The field of sex and porn addiction is rapidly changing and there has been an explosion of research since CSBD (Compulsive Sexual Behaviour Disorder) was accepted into ICD-11 by the World Health Organisation in 2019. Until this point, any academics who wanted to research sex addiction or porn addiction were at risk of having their work turned down by a professional journal because the conditions weren’t recognised. The label of CSBD has made the problem legitimate and that means we can finally crack on with much needed research.
As many readers will already know, the field of sex and porn addiction has been bogged down for many years by academic debates around whether or not it’s really an ‘addiction’, or whether a classification of ‘compulsion’ or ‘impulsivity’ is more accurate. Many people may wonder why this is important, and frankly I’m often one of them, but it matters because these debates get in the way of developing services for people who struggle with this problem. We desperately need accessible and affordable services for people who can’t afford traditional therapy and we need a comprehensive, nationwide education policy to reduce the number of people getting hooked in the first place. We also need support services for partners who so often feel like the forgotten victims of this. We’re still a long way off, but as I read the latest research, I dare to hope we’re getting closer.
What the research says
The first thing to say is that 10 years ago, some professionals were saying sex and porn addiction didn’t exist at all, regardless of what you called it. They publicly said that anyone who claimed their sexual behaviour was out of control were either using it as an excuse for infidelity or were weak-willed. Thankfully we’ve moved a long, long way from there and now we recognise that CSBD is very real problem and porn addiction or PPU (problematic pornography use) as the academics refer to it, is the most common type of CSBD. A recent study found that approximately 1 in 20 people around the world struggle with CSBD and in a Polish research paper which focussed on PPU, the figure was closer to 1 in 5.
Is porn addiction really an addiction?
It seems that the more researchers investigate CSBD, the more they think ‘addiction’ is probably the most accurate classification. Currently CSBD is categorised as an impulsive control disorder, but if you look at the core characteristics of an impulse control disorder you’ll see that one of them is ‘impulsively repeating something that is rewarding or pleasurable’. This creates a bit of a dilemma for CSBD’s current classification because one of WHO’s diagnostic criteria is ‘deriving little or no satisfaction from their sexual behaviour’. Another dilemma is this – it’s called ‘compulsive’ sexual behaviour disorder and a core characteristic of compulsivity is that the behaviour is used for emotional regulation. But WHO’s diagnostic criteria doesn’t mention emotional regulation at all. This means the current diagnostic criteria contradicts a classification of both impulsivity and compulsion.
However, many researchers are now suggesting that if CSBD were to be categorised as an addiction the contradictions would cease to exist, because impulsivity and compulsivity are both widely recognised components of addictive disorders. When you look at other accepted behavioural addictions such as gambling disorder, or substance related addictions which have been heavily researched for many years, you’ll see that impulsivity and compulsivity are common traits.
How to treat porn addiction and CSBD?
The big question of course is ‘does it matter what it’s called? And, at the end of the day, I maintain that what matters most is how we help those who struggle with this condition, not what it’s called. BUT, accurate diagnosis is important when it comes to research. And research is important because it allows us to more accurately consider how to both treat and prevent the problem in the first place. As we get to the end of 2023, I wonder what the research will be telling us in 12 months’ time. Hopefully we’ll have ended this debate, or at least be much closer to doing so, and we can crack on with developing more evidence-based treatments.
If you’re struggling with sex or porn addiction, or are close to someone who does and you want to know more about how we work at the Laurel Centre, then you can use our ‘Talk to a Therapist’ service. Simply follow this link and choose a date and time that suits you best and we’ll help you find the best approach for you.
