It’s not always easy for a person addicted to Internet pornography to find professional mental health care to help them break free of their addiction.
At the time of this publication, the authoritative text of the professional mental health world – the Diagnostic and Statistical Manual of Mental Disorders (often abbreviated “DSM” which is currently in its 5th version) – hasn’t yet listed Internet pornography addiction. This is leaving many clinical professionals in the dark about the phenomenon and many compulsive porn users struggling onward alone and uninformed.
It may be a generational thing. Many current mental health care professionals came of age in an era when porn was a physical, printed product, perhaps some of them hiding their copies of Playboy or Hustler in their medical textbooks. Or, if they were up on the latest tech, sharing VHS tapes with their friends. Today’s Internet porn is nothing like any previous generation has experienced. Getting your hands on porn used to take actual effort, maybe even some form of government ID to prove your age!
Some of the older people we’ve spoken to around this issue call themselves “original porn addicts.” They tell us that they had to actually spend time and money to acquire porn. That’s a barrier of entry that’s much higher than a couple of mouse clicks or smartphone taps. While they like to poke fun at the young people who “didn’t have to work for it,” many of them are grateful that they didn’t have access to Internet porn until after puberty. Reports from rebooters suggest that many of these older people take less time to recover because they didn’t grow up with modern high-speed Internet porn. These days, there is an endless supply of Internet porn, all available for free within seconds. It isn’t possible for one human to consume all of the Internet porn that exists – and we do not suggest that anybody actually try to!
This means that many counselors, psychologists, psychiatrists, and therapists are bringing a paper-age approach to a digital-age problem. In droves, young people are compulsively using pornography and experiencing unexpected, unpleasant side effects. When they go to find help, they’re often met with confusion, or therapy that doesn’t fit the bill. Many therapists will lump online porn addiction in with sex addiction. Even more problematically, some porn addicts will be advised by their therapists to only work on eliminating their shame around their porn use, which is painted as a “sex-positive” and “healthy” expression of human sexuality. Some therapists will actively promote the use of pornography.
When should you seek a therapist for help? When is using NoFap® not enough?
Therapy is rarely a bad decision, especially if you have the insurance and the financial means to pursue it. There are plenty of people without diagnosable mental issues who see therapists because, well, therapy can be therapeutic. It often feels good to do it.
If you feel like Internet porn addiction is having a strong negative effect on your life and NoFap® or other online resources aren’t helping, it could well be a good idea to seek professional mental health care.
You can still use NoFap® and even participate in our programs under the guidance of a mental health care professional. Just because you get a therapist doesn’t mean you have to shut off other useful avenues of help. In fact, recovery tends to be more effective when you combine multiple avenues, including therapy and support networks.
What about porn addiction recovery “coaches”?
There is also a growing industry in coaching that is marketed to help with porn addiction. It certainly can’t hurt to connect with a coach, especially one that has experience or expertise in porn addiction recovery.
However, it’s important to understand what a coach is and is not. Coaches aren’t usually qualified mental health care professionals and coaching will not deal with diagnosable mental disorders. You should be in a stable condition and not suffering from distress to consider coaching over formal therapy. In fact, any professional coach should decline to offer their services to a person that is better suited for therapy.
If you do decide to enlist the services of a porn recovery coach, you should make sure that they’ve graduated from a program that’s International Coach Federation (abbreviated ICF) accredited. The ICF also has individual accreditation for coaches – and coaches who are registered with the ICF have to abide by a strict set of ethics guidelines.
What are some signs that I should seek mental health care?
We are all different and we all have different tolerances for distress. It is always OK to inquire about help, especially if you are feeling distress. In short, if you feel like your thoughts and feelings are impacting your day-to-day life, that’s a good sign that you might benefit from mental health care.
The UK mental health charity Mind offers this brief take on why you might want to reach out for help:
- If you are finding it difficult to cope with your thoughts are feelings
- If your thoughts and feelings are having an impact on your day-to-day life
- Or if you feel you want to find out about what support is available to you
Please remember that if your distress is leading to dangerous thoughts of behavior, including thoughts of suicide of self-harm you should seek emergency help immediately. Waiting until an initial consultation might be too long for people going through significant mental distress.
You can go to your local mental hospital, emergency room, or call a crisis center. The USA’s National Suicide Prevention Hotline is 1-800-273-TALK (8255) and will connect you to a skilled, trained counselor at a crisis center in your area anytime – even in the middle of the night. For those located outside of the United States, Suicide.org maintains an international list of hotline phone numbers on their page.
