use will present for psychological treatment; this is usually in the context of vocational, forensic and/or relationship issues. It is perhaps not surprising that published, empirically validated treatment protocols specific to pornography addiction are sparse given the lack of a consistent definition and agreed diagnostic criteria, or even consensus that sexual addiction as a unique diagnosis exists (Briken, Habermann, Berner, & Hill, 2007). This is further complicated by the comorbidity for anxiety, mood and impulse control disorders within the population of individuals presenting for treatment for problematic pornography use.

There is a limited literature pertaining to treatment of Internet addiction per se (e.g., King, Delfabbro, Griffiths, & Gradisar, 2011; Winkler et al., 2013), which can arguably be usefully applied to the problem of pornography addiction. Cognitive-behaviour therapy interventions for Internet addiction, that target both the addictive behaviour and cognitions and the comorbidities, have shown superiority to other pharmacological and therapeutic interventions (Yellowlees & Marks, 2007). Acceptance and commitment therapy, with its growing evidence base for treating addictions, has also shown some promise as a treatment for problematic Internet pornography use (Twohig & Crosby, 2010).

Given the scarcity of literature on the treatment of pornography addiction, some general guidelines and principles for psychological management are considered here.

General principles for treatment

From a theoretical and practical perspective, a fundamental question is whether the therapeutic goal should be to eliminate all pornography use (i.e., abstinence) or to pursue a ‘controlled’ usage paradigm. Whilst this is typically a decision made at the level of the individual client, there are clear moral, ethical and legal issues if the content is socially prohibited (e.g., extremely violent pornography, child pornography). In the latter case, the only permissible treatment goal is one of abstinence.

Regardless of the therapeutic goal, assessment and therapy must be directed towards an understanding of the content and mechanisms, and underlying motives driving sexual arousal in that individual (e.g., avoidance of partnered sexual intimacy), as well as the broader motivation for participating in the therapeutic process (e.g., mandated, partner demand). Successful therapeutic outcomes are more likely with clients who are motivated to address their problematic pornography use, have insight into the ramifications for themselves and others, and do not have any associated paraphilia (Delmonico & Griffin, 2011).

There is general agreement that essential in the management of problematic use is the requirement to manage the environment and thus assist the individual with more externalised controls. Examples of environmental management, where practical, include: limiting the use of computers to public areas of work and home and having the monitor more visible to others; installing filtering software to make it more difficult to act impulsively (and to protect others from incidental access); and limiting both overall time and time of day online (Delmonico & Griffin, 2011; Young, 2008). Environmental management is particularly helpful in the early stages of treatment. Additionally, in the context of pornography use being associated with a relationship problem, it is helpful for individuals to communicate the rationale for these ecological changes in an open and transparent manner to their partner.

Models of intervention

An intuitively useful model of intervention that emphasises insight-oriented cognitive and behavioural (CBT) strategies is that of Young (2001). In this model, Young emphasises that individuals with Internet pornography addictions must learn healthy patterns of interacting with the Internet and, in so doing, either establish or re-establish positive ‘real life’ relationships and patterns of social engagement. As with all CBT approaches, Young stresses that the recovery process must include self-exploration that separates the inappropriate behaviour from the individual and, in this way, allows the person to perceive him or herself and to be perceived by others in a more positive light.

In exploring individuals’ behaviour, it is critical not only to understand their reported actions in the chain of events leading to problematic pornography use, but also the myriad of seemingly ‘innocent’ behaviours and decisions that enable the activity to occur and to be maintained. For example, in terms of Internet pornography, while it may be individuals’ expressed intention only to use the computer for ‘legitimate’ purposes (e.g., checking emails), the act of switching to a pornographic site simply to ‘test’ their resolve is clearly a decision that places them at immediate risk of problematic use. It is relevant to note that ‘impulsivity’ per se is not predictive of problematic Internet pornography use (Wetterneck et al., 2012).

Relapse prevention

As in all empirically validated addiction models of intervention, relapse prevention is an integral component of treatment and should be incorporated into the treatment plan for pornography misuse/addiction. Typically, relapse prevention models include an analysis of high-risk situations to formulate a clear understanding of the pattern of contextual, cognitive (e.g., sexual fantasy) and personal factors (i.e., sexual urges, heightened anxiety, arousal, avoidance) that are primarily associated with inappropriate pornography use. Such models also include detailed analysis with the individual of these variables in relation to situations where inappropriate use did not occur. As a consequence, there is an increased awareness of risk as well as increased awareness of control factors, including self-efficacy. Additionally, effective models of intervention also include strategies for managing urges and lapses if they were to occur, and to reconceptualise these as important learning opportunities for positive change.

Management of comorbidities

Therapeutic attention should concurrently address any comorbid issues/conditions (e.g., depression, social anxiety, relationship issues) and within the therapeutic plan, decisions about the balancing and ordering of therapeutic targets will need to be considered. For example, if depression is moderate to severe, it may be more necessary to address mood issues prior to or parallel with any direct management of pornography issues. As for all presentations, the global strategy of assisting clients to balance their lifestyle in order to promote general wellbeing should also be considered. Similarly, the question of whether pharmacological intervention could be of assistance should be considered in the management of cormorbid mood or anxiety disorders. This issue is particularly salient for individuals with prominent comorbidities, the adjunctive pharmacological treatment of which may assist the individual to engage successfully in the direct psychological treatment for pornography addiction (e.g., by reducing anxiety levels, enhancing mood).

Conclusion

While use of Internet pornography, or pornography via other mediums, can be a healthy aspect of sexual expression, for some vulnerable individuals, couples and relationships it can be problematic. Although there are disagreements about the existence of, and diagnostic crieteria for, pornography addiction, there is no doubt that a relatively small proportion of individuals who use pornography do so in a maladaptive way. Given the increased accessibility, anonymity and affordability of pornography via the Internet, the majority of individuals with problematic pornography use present with a cyber addiction. Although there is a wealth of studies documenting the increasing use of Internet pornography, there is a dearth of systematic, randomised controlled trials of interventions for the treatment of problematic Internet pornography viewing. Instead, the available literature points to the use of strategies derived and evaluated for the treatment of other addictions and offending behaviours. Given the explosion in online access to pornography, this is an area where important, ‘real life’ research opportunities exist for psychology.

The author can be contacted at [email protected]