Since then, some clinicians have taken a more rehabilitative approach and have even crafted new diagnostic models. Tal Croitoru, MSW/MBA, places "porn addiction" in the same category as PTSD and has been pioneering EMDR (eye movement desensitization and reprocessing) with her patients -- undoing "porn trauma" by watching the traumatizing videos and reprocessing them -- and she has reported positive results. Others promote an extinction training or cognitive behavior therapy approach (even through an online program) to stop the mental "reruns" of pornography and ultimately replace those images with more appropriate ones.

Still, for some of us, porn's most significant disruption is the wedge it creates between us and our intimate partners. In recognition of this, some psychotherapists have provided narratives of successful couples-based approaches to treatment.

In her book The Men on My Couch, Dr. Brandy Engler describes how Casey suffered a "fractured sexual identity" in his relationship with his girlfriend Amy because his porn-inspired fantasies felt like a betrayal to her -- so he hid them. Dr. Engler helped the pair untangle their abstracted associations of love with sexual fantasy, allowing Casey to shed his shame and Amy to explore eroticism.

Some critics of the porn addiction model frame behavioral addiction treatment and psychotherapy as being at odds with one another. Robert Weiss, LCSW, an international sex addiction expert and the founder of the Sexual Recovery Institute, strongly disagrees.

Weiss explained to me that traditional addiction treatments like cognitive behavior therapy with social group-based support and accountability have clearly proven effective for curbing undesirable behavior. Which he thinks is a necessary first step. "Many of my patients don't have the ability to look at childhood problems. Addiction treatment gets people ready for psychotherapy." Perhaps more distressing, Weiss has seen patients who had been in psychotherapy only, without any behavioral intervention, who had gotten fired or divorced during therapy because they hadn't reined in their destructive porn habits.

Learning all this was making me feel less self-conscious with my own significant other about my predilection for kink and occasional issues with delayed ejaculation. She should be my partner in overcoming my shame, not the judge and jury.

Talking about porn

As this gets more attention, hopefully researchers will study all kinds of treatments. But for now, the one thing that everyone agrees on -- from Reddit's fapstronauts to sex therapists -- is that talking about it helps.

On an episode of Gary Wilson's "Your Brain in the Cybersex Jungle" radio show, Wendy Maltz discussed the importance of breaking the silence on porn addiction:

The main thing is overcoming shame and coming out of isolation. Find someone to talk to -- it could be a therapist, it could be a friend, it could be a relative, it could be a spouse or a partner. If that feels like too scary a step, back up a bit and just educate yourself about today's pornography. It's really different than the Playboy magazines of the past. Education reduces the shame. You realize you're not alone and that this is a new phenomenon.

Although learning about porn addiction and finding a community to talk about it with has been liberating for some, the shame -- that goes to the heart of commonly held notions of gender roles and sexuality -- has kept many quiet. This was one response I got from a reader who watched porn like S&M, Diaper, and Furry: