Basics of Treating Pornography Problems: 

Many of my couple cases involve a man (and sometimes a woman) with a pornography habit the couple would rather do without. This makes sense. Pornography can be highly addictive, time consuming, thought occupying, is often produced from a system of sexual exploitation, almost always conveys a false sense of what sex looks like, and produces a dopamine rush that can reduce the relative pleasure of other activities. Assuming these men do not want to continue using porn and hurting their families, we shall assume that their porn habit is a symptom of an underlying problem, not itself an illness or character flaw. Here is a brief review of how to treat this using the 3 Ss: 

SYMPTOM: For those reporting issues with porn, it is almost always used as a coping mechanism--people use it when stressed or depressed. Porn gives a quick concentrated shot of endorphins, temporarily reducing stress and depression immediately. This exposure trains the brain to continue using this source of relief to the point of compulsion; the brain overrides a person’s logic and willpower to the same degree that a person will prioritize food and water over logic under high stress. We treat the symptom initially by creating a state of abstinence: restricted access until the brain wiring that drives one to use fades to a certain degree. However, this source of relief needs to be replaced with healthy ways of processing stress, or the brain feels starved for relief, and the chance of relapse is high. 

SOURCE: There are reasons the user feels the need for pain-medicating pornography. The most common reason I see for relapse is high stress or depressive symptoms. Thus, to increase the chance of abstinence, a person’s sources of stress need to be treated (marital conflict, childhood trauma, low self-esteem, work or school stress, etc.). In my experience, the most important source of these symptoms is a low sense of self-worth instilled from invalidating life experiences. 

SYSTEM: The user must be in a system that keeps the cycle of porn use in check. Are other coping mechanisms available? Is there contact with individuals or situations that cause excessive stress? Is there unconditional love and support? How will a relapse be handled? How are abstinence restrictions managed? Does the user feel safe discussing underlying sources of stress? 

Bad Example: A man comes home from a hard day at work but feels unsafe talking to his wife, as she has been cold, angry, and citing scriptures to him since she found out about his habit. She confiscates his phone and scans through it, as she decided was necessary to save the marriage. He tries to wind down without porn, but then his wife makes a passive aggressive remark about him looking at sluts all day. The man, reminded that his wife and God hate him, crosses the stress threshold in his brain and has the sensation that he will die without porn, or that he is worthless and it wouldn't matter anyway. He hides a tablet under his shirt and pretends to take a long shower. The wife’s resentment increases, and he suffers from added relapse shame later. 

Good Example: The man relapses at work under high stress, then comes home and feels safe telling his wife. He offers to let her see his browsing history. She is sorry for him, but her self-esteem exists independently of his symptoms. She shows unconditional care for him and offers to help, but does not nag him like an angry mother. The man feels loved and relieved and discusses his work stress, which helps him get through the next hard day without relapse. However, the wife is not permissive--she has made her limits clear (and will actually follow through enforcing boundaries) and expects notable efforts to change--but she is also as helpful as possible. 

Obviously, getting things to run like the good example takes a ton of work. I would not expect this pattern to occur overnight. But it is possible, and I think necessary for permanent change.