Dana Kirkpatrick, a licensed professional counselor (LPC) and certified sex therapist (CST) and supervisor in Pennsylvania, is only half joking when she says she “specializes in talking about really uncomfortable things — and business is booming.”
She often supports clients as they delve into what is and isn’t working in their sex lives and how that intertwines with mental health, relationships and other aspects of life. Those discussions frequently include open and honest conversations about pornography, Kirkpatrick says.
Pornography use, like many other topics related to sexuality, can tie into other concerns that individuals and couples bring to counseling. Clients’ attitudes and beliefs regarding pornography are typically internalized based on social, cultural and moral influences. It is up to practitioners to raise the topic and create a nonjudgmental space for clients to explore the role pornography might play in their own sexuality and relationships, says Kirkpatrick, an American Counseling Association member and owner of the counseling practice Calm Pittsburgh.
This is unexplored territory for most clients, she points out, especially for couples, many of whom have never spoken out loud to each other about their use of or views on pornography. It is a complicated topic that can involve feelings of shame, hurt or embarrassment, and individuals often don’t know how to begin to talk about it.
“The important thing is [for counselors] to prompt that dialogue,” notes Robert Zeglin, a licensed mental health counselor and CST in Florida who is the founding editor of the Journal of Counseling Sexology & Sexual Wellness. “[A client] may think their partner is watching porn for one reason, but they may be wrong, entirely wrong — and they need to talk that through. … It’s a very powerful thing when people are openly allowed to talk through these things: Why am I so opposed to porn? Or why am I drawn to it? It’s really powerful to facilitate and be a part of that [exploration].”
Unrealistic expectations and assumptions
Kirkpatrick says pornography can shape a person’s sexuality much like romantic comedies do. Both set people up with unrealistic expectations concerning sex, attraction and romance, she explains.
“If [the film] Pretty Woman was your first view of romance, then that’s what you see as romance,” Kirkpatrick says. “It’s the same for porn or 50 Shades of Grey. If that’s what you see first, it’s an expectation. Both scenarios create delusions of grandeur that set you up for failure.”
“Just as with romantic comedies, we know they’re actors, but [pornography] can still lead to unrealistic expectations,” she notes.
Pornography use can have negative effects on clients’ sexual wellness when it is used as a substitute for or an addition to sex education during a client’s formative years or when it is consumed without the intentional mindset that pornography is fictitious, with actors who are performing in scenes and stories that are created, curated and edited by a full crew of professionals.
Zeglin, an associate professor and program director for clinical mental health counseling at the University of North Florida in Jacksonville, refers to this tendency to view pornography as factual or real as “bad porn literacy.” Clients who have this mindset can struggle with body image issues and negative thought patterns as they compare their bodies to the above average (and often augmented) bodies they see portrayed in pornography, he explains.
“Body shame is a common theme when talking about pornography [with clients],” Zeglin says. “Just as not everyone looks like the cast of [the TV drama] Grey’s Anatomy, we need to emphasize that [pornography] is entertainment. There are so many bad expectations that can leak into sex and body expectation.”
Similarly, clients can harbor unrealistic expectations about what sex is or should be, Kirkpatrick adds. This can especially be true for people who started viewing pornography at a young age. Young adults may expect their partners to do certain things and respond in the same way that they’ve witnessed on screen, she notes.
Aydrelle Collins, an LPC who specializes in Black sexuality at her Dallas practice, Melanin Sex Therapy, says that pornography is where many of her clients first learned about sex or saw other people be sexual. In addition to body image issues, this can lead to a narrow or incomplete understanding of sexuality, she says.
In pornography, “the focus is on the orgasm, and if there’s not one [in real life], it can lead to disappointment,” Collins says. “That robs people of being in the moment of sex, the full experience, and can lead to the assumption that they have to have performance-type sex.”
Pornography use can also lead to misconceptions about what a partner may want in sexual situations. For example, a pizza delivery person in a pornography scene may knock on the door ready and willing to have sex with the resident, but is that realistic or accurate? Of course not, Kirkpatrick says. Counselors can help clients talk through and clear up any assumptions they’ve internalized that may be leading to frustrations or challenges in their relationships or sexual wellness.
Zeglin, an ACA member, also emphasizes that counselors can offer psychoeducation for clients who harbor unhealthy expectations or assumptions gleaned from pornography. One important message, he says, is the reality that sex is often just OK, with some really great and really disappointing experiences thrown into the mix.
Clients’ lives and relationships can also be negatively affected by pornography when it is used compulsively. If a counselor hears a client talk about their pornography usage with language that might indicate a dependence or addiction — including viewing it at inappropriate times, such as when they’re at work or school — further assessment or specialized treatment may be needed. (For more on the nuances of helping clients who use pornography compulsively, see the articles “Six steps for addressing behavioral addictions in clinical work” and “Addicted to sex?”)
Broaching and breaking unhealthy cycles
Laura Morse, an LPC and CST in private practice in Lancaster, Pennsylvania, says her clients bring up the topic of pornography almost daily, most frequently through questions related to the theme of “Am I normal?” Clients often wonder if what they are watching and the amount of time they spend watching is “OK” or “normal”; others question whether they should be watching it at all, Morse says.
“As clinicians, we work with clients who may be struggling with unpacking the messages they receive about sex — messages which can have negative impacts on their own sexuality and their relationships,” says Morse, an ACA member and Gottman-trained couples therapist. “It’s essential that we use evidence-based tools to evaluate what role pornography serves in our clients’ lives and assess what concerns they may have about their usage. Is it impacting time away from work? [Causing them to] spend too much money? [Resulting in] loss of interest in sexual desire with their partner? All of these assessment questions help inform treatment planning.”
Morse and Collins both recommend the PLISSIT model (developed by Jack Annon in the 1970s) for prompting discussions to assess clients’ thoughts on and relationship with pornography. The model’s acronym represents its four intervention levels: permission, limited information, specific suggestions and intensive therapy. Breaking discussion into these ascending levels helps practitioners decide whether they need to continue or intensify conversations with a client and match the individual(s) with an intervention that meets their level of need.
The model’s first level can help broach sexuality-related subjects in an open way, as the practitioner invites and gives the client(s) permission to talk about and explore issues they might have previously considered taboo, including pornography, Morse says.
Feelings of shame regarding pornography use — either self-described in individual clients or shaming language used toward a partner in couples counseling — can also indicate that a counselor needs to facilitate discussion about the topic, Zeglin says. This can include the need to unpack the assumption that because one partner views pornography, it means they don’t find their partner attractive anymore, he notes. When left unprocessed, these emotions can lead to an unhealthy cycle.
“Because of that shame, they start to hide the porn use, [and] secret-keeping and hiding things is never good for relationships,” Zeglin says. “It creates a cycle, and it’s a pretty common manifestation within couples [where one or both partners] have an overall values system that porn is taboo.”
In addition to feelings of blame, shame and embarrassment, Collins says that pornography use can lead to a disconnect between couples. This is especially so for couples who have never talked about the subject together.
“It can create a disconnect in the relationship, in multiple layers. It’s not just the porn, but everything surrounding it and the shame that can come up,” says Collins, who is fully trained but not yet certified as a CST. “It can show up as resentment, lack of sex and connection, or arguments. It can be a spiral where one person is caught watching porn and they’re not having [frequent] sex already, and then that person is shamed [by their partner]. It causes them to retreat and furthers the lack of intimacy.”
Hurt feelings surrounding pornography use are often magnified when a couple isn’t having sex regularly or as frequently as one or both partners would like, Collins adds. Blame can become intensified if one partner feels the other is choosing pornography over sex within their relationship.
In these cases, a counselor can help clients talk through not only their feelings regarding pornography but also the many complicated layers that can accompany those feelings. This can include trust issues, Collins notes.
“You don’t trust [your partner] if you feel like you’ve been misled or lied to or shamed or ridiculed for something that you feel is normal and natural and everyone does it. Once that trust gets broken, there comes a disconnect,” Collins says. “We all bring our own messages that we’ve received about sex and sexuality into relationships, and that’s the biggest underlying thing. Sex brings up a lot of feelings of uncomfortableness if you haven’t had a chance to explore your own feelings about sexuality. … We all have attitudes and biases, including around porn. We all have different feelings about what’s healthy and not healthy, whether it’s OK to watch, and how much is OK to watch.”
Collins has worked with couples who have differing views on the consumption of pornography and admits that it can be a sensitive subject to broach. She emphasizes that practitioners should validate each partner’s views about pornography and focus on repairing the disconnect between partners by helping them process their underlying emotions.
To foster discussion in sessions, Collins often creates a “sexual health plan” with couples to outline what they’d like their sex life to look like together and the role that pornography will or will not play in it.
“In cases like these, I explore clients’ views on porn watching and what that means for their relationship,” Collins says. “These conversations can be difficult to facilitate, and working with this dynamic [when partners have differing views on pornography] can be a tender topic for couples. My advice to counselors working with couples is [to] focus on the underlying emotional hurt that is there. What are their goals for their relationship? The best thing a counselor can do to facilitate these discussions is to check their own views and bias around porn in order not to take sides.”
