Pressure to Abstain From Porn Use May Mean Mental Distress

Source: Tumisu/Pixabay

Online groups promote an intervention strategy known as “rebooting” to overwhelmingly male audiences, recommending that they refrain from masturbation or viewing of pornography for at least 90 days, in order to “reboot” their sexuality. This intervention emerged from an unscientific tradition in "sex addiction" treatment, where individuals seeking treatment were encouraged to be fully sexually abstinent for at least three months to demonstrate a commitment to sexual self-control before resuming healthy sexuality.

New Study of "Reboot" Treatments

When applied to abstinence from masturbation and pornography, this period of abstinence is referred to as “rebooting,” evoking the idea that the human brain and sexuality are like a computer, where rebooting clears harmful or destructive material and restores it to original patterns. Of course, the brain doesn’t work like this, and it isn’t a computer. Now, a new quantitative study of these treatments and online electronic forums where this reboot intervention is promoted reveals that this intervention seems to be potentially harmful.

The researchers found that rebooting in these groups is generally defined as “not allowed to masturbate under any circumstances (no edging). Absolutely no deliberate viewing of pornography or anything close to it…unless if it is sex with someone [you] actually care about (no booty calls or casual sex).” Such abstinence is promoted in these groups as a cure for erectile dysfunction, a way to increase penis size, and a cure for "pornography addiction," a disorder not recognized by any medical body. Past research by Yaniv Efrati found that setting abstinence from masturbation as a goal may paradoxically increase thoughts of it, and a spiral of anxiety and shame.

The new study is titled “Iatrogenic Effects of Reboot/NoFap on Public Health: A Preregistered Survey Study,” and it is published in the journal Sexualities. Iatrogenic effects describe “healer-caused” harm from treatments. Iatrogenic infections, for instance, may refer to acquiring an antibiotic-resistant staph infection when receiving surgery. In the case of this research, the researchers found that people who pursued abstinence from masturbation and pornography use experienced negative emotional and sexual effects from the rebooting intervention.

Other research has found that these online discussions of semen retention and masturbation abstinence are much less medically accurate, compared to other online discussions of men’s sexual health, and are least likely to have actual medical professionals participating.

In this new research, 587 men completed a survey assessing effects and experiences of participating in Reboot discussions and efforts; 74 percent of the men were heterosexual, and 65 percent were white. While these demographics indicate some constricted diversity, these reflect the limited diversity in people who participate in these forums, as other research has found these groups are overwhelmingly populated by men from conservative backgrounds.

Almost 30 percent of participants reported that they had experienced thoughts of suicide that they attributed to the “relapse” or failure at efforts to maintain abstinence, as defined by the reboot program. The more these individuals participated in these online groups, the worse they felt when they relapsed, and the more likely they reported having been told to hurt or kill themselves in these online forums, in response to a relapse.

Increased Sexual Dysfunction, Depression, and Anxiety

In contrast to the stated goal of rebooting to “cure” erectile dysfunction, data in this research indicated that higher levels of participation in these online groups predicted higher levels of sexual dysfunction. In addition, more participation in online abstinence groups correlated with increased levels of depression and anxiety and less likelihood of seeking medical care from licensed professionals to treat these problems. Importantly, this did not appear to be due to the fact that people with more severe problems were more involved in therapy. Studies of other online support groups and programs find that more participation generally predicts fewer symptoms.

Participants who identified themselves as “addicted to pornography” were more likely to experience erectile dysfunction and higher anxiety, but were also more narcissistic. The finding regarding the role of narcissism in this self-identification is relatively novel. It raises questions about whether self-labeling as an “addict” may be attractive to Reboot participants because they believe that they are the “elite” and have special insight or knowledge that others do not have.

Framing as a Masculinity Challenge

Abstinence reboot interventions in these groups are promoted by nonlicensed “coaches” and advocates, who are themselves self-identified porn addicts who report that reboot improved their own sexual health. These coaches and group discussions put intense pressure and value on succeeding in abstinence. Achieving abstinence in reboots is “framed as a masculinity challenge, where failure means you are not a [heterosexual] man deserving of a sexual relationship.”

Pornography Essential Reads

Treatments for Problematic Pornography Use

Do Accessibility and Anonymity Lead to Problematic Porn Use?

Because failing in achieving abstinence is portrayed as being a failed man, these group discussions contain high levels of anger toward groups seen as “causing” these failures. Threats to masculinity are, unfortunately, often responded to with violence and threats of violence by men. In these forums, the researchers found extraordinarily violent posts and comments, including threats to murder or mutilate people who produce or distribute pornography, as well as comments suggesting that women who tempt rebooters to “relapse” deserved murder and/or rape. Of the participants who visited these forums, about one in five reported witnessing such homicidal threats.

Belief in Conspiracy Theories

Exploratory analyses in this research found that participants in these abstinence groups report higher levels of belief in conspiracy theories, including ideas that the pornography industry is controlled by a secret Jewish organization with the intent to affect reproduction by white men. The forums appear to frequently include the phrase “deus vult,” a modern-day call to kill Muslim and Jewish persons. Rebooters and their coaches also endorsed the false belief that pharmaceutical companies secretly conspire to promote online pornography to create sexual dysfunction in men, increasing sales of medications that treat erectile dysfunction. Past research found erectile function in this group actually is unrelated to pornography viewing.

Given the highly polarized and contentious nature of these online groups, the researchers were careful to preregister the research, their planned analyses, even their analytic code, and their hypotheses. Preregistration of research is a modern way to assure research transparency and ethics. Nevertheless, participants in these online abstinence groups openly attempted to sabotage the research, block participants from participating, and limit information about the research. In some cases, the researchers received personal threats from moderators of these online groups. To get around the resistance to forum readers learning about the research opportunity, the researchers directly advertised to the groups using paid ads.

The behavior toward this research parallels the threatening, violent, polarized dynamics which, in this research, appear to drive the iatrogenic harm from participating in the groups. As a result, these attacks on the research serve as an unexpected form of replication of the unhealthy dynamics associated with these forums. After the research was published, these groups began to attack the research, with comments and responses that invoke the themes identified above, further replicating the research. A few of the comments were:

"remember, the fight is hard, it involves a demonic and billionaire industry, these fake news are paid with money from the porn industry, the effects of abstaining from porn and masturbation is just the opposite, we all know it, let's pray that more scientific research is done to destroy this evil industry once and for all"

"The pharmaceutical companies want all men on PE pills"

"They want world full of feminism, stay strong my brother's."

Of course, there were some individuals who did not report negative experiences or negative emotional outcomes associated with participating in these groups. It is currently unclear to what extent the particular groups, or the reboot approach they promote, may or may not be harmful. However, the more people reported participating in the online groups, the more likely that they experienced harms.

Clinically, this research suggests that clinicians should consider discouraging individuals who want to control or limit their pornography use from participating in reboot forums. A licensed clinician who refers individuals to these groups may be concerned about potential malpractice, in recommending a harmful, damaging intervention. Individuals who are participating in these forums and experiencing anxiety, distress, suicidal ideation, or sexual dysfunction should consider ceasing participation and seeking treatment from licensed health care providers.