Dysregulated Pornography Use and the Possibility of a Unipathway Approach
In this Commentary, after providing a brief overview of my background and research interests in relation to the topics covered by Grubbs, Perry, Wilt, and Reid’s (2018) Pornography Problems Due to Moral Incongruence model (PPMI), I review the tenets of the PPMI, their conceptual justification, and their empirical support. I then propose five questions (with related sub-questions) about the PPMI for its developers to contemplate. These have to do with whether the model should consider a “denial of pornography problems due to amoral commitment” pathway, if the model’s identification of a specific “moral incongruence” pathway opens the door to an indefinite number of possible pathways, whether a unipathway approach may be preferable to the current dual-pathway approach, implications of the model for treatment, and potential methodological considerations. While the PPMI hopes to extend to a variety of self-perceived “pornography problems,” I focus on perceived pornography addiction, as this is the variable that has been the focus of most research and is the most controversial.
Qualification and Contextualization
Scientific research in a particular area can be said to have three generalized audiences: (1) other scientists who share the same specialty, (2) other scientists who do not specialize in the area, but have an interest in it, and (3) the interested public (e.g., undergraduate students, science writers). The importance of feedback from fellow scientists who specialize in the same area is self-evident and reflected in the peer-review processes of scientific journals. Feedback from those who do not specialize in the area or are not trained to conduct scientific research is also important, however, as these constituencies read, interpret, discuss, and are potentially impacted by the research in question.
My Ph.D. minor was in human development and family studies, and I read, review, and teach in a variety of areas in the social and behavioral sciences. But my education and training are primarily in communication processes and effects (undergraduate degree in communications, masters in communication theory, doctorate major in communication). Although I have published in the area of dysregulated sexuality, these studies have focused on health communication and interpersonal dynamics (e.g., Wright, 2010, 2011; Wright & McKinley, 2010). Likewise, while pornography is a regular focal point of my research (e.g., Wright, 2018; Wright, Bae, & Funk, 2013; Wright, Sun, & Steffen, 2018), I specialize in socialization, not dysregulation. I categorize myself, then, as a scientist interested in topics covered by the PPMI, but not an expert. I ask that readers of this commentary keep this in mind as they consider my review and evaluation, and that the authors of the PPMI have patience with me for any misunderstandings or statements reflecting my lack of expertise. Regarding the latter, I also encourage the PPMI developers to remember that I may be symbolic of similar non-experts who will read the piece and to consider their response to my commentary as an opportunity for clarification and furthered understanding among this segment of the interested audience.
The PPMI posits a straightforward set of relationships between religiosity, moral incongruence, pornography use, and self-perceived addiction. First, the model asserts that regular consumption should lead some individuals to perceive that they are addicted to pornography. While acknowledging the lack of hard data evaluating theoretical arguments made by Cooper, Young, and others about how the technological affordances of modern-day (i.e., online) pornography can combine with personality and developmental susceptibility factors to lead to dysregulated pornography use (Cooper, Delmonico, & Burg, 2000; Young, 2008), the PPMI points to the wealth of personal testimony generated by self-identified pornography addicts and the clinicians who they seek assistance from, as well as some quantitative data (e.g., Reid et al., 2012), to argue that there are frequent and intense users of pornography who do not feel as if their behavior is volitional. This seems a reasonable hypothesis, given the continuous and barrier-free access to pornography provided by the internet, the ability of sexual arousal to change affective states, the physiological rewards resulting from orgasm, and diagnostic indicators suggesting a correlation between more frequent use and addiction likelihood for other evolutionarily related but non-substance behavioral addictions such as “gambling addiction or compulsive gambling” (American Psychiatric Association, 2016; Li, van Vugt, & Colarelli, 2018; Spinella, 2003). The available data supported this PPMI prediction, with self-perceived addiction positively correlating at a moderate level with more frequent use of pornography.
Second, the PPMI asserts that among pornography users, religiousness correlates with moral incongruence surrounding the consumption of pornography and that moral incongruence exacerbates the feeling that one’s behavior is an addiction. Given the acceptance of pornography among secular persons coupled with the intense opposition to pornography among the religious (Arterburn, Stoeker, & Yorkey, 2009; Dallas, 2009; Paul, 2007; Weinberg, Williams, Kleiner, & Irizarry, 2010), it is intuitive that higher religiosity would correspond to higher moral incongruence. It is also intuitive that repeatedly engaging in a behavior that one strongly opposes would foster a feeling of nonvolition (i.e., of being addicted). The available data also supported these PPMI predictions, with religiosity strongly predicting moral incongruence and moral incongruence strongly predicting self-perceived addiction.
