Secular Definitions
You may be wondering how a therapist or a counselor might diagnose the degree or level of your pornography use.
The Diagnostic and Statistical Manual of the American Psychiatric Association Fifth Edition- Text Revision (DSM V-TR) general definition for “substance related and addictive disorders” are grouped in the following criteria:
- Substance or behavior is taken/engaged in larger amounts or over a longer period than initially intended.
- Individual expresses desire to reduce or cease use, though reports experiencing multiple unsuccessful efforts to reduce or cease use.
- Individual may spend significant time obtaining, using, or recovering from substance.
- Craving: an intense desire or urge for substance that may occur at any time but would be more likely in an environment where substance was previously obtained or used.
An individual must meet 2 or more of these criteria, and must occur for at least 12 months or more.
A therapist may diagnose or present pornography use based on these criteria.
Despite these criteria for substance related and addictive disorders, it is worth noting that an official diagnosis for Pornography use or is not present in the DSM V-TR due to lack of sufficient research and evidence at this time.
Compulsive Sexual Behavior Disorder (CSBD)
That said, the World Health Organization (WHO) (2019) has developed a set of criteria for Compulsive Sexual Behavior Disorder for their International Classification of Diseases -11:
A persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior, must be manifested in one or more of the following:
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- Engaging in repetitive sexual activities has become a central focus of the person’s life to the point of neglecting health and personal care or other interests and activities.
- The person has made numerous unsuccessful attempts to control or significantly reduce repetitive sexual behavior.
- The person continues repetitive use of sexual behaviors despite adverse consequences.
- The person continues to engage in repetitive sexual behavior even when the individual derives little or no satisfaction from it.
- The pattern of failure to control intense, sexual impulses or urges occurs for 6 months or more.
- The pattern of repetitive sexual behavior causes distress or significant impairment in various areas of functioning (personal, social, family, educational, occupational).
It is worth noting that a diagnosis is not met if distress is entirely related to moral judgements or disapproval about sexual impulses, urges or behaviors.
A more secular definition…
Adapted from DSM-IV
Abuse
The use of the substance (here – pornography) occurs in a pattern within the last 12 months that has produced measurable and significant impairment or distress. This impairment or distress would be seen by one or more of the following four areas:
- Recurrent pornography use resulting in a failure to fulfill major role obligations at work, school, or home
- Recurrent pornography use in situations in which it is physically hazardous
- Recurrent pornography-related legal problems
- Continued pornography use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the use of pornography
- The symptoms have never met the criteria for substance dependence for this class of substance
Example: Joan is a 30-year-old single who has been using pornography since age 10.
She has used pornography in the last 12 month period. She has tried to stop using porn three times in her life and has always gone back to it. She is ashamed of her pornography use and feels that if anyone really knew her, they would not love her. This has led problems in relationships with men and with her parents.
God’s Definition
Anyone who looks at a woman lustfully has already committed adultery with her in his heart.
Lust is the sin.
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Dependence
The use of the substance (pornography) in a 12-month period leads to a pattern that has produced measurable and significant impairment or distress, as shown by three or more of the following occurring in the same 12-month period:
- Tolerance – It takes more porn to get the same results
- Withdrawal – symptoms of distress occur when porn is not used for awhile
- Pornography is often used in larger amounts over a longer period of time than was intended. (Planned to limit the use, but could not.)
- A persistent, but unsuccessful effort to cut down the use
- A great deal of time is spent to obtain pornography or to Recover from its affects.
- Important social, occupational, or recreational activities are given up or reduced because of the pornography use
- The pornography use is continued despite knowledge of its negative impact on physical or mental health
Example: Peter is a 32 year old male who has been using pornography since age 16.
He says that he has tried to stop four times over the years and he has failed each time. When he is not using pornography he is nervous and anxious. He describes himself needing more and more graphic images to reach the pleasurable release that he wants and feels he needs. He says that often he will start off using porn and saying to himself that he will only be on it for 15 minutes. He finds that generally speaking he cannot keep his limits. He spends hours at his computer using porn and is constantly searching for new stuff. Peter is married with an 8 year old daughter and a 6 year old son. His wife recently discovered that he has starting using porn again (even though he has used it and hid it from her for the last two years) and there is a lot of tension in his marriage.
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