Client GK was a man in his thirties who came to see me regarding addiction to porn. He stated that he used porn somewhere from two to six times per day. In addition, he felt his pornography preferrence was now become increasingly bizarre and taboo in nature and was uncomfortable with the direction his preferences were moving towards.

GK stated that he wanted to be able to use pornography in a healthy manner (once or twice per week). He also wanted to be able to manage his kinks which were centered around BDSM and dominatrix fetishism. At this point he felt he had lost control over his pornography use. 

This case is useful for anyone who would like more information about how I approach:

• Pornography Addiction.
• Idealisation of shame and being shamed.
• Fetishism understanding and control.
• Addiction in general. 
• Improving self esteem.

For our initial session I spent some time gaining some understanding of GK as a person as well as some insight on the nature of his addiction.

GK stated he viewed pornography several times per day nearly always relating to BDSM, domination and shame. When asked why he said he enjoyed the feeling of being controlled by a woman and wanted them to humiliate him. I asked him why he might want them to do that, he replied that he didn’t know but he nevertheless had an attraction towards these ideas.

I asked GK if these fetishes were acted out with his wife (named BK). He said no, as he didn’t like the idea of her preforming such acts and didn’t want to have have her associated in his mind with pornography. When asked why he said that he didn’t like the idea of her doing that to him and already felt criticized enough by her. He wanted the woman to shame him to be different each time. I asked him if he would like to feel differently about this association. He said no, at this point he would rather just not have the fetishism. In terms of sex with his wife he wanted to be more satisfied with more vanilla encounters. It was clear there was a wide separation between his desired sex life and the sex life he had with his wife.

GK mentioned his wife BK had threatened to leave many times, including saying she would leave him if the therapy with myself was a failure. GK said her behaviour was understandable given how many times he had broken her trust and let her down. 

GK stated that he had lost interest in having sex with his wife some time ago as their sex was not satisfying his kinks. In turn she had become somewhat reluctant to engage with GK after discovering about his fetishes and sexual behaviour. At one point GK had frequented a prostitute to perform some such kinky acts with him. GK’s wife had found out about this some time later and confronted GK. As a result the relationship between them was becoming increasingly strained. In addition these fetishisms had become known by members of his and her family/ friends and the embarrassment of the situation had caused further strain on their marriage. After talking further we agreed that if he didn’t discountinue his use of pornography then his wife would most likely leave him in the coming year. GK said he wanted to avoid this if at all possible.

Please note: I have no judgement or opinion on a client’s fetish and I understand that fetishism is a mechanism outside of conscious control. It is in many ways a manifestation of the subconscious mind and whilst it can be managed, it cannot be ignored. We do not get to choose what we are attracted to. I am however also aware that most people do not view fetishism in such a manner. This can cause individuals with certain fetishism to have social, cultural and familial issues which may need to be resolved. 

At this point we discussed the treatment plan and we outlined some goals GK could work towards.  These goals being to:

• Understand his pornography usage and the subconscious mechanism influencing his use.
• Reduce his pornography usage.
• Understand and manage his kinks.
• Repair his relationship with his wife as much as possible.
• Improve his career.
• Improve his self esteem.

We discussed his past use of pornography and where he believed these fetishes came from. Whilst not having a clear idea, GK stated he believed this kink came from an experience with an ex-girlfriend from his younger days. She had frequently been abusive to him and much of their sex revolved around some element of BDSM, shame and pleasure denial. GK stated he thought about this time a lot and although it had been an abusive relationship he had found his sex life to have been the most enjoyable with this ex. 

He also said that he had a friend of his sister who was older and frequently tied him up and would play fight with him. This was when he was around 7 years old. Whilst this was not a critical turning in his sexuality GK believed this may be influential. In addition, GK said he had slept with quite a lot of women throughout his life and he spent a great deal of time fantasizing about past sexual encounters with them. 

I asked if he would want a similar relationship with his wife as he did with his ex. He said no as it would hurt the relationship he had with his wife. In addition he was not happy in this past abusive relationship and was not interested in turning his relationship with his wife into something that resembled that abusive relationship. It was more the affect her behaviour had on his sex life that he missed, not the rest of the relationship. 

We further discussed his history with pornography. He has found some of his father’s porn at age 12 and whilst frightened was curious and his appetite for its use had been continuous since then. GK said there was no particular memorable moment with regards his use of pornography, although his mother had lightly scolded him a couple of times after finding his pornography. 

We then spoke about how GK’s pornography use was also tied to his self esteem, creating a continuous negative cycle. This started with him feeling aroused, using pornography, then feeling guilty in terms of its use, but taking some joy in breaking the taboo. This process affects his self image a  little. As he took some joy in using he will use again. Later on when GK becomes aroused again he will return to porn as he received some joy from it, thus starting the negative cycle again.  The more this pornography was supposed to be restricted to him, the more he craved it’s use, given that it breaks the taboo even more. 