Third and finally, the PPMI predicts that moral incongruence will be a stronger predictor of self-perceived addiction than consumption frequency. This is also a logical argument, for three reasons. First, perceptions of immorality are associated with perceptions of negative consequences (i.e., people only identify behaviors as “immoral” when they perceive them as harmful). Second, both professional health and self-help organizations mention continuation of a behavior in spite of negative consequences as often as they mention behavioral frequency in their diagnostic criteria (Alcoholics Anonymous, 2018; American Psychiatric Association, 2016; World Health Organization, 2018). Third, it is often said by practitioners that “denial is the hallmark of addiction” (Lancer, 2017—i.e., many frequent users may be in denial). To synthesize, it is reasonable to hypothesize that moral incongruence will predict self-perceived addiction more powerfully than behavioral frequency because (1) the identification of a behavior as harmful is a prerequisite for perceiving it as an addiction and evaluations of harm and immorality are inextricably linked, and (2) according to therapists many addicts do not perceive themselves as such because they are in denial about the adverse consequences of their actions (Weiss, 2015). The available data also supported this PPMI prediction, as associations between moral incongruence and self-perceived addiction have been stronger than associations between consumption frequency and self-perceived addiction.
In sum, the PPMI is constituted by a logical and internally consistent set of hypotheses about how religiosity, moral incongruence, pornography use, and self-perceived addiction intercorrelate, and the available data support each of the model’s predictions.
Questions for Consideration
Pathway to Denial?
As outlined previously, it is the perception of harm that leads to the perception of immorality and an addicted individual will only self-identify as such if they perceive their behavior as harmful. The PPMI posits that some devout individuals perceive pornography as so harmful that even a few indulgences may lead to the incorrect conclusion that their behavior has spiraled out of control. These cases might be called self-diagnostic false positives due to an anti-pornography morality commitment.
But what about the opposite end of the continuum? Just as there are persons who see all pornography use as harmful, there are those who with an equal degree of ideological rigidity insist that unless it is an indisputable, immediate, and direct cause of sexual violence, pornography cannot have any negative effects (see Hald, Seaman, & Linz, 2014; Linz & Malamuth, 1993). If a person is ideologically committed to the harmlessness of pornography, does it not follow that they would attribute the harms to them and others caused by their dysregulated consumption to anything other than the true cause? These persons might be called self-diagnostic false negatives due to a pro-pornography amorality commitment.
Indefinite Incongruent Pathways?
The PPMI posits two pathways to the self-perception of pornography addiction. In the first pathway, an individual’s use of pornography is so dysregulated and so obviously problematic that they have no choice but to conclude that they have a problem. In the second pathway, an individual has a moral compunction against the use of pornography but continues to use it anyway, and this discrepancy between their morality and their behavior leads to the self-perception of addiction.
This second pathway is called “pornography problems due to moral incongruence” because the incongruence between the person’s moral views against pornography and their use of pornography leads to the perception that they are addicted. The specific identification of a “moral incongruence” pathway raises the question of the need for other possible pathways, such as “pornography problems due to financial incongruence,” “pornography problems due to relational incongruence,” and “pornography problems due to professional incongruence” (Carnes, Delmonico, & Griffin, 2009; Schneider & Weiss, 2001). In the financial incongruence pathway, a person perceives their pornography use as out of control because they cannot afford to keep subscribing to paid pornography websites but continue to do so anyway. In the relational incongruence pathway, a person perceives their pornography use as out of control because their partner has said they will end the relationship if their behavior persists, but they continue to use in spite of their not wanting the relationship to end. In the professional incongruence pathway, the person perceives their pornography use as out of control because their employer has a policy against viewing pornography at work, but they continue to do so anyway.
These are only a few possible examples of how a discrepancy between a person’s use of pornography and a legitimate reason for why they should not be viewing pornography may lead to the feeling of being “addicted.” Given that there are many other possible origins for discrepancies, the question arises as to whether the best way to approach model building is to identify a new pathway for each specific type of incongruence.
