It’s ironic, but it is hard to have an adult conversation about sex. In some areas, topics are so taboo that you risk your reputation even to raise them.
I’ll give you one. There are lots of folks whose lives are disrupted by the manner or amount of time they spend watching porn.
Hey. Quick. Before you close your ears, hear me out.
I’m not saying that I think porn watching of X amount (or even XXX amount) is too much. I have no numeric scale of that kind to provide and if you watch porn and feel comfortable about it, that is fine with me. Really. I’m not trying to mix my role as a psychologist with that of the morality police. I’m just saying that in some people’s lives, viewing pornography can occur in a way or in an amount that has serious costs — according to them. People may spend so much time viewing porn that other important things are put to the side. They may be obsessed with disturbing images and alternate between viewing and self-loathing. They may allow their viewing patterns to become a barrier between themselves and their partners or may risk their financial security by viewing pornography while on the job.
It is not as though we are unaware of this inconvenient truth, despite its political incorrectness in the mainstream culture. Recent research suggests that about 17 percent of individuals who view porn on the Internet meet criteria for sexual compulsivity. That translates to a lot of people, given that about 12 percent of all the Internet traffic is porn and nearly 90 percent of the young male population (about 30 percent of the young female population) view pornography at least occasionally. Unfortunately, this issue is so tricky politically that clinical researchers almost run the other way rather than address it.
Through August 2010 not a single controlled treatment study had ever been published on the “problem that must not be named.” The federal government is no better: they have never funded even one treatment study focused on this problem and have told researchers not even to try to get the funds for such research through normal scientific funding channels. That pattern of avoidance protects psychologists or bureaucrats fearful of getting their fingers caught in this cultural wringer all right, but it leaves people struggling with the issue without methods that are tested and known to be helpful.
Part of the problem may also be that the area is so counterintuitive that psychologists simply do not know what to do. Utah State University psychologist Michael Twohig (open disclosure: a former student of mine) and his students have recently discovered that there is an ironic process in problematic viewing. Struggling with urges to view leads to more viewing and more psychological problems. In other words, the normal ways we know to reduce things in our lives (avoid or deliberately change what you do not want) has the exact opposite effect than what was intended.
We have seen that pattern before in areas such as obsessive compulsive disorder (OCD). Here is the recipe. Take an urge or an odd thought; mix thoroughly with negative emotions, sensations or images; then fold in a heaping helping of suppression and avoidance (pushing out of mind, engaging in ritualistic undoing). Voila. Obsessive stew.
Every time you check to see if your suppression worked — well, it didn’t. You just thought of it. Again. More negative emotions. More attempts to control. More checking to see if it went away. More struggling.
Obsessive stew.
Treatment researchers have recently found ways to break the self-amplifying pattern of urge suppression and urge indulgence in OCD, and in OCD spectrum disorders such as hair pulling or skin picking, by using Acceptance and Commitment Therapy (“ACT” is said as a word, not initials). Several controlled studies (mostly by Twohig or by University of Wisconsin, Milwaukee psychologist Doug Woods and their students) have found positive effects for ACT by teaching people to walk in the exact opposite direction than that suggested by the problem-solving organ between our ears. Instead of controlling urges, ACT teaches acceptance and mindful awareness of them. Instead of self-loathing and criticism, ACT teaches self-compassion. Instead of avoidance, ACT instigates approaching ones’ values.
This is counterintuitive. Suppressive avoidance is what the mind knows how to do. A highly religious young man struggling with pornography viewing is likely to criticize himself horribly, and then try to eliminate the urge and suppress all thoughts about it. It almost looks as though that is the moral thing to do, but instead this research suggests that it is a route toward more struggle, more suffering and ironically, toward more obsessive viewing.
It has to be said: it is also bad theology. Even Christ was tempted, after all. Simply having a thought or feeling a temptation is not yet sinful in the world’s major religious philosophies. Sins require an act of the will. A normal problem-solving mode of mind can’t quite get that distinction.
The first controlled study ever done on how to address problematic Internet pornography viewing was published in the September 2010 issue of the well-respected clinical research journal, Behavior Therapy. Twohig and co-author Jess Crosby applied eight sessions of Acceptance and Commitment Therapy to problematic viewing. As participants learned to accept the urge, to watch it rise and fall mindfully, to embrace themselves in a kinder and less judgmental way, and to pivot toward valued actions, something remarkable happened. Viewing became far less frequent, but what was remarkable was how that happened. People softened. Religious obsessions went down but positive commitments went up. Obsessive thinking was relieved and with it worry that unbidden thoughts alone cause harm. People became more accepting of their emotions and less entangled with their thoughts. And they were more able to act in accord with their values as a positive goal, carrying difficult thoughts and feelings with them in a more compassionate way.
It seems that both sides of the culture debate have a little piece of that success. Maybe it is time to have an adult conversation about the problem that must not be named.
(PS. There are a number of popular books that can help teach these ACT skills, such as Russ Harris’s “Happiness Trap” or my own “Get Out of Your Mind and Into Your Life.”)
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