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Though porn is not diagnosable, and never has been, there is a large industry surrounding the concept. Mostly online (though in religious areas, such as Utah, there are numerous in-person treatment sites), this industry promotes the idea that modern access to the Internet, and the porn that thrives there, has led to an epidemic of dysregulated, out-of-control porn use, and significant life problems as a result.

Over recent years, numerous studies have begun to suggest that there is more to the story than just porn. Instead, we’ve had growing hints that the conflicts and struggles over porn use have more to do with and religion, rather than itself. I’ve covered this surge of research in numerous posts and articles.

Now, researchers have put a nail in the coffin of porn addiction. Josh Grubbs, Samuel Perry and Joshua Wilt are some of the leading researchers on America’s struggles with porn, having published numerous studies examining the impact of porn use, belief in porn addiction, and the effect of porn on marriages. And Rory Reid is a UCLA researcher who was a leading proponent gathering information about the concept of disorder for the . These four researchers, all of whom have history of neutrality, if not outright support of the concepts of porn addiction, have conducted a meta-analysis of research on pornography and concluded that porn use does not predict problems with porn, but that does.

The researchers lay out their argument and theory extremely thoroughly, suggesting that Pornography Problems due to Moral Incongruence (PPMI) appear to be the driving force in many of the people who report dysregulated, uncontrollable, or problematic pornography use. Even though many people who grew up in religious, sexually conservative households have strong negative feelings about pornography, many of those same people continue to use pornography. And then they feel guilty and ashamed of their behavior, and angry at themselves and their desire to watch more.

In the early 1990’s, as the internet burst upon the world's screens, Al Cooper was a psychologist who suggested that the Affordability, Anonymity, and Accessibility of the internet was leading to an explosion of porn addiction. Though intuitively appealing and often cited, Cooper’s theory was only empirically evaluated once, in 2004, when it was found that the variables of accessibility, affordability, and anonymity actually had no empirical connection sexual behaviors, change, or use of Internet porn. But what the Internet did was to put porn in the hands of people woefully unprepared to manage it or their sexual desires. Religiosity is associated with a host of sexual difficulties; porn-related problems can now be added to that list.

In their study, Grubbs, et al., analyzed data from about 15 different studies by varied researchers (and reviewed many more), comprising nearly 7,000 different participants. Studies were conducted in-person and online, in the United States and Europe. The team found that, first, religiousness was a strong, clear predictor of moral incongruence regarding porn use. This is important, as it indicates that we can and should use a person’s religiousness as an indicator of the likelihood of moral conflict over porn use. Not all people who are morally opposed to porn are religious, but it appears that religiosity captures the majority of people who feel this way. Given that the WHO and ICD-11 recommend an exclusion of moral conflict over sex from the diagnosis of Compulsive Sexual Behavior Disorder, this finding suggests that when diagnosing CSBD, a person’s religiousness is a critically important factor.

Secondly, and more to the point, the meta-analysis found that “[M]oral incongruence around pornography use is consistently the best predictor of the belief one is experiencing pornography-related problems or dysregulation, and comparisons of aggregate effects reveal that it is consistently a much better predictor than pornography use itself…” The analysis did find small effects between use of pornography and self-perceived problems with pornography, but the researchers suggest that this is likely an artifact of the simple fact that, in order to feel morally conflicted over your use of porn, you actually have to use some porn. If the concept of were true, then porn-related problems would go up, regardless of morality, as porn use goes up. But the researchers didn’t find that. In fact, they cite numerous studies showing that even feeling like you struggle to control your porn use doesn’t actually predict more porn use. What that means is that the people who report great anguish over controlling their porn use aren’t actually using more porn; they just feel worse about it.

Having moral conflict over your porn use (PPMI) does turn out to be bad for you. But that's not because of the porn. Instead, higher levels of moral conflict over porn use predict higher levels of , , , and diminished sexual well-being, as well as religious and struggles. In one study by Perry and Whitehead, pornography use predicted depression over a period of six years, but only in men who disapproved of porn use. Continuing to use porn when you believe that it is bad is harmful. Believing that you are addicted to porn and telling yourself that you're unable to control your porn use hurts your well-being. It's not the porn, but the unresolved, unexamined moral conflict.

Even though Grubbs et al. left the window open, acknowledging that there may be people who report porn dysregulation without a moral conflict, and that there also may be people who actually demonstrate objectively dysregulated porn use and have moral conflict over it — in other words, they feel bad about it and they are actually using a lot of it — neither of these two data patterns appear to occur in the studies and participants they analyzed. Instead, across all of these studies, which would surely include these two groups if they existed, the statistically significant finding is that it’s not porn use itself which creates porn addiction, and that it is the use of porn by people with moral conflicts about it that fuels modern porn-related issues.

I will add something to the arguments made by the authors of this study: Having demonstrated that it is the moral conflict and self- of porn addict which is harmful, it is thus upon us to confront the social, media, and clinical use of this concept. It causes and perpetuates harm by focusing upon porn rather than the true cause: the moral conflict over one’s sexual desires. Clinicians who continue to promote the idea of porn addiction are, like those who promote age- or recovered memory therapy, engaging in malpractice. Websites and advocacy groups that promote and encourage identification as porn addicts are doing harm to their followers, and can become like the hucksters promoting naturopathic treatment despite federal medical groups identifying such treatments as ineffective and potentially harmful. Ultimately, all should be held accountable for their inaccurate, outdated, and exploitative actions.

It is noteworthy that in this research, and in the numerous commentaries in response, no one is defending the porn-addiction model. None of the researchers looking at data on porn-related problems have chosen to argue that an addiction model or treatment strategy is appropriate. To be sure, some researchers still defend a compulsive model, or suggest that pornography itself is too broad a concept to be neatly captured by a single theory. The editors of the Archives of Sexual Behavior invited commentaries on this article only from researchers, who must argue based on science, as opposed to anecdote. None of them argue that porn is addictive, that it changes the brain or one's , or that the use of porn leads to tolerance, withdrawal, or other addiction-related syndromes. Put simply, while the nuance of porn-related problems is still being sussed out, the idea that porn can be called addictive is done, at least in the halls of sexual science.

Clinically, what these findings mean is that instead of assessing porn use in people who seek help for porn-related issues, clinicians and therapists should be assessing a person’s moral attitudes toward porn, as well as their level of religiosity. In , instead of trying to change people’s porn use patterns, we should instead be focused on helping them make their values and behaviors congruent, and learning to understand and recognize the impact of their moral beliefs. This conflict between morality and sexual behaviors may be resolved by changing one’s sexual behaviors or by changing one’s values or simply by helping people become conscious and mindful of this internal conflict.

Many of the moral values we were raised with, about sex, race or , are no longer fully applicable to the modern world. Because of religious opposition to sexual , many people struggling with don’t understand what is normal, or that their sexual interests are healthy. Helping people to consciously examine and consider their religious beliefs about sex, masturbation, and porn with modern, adult, self-determining eyes, may help them reduce the pain and suffering caused by this moral conflict.