I asked him if any sexual or physical assault had happened to him. He said no trauma of any real significance had happened whilst he was growing up. 

At this point we had talked for some time and I set him some homework in the form of a life wheel tool (this is a tool that looks at all areas of your life and helps determine which elements are the most important to work upon).and a goal orientation tool. 

In addition I asked GK to observe his pornography use this week. This being to record how many times he would used pornography over the course of the week as well as to identify what it was that he felt attracted to, writing it down in detail. I had some idea of what this was already but I wanted GK to really start thinking about his porn use and trying to manage it as a problem in his life, rather than simply something he did when he was bored. 

Finally, I had him start watching the first episode of Dr. Carran series on understanding addiction. This is the link if you are interested  https://youtu.be/-kpOod1xlb0

Upon our next session GK was in a positive mood. Having done the homework set, we went through each part. The life wheel measures several areas of the client’s life but for brevity sake we will focus on the areas GK wanted to improve the most. These being; his career (2/10), personal growth (3/10) and his relationship (3/10). He wanted all of these to be an 8/10 if possible. These would be the areas of his life we would first focus on working on.

In terms of notes about his pornography use GK identified the following points: 

• He found himself having the desire to use porn mainly when he was either angry at his wife, bored or disappointed about something. 
• He had felt more self aware of his kinks and started to find them stranger in nature.
• As a result he seemed a little less interested in the kinks (although he was still turned on by the same fetishes).  
• Having sex with his wife didn’t seem to help with porn use. He found himself thinking about porn whilst having sex with his wife. Also he said he has felt awkward having sex with her and could tell she did not find that she could relax during sex.  
• He was not particularly interested in initiating sex with his wife.

Throughout the last week it had become apparent to GK that his marriage was in far worse a state than he had previously thought. Whilst he did love his wife he felt distant and disconnected from her. His boredom of his sex life had lead to putting in little to no effort in maintaining their friendship and romance. 

At this point it became apparent that I would need to speak with GK’s wife BK and indeed after this session I scheduled to speak with her (I go on to work further with GK and BK in case eight with regards marital counselling). 

When looking through the goal orientation exercise, the key goals he listed were:

• To improve his relationship with his wife and have her be proud of him again.
• To feel like he is achieving something with his career and not wasting his time.
• To not be a slave to his pornographic usage.
• To improve his sex life. 
• To feel better about himself as a person.

After some discussion we decided that we would approach the problem on three fronts:

• To work on his relationship with SH and in particular  to work on rebuilding trust and respect between the two of them. In addition he would prioritize working on his friendship with her. 
• To minimise pornographic use and create a list of alternatives actions to porn use. Some examples being to: go on a short walk, do wim hof breathing (see breathing section of website), exercise, sex, playing an instrument, working on a skill etc. 
• When masturbating I advised GK to minimise his pornography use for some time (2 weeks) and to monitor its affect on his relationship and the attraction to his wife.
• To work on his physical health with an exercise routine and to work on his mental health in the form of a journal.

These goals were considered to be moderately difficult and achievable. GK was satisfied with this approach and endeavoured to work on these three items over the course of the week. 

GK returned having worked on the routine throughout the week. He described the routine as being good although he was still struggling to find the motivation to make changes as well. He suggested he had some success but not as much as he would have liked. He had watched porn several times and had found it very difficult to resist using. However in other areas of his life including his relationship he felt was starting to see some improvement. 

At this point it was important that we try to understand why GK had the fetishes he had, as well as how we were going to attempt to manage them. To do this we then spent some time discussing what most likely would have created his fetishism towards shame and abuse. After some discussion we agreed one of the reasons why GK was using pornography so frequently as well as why he wanted to be shamed was due to his poor self image and inability to accept himself as well as lack of responsibility taken to rectify the situation. GK stated he had spent much of his time feeling ashamed of himself but had never seen an alternative lifestyle that he would be comfortable living. 

As GK life had progressed he had become continuously motivated by short term pleasures and instant gratification. This could in some ways be attributed to his career choice. GK was a musician and had had some success in touring. During certain parts of his career the band he was touring with was selling out venues with relative ease. He had played to tens of thousands. At this time GK said he was on something on an emotional rollercoaster and greatly missed some of those highs. He had kept much of this thrill seeking nature and indulgent attitude from this time and felt motivated to get back to this same life in some form or another. This was of course never going to happen. Not that GK could not play to such numbers again, but the lifestyle was never going to be the same as he was older now. He was also married and had some health issues. Such unattainable goals had left GK in a state of depression along with the development of some narcissistic tendencies and bitterness. 

