Is Porn Addiction Just a Medical Problem?

In my first blog post in this series, “Porn Addiction?”, I looked at three ways a disease model of addiction can be helpful in explaining habitual sexual sin patterns. The disease model highlights what it feels like not being able to stop, and the insanity that comes in a moment of temptation. It also rightly shows the need for a zero-tolerance policy on sin. These ideas are constructive as we consider how to patiently and lovingly walk alongside men and women who are caught up in years of addictive sexual behavior.

But the church needs to be aware that the fundamental anthropology of a disease model for a porn addiction falls far short of the way God describes humanity’s experience as his fallen image bearers.

Robert Weiss, an addiction specialist, said in a recent USA Today article, “We don’t look at alcoholics and drugs addicts and say, ‘You’re a bad person,’ we say, ‘You have a problem.’”

In the same article, Milton Magness, a sex addictions therapist said, “Most of the people I work with are people with very high morals, very responsible, leaders in their industries; many are even clergy or physicians. And they are involved in behaviors they do not want and repeat them, despite repeated attempts to stop.”

Both of these specialists are seeking to locate the problem of the struggler outside of the person’s will. A disease model sees sexual addiction as a medical problem, not a moral one.  And I believe this is a genuine attempt to explain how someone’s life can look so good in some areas while being completely out of control in others.

But the Bible always locates sin in one place: the human heart. This doesn’t mean that environmental and physiological factors don’t play a role in addictions, but the Bible sees every external factor as the context for the desires, responses, and engagements of the heart. In other words, Scripture says the entire person—the body, mind, and heart—works together in all of our behaviors.  

But the church must be careful to go beyond helping someone make the right choices; it must also grasp the compromised ability of someone in an addiction to make the right choices.

In 21st century America, we are all spiritually sick, but we desperately want to hear the words that we are not the problem. But Jeremiah 17:9 says, “The heart is deceitful above all things, and desperately sick; who can understand it?”(ESV)

The typical secular worldview is that we are good people, but there are external forces that trip us up, causing us to do wrong. The biblical worldview is that these external forces (upbringing, brain chemistry, trauma, to name just a few) do impact our behavior, but there is something more fundamental to who we are that causes our problems. We have a natural bent toward evil; we are fallen.

The problem is our sinful heart, and as I said in my last blog, “sin is enslaving,” and there is only one physician who can bring life out of what was once dead.

For the Christian, God has performed a heart transplant for those who trust in him. In Christ, we have died to sin and have been raised with him to walk in newness of life (Romans 6:4). But this definitive transfer from death to life does not mean we don’t still struggle with ongoing sinful desires and inclinations of the heart.

There are two pitfalls we must avoid when helping Christians work through issues of sexual addiction.

The first pitfall is to focus only on moral responsibility. The church has historically helped those with addictive struggles to make good moral choices, focusing on the will. But the church must be careful to go beyond helping someone make the right choices; it must also grasp the compromised ability of someone in an addiction to make the right choices.

But this is the other pitfall, an echo of Adam’s complaint to God: It’s not my fault; it’s this brain you gave me. The culture highlights only the context for the problem (the brain, trauma, family of origin issues, etc.) But the disease model does not account for the wickedness of our fallen hearts. While the addiction model seeks to place the blame on external factors, it misses the complexity of the human heart and its central role in behavior.

The battle against addiction is not won or lost when you are faced with severe temptation, it’s determined by a multitude of choices we make each and every day. 

Landing in either of these pitfalls flattens our experience of being human.

So what is a realistic, compassionate, and practical way forward for new creations in Christ who are caught up in sexual addiction?

We must understand that our hearts are engaged in every moment of life. It often feels like a losing battle to addiction because we are only thinking about our hearts in the moment of severe temptation. But what actually matters the most is what is happening in our hearts when we’re not tempted. Despite what is commonly said, men are not thinking about sex every seven seconds.

For the believer, every single day there are moments of clarity and good godly desires that need to be nurtured. The battle against addiction is not won or lost when you are faced with severe temptation, it’s determined by a multitude of choices we make each and every day.  These choices include laying aside every weight that hinders us (Hebrews 12:1), like getting rid of unfettered internet access. They also include the good choices to invest time in prayer, the Word, service, and intentional fellowship and accountability with members of Christ’s body.

The resistance to taking steps to fight sinful addictions is a matter of the heart.  People’s hearts idolatrously want to maintain at all costs the comfort and pride that their isolated, unaccountable lifestyle provides. That unwillingness to humble oneself before God and others is often where repentance needs to start.

We do have a disease; it’s called sin. 

Deliberate choices—daily decisions in advance of overwhelming temptation— to live humbly and intentionally lay the groundwork for ongoing repentance toward God and others. This submission to accountability and radical amputation of avoidable temptations frees a person to begin to examine what they are really living for. How have they rejected Christ as their source of life and satisfaction? What lies are they believing about God’s love for them and their responsibility in living for him? How have they turned other people into objects to be consumed instead of image bearers to be loved?

This kind of deep heart examination cannot happen when someone is isolated and in the throes of constant addictive behavior. The fog of addiction can be too thick to make real progress, which is why the Lord will often allow severe tragedy to enter a person’s life in order for a season of clarity to enter in. The question is, will they use those moments of clarity to humble themselves and seek the real help they need?

Yes, our brains need rewiring. Yes, the fog of addiction needs to be lifted. But all of this happens under the umbrella of heart repentance towards Christ. We do have a disease; it’s called sin.  But Jesus, the Great Physician, did not come for the healthy; he came for those who are sick.  And he came that they might have life in him and have it abundantly.

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Mark shares more thoughts on this topic in the accompanying video: What Can Pastors Do When People Say They Feel Addicted to Porn? These short videos can be used as discussion starters in small group settings, mentoring relationships, men’s and women’s groups, etc.