Unpacking the complicated layers that can surround clients’ pornography use may also include talking or asking about physical problems that are affecting clients’ sex lives and debunking misunderstandings or assumptions they may have regarding their or their partner’s sexual challenges.
Collins emphasizes there is no confirmed connection between the consumption of pornography and physical problems such as delayed ejaculation or erectile dysfunction. However, client assumptions regarding this topic can lead to an unhealthy cycle, she notes.
“Many people have the misconception that masturbating or watching too much pornography can desensitize people and cause them to not be able to perform or get an erection for sex,” Collins explains. “And those assumptions can exacerbate the problem if you have those [physical] problems already.”
The counselor’s role
Kirkpatrick notes that when working with couples who are processing their feelings regarding pornography and its effects on their relationship, a helpful first step is to invite both partners to describe what they feel pornography is. Each person will have a different definition, and couples will benefit from understanding each other’s boundaries, she says. Is it acceptable to look at Playboy magazine? Browse the website Pornhub? Watch the TV show Game of Thrones? Visit interactive mediums where the user communicates with another person (such as virtual reality or video chat)?
“Help the partners define what their beliefs are [regarding] pornography use — good or bad — and what feelings they are having presently related to [their] pornography use. The key is finding the partners’ definition of their feelings and validating those feelings,” Kirkpatrick explains. “Then [counselors] can help them work on where their views come from and if they are being kind to themselves. Do they feel betrayed? Confused? Left out? Jealous? Once we can identify what that feeling is, then we can address it.”
Kirkpatrick also suggests that counselors include a range of questions about client sexuality, including pornography use and masturbation habits, during intake. This information will provide the practitioner with more context, and it lets the client know that the counselor is interested in and open to discussing these often-taboo subjects.
The counselors interviewed for this article agree that when unpacking the topic of pornography (both with individual clients and couples), a practitioner’s role is to serve as a neutral facilitator, prompting clients to explore the values, emotions and thoughts they hold regarding its use. With couples, this includes making equal time for each partner to explain their likes, dislikes and range of feelings.
Counselors should remain neutral — “without putting their thumb on either side of the scale” — while facilitating these conversations, Zeglin stresses. This mediator role includes the exploration of differences between couples and the differences that individuals hold within themselves on the topic.
“Have frank conversations about [the client’s] comfort levels and interest, [saying,] ‘Tell me a little bit about your values about sexual stimuli and porn. Is there anything that would get in the way of enjoying that?’ It’s the same as [addressing] anything that would put them outside of their comfort zone,” Zeglin says. “We need to give time and space to all voices, all the complex and dynamic parts of the people in the room.”
If pornography has led to conflict, feelings of betrayal or other hurtful emotions between partners, it may be appropriate to have them agree to temporarily pause their pornography consumption while they unpack their feelings and thoughts during this phase of therapy, Kirkpatrick says.
Because pornography consumption is an intense subject, clients may feel more comfortable talking about it if the counselor offers to look in another direction or turn their camera off in sessions held via telebehavioral health, she adds.
Inviting clients to frame their conversations about pornography through the lens of “this is what I’m into” empowers clients and allows them to present their thoughts in an open, positive way, Kirkpatrick says. In couples counseling, this approach can also spark questions, further dialogue between partners and, in some cases, reveal that the couple shares similar interests.
Kirkpatrick advises counselors to create an open and safe place for clients to talk about pornography use because it helps take away the power of shame that often accompanies the topic. She sometimes uses a “yes, no, maybe” chart that lists a variety of sexual interests, including different types of intercourse, use of vibrators, pornography and other preferences, to encourage open discussion between couples. Each partner fills out their own chart, selecting “yes,” “no” or “maybe” for each item. Afterward, couples have an avenue to talk about things honestly with each other (both inside and outside of counseling sessions). This tool can also help with overcoming shyness, Kirkpatrick says, and reveal sexual interests that both partners share, including ones they may not have known about or considered previously.
Kirkpatrick also sometimes suggests that clients use the app MojoUpgrade, which has a similar quiz to help couples explore and spark discussion about sexual interests and desires. The app shows only items for which both partners have responded “yes,” which can also help with overcoming shyness, Kirkpatrick says.
