By Stefanie Carnes, PhD
When a client enters your office complaining of internet pornography addiction, your first response may be to run, hide from him or to refer him to another therapist. For many therapists discomfort in dealing with sexual issues will keep them from asking the most important question: “What kind of internet pornography are you viewing?”
Consider the difference in the pathology of the patient viewing videos of women being degraded and humiliated or other exploitive forms of pornography such as child porn or elder erotica (sometimes referred to as “granny porn”). The patient may be viewing consensual “vanilla” sex, “wife swapping” or voyeuristic websites.
For many individuals, the type of pornography that they are viewing may be reflective of a past trauma or deep-seated psychological issue, or it may tell a story about their sexual development. Our early childhood years can be formative for our developing sexuality.
Many clinicians use the term “arousal template” to describe an individual’s erotic map – or what it is they are stimulated by or attracted to. The arousal template includes things such as body types, partner characteristics, behaviors, sex acts, objects and settings that cause sexual pleasure for an individual.
For example, if one of your first sexual experiences included oral sex, this could be a powerful element on your arousal template. It is not uncommon for individuals who have arousal templates that are considered “deviant” to have experienced childhood trauma that distorted their sexuality at an early age.
The internet affords the opportunity for people to explore the far reaches of their sexuality, including viewing and/or participating in behaviors that they would be afraid to indulge in an intimate relationship. Cybersex users can explore new powerful templates that, when viewed repeatedly, can be strengthened and fixated. This is especially dangerous when the arousal template is unhealthy, such as child pornography.
The reality is that most therapists are unaware of the genres of pornography and the numerous typologies of fetish behaviors that exist online. Additionally, therapists may be uncomfortable exploring these issues with their clients. When this occurs, important assessment information is missed and clients are unable to process traumatic issues around their sexuality that may be confusing for them.
It is helpful for clinicians to have a general understanding of the common types of internet porn, so that they can ask pertinent questions during the assessment process.
Excerpt from Psychotherapy Practice Tips, Part 1