The perspectives of mental health professionals on problematic pornography use

Abstract

This study explored mental health professionals’ perspectives on problematic pornography use (PPU), how they work with this issue in therapy, and any challenges encountered. Six semi-structured interviews were carried out with professionals trained in different areas such as family therapy and psychotherapy. These were analysed using Reflexive Thematic Analysis. Five themes were identified: ‘conceptualisation of problematic pornography use’, ‘the presentation of problematic pornography use in therapy’, ‘approaches to treatment’, ‘guilt, shame, and the Maltese context’, and ‘the personhood of the therapist’. Participants conceptualised PPU as a behaviour which interferes with daily functioning, leading to psychological distress and a disruption in relationships. Moreover, the framework in which professionals conceptualise PPU impacts how they intervene. Results describe how PPU can cause feelings of shame, especially given the Maltese context. In the light of this, therapy involved going beyond behavioural interventions and including working with underlying shame and how it relates to the person's culture, values, sexuality, and pornography use. The findings emphasise the importance of the personhood of the therapist. Reflecting on how one’s shame, context, and experiences of sexuality and pornography can influence their work with clients is crucial. Moreover, the area of sexuality and PPU need to be given more importance in the training of professionals and continuous professional development.