UnHappy Endings
Patients’ Strange Loyalty to Pornography
Patients struggling with compulsive use of pornography often want to stop yet cannot. The reasons for the former are clear: it diminishes intimacy, strains relationships, and leaves behind shame and self-criticism. Ask with empathic interest why it might be hard to stop, and the room falls silent. There is no apparent reason to continue, just “weakness”: a clue to the odd puzzle of the patient’s loyalty.
Over time, solitary sexual stimulation—especially when paired with pornography—becomes (for some patients) more powerfully immediate, controllable, and intense than navigated real-time intimacy; a perfect snapshot of Freud’s pleasure principle. (Freud in fact called masturbation the primary addiction, leading to other compulsions—including perhaps his own habit of twenty cigars a day.)
Such compulsion closes a loop, creating a circular containment both protective yet suffocating, an Ouroboros-like cycle of tension, stimulation, release, and fleeting restoration. What is foreclosed here is relational negotiation, encountering another mind—the spacious uncertainties that make relational life possible.
Meantime the behavior persists, like the ticking of a hidden clock, close at hand yet unfindable. Most do not have so much as a flashlight.
This often leads to the usual therapeutic question: what unacknowledged affectivity, experienced and disavowed, drives this behavior?
The question itself misleads. It implies something is “there,” to be unveiled, as if the behavior is obscured by something. What is unacknowledged here is the practice or value of such recognition.
In most cases, having almost any need at all is risky, shameful; many of these patients were parentified very early on, especially by their mothers, within a rigid system—all leading to an implicit demand for a precocity strangling the child’s ability to verbalize their own needs and wants.
Wittgenstein described inner sensation as “not a something, but not a nothing either”—something present but not yet formed into language. What makes it something is a shared ambience of responsiveness that is lived, a relational dance absorbed as second nature.
Thus in some ways nothing is driving porn use—because motives cannot speak above the noise of the compulsion, have yet to be thought or felt. Like a driver dizzying himself by driving in circles, the dizziness becomes the destination.
Such existential confusion is part of what cannot be said, like sensing but not seeing the elephant in the room—or even recognizing its name.
Sometimes the person feels like they will die if they stop—which in a sense is true, because what might die, what needs to die, is a perpetuated system slowly choking them off from psychic coexistence.
We begin to see why group activity, such as outpatient or twelve-step programs, can be so healing, when such dilemmas become shared and relatable, along with a new way of living.
In other words, very early on the behavior becomes a way of “fixing it oneself,” in early dysphoric systems, avoiding the need to discover pleasure, meaning, and compromise in relation to others.
Over time, the behavior intensifies, attempting to blot out a growing zone of forestalled affectivity. (Rapid dopamine delivery is like running up a credit card.) This only deepens the very shame that sustains the whole enterprise. Soon therapy begins to circle in the same way. (Another clue.)
Often the patient wants to avoid discussing why stopping is difficult. I often respond with, If it were easy, you wouldn’t be here. True work begins by understanding the necessity of the behavior, a space filled by therapy over time, we hope: a discussion requiring trust and safety, another vein of exploration. (This does not mean using necessity as an excuse to continue living in a cocoon; in a way, for these kinds of discussions to gain traction, such cocoons must become permeable.)
Complicating matters is the fact that such patients have often co-formed a system with partners who have also emerged from traumatic systems, albeit from a different position. Said partners are often very hurt and injured themselves, but such injury can turn into rage or demands, as the partnership soon comes to resemble an impossible binary of pursuer/pursued, victim/perpetrator, circling into yet another stalemate.
Stopping is often intolerable at first. One patient described it as “starving myself.” This is not a casual metaphor.
As Otto Kernberg has observed, masturbation becomes central “when there is no other outlet.” For many patients, there has been no reliable relational outlet from day one—leading to foundational abandonment, abuse, intrusion, instability, or neglect. This habit becomes a primal means of self-regulation, with no other real possibility for comparison. Hard to say what is false when what is “true” is so elusive.
Thus develops a kind of loyalty to a way of living that both sustains and confines them—one that preserves the very condition in which their needs and desires remain unspeakable.
Clinically, such patients often present as competent, self-possessed, and even impressive in their functioning. Yet something in the encounter can feel flattened, pre-assembled, even slick. They present themselves in what can sound like a sales pitch.
They speak with clarity but not curiosity, as though experience has been packaged in advance. What is most affectively alive—dysphoric discomfort, existential angst—remains present but inaccessible, again that elusive ticking, or concretely located: the love of a particular person, a promotion, and so on. All palpably felt yet externally located, in the latter case, and elusive to sustained exploration.
Both participants will have to learn a new language—the language of psychological life, of not only the psyche but this unique and distinctive mind. Each speaks an idiom of their own.
Such diligent, sometimes gritty process leads gradually to an integration of painful, frightening yet amorphous experience: that which the patient has lived through but never fully recognized or accepted as theirs.
The worst, in that sense, has already happened, though the overwhelm and fear often need convincing.