Given the increasing normalization of pornography in popular media and secular society more generally, the role of denial in minimizing problematic addictive behavior, and the emphasis many religions and religious groups place on the harms of pornography, is it possible that dysregulated religious pornography users are simply more sensitive to the already experienced and potential future negative consequences of their behavior than dysregulated pornography users who are not religious? And that when religious pornography users continue their behavior despite the realization of harm (actual and potential), they are more quick to acknowledge the addictive potential of their activities than nonreligious pornography users? To rephrase using a term common in the addiction recovery literature, is it possible that dysregulated religious pornography users are simply more likely to acknowledge that they have “hit bottom” and need help than dysregulated nonreligious pornography users?
This commentary has assumed that moral judgments are directly related to perceptions of negative consequences; it is because behaviors are perceived as harmful that they are labeled immoral. It has also proposed that self-identification as an addict is most likely when people believe their behavior is harmful yet continue to engage in it. From this perspective, dysregulated pornography use interacts with moral views about pornography to predict self-perceived addiction, and moral views are due to perceptions of harm. Moral incongruence is measured with questions such as “Viewing pornography online troubles my conscience” and “I believe that viewing pornography online is morally wrong” (Grubbs, Exline, Pargament, Hook, & Carlisle, 2015). Since religious perspectives on pornography emphasize a variety of harms (e.g., relational disruption, decreased virility, self-centeredness, aggressive tendencies, reduced compassion for women, propagation of sexual stereotypes, including those involving race, financial loss—Foubert, 2017), dysregulated religious pornography users may recognize the manifestation of or potential for negative consequences more readily than the nonreligious. Continuing to use pornography despite having recognized or perceived its capacity for harm then hastens the perception of being addicted. Some dysregulated nonreligious pornography users will ultimately come to the same conclusion, but their use would need to be more intense and of longer duration, and they would need to experience more indisputable adverse effects.
Implications for Treatment?
The dual-pathway approach leads to differing expectations for treatment. People who fall into the first pathway (people whose pornography consumption is “truly” dysregulated) would need some sort of program providing them with the agency to cease or modulate their pornography use. It is beyond the scope of this Commentary to review and evaluate the research associated with the “Acceptance and Commitment Therapy” approach (Twohig & Crosby, 2010) identified in the Target Article, but it seems like a promising avenue for behavioral change. Peer-to-peer communication, as well as mentoring from others who have more personal experience with regulating their pornography use, may also be effective (Wright, 2010).
The treatment that people would receive who fall into the second pathway is less clear (i.e., people whose perceptions of pornography addiction are due to moral incongruence). When a person engages in a behavior that troubles their moral conscience, they have two choices: lower their morals to match their behavior or improve their behavior to match their morals. The Target Article seems to imply that both of these are options. Regarding the former, the article suggests “resolution of internal conflicts related to morals.” Regarding the latter, the article suggests “efforts to enhance value-congruent behavior patterns.” Because it will be difficult to convince the religious that their moral code is sexually repressive and they should embrace their use of pornography, clinicians are left with helping religious people to stop using pornography. However, by the time a religious pornography consumer seeks clinical assistance, it is likely that they have already tried to stop many times and have been unsuccessful. This brings the Commentary back to the unipathway approach, which suggests that the religious and nonreligious dysregulated pornography user are different in degree, but similar in kind, and the behavioral change mechanisms that are good for one will be good for the other (although perhaps in programs that are secular for the nonreligious and spiritual for the religious).
If the religious person’s pornography use has been volitional and exploratory and their only malady is a conflicted conscience, the course of treatment can be quite brief. The case is presented by the client; the clinicians say “If it bothers you, don’t do it,” and the course of treatment is concluded. If, as the Target Article suggests, many such self-perceived addicts who are religious fall into this category, this is good news. A simple one- or two-sentence reminder that the best way to not feel bad about a behavior is to avoid it should suffice. As with all entertainment media, the use of pornography is unnecessary for functional living, and this category of user is in total control of their behavior despite their religiously induced sex guilt. Consequently, treatment should not be particularly complicated.