In addition, he had heavily used recreational substances during this time as well as slept with many women. GK said he often fantasized about the past and previous sexual encounters. When asked GK opening admitted to wanting to relive these days. He considered these  experiences to have occurred at a better time in his life. I asked if he had been happy at the time, he says he was conflicted and had struggled with himself, but having sex with woman and being high had been when he felt most comfortable. During this time he had been heavily abusing short term gratification to the point where he was prepared to ignore his self-respect and societal norms. His pursuit of pleasure had ultimately cost him many relationships and lost him many opportunities. 

There was a clear lack of self-actualisation done by GK over the years, which GK openly admitted to, stating he repeatedly made poor decisions and was often beareated for it. However arguably GH was not given any method so far of redeeming himself for his shame nor a path on how he should change. Criticism is not useful if it does not provide a possible and plausible alternative. He knew what he needed to do to be a good husband, but could not do it due to subconscious drivers

It was clear that this repeated need for self indulgences had left GK with some warped views on how to live and how to be happy. This may explain why GK fetishized shame. For example, in a scenario where a person is shamed for some manner the individual either has to accept the shame and admit to it, resolve the shame through debate or deny the shame to themselves and others. In the beginning an individual will try and resolve their shame. If this is not possible however they are forced into going into denial over the situation. This is because we are often further shamed if we admit to wrongdoing. In addition an acknowledgement of wrongdoing forces us to change and work harder on improving ourselves for others. Indeed, it is possible for a person to be in so denial over their behaviour that they refuse to accept it had occurred at all, even to themselves. I believed some semblance of this had manifested in GK personality. 

GK wife BK had shamed him many times over his use of porngraphy and his affair. GK of course did not want to make his wife unhappy, but at the same time could not alter the sexual fantasies he had. At first he had tried to deny his use and hide it from his wife. When he could no longer deny this was a problem BK had forced him to confront it by threatening to leave him if therapy didn’t work. This shame had become something GK was used to and even comfortable with to some extent. BK’s use of shame to motivate GK to change had been largely unsuccessful and in some ways the wrong approach.

There is a counter argument that suggests GK should feel a constant sense of guilt over what he has done, especially with regards to the affair. However the key issue with this is GK will not be able to accept himself, as living with guilt can be overwhelmingly oppressive on an individual’s mental health. This causes a great deal of stress and negative rhetoric within the mind over who he is and how he should act. As GK could not correct negative rhetoric in his head he had to go into a form of denial whereby either other people are wrong, or it’s okay to be shamed. To be around something who is depressed and uncomfortable in themselves is an unpleasant experience for those around them. GK poor mental health was making BK mental health worse and in a cyclical manner they were both making life worse for each other. For guilt to be used effectively it needs to be used as a catalyst for change, rather than an endless form of punishment. Part of the therapeutic process would be a change in the behaviour BK displayed towards GK (see case eight for details).

There are some other factors which may have influenced this fetishism. For example GK was often made to feel ashamed of masturbating and so had some association between the two sensations. Whilst it was an abundance of shaming placed on him by his mother, he said he does remember it vividly and being told several times. In addition, often individuals who suffer for sex addiction are exposed to sex at a young age. This was the case with GK who had his first sexual encounter at twelve years of age, with a girl who was fifteen. He said he had greatly enjoyed the experience. Thematically this would fall in line with GK’s desire to be controlled by women. All of these points in combination are most likely the cause of GK’s shame fetishism.

At this point it has become apparent that GK needed to improve his self image if he was going to have a mental shift in what he believed was an acceptable way to be treated. The primary method I use to raise a client’s self-esteem is to change the mental template they have in their mind of themselves. This can be done through the BWRT process. 

Please note for brevity sake I will note go into a full explanation of BWRT. If you would like information on how BWRT works, please see case one (regarding phobia) and case three (regarding childhood trauma and self-esteem) for more extended details. 

Also please note before doing self esteem work we will use BWRT to remove the negative emotional association from any highly anxious memories the client has. These anxious memories being any memory that creates a highly uncomfortable sensation to recall. GK had no such memories that scored high enough to work on so we did not conduct any level 1 BWRT on anxious memories and instead moved directly on to level 2.

For my work with GK self-esteem I used the same methodology highlighted in the self esteem case with some slight modifications. Firstly I asked GK a series of questions to determine what is the most negative image he could think of about himself. What are his worst characteristics and actions. I then asked him what does he consider to be his best characteristics and what would the best version of himself look like in his minds-eye. 

For the BWRT process I had GK bring to mind and picture a sad caricature version of himself. It was sad, pathetic, sex addicted and miserable. I had him imagine looking into a mirror and seeing a small video playing of him seeing this negative version of himself. To picture this image should make the client feel uncomfortable to picture. I then had him freeze this image overlaying a more happy and responsible version of himself over the top. A superhero version of themselves. The BWRT method involves taking this positive imagery and layering it repeatedly over the top of the negative imagery within the clients mind eye. This is done multiple times until the negative self image has the negative emotional response removed from it. After the BWRT process was completed I then put GK into a relaxed state for a short time and then tested the strength of emotional response of the negative image of himself to see if there had been any reduction in its uncomfortableness. GK replied he felt much better and the frozen negative image had little to no emotional response anymore. 