In couples counseling, the clinician should ensure that conversations about pornography remain respectful and refrain from assigning blame or shame toward either partner, Collins says. Society often views pornography in black-and-white terms of either all good or all bad, but it’s more complex than that. A counselor can help clients understand that it’s natural to have multifaceted feelings on the topic.
“The truth is you can put up boundaries for what you want, but you need to get there without shaming your partner,” Collins says. “Have clients really flesh out what their narrative is around sex. If they feel like porn is not the best thing for their partner to watch, explore why that is without shaming their partner. [Prompt] conversation about what they are getting out of watching porn: Is it fantasy or being curious, etc.? Everyone is allowed to have their own feelings about what is healthy and boundaries on what they want out of sexuality.”
Collins notes that using a narrative focus can be helpful in this realm. Prompting clients to explore their sexual narrative frames the conversation in an empowering way and allows them to talk through and reject stereotypes and internalized messages that they no longer feel are helpful or accurate, Collins says.
An important aspect of this work includes asking clients questions about their sexual history. Collins does a sexual genogram with clients to find out where they first learned about sex, who they have discussed sexual issues with and other details. Asking questions about when and how they began to view pornography can also give the counselor and client(s) more context on factors that influence how they feel about and interact with pornography currently.
“I go line by line, unpacking everything they’ve ever taken in about sex, and assess how that impacts how they view sex now and how they view themselves as a sexual being,” Collins says. “[This allows them to] leave the things that no longer suit them and find the things that help them define their sexuality. … Our role as therapists is to help clients [find] their own narrative — not what they’ve been told or our narrative, but what works for them.”
Allowing clients to “be present and accept that they are sexual creatures” leads to empowerment and stronger confidence and decision-making, she adds.
Back to basics
Zeglin advises practitioners who are helping clients process their feelings and thoughts on pornography to “take the sex out of it.” Instead, counselors should draw upon the same toolbox of methods they would use to help a client who is wrestling with a nonsexual dilemma.
“Anything that distracts from the relationship can impact it negatively; it’s not the porn per se,” Zeglin says. “It’s just like anything — it’s really the use of it and not the thing itself that can cause problems.”
In fact, research has shown that the level of dopamine released by the brain when a person watches pornography is the same as when a person does other things they enjoy or find pleasurable, he adds.
Zeglin finds that Gestalt theory is a helpful lens to use as he prompts clients to explore and “give voice” to the parts of themselves that are in competition. For example, perhaps a client is conflicted because they want their partner to be happy, but they also feel that their partner must think they are ugly because their partner chooses to watch pornography. Or maybe a client is drawn to pornography because it entertains them or brings them pleasure, but they also feel guilt and shame for watching it.
“If you take the sex out of it, it becomes a counseling 101 values conflict,” Zeglin says.
Perhaps a counselor is working with a couple experiencing a common scenario: One person is watching pornography and is compelled to hide it, and the other partner finds out and is hurt. By taking the sex out of it, Zeglin says, counselors can flip this conversation and ask, what if the person had set a goal to lose weight and the partner found them sneaking Oreo cookies? In both scenarios, the practitioner and clients would need to explore the couple’s lack of communication, the sense of broken trust, and other thoughts and feelings related to the behavior, he explains.
“Don’t make the problem the porn. Focus on the relationship. Sex is so moralized that we get distracted by that sometimes,” says Zeglin, a co-founder and past president of the Association of Counseling Sexology and Sexual Wellness, an organizational affiliate of ACA. “Counselors already have the tools to address it, but it just feels different because sex is involved.”
When it’s a good thing
Adult couples who have talked through their feelings and preferences and are accepting of pornography may find that viewing certain things together can enhance their sexual relationship. The counselors interviewed for this article noted that some clients (consenting adults) on their caseloads have benefited from incorporating pornography into their sex lives as a way to explore new things together. This can happen organically, such as when couples come up with the idea on their own, or when a counselor suggests it (when appropriate) as a bonding exercise for a couple outside of session.
“First, you have to make sure it’s accepted by the couple and culturally appropriate,” says Kirkpatrick, who co-presented a session, “Sex Positivity: Increasing Competencies in Addressing Sexuality Issues in Counseling” at the 2021 ACA Virtual Conference Experience. “There are body-positive sites, or sites with [instructional-style videos on] things to try. It’s using it as a tool, not a replacement. It should be something to enhance your sex life, not replace your sex life.”
Kirkpatrick has a list of sex-positive websites she offers to clients who express an interest in watching pornography together. It can be a means to grow together and learn what each partner does and does not like, she says. It can also be a way for couples who have a low sex drive or sexual desire to begin thinking about sex before becoming intimate together. Depending on a couple’s interests and comfort level, Kirkpatrick’s sex-positive recommendations can include pornography that involves writing (such as erotic fiction), photographs or images, or videos.
