Dr. Kleponis: Well, we have two basic categories of addiction: There are chemical addictions, and there are process addictions. What we are more familiar with are the chemical addictions, such as drugs and alcohol. What we are dealing with when we talk about pornography addiction is more of a process or behavioral addiction where the effect on the brain is the same, but you’re not putting a foreign chemical into your body. The most common process addiction we would look at would be gambling, but it can include other types of addictions and compulsive behaviors, such as food and so forth. So that’s the category that we would put pornography addiction into.
CATR: Interesting. Can you tell me about the difference between pornography addiction and sex addiction?
Dr. Kleponis: Well, sex addiction is really sort of an umbrella term that can encompass many different types of sexual behaviors. For some people, it could be exhibitionism, or it could be voyeurism. Pornography is just one behavior that we would put under that umbrella. And for some people who become sex addicts, it actually starts out with pornography—as a sort of gateway drug.
CATR: I see. What’s the natural history of pornography addiction? How does it progress?
Dr. Kleponis: Well, like any addiction, we see an escalation of behaviors and a loss of control. So what we find for a lot of people is they start with soft porn, maybe even just a lingerie catalogue or whatever. But after a while that doesn’t do it for them anymore, and eventually they progress to more hardcore pornography. This can include deviant forms of sex; it can include violent sex; it can include fetishes, all kinds of things that never would have interested them at the beginning. So we see the behaviors becoming more severe.
CATR: What is it that makes pornography so dangerous?
Dr. Kleponis: Well, first of all, it’s not about moral judgment. It’s a disease like any other addiction. For many patients, pornography becomes the “drug” of choice for reasons that I call the “five As”: It’s Affordable, Accessible, Anonymous, Accepted, and Aggressive. It’s affordable because while you’ve got to buy drugs and alcohol, porn can be had for free. It’s accessible because it’s only a click away. It’s anonymous because it’s easy to hide; it’s not like being drunk in public. Many people feel it’s acceptable to view pornography, especially younger people, although I disagree. And finally, it’s aggressive in its effects. For example, when you drink alcohol, you’ve got to wait for it to go through your system and get to your brain before you feel the buzz. But with pornography, it goes through the eyes and straight to the brain—the gratification is instant.
CATR: I know that you’ve developed a seven-point approach to helping patients with pornography addiction. Can you describe it?
Dr. Kleponis: Sure. I developed this approach after reviewing other programs for various types of addiction. Point number one involves honesty, self-knowledge, and commitment. Honesty means you admit you have the problem and you take full responsibility for it. Self-knowledge involves learning the triggers that lead you back into pornography. It means understanding the times, places, or situations where you are more likely to use porn. And with that information, we can develop a plan to avoid acting on the urge to use. I call it a battle plan. Commitment means you’re committed to doing whatever it takes to recover.