After the BWRT process was completed we concluded the session. For homework I had him complete the BWRT level 2 worksheet which involves self reflecting on the negative image. 

In addition I had him work on some other self esteem exercises and a guide on how to manage negative intrusive thoughts.

GK came to the session quite spirited and motivated to improve his life. He felt much better about himself and had a strong desire to continue working on himself. However we had yet to alter his kink preferences and his fetishism towards shame. At this point the most effective course of action was to use BWRT to remove the mental template GK had in his mind of BDSM and dominatrix fetishism. We would now work on removing the sexual allure of the kink and replacing it with one of neutrality or of disgust.if necessary. 

Please note once again for brevity sake I will not go into a full explanation of BWRT. If you would like information on how BWRT works, please see case one and case three for more extended details. 

This requires a delicate touch as we are not trying to remove the desire to have sex only remove the desire for embrassment and shame as a motivator for sex. The apparent issue was the fetishism GK had in his mind could not be replicated by his wife, thus splitting his desired sex life from his actual sex life.

In terms of using BWRT with regards to fetishism management, the methodology involves taking the image of fetish into the minds-eye and bringing to mind making it as alluring as possible. To play it as a short video within his mind. I asked him to picture this imagery as vividly as possible. We then freeze this sexualised image. Then a negative image is then overlaid on top of this fetishsized image within the minds-eye. This image might be one that creates a nauseous or bored feeling to recall, an emotion that would be the opposite of arousal. Given that GK addictive image was strongly rooted and he had tried to treat it several.times before we used a previous memory of GK throwing up from alcohol (one of nauseous). We overlaid this imagery many times using the BWRT process until the original arousing image no longer created a sense of arousal. The idea is to remove the attraction to the fetisihisized image, thus dulling the fetish. 

Please note that couples can be happy without one partner needing to fulfill all the fetishism of the other. However for most individuals in a coupling to feel satisfied there needs to be a mutual attraction for one another and mutual desire to please one another. This should in some ways present itself as a desire to better themselves for one another, both physically and mentally. In addition a drive to become more symbolically involved, to grow together. Without this feeling couples find themselves feeling bored in the relationship believing they are wasting their time on someone who does not fully fulfill them. To keep this sense of desire couples need to be open with one another about what they want and how they want it, as well as why they feel they want it. Excessive use of pornography in a relationship if often a symptom of a couple’s poor communication. 

In this case GK did not want to feel aroused by such fetishized imagery and did not want to bring the fetisism into his relationship either. Not did he want to be repeatedly shamed and to continue having a low self-esteem. For this reason we both considered BWRT to remove the fetishized image to be the more sensible solution. I won’t necessarily approach other cases regarding porngraphy addiction in the same manner.

After this BWRT work we concluded the session. I told him to reflect on the fetishized frozen memory we used. He said he now didn’t find the imagery to be sexy anymore and didn’t feel any strong emotional response to it. 

For homework I told him to spend a bit of time recalling the frozen memory each day and check how it made him feel. 

In addition I gave him a variety of CBT activities to work on. I asked him to spend the week working on his career. He wanted to continue to work in music, but in a different manner so I told him to look into some new careers he might enjoy as well to come up with a list of prerequisites.

At this point the main issues affecting GK was the relationship he had with his wife and the future of his career. He said his porngraphy use had decreased significantly since conducting the BWRT. However there was still a great deal of work to be done on improving the relationship GK had with his wife given the cumulative past damage caused. 

In case eight I work with both GK and BK to help manage and resolve their marital difficulties. I suggest reading case eight for how sessions with GK were concluded. 

However, to briefly summarise case eight and the end of this case, after working on GK and BK communication and respect for one another over the next few weeks, GK porn reduced further and he felt more comfortable in sharing his preference with his wife and started incorporating more roleplay. Aside from improvements in sex life we also worked further to build GK career and give him a life he could be satisfied with. In addition I used several tools including the Gottman method to identify the mistakes and successes both individuals were making. 

In addition GK decided to go back to university with the idea of reinventing his career. He wanted to go into sound design and needed a short degree to do so. Given that he already had some experience in this area and he was passionate about sound design it seemed like a sensible option. GK was very happy and motivated with this move.

Whilst GK could of course still cheat again the motive to do so has been greatly reduced and when I last spoke them, they both seemed genuinely happy.

If you would like more details on this case or would like to schedule a free consultation. Please send me an email at info@ryanmcconnell.co.uk