Please note that this criteria is informational and doesn’t replace a mental health consultation. If you are questioning whether or not if you should see a therapist, it is a good idea to get an initial evaluation.
Where do I start?
If your distress is not an emergency matter, you can begin by researching professionals near you. You can start with Google searching “<my city> porn addiction therapist” and see what comes up. Furthermore, you can utilize sexual health membership organizations that maintain directory listings of their members in good-standing:
- SASH – The Society for the Advancement of Sexual Health provides a “Member Directory.” This is our top recommendation. But if you can’t find a SASH member, there are other options available.
- IITAP – The International Institute for Trauma and Addiction Professionals has a “Therapist Directory” search tool. Many of their listed professionals aren’t yet “porn addiction-literate,” but you might be able to find somebody with enough manual screening, described further down.
These organizations have members outside of the United States but international citizens might need to perform a Google search to find a local clinician. Something like “<my city> porn addiction therapist” should do the trick.
These sites simply list mental health care professionals. You’ll have to do some research to find out which therapists are porn-literate.
Manually screen professionals for people who appear to be porn-literate.
You can get some clues about the suitability of these therapists for porn addiction treatment from the way they describe their services.
It may be a bad sign if the therapist you are researching uses dogmatic language from the “etiological model” to describe addiction in black-or-white terms. For example, “sex addiction can sometimes be an attachment disorder” is a much more hopeful sign than “sex addiction is always an attachment disorder.” The same may be true if the terms “intimacy disorder” or “trauma disorder” are used in the same way.
The pre-Internet model of addiction uses statistics that support the view that the vast majority of sex addicts are addicted as a result of some trauma in their past. Be cautious about therapists who still subscribe to this view, which may be outdated in the age of almost universal access to endless online porn. In fact, if a clinician doesn’t mention porn addiction but only talks about sex addiction it is possible that they believe the two problems are identical. The use of the word “porn” or “pornography” or “porn addiction” is probably a good sign. But talking of “sex and porn addiction” could cut either way. Make sure that they differentiate them theoretically, rather than just semantically.
Frequent use of the word “porn” is something good when you seek out a therapist. Acknowledgement of Internet or online porn in an ad or service description is even better. And if their expertise extends to other Internet-related addictions such as gaming, gambling, or “Internet-related addictions” in-general, that, too, is a good sign.
Feel free to ask questions of any therapist you are considering consulting.
Contact them for an initial consultation.
If you’re ready to meet with a therapist, you can contact their office to set up an initial session. Use this visit to vet them using the criteria outlined above. If they tell you that your perceived pornography addiction is definitely a result of something else being expressed, that is probably a sign to continue shopping around. If their main goal seems to be to help you come to terms with your porn use rather than quit using porn, since they believe that Internet porn use is a healthy expression of human sexuality and they aren’t willing to help you establish a sexuality not influenced by pornography, that is another good sign to continue seeking alternative therapy options.
The best advice that we have is to “go with your gut.” The relationship with a therapist can be very personal and even intense. You have to be able to talk openly to this person and if you are uncomfortable, remember you are under zero obligation to continue seeing any particular therapist. Although “breaking up” with a therapist can be awkward, don’t worry, it happens all the time. It may take meetings with several therapists before you settle on one – or maybe you’ll get lucky the first time! You have to find the right fit.
In some situations, any licensed therapist is better than not having a therapist at all.
Sometimes, seeing a non-porn-literate therapist is preferable to not having any mental health care support at all.
If you are considering harmful behavior to yourself or others, or are in significant mental distress, you should seek out mental health care as soon as possible. Once you are seeing a licensed therapist, you’ll get the immediate support that you need, and from there could consider other options. You could always change therapists later!
If you are in significant mental distress, make sure that you have another mental health care professional lined up, with the initial consultation out of the way and recurring appointments scheduled, before leaving your current provider. In periods of distress, any mental health care is ideal, and even if a particular therapist isn’t porn-literate, they are still thoroughly trained to help you manage your feelings.
Spread the word.
If you have a good (or even a bad) experience with a clinical therapist, please tell us about it. There aren’t enough porn-literate mental health care professionals out there yet and many of our users have trouble finding the help that they need.
Be sure to post a review for them on online reviewing websites so that other people know that they’re a good option. And be sure to post about your experience on our forum or leave a comment below.
A previous version of this article recommended that people utilize AASECT (the “American Association of Sexuality Educators, Counselors and Therapists”) for help seeking porn-literate therapists. This recommendation has now been removed and we no longer recommend this organization.