While most people who view pornography report neutral to positive experiences, some people report struggles with their viewing of erotic videos, particularly online. Historically, most people who identified as having sexual disorders were heterosexual men engaging in extramarital sex.

However, the rise of internet pornography has shifted this, with pornography-related problems now making up a majority of the people diagnosed with compulsive sexual behavior disorder—predominantly in Europe, where this diagnosis was adopted under the International Classification of Diseases 11th Revision (ICD-11). Porn addiction is not recognized in the U.S.

Most people who identify as struggling with pornography may get better on their own, without treatment, according to longitudinal research in Canada. But, for those individuals who seek out clinical treatment for their pornography use, what treatments are effective?

First, it's important to recognize that people may self-identify as having problems related to their pornography use for many different reasons, not all of which have to do with the pornography itself. Moral incongruence and sexual shame contribute significantly to this feeling, as people report struggling with their use of pornography.

One large study found that the average self-identified porn addict viewed porn only around 10 times a year, so this isn't clearly about frequency of use. Instead, pornography appears to be often a stand-in for sexual desires or interests that a person wishes they didn't have.

A recent study found that in sexual minorities, internalized homophobia, lack of social support, and substance abuse problems predicted problems with pornography. Depression and anxiety are frequently reported symptoms in persons who struggle with pornography, and it appears that many of these persons use pornography viewing as a means to cope with these negative feelings.

Finally, personality features such as narcissism play a significant role in self-reported problems with pornography and may reflect efforts to externalize responsibility and blame for one's sexual desires and behaviors.

All of these issues, and more, must be........

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