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Internet Sex Addiction: Case Studies and Treatment

Is Internet sex addiction ruining your relationship?
The expanding importance and role of the Internet in everyday life has an interesting side-effect, that of an increase in cyber-sex addiction. Clinicians who treat sex addiction have noticed more individuals and couples coming into treatment where compulsive viewing or pornography has led to psychological issues necessitating treatment. I will describe a few cases and then explore clinical aspects of the problem in this brief paper.


Case Studies: (all names and identifying information have been changed)

Mike:
A 24 year old single man living with his girl friend (Dora) of four years reveals that he has an "unhealthy" sexual desire for teen age girls. He requests treatment to help "cure" him of this sexual interest. While not acting out his sexual desire, he has been secretly spending 3-8 hours per week hunting images of young girls on the internet. He acknowledges that his compulsion has hurt his relationship and his sex life. He is extremely ambivalent about his relationship but has not talked about his feelings openly with Dora. He has been avoiding sexual contact with Dora as well as having difficulty getting himself to the gym and other outside interests and activities. He states that his mood has been more depressed and he is anxious about his compulsion being revealed. He feels guilty, ashamed, and preoccupied.

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George:
George is a 49 year old married man with a two year old boy. He has a history of alcohol addiction and cyber-porn addiction. Four years ago he was successfully treated for these addictions with a combination of in-patient, outpatient, and group psychotherapy. He is a writer and has taught English at a variety of local colleges. After three years of recovery from alcohol and cyber-porn addiction, he relapsed following his being laid off from his teaching position in an administration change. He has not begun drinking but is again "medicating" his anxiety by spending large chunks of time watching cyber-porn. He presented to treatment after becoming increasingly more agitated, depressed, ashamed and "fed-up" with himself.

Beth:
Beth is a 42 year old married woman with two children requesting a consultation regarding her husband Frank's behavior and her marital situation. She had discovered Frank had been visiting porn sites on his computer. She confronted him and he became outraged, defensive and accused her of violating his privacy. He refused to join her in seeking treatment. She did not know how much time he spends visiting porn sites but had a list of the particular sites he visits. When she looked at the sites, she was shocked and disgusted at the graphic images, some of which involved gay sex. She said that she has been concerned for a long time about their diminishing sex life and the emotional disconnection she feels. She is confused and scared about what this porn viewing suggests about Frank's sexuality and about the future of her relationship. She would like help sorting her feelings out and developing a plan about dealing with this with Frank.

Clinical Aspects:

The scenarios above are recent cases in my practice where the compulsion to view pornographic images on the internet is a crucial aspect of the presenting problem. As a sex and couples therapist, I have been impressed with how often issues around cyber-porn find their way to my office. The common link in these cases is that the client (or spouse) is spending time chasing sexual images on the easily available and often free porn sites on the internet. What eventually motivates the person to seek treatment is that this behavior begins to significantly effect his mood, functioning or and/or relationship. Mental anguish, profound worry and dismay, shame, anxiety and depression accompany this addiction as well as feelings of being out of control. There are powerful feelings of shock, fear, loss, and worry on the part of the spouse who discovers her partner's predilection. As such, it poses a significant threat to the relationship.

In my experience there are deeper causative factors which form the "fertile soil" of this addiction. Sometimes it is a history of sexual abuse or pre-mature entry into sexuality (prior to mid-adolescence). The person becomes fixated at the age to which they were "initiated" into sex. As a result, they are attracted to girls the same age as they were when the abuse occurred. I have also seen a greater than expected frequency of mood disorder (depression, bi-polar disorder) in these clients.

It is also my experience that once the cyber-porn addiction is discovered it leads to an issue in the relationship. Typically, there is an emotional disconnection between partners, a "walling-off" in the relationship leading to a reduction in sexual contact and intimacy. Instead of directly and honestly attending to the breach, there is escape into the easily available and non-demanding world of cyber-sex and self-stimulation. The viewing becomes compulsive, immediately gratifying and soothing of anxiety states. This behavior is highly reinforced and therefore tends to progress or increase in frequency.

Is Cyber-Porn Viewing an Addiction?