Three methodology-related suggestions arose while reading the Target Article. First, several of the studies constituting the meta-analysis used single-item assessments of pornography use frequency. While single-item pornography use measures have demonstrated convergent and predictive validity in multiple cross-sectional studies and test–retest reliability in multiple longitudinal studies, the effect sizes they produce may be slightly attenuated from the values that might have been generated had multiple-item measures been employed. In other words, there is a possibility that the meta-analytic results may be underestimating a bit the true strength of the relationship between the frequency of pornography use and self-perceived addiction (Wright, Tokunaga, Kraus, & Klann, 2017). Second, while the pattern of results suggests that participants are considering their own personal pornography use when they answer questions related to their moral disapproval of pornography, this should be stated explicitly in questionnaires prefacing these questions. It is possible that participants are thinking of others’ pornography use more so than their own when they answer questions such as “I believe that viewing pornography online is morally wrong.” If people rationalize their own pornography consumption but condemn others’ use, this could be problematic (Rojas, Shah, & Faber, 1996). Third, when interpreting the lack of an association between perceived pornography addiction and pornography use over time, it must be remembered that many persons in recovery abide by the phrase “once an addict, always an addict” (Louie, 2016). Persons in formal recovery and persons not in formal recovery who have learned about and identified with this mantra will answer affirmatively to questions such as “I believe I am addicted to Internet pornography” even though their actual pornography use has abated or extinguished. Given this, as well as the fact that most addiction models emphasize consequences and control more so than behavioral frequency, it is perhaps not surprising that self-perceived addiction at present does not reliably predict pornography use frequency later (Grubbs, Wilt, Exline, & Pargament, 2018).
The PPMI model is an intriguing and important synthesis of concepts and research on religiosity, moral incongruence, pornography use, and self-perceived addiction. My goals for this Commentary were to laud the originators of the model for their hard work and ingenuity and provide some possible ideas for future theorizing and research. The increasingly common self-identification as a pornography addict, coupled with the ongoing diversity of opinion among researchers and professionals about how to classify and help such individuals, demands that unifying work in this area continue to be a high priority.
- Alcoholics Anonymous. (2018). Is A.A. for you? Retrieved from www.aa.org.
- American Psychiatric Association. (2016). What is gambling disorder? Retrieved from www.psychiatry.org/patients-families/gambling-disorder/what-is-gambling-disorder.
- Arterburn, S., Stoeker, F., & Yorkey, M. (2009). Every man’s battle: Winning the war on sexual temptation one victory at a time. Colorado Springs, CO: WaterBrook Press.Google Scholar
- Carnes, P. J., Delmonico, D. L., & Griffin, E. (2009). In the shadows of the net: Breaking free of compulsive online sexual behavior. Center City, MN: Hazelden.Google Scholar
- Dallas, J. (2009). 5 steps to breaking free from porn. Eugene, OR: Harvest House Publishers.Google Scholar
- Foubert, J. D. (2017). How pornography harms. Bloomington, IN: LifeRich.Google Scholar
- Grubbs, J. B., Exline, J. J., Pargament, K. I., Hook, J. N., & Carlisle, R. D. (2015). Transgression as addiction: Religiosity and moral disapproval as predictors of perceived addiction to pornography. Archives of Sexual Behavior, 44, 125–136. https://doi.org/10.1007/s10508-013-0257-z.CrossRefPubMedGoogle Scholar
- Hald, G. M., Seaman, C., & Linz, D. (2014). Sexuality and pornography. In D. L. Tolman & L. M. Diamond (Eds.), APA handbook of sexuality and psychology (pp. 3–35). Washington DC: American Psychological Association.Google Scholar
- Lancer, D. (2017). When someone you love is an alcoholic or addict. Retrieved from www.psychologytoday.com.
- Louie, S. (2016). Once an addict, always an addict. Retrieved from www.psychologytoday.com.
- Paul, P. (2007). Pornified: How pornography is transforming our lives, our relationships, and our families. New York: Owl Books.Google Scholar
- Schneider, J. P., & Weiss, R. (2001). Cybersex exposed: Simple fantasy or obsession? Center City, MN: Hazelden.Google Scholar
- Weiss, R. (2015). Sex addiction: Understanding the role of denial. Retrieved from www.addiction.com.
- World Health Organization. (2018). Gaming disorder. Retrieved from http://www.who.int/features/qa/gaming-disorder/en/.