In 2014, Mahesh* was an average techie living in Bengaluru. He had been married for two years and was leading a normal life with his wife. He even had a 7-month-old baby. But he had one problem - the habit of watching porn excessively. For a few months then, he was not able to give enough time to his wife and newly born, leading to conflicts in the family. Despite a healthy sex-life with his wife, he was not able to control his urge to watch porn.
Later that year when things came to a flashpoint, Mahesh started asking himself, was he addicted to porn? Was it a medical or a psychological problem? That’s when he decided to visit the Service for Healthy Use of Technology (SHUT) clinic at the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru.
“That was the first case in which the patient himself came to us to get himself ‘treated’ for this problem”, says Dr Manoj Kumar Sharma, Additional Professor at SHUT.
The SHUT clinic was an idea born out of a study on behavioural addiction in Bengaluru, funded by the Indian Council for Medical Research. Dr Sharma and three other doctors were a part of the study, and it is during that study that the idea emerged that a clinic like SHUT, which exclusively deals with addiction to technology, was required. “Through the study, we found out that 4-7 % of the respondents were behavioural addicts to technology related activities like watching porn, gambling, shopping and many more” says Dr. Sharma, who has been one of the primary innovators of SHUT clinic which deals with addiction to technology. After the ICMR study was completed, Dr. Sharma and his colleagues proposed the idea to NIMHANS and SHUT was thrown open in August 2014.
In the past one year, Dr Sharma has attended to over 60 cases of technology addiction, of which 7 involved porn addicts or those at the risk of becoming one. And as the word spreads about the clinic, they are getting more cases of technological behavioural addiction, including addiction to porn.
Dr. Sharma says that almost all his patients belonged to the middle or higher socio-economic strata and in most cases the patient was the parent's only child. “It is likely possible that the pampering and demands that are fulfilled by the family, the child tends to use technology and is eventually exposed to porn.”
Representational picture. Image: By Irais Esparza via Wikimedia Commons
Unlike other types of addiction, the dependence on porn has to be dealt with differently. Dr. Prabhat Chand, Associate Professor of Psychiatry, Center for De-Addiction Medicine at NIMHANS, says that porn addiction comes under behavioral addiction, which means that the person is not addicted to any substance which is the case in tobacco or alcohol addiction.
Dr Prabhat also says that there is no global definition of porn addiction and that those who come to them, come with a secondary problem like internet addiction. “Porn addiction can be a problem, but not until it starts affecting other parts of a person’s life,” he says.
There is no global definition for porn addiction, but Dr Sharma believes it involves four steps, the 4 Cs - Craving, loss of Control, Compulsion and Consequences.
The first step is when the person has developed a craving to watch porn. Next, the person finds it difficult to control the habit. In some cases, a person watching porn might feel guilty about it but to overcome that guilt he might watch more porn, the habit becoming a vicious cycle. After this, watching porn becomes a compulsion for the person. The person might even replace their daily chores with watching porn. Finally, the consequences of porn-addiction become visible. The person might become aggressive and it would start affecting their sexual life, like increased masturbation or reduced stimulation with partner.
The treatment procedure differs from case to case. Sometimes treatment may end within a month or it could even go on for 6 months with high frequency of sessions.
The procedure at SHUT usually begins with a clinical assessment where they try to find out the intensity of the person’s addiction. They assess time spent in watching porn, pattern of use and nature of dysfunction. “Here we simply try to quantify the person’s addiction, if at all”, he adds.
Next, psycho-education follows. In this step the person is informed about his habits. “We do not give them any advice. We simply inform them about their habits and this is a non-directive approach. This way we give the patient all the right to decide on the future course of action.” In most of the cases, the patient agrees that they wish to change and this willingness boosts the treatment procedure in a positive way.
The treatment to the porn addiction involves counselling sessions, there is no medication or any other procedure involved. Sometimes, even the parents are involved as co-therapists, but that happens only if the parents know of the addiction, and the patient and parents are willing to get through it together. The doctors encourage the patients to replace their porn-watching time with other activities, like family walks or other outings. They advice life-style change and motivate the patient to step out of the addiction.
But treating porn addiction is not easy, and there can be no assured success.
In the case of Mahesh, he came forward willingly and made efforts towards treatment, as a result of which he is now leading a happy life. But not everyone’s treatment ends like that.
Dr Manoj Kumar Sharma at SHUT in NIMHANS
Dr. Sharma recalls a case where a single child who was also an emotionally unstable person, was unable to get rid of his porn addiction. “This B.E student from Bengaluru was so addicted to porn that he used to spend 7-8 hours watching porn. When his parents brought him to us, even he acknowledged the fact that his addiction could spoil his life and career as he was not searching for a job after his degree,” says Dr Sharma.
When Dr Sharma began his treatment, the student was doing quite well. “He willingly disconnected his internet and also replaced his smart-phone with a older one with no internet connection. Within a month, he showed tremendous improvement and his parents seemed to be happy about it. However after a month due to his unstable emotional psychology he reacted overly to a small family fight and in reaction to it, he resumed watching porn.” Dr Sharma says this case did not work for him but they are still in touch with his family who are trying to fix things for their only son.
The doctors at SHUT are now trying to increase awareness and encourage people to come in if they feel they need help.
The ‘menace’ of porn has also grabbed the attention of the Indian government, so much so that recently the government ordered all Internet Service Providers to block more than 800 pornographic websites across the country, making it a offence for any ISP to violate the order. It was after instant public backlash that the government restricted the order to child-porn content. But the government maintained that watching porn were causing real problems in the society.
Will a national ban on porn help people with addiction? Dr Sharma was quick to respond, “Just like in a dry state where ban on alcohol only means that it will be available in the black market, ban on porn will only mean that people might most likely shift the focus from visual sexual content to other sources like may be text.” He also says that instead of banning porn, technology literacy and sex education can help in a far better way