Compulsive viewing of cyber-pornography, a sub-group of sexual addiction, appears to have a recognizable behavior pattern similar to other addictions (Carnes, 1999). This involves acting out a pattern of out-of-control sexual behavior (e.g. compulsive masturbation, persistent viewing of pornography, having consistent affairs, etc.) In which severe mood change relate to sexual activity. The sex addict experiences severe consequences due to sexual behaviors and an inability to stop despite these consequences. These consequences can include loss of a partner, severe marital or relationship problems, loss of career opportunities, suicidal obsessions, exposure to STDs. Sex addicts gradually increase the amount of sexual activity because the current level of activity is no longer sufficiently satisfying. As tolerance develops, individuals may find themselves seeking out more unusual sexual experiences and more graphic pornography.

The explosion of the internet into the day-to-day lives of your average Joe has transformed the use and popularity of pornography and has ratcheted up the rates of cyber-porn addiction. Explicit X-rated porn catering to all possible tastes and predilections are now merely a click away from any room in your house. Now with hand-held access to the internet, porn can be viewed anywhere. Those vulnerable to this form of addiction no longer have to leave the safety of their own homes and confront embarrassment and shame about buying porn; they simply surf from their home computer of hand-held device.

Besides the pornographic images available to the viewer, the internet makes other forms of cyber-sex experiences easily available. They include interactive experiences and a smorgasbord of virtual intimacy for users. On-line videos, chat rooms, games, photo-galleries, web-cams, meet-n-greet sites provide users with several different mediums through which they can obtain and experience porn or hook up virtually or in real life. What is so attractive, compelling, and reinforcing is that this alternative universe of sexuality can be accessed from any computer where users can safely and anonymously fantasize, flirt, and get intimate.

A Growth Industry:

It is clear that cyber-porn addiction is a growing problem. Anecdotally, I have seen a significant increase in referrals to my sex therapy practice of people looking for help with this issue. A 1998 study (San Jose Marital and Sexuality Clinic & MSNBC.com) found that almost in almost 10,000 users surveyed, almost 80% used their home computer for sexual purposes. In addiction, 1% could be classified as a cyber-sex addict (used the internet for sexual purposes for 11 or so hours per week). I think this is underestimating the frequency of the problem with their definition of what defines a cyber-sex addict. It might not be the hours spent per se that defines the addiction but how it is affecting the person's functioning and relationships. Other interesting results of this study were that 7of 10 participant's kept online sex a secret and that six times as many men engage in online sexual pursuits as women. In addition, the study suggests that as many as 17% of respondents that were not at risk before the internet may now be vulnerable to sex addiction that interferes with their daily lives.

When Professional Help May Be Needed:

Unlike most women, men will typically view pornography as innocent and will believe that its viewing has little negative effect on the relationship. Often these men rationalize their pornography interest as a solution for loneliness and not having a partner. In the context of a functional relationship, the viewing of erotic images can be used to enhance the sexual relationship. For many couples, sharing fantasies and communicating about them can be a positive and healthy aspect of the relationship. It can intensify a couples' sexual relationship and introduce novelty, inspire experimentation and generally add some spice to lovemaking.

This being said, there is a discernable boundary between healthy viewing of erotica and secretive and compulsive use as there is a difference between moderate or recreational drinking and excessive use of alcohol. It is also a different story when both partners are in agreement to view pornographic images ("informed consent") as opposed to there being secretive use and the use serves a self-medication function. As in most cases where there is a secret in the marriage, when discovered the partner can feel deceived and betrayed and this is obviously corrosive to the marriage.

If a man's use of pornography is discovered and his partner has strong feelings about the issue, this is by definition a conflict in the relationship and needs to be dealt with. It is in the process of managing the conflict that will determine the degree of relationship dysfunction. It seems pointless to argue over whose right or wrong. There are very strong feelings at work and this need to be validated by each partner if disconnection and disruption is to be avoided. If the issue cannot be discussed in a calm and respectful manner, professional help may be needed. Clearly, reliance on pornography at the expense or avoidance of the emotional and/or physical relationship suggests a deeper problem. It may be not be so helpful to get into a debate over the moral issues around the viewing or pornography (how women are depicted, degraded and so on) as to focus on how the use is impacting on the user's presence and functioning in the relationship and how his partner feels about it. In other words, it seems the better strategy in the onset of the discussion about the issue to emphasize the emotional and relational costs and consequences of the viewing. Again, while the man might see his use of pornography as totally innocent, the fact that his partner has such strong feelings and it is effecting the relationship makes it no so innocent. As in many of the issues that divide couples, the capacity to speak the truth about the issue and be validated by his/her partner and then compromise separates a functional relationship from one that might need help.


Dan F. Pollets, Ph.D. is a licensed clinical psychologist and certified sex therapist. more...

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