by Duncan E. Stafford (psychotherapist, supervisor and author)

People who consult with me often report a negative experience with a previous therapist when trying to discuss pornography or cybersex usage. They have typically been told by the therapist: ‘I don’t work with this issue’ or ‘You really need to work with a sex therapist on this’. It could, of course, be that reports of therapists looking ‘too uncomfortable’ with what clients are saying or ‘not offering any comment’ might be part of a misunderstanding of the therapy process or transference issues on the client’s behalf. However, people reporting on therapists closing them down when they try to talk about their habits is, for me, worrying. Since what might be considered prosecutable pornography (see Crown Prosecuting Service) co-habits many mainstream porn sites, there should be a worry for our profession that not picking up on a patient’s distress and need to talk will, for at least a small percentage of users, lead to increasingly extreme usage and, ultimately, into illegal viewing habits with concomitant distress and trauma for these users (and those associated with them). While I obviously applaud a therapist who recognizes their limit of safe practice, it appears to me that pornography (and cybersexual issues) are so much a part of twenty-first-century life for such a wide range of people that all therapists in general practice should now be able to work competently in an un-anxious manner with the basics of this issue (when raised) and refer appropriately if, or when, this might be necessary.

I understand that many practitioners might feel they have no personal need to enquire into the pornized part of society presented here. However, I am left wondering what mechanism is actually at work in the therapist who allows the exclusion of a significant part of the modern world from their practice. Perhaps professional therapeutic journals need to take some responsibility in their scant publication of articles in this area, thus failing to reflect the relative importance of this issue to a wide range of therapists (especially when seen against the background of a 2011 online poll for BBC/TNS of 1,057 18–24 year-olds who reported that 77 per cent of males and 35 per cent of females viewed Internet porn)? Is there not some concern, then, that even if a general practice therapist believes there is no direct engagement with porn and cybersex in their client group, this is almost certainly erroneous? While many users of porn (and those close to them) have no issue with their habit, there are also many who do. Having peeled away the issues around porn itself, the work to be done subsequently is not about addiction but about depression, anxiety, boundary issues, trauma, and feelings of meaninglessness and disconnectedness (to name a few). Pornography is a cover story.

In an attempt to help inform therapists of how deeply pornography and cybersex can affect people’s lives, I spent 2008/9 researching modern, Internet-based pornography, culminating in the publication of Turned On: Intimacy in a Pornized Society. It is a hard-hitting tale about some of the causes and outcomes of porn and cybersexual addiction. Told in three parts, it outlines the stories of those most affected by it, and seeks out the underlying causes and potential resolutions through the voices of the ‘user’, Marc; the psychotherapist; and a lifetime disadvantaged sex worker, Louise. (Chapter three from Turned On: Intimacy in a Pornized Society). But, of course, not all porn users are like Marc and, indeed, not all porn users are men (Stephanie’s story).

Duncan E. Stafford will conclude ‘why therapists need to know about porn’ in part 5 .