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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 101-103

Mindfulness-based interventions: Potentials for treatment of pornography


1 Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
2 Department of Integrative Medicine, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
3 Division of Yoga and Life Sciences, S-VYASA, Bengaluru, Karnataka, India
4 Department of Physiotherapy, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Date of Submission05-Jan-2022
Date of Acceptance21-Jan-2022
Date of Web Publication29-Jun-2022

Correspondence Address:
Manoj Kumar Sharma
Department of Clinical Psychology, NIMHANS Centre for Well-Being, SHUT Clinic (Service for Healthy Use of Technology), National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AYUHOM.AYUHOM_3_22

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How to cite this article:
Sharma MK, Kumar A, Bhargav H, Bhat R, Anand N, Digambhar V, Menaria S. Mindfulness-based interventions: Potentials for treatment of pornography. AYUHOM 2021;8:101-3

How to cite this URL:
Sharma MK, Kumar A, Bhargav H, Bhat R, Anand N, Digambhar V, Menaria S. Mindfulness-based interventions: Potentials for treatment of pornography. AYUHOM [serial online] 2021 [cited 2022 Nov 27];8:101-3. Available from: http://www.ayuhom.com/text.asp?2021/8/2/101/348857



The past few decades have witnessed an increased use and acceptance of pornography.[1] The market for pornography has been progressively increasing with the advancements in information and communication technology.[2] The accessibility, affordability, and anonymity of Internet pornography have made it a powerful force in the area of sexuality.[3],[4] The self-report studies carried out in the US (n = 2,075)[5] and Polish (n = 1036)[6] samples showed that 9%–11% of adult men and around 3% of adult women expressed acknowledgment with the statement “I am addicted to pornography.” The inability of the user to regulate the consumption of pornography characterizes pornography addiction and is associated with a variety of negative emotional, cognitive, and behavioral outcomes such as anxiety, depression, social isolation, relationship problems, a decline in work performance, etc.[7] Given the cost involved in pornography addiction, the problem contributes to a substantial financial burden. Thus, studying this phenomenon and coming up with effective interventions is essential. The double spiral model of pornography addiction suggests that integrated psychotherapies such as acceptance and commitment therapy (ACT) and mindfulness-based relapse prevention (MBRP) can be used for the management of addictive behaviors.[3] However, there have been only a few studies on a better understanding of mindfulness and pornography. Guided by the preferred reporting items for systematic reviews and meta-analyses model, we searched for peer-reviewed English language publications indexed in PubMed, Google Scholar, Scopus, and ResearchGate using the keywords “mindfulness, internet use, and pornography.” The search was conducted from January 2011 to February 2021. Studies that were mixed methods or qualitative were excluded. The reference list of primary retrieved articles was screened to identify any relevant articles for inclusion in the synthesis. Out of 18 articles that were retrieved initially, 11 articles that met inclusion were included after removing duplicates.

Data were extracted on broad categories of (1) dispositional mindfulness, (2) metacognitive awareness, and (3) mindfulness as a treatment modality.


  Dispositional Mindfulness Top


Mindfulness is nonjudgmental awareness of thought and attention to moment-by-moment cognition, emotion, and sensation without fixation on thoughts of past and future.[8] Dispositional mindfulness is a trait-like feature that expresses in terms of one's predisposition to be mindful in daily life. Research shows that individuals with dispositional mindfulness display less problematic pornography use, and such an association was mediated through emotion regulation in a group of partnered individuals and long-term single individuals.[9] In another study, examining the role of dispositional mindfulness in the relationship between compulsive sexual behavior (CSB) and shame among men diagnosed with substance use disorders, it was found that males with low levels of dispositional mindfulness were more likely to experience shame when engaging in CSB, which will affect the treatment outcome of substance use disorder.[10] This is a significant finding as shame promotes emotional avoidance and aggression and contributes to maladaptive behavior for externalization.[11] Greater mindfulness and self-compassion often attained through frequent mindfulness meditation was resulting in reduced shame proneness.[12]