Collins agrees that pornography can be a helpful tool for some clients. Couples who have trouble with physical issues, such as erectile dysfunction, can use it to find and explore other avenues of sexuality that may work better for them, she notes.
“A lot of people figure out what turns them on by watching porn,” Collins says. “It can be a way to educate, watch together and … explore fantasy, broaden your sexuality or get out of a rut. It can give people options, room to explore, and open up dialogue and conversation around sex.”
It can also be a way for couples to bond and even laugh, Zeglin adds. “Couples need to explore both mentally and physically, and things change over the life span. Desires change, bodies change as we age. Just like anything, porn can serve as an opportunity to see what strikes your fancy,” he says. “Or you can giggle together about how unrealistic it is [and] how bad the dialogue is.”
Professional counselors must always assume a nonjudgmental lens when working with clients, especially ones who are wrestling with thoughts and feelings about the complex and sometimes uncomfortable topic of pornography. The professionals interviewed for this article agree that counselors have a responsibility not only to leave their personal feelings out of the equation but also to seek training, continuing education or consultation when they don’t understand or know how to best treat a client’s questions or conflicts regarding pornography.
“We [counselors] are licensed as health providers, and we have to remember that what is and isn’t healthy is different than what is or isn’t personally important to us,” Zeglin says.
Collins agrees, noting that the last thing she wants to do is add another voice to a client’s understanding of a topic that is already heavily influenced by cultural, societal and other factors.
“I want them to find their own voice,” Collins says. “We [counselors] need to be checking our own biases and our own narratives around sex so that we are not imposing what we feel about sex and porn [on clients]. When our stuff comes into a session, it takes away from the work that we are doing with the client. Sometimes, with sex, [practitioners] tend to forget that.”
Practitioners also shouldn’t make assumptions about clients’ views on pornography. For example, clients who come from conservative religious or cultural backgrounds may not automatically be opposed to pornography use, whereas clients who come from more liberal backgrounds won’t necessarily embrace it, Kirkpatrick points out. In addition, clients will have a range of feelings about pornography that won’t necessarily fall into binary categories of “pro-pornography” or “anti-pornography,” she says.
Kirkpatrick urges counselors not to feel that they should refer a client whenever sexual wellness issues arise in counseling work. Instead, she encourages counselors to seek training, supervision or consultation with a local sex therapist. Counselors and CSTs can also co-treat clients, when appropriate, she notes. (Find a local CST and continuing education offerings at the American Association of Sexuality Educators, Counselors and Therapists website, aasect.org.)
Counselors who find they are interested in facilitating dialogues about pornography should consider seeking certification as a sex therapist, she adds.
“Don’t automatically refer. We need more people to be able to talk about this comfortably,” Kirkpatrick stresses. “Also, ask the client. I learn more from my clients than anyone else. … They are the experts in their sexuality because it’s so complicated. They are the experts on themselves.”
Pornography use during the COVID-19 pandemic
As the COVID-19 pandemic began to stretch across the globe, causing millions of people to stay home, many individuals and organizations predicted or assumed that the isolation, loneliness and boredom would result in an increase in pornography consumption.
In spring 2020, Pornhub announced that the online platform’s “premium” content would temporarily be free to users who were on lockdown because of COVID-19. As a result, the company reported a 38%-61% increase in web traffic from regions that had lockdowns and restrictive stay-at-home orders. This usage was above and beyond the more than 1 million daily unique web visits that Pornhub reported in 2019.
However, a study published recently in the Archives of Sexual Behavior polled more than 2,000 men and women in February, May, August and October 2020 and found that pornography consumption among American adults decreased overall in 2020.
In May, immediately following the United States’ first wave of pandemic-related restrictions, there was a small increase in the number of people who said they had viewed pornography in the past month, but less so than in the baseline data, which indicated that 38% of participants — 59% of men and 21% of women — reported using pornography at least once per month.
“Among those who reported use in May 2020, only 14% reported increases in use since the start of the pandemic, and their use returned to levels similar to all other users by August 2020,” wrote the study’s co-authors. “In general, pornography use trended downward over the pandemic, for both men and women. Problematic [compulsive or uncontrolled] pornography use trended downward for men and remained low and unchanged in women. Collectively, these results suggest that many fears about pornography use during pandemic-related lockdowns were largely not supported by available data.”
Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at firstname.lastname@example.org.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.