A Blog by Paula Hall, Counsellor & Psychotherapist (BACP, UKCP, COSRT, ATSAC), Clinical Director, The Laurel Centre.

When I first came to iCAAD eight years ago, (known then as UKESAD), to talk about sex addiction, very few people had any experience with the problem and some were sceptical that it even existed. Fast forward to 2019 and it’s quite a different story. There’s almost no-one now in the addiction field who doubts the existence of sex or porn addiction and many are now recognising it as a primary addiction that requires specialist treatment protocols.

One area that is still in debate is whether or not sex and porn addiction really are an ‘addiction’ or if we should be calling it something else. In May this year, the World Health Assembly formally adopted the next edition of International Classification of Diseases (ICD-11) and when it is published and in full use in January 2022, it will include Compulsive Sexual Behaviour Disorder (CSBD) – aka sex addiction. CSBD will be classified as an ‘impulse control disorder’ not an ‘addictive disorder’ until further research has been undertaken to identify if the processes involved in the development and maintenance of the disorder are similar to those currently classified under behavioural addiction, such as gaming and gambling. In the meantime research into sex and porn addiction is doubling year on year, and much of it is demonstrating the same neurological changes as happen with other addictions. But importantly, it’s my belief that wherever CSBD finally finds its home, the grassroots name will continue to be ‘addiction’. In the same way as ‘substance misuse disorder’ will always be known as ‘drug addiction’, whatever the experts say. And many will find health and healing through traditional addiction treatment programmemes such as the 12-Steps.

One of the reasons we’re unlikely to see the language change is because of the prevalence of porn addiction recovery networks on the web and other social media platforms. Two of the best known online self-help forums for overcoming porn addiction, no-fap.com and rebootnation.org, have members in excess of 250,000, with an estimated equal number of regular followers. And the network of the S fellowships is rapidly expanding. This is perhaps unsurprising if you believe the latest research from Dickensen et al citing prevalence figures of 10% of men and 7% of women in the US, struggling with sex or porn addiction.

At the Laurel Centre there is no doubt that we are receiving an ever growing number of enquiries and referrals from other health and addiction professionals. Our group work programmemes for addiction and support groups for partners continue to increase in both London and Leamington Spa as well as our online services for those in other locations and our individual and couple work. Interestingly one of the parts of the world where we’re seeing the biggest growth in enquiries is from the Middle East, though many still attend our residential programmemes from all around Europe.

We also seeing a significant increase in requests for our training, both in-house and through our accredited diploma as more and more people recognise the challenges of establishing ‘positive sexuality’ as opposed to sobriety. And gain more experience about the significant impact on partnered relationships and sexual functioning.

What’s different when treating sex & porn addiction?

Getting into recovery from sex and porn addiction has many similarities to other addictions, but also many differences. Like other addictions it requires a multi-disciplinary approach. Understanding addictive cycles, triggers, cognitive distortions and relapse prevention techniques is essential, along with the ability to work in depth with the core issues. In addition, when working with sex and porn addiction, a knowledge of human sexuality and an ability to work with diversity and sexual difficulties is also required to ensure positive sexuality is found and recovery established.

At the Laurel Centre we use the integrative CHOICE Recovery Model which is more than just a structured treatment plan, but also a philosophy. The CHOICE model is not simply a strategy for stopping compulsive behaviours and enduring reluctant sobriety, but a roadmap to establish confident recovery and change your life. The acrostic CHOICE stands for:-

C – Challenge Core Beliefs

H – Have a Vision

O – Overcome Compulsive Behaviours

I – Identify Positive Sexuality

C – Connect with Others

E – Establish Confident Recovery

You can find a lot more about this model and others used in treating sex and porn addiction in the second edition of my book, Understanding & Treating Sex & Pornography Addiction (Routlege 2018).

The other key difference when working with sex and porn addiction is the impact on partners and couple relationships. Unlike other addictions, many partners are completely unaware of the addiction and hence the co-dependency model often doesn’t fit. Furthermore, not only are you working with a partner of an addict, but also someone who has been repeatedly sexually betrayed. The shame that the addicted and non-addicted partner face is also something that is often much harder to face than the shame felt within other addictions.

Sex and porn addiction is rapidly growing and more and more people are seeking help. Thankfully our understanding of how to work with it is also growing.