  Metacognitive Awareness Top


Metacognition is defined as any cognitive process that is involved in the appraisal, monitoring, or control of cognition.[13] Research indicates that problematic pornography use is characterized by a predominant urge for behavioral engagement, referred to as craving,[14] which is influenced by voluntary engagement in cognitive elaboration (i.e., desire thinking such as “I need to think about viewing pornography to avoid feeling overwhelmed.”) These clients have appraisals about the uncontrollability of behavior-related thoughts such as “when I begin thinking about viewing pornography I cannot stop.” This makes even more difficult to distance from engaging in pornography. Metacognitions influence desire thinking because they reflect either positive or negative information that an individual has about their own desire thinking processes.[15] The perseveration of desire thinking through positive and negative metacognitions leads to escalation of craving henceforth maintaining pornography.[15] Mindfulness practices enhance an individual's metacognitive awareness about craving and interrupt the automatic processes involved in the maintenance of undesired behavior.[16]


  Mindfulness as an Intervention Top


The meditation awareness training (a third generation of behavioral intervention) resulted in improvements in addictive behavior along with other outcomes such as reduction in depression, emotional distress, etc.[17] Similarly, studies showed that participants who meditated regularly showed reductions in viewing pornography, less time spent ruminating over pornography, and experienced less guilt and shame.[18] MBRP is recognized as an effective intervention treating addictions.[19] A pilot study found that after 8 weeks of MBRP, men seeking treatment for CSB disorder reported less anxiety, depression, and obsessive‒compulsive disorder along with less time spent viewing pornography.[20] Mindfulness promotes emotional well-being, which brings a reduction in the factors associated with pornography use.[21] ACT which utilizes the principles of mindfulness such as acceptance and present moment awareness can become a potential therapy for the treatment of pornography addiction than traditional models like cognitive behavior therapy.[7] In a study conducted among 6 Caucasian males reporting problematic pornography viewing, 8 sessions of ACT resulted in a significant reduction in porn viewing, which was maintained at a 3-month follow-up.[22]

Mindfulness is about being in the present moment with whatever arises including uncomfortable or stressful experiences. The present work documents the role of the presence of dispositional mindfulness results in high psychological flexibility and self-regulation which is antidote to negative emotional states and pornography-related rumination; henceforth, the trait of being mindfulness will facilitate alternate value-based behaviors than addiction to porn. Mindfulness-based therapies have emerged as a promising approach to treat addictions, including pornography addiction.[20] The neurobiological shreds of evidence show that MBRP affects both bottom-up limbic-striatal brain circuitry and top-down prefrontal networks serving metacognitive attentional control implicated in substance addiction disorder.[23] Similar mechanism may be applicable to understand pornography use. Future studies can also explore the underlying neurobehavioral mechanisms of pornography consumption reduction following MBRP, as well as other psychosocial interventions such as cognitive behavioral therapy, ACT, motivation enhancement therapy, or emotion-focused therapy to validate treatment protocol for the management of pornography addiction.

Dispositional mindfulness results in high self-regulation which is antidote to negative emotional states and pornography-related rumination; henceforth, being mindfulness will facilitate alternate value-based behaviors than addiction.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kor A, Zilcha-Mano S, Fogel YA, Mikulincer M, Reid RC, Potenza MN. Psychometric development of the Problematic Pornography Use Scale. Addict Behav 2014;39:861-8.  Back to cited text no. 1
    
2.
D'Orlando F. The demand for pornography. J Happiness Stud 2011;12:51-75.  Back to cited text no. 2
    
3.
Chisholm M, Gall TL. Shame and the X-rated Addiction: The role of spirituality in treating male pornography addiction. Sex Addict Compulsivity 2015;22:259-72.  Back to cited text no. 3
    
4.
Cooper A. Sexuality and the Internet: Surfing into the New Millennium. CyberPsychology & Behavior1998; 1(2):187-193.  Back to cited text no. 4
    
5.
Grubbs JB, Kraus SW, Perry SL. Self-reported addiction to pornography in a nationally representative sample: The roles of use habits, religiousness, and moral incongruence. J Behav Addict 2019;8:88-93.  Back to cited text no. 5
    
6.
Lewczuk K, Glica A, Nowakowska I, Gola M, Grubbs JB. Evaluating pornography problems due to moral incongruence model. J Sex Med 2020;17:300-11.  Back to cited text no. 6
    
7.
Fraumeni-McBride J. Addiction and mindfulness; pornography addiction and mindfulness-based therapy ACT. Sex Addict Compulsivity 2019;26:42-53.  Back to cited text no. 7
    
8.
Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. IInd ed,Random House Publishing Group, New York, United States 2013.  Back to cited text no. 8
    
9.
Pepping CA, Cronin TJ, Lyons A, Caldwell JG. The effects of mindfulness on sexual outcomes: The role of emotion regulation. Arch Sex Behav 2018;47:1601-12.  Back to cited text no. 9
    
10.
Brem MJ, Shorey RC, Anderson S, Stuart GL. Dispositional mindfulness, shame, and compulsive sexual behaviors among men in residential treatment for substance use disorders. Mindfulness (N Y) 2017;8:1552-8.  Back to cited text no. 10
    
11.
Gilliland R, South M, Carpenter BN, Hardy SA. The roles of shame and guilt in hypersexual behavior. Sex Addict Compulsivity 2011;18:12-29.  Back to cited text no. 11
    
12.
Woods H, Proeve M. Relationships of mindfulness, self-compassion, and meditation experience with shame-proneness. J Cogn Psychother 2014;28:20-33.  Back to cited text no. 12
    
13.
Flavell JH. Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry. Am Psychol 1979;34:906-11.  Back to cited text no. 13
    
14.
Kraus S, Rosenberg H. The pornography craving questionnaire: Psychometric properties. Arch Sex Behav 2014;43:451-62.  Back to cited text no. 14
    
15.
Caselli G, Spada MM. Desire thinking: What is it and what drives it? Addict Behav 2015;44:71-9.  Back to cited text no. 15
    
16.
Li W, Howard MO, Garland EL, McGovern P, Lazar M. Mindfulness treatment for substance misuse: A systematic review and meta-analysis. J Subst Abuse Treat 2017;75:62-96.  Back to cited text no. 16
    
17.
Van Gordon W, Shonin E, Griffiths MD. Meditation awareness training for the treatment of sex addiction: A case study. J Behav Addict 2016;5:363-72.  Back to cited text no. 17
    
18.
Sniewski L, Krägeloh C, Farvid P, Carter P. Meditation as an Intervention for Men with Self-Perceived Problematic Pornography Use: A Series of Single Case Studies. Current Psycholology 2020.  Back to cited text no. 18
    
19.
Blycker GR, Potenza MN. A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder. J Behav Addict 2018;7:917-29.  Back to cited text no. 19
    
20.
Holas P, Draps M, Kowalewska E, Lewczuk K, Gola M. A pilot study of mindfulness-based relapse prevention for compulsive sexual behaviour disorder. J Behav Addict 2020;9:1088-92.  Back to cited text no. 20
    
21.
Reid RC, Bramen JE, Anderson A, Cohen MS. Mindfulness, emotional dysregulation, impulsivity, and stress proneness among hypersexual patients. J Clin Psychol 2014;70:313-21.  Back to cited text no. 21
    
22.
Twohig MP, Crosby JM. Acceptance and commitment therapy as a treatment for problematic internet pornography viewing. Behav Ther 2010;41:285-95.  Back to cited text no. 22
    
23.
Witkiewitz K, Lustyk MK, Bowen S. Retraining the addicted brain: A review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention. Psychol Addict Behav 2013;27:351-65.  Back to cited text no. 23
    




 

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