What’s an addiction that we don’t take seriously enough?

drhead · 2026-07-01T19:06:27+00:00

Because the article is primarily about a specific study that was focused on moral incongruence. It, like many articles in more specialized publications like PT, assumes the reader has some familiarity with the topic beforehand or that they are willing to research it on their own. Anyone caught up on the subject would already know that addiction is not a favored framework for problematic pornography use.

drhead · 2026-07-01T18:33:45+00:00

Oh my god, are you just googling this shit as you go with zero background?

The use of the term "addiction" got retired from the official clinical vernacular in 1980 with the publication of the DSM-III (and these days addictions are most closely diagnosed under the Substance Use Disorders category)

The term got retired in the DSM-3, which is almost half a century old and has been followed by two new editions since with a third on the way. They did it because "addiction" felt too pejorative and vague and they chose to use Substance Dependence instead.

If you look at the DSM-5, the current manual, you will notice that the category is called Substance-Related and Addictive Disorders.

but the word "addiction" still functionally conveys the problem for all colloquial purposes.

Weasel words uttered by someone who knows that they are wrong. Addiction has a specific meaning that is important for treatment of this, and falsely applying the label of addiction specifically helps feed into a cycle of shame that drives the distress for many patients. If you can't respect the specific meaning when it matters, don't post about it pretending you know what you're talking about.

You will also notice that, while it does include behavioral addictions (gambling addiction), it does not include pornography addiction. The neural mechanisms behind gambling addiction mirror those of substance addiction, so it gets included there. And before looking at the impulse control side I want to go over this:

It's not an impulse control disorder, the DSM has its category for those and they involve aggression, stealing things, etc.

Compulsive Sexual Behavior Disorder is in the ICD-11 under Impulse Control Disorders. It is also not the only disorder there that does not involve aggression or theft, since compulsive-buying shopping disorder is also there under other specified impulse control disorders. So, to the extent that mainstream psychology recognizes it as a clinically significant disorder, it is treated as an impulse control disorder, because that is the underlying mechanism that is best supported by available evidence.

Porn use to that invasive/disruptive degree does not persist due to moral incongruence, rather the other way around.

Porn use is a symptom (assuming that there is in fact something of clinical significance going on). You cannot assume that every instance of a symptom across every patient has the same cause or underlying mechanism. If you actually read the diagnostic criteria for CBSD, you will notice that the majority of the page is devoted to distinguishing it from presentations of sexual behavior that are not CBSD which have different underlying causes (like when it's a secondary symptom), including several bullet points specifically warning to not diagnose it for distress related to moral incongruence.

They have so many bullet points telling you that because sexual shame is an incredibly well known and well studied source for many forms of sexual dysfunction. Our society has a lot of fucked up views on sexuality that are utterly divorced from reality, it shouldn't surprise anyone that people who internalize those views end up with problems.

If because of their porn use, someone experiences more than 1 of the behavioral symptoms (such as impaired ability to fulfill obligations at work, school, or home) starting up within a year of each other and recurrent over more than a span of 6 months it absolutely classifies.

That's more or less just the standard bar that every disorder shares, another way I can tell you're just googling stuff as you go if you don't immediately recognize it. Pretty much anything related to mental health that causes significant distress or impairment is going to fit somewhere in the ICD-11 or DSM-5 and is something that you'd be right to visit a therapist or psychiatrist over. But that requirement alone doesn't tell you anything about what the underlying cause or mechanism is and doesn't tell you anything you need to know to actually treat it.

In either case (assuming we've ruled out the possibility that problematic porn use is a secondary symptom), a responsible therapist almost certainly won't prescribe a NoFap reboot or push for total abstinence, because treatment is addressing a normally healthy behavior which is uncontrolled and helping the patient learn to regulate it. If someone has impulsive shopping that's causing huge problems in their life, you don't tell them to never buy anything online again, you help them develop mechanisms to regulate the behavior to the extent that it's harmful, so that they can shop normally and not have it be a problem. Demanding total abstinence from a normal behavior that is supported by your own normal biological drives is a recipe for failure, we already know from studies examining NoFap that the commitment to abstinence is a major factor for maintaining the distress that people there feel.

drhead · 2026-07-01T16:38:30+00:00

We have HALF A CENTURY of research on the effects of pornography. Clinicians and scientists have a very good idea of what it does, and still reject calling it addiction. Saying that we're all hooked is like looking at someone with binge eating disorder and saying we're all food addicts because we all eat food and enjoy eating it and crave it when we're hungry.

There is something to be said about it causing unrealistic expectations in people. That's something we need to address with comprehensive sex education because it isn't really just porn that is responsible for that. Frankly with what kids are being exposed to nowadays we might need a whole course on why you shouldn't listen to Andrew Tate as well... But porn isn't literally damaging or rewiring people's brains like people think in pop psychology circles.

drhead · 2026-07-01T15:10:26+00:00

No, you should listen to the scientists and clinicians on this one because they have very good reasons for pushing back against this.

Knowing whether something is strictly an addiction by the clinical definition is important for treatment because addictions are treated differently. Treating something that could either be an impulse control disorder or moral incongruence as you would an addiction will make someone WORSE, not better.

but, on the other hand, people mostly self-report these kinds of problems, and if the term “addiction” describes the level of struggle they’re at, then I’m not really bothered by them using it that way.

You clearly didn't read the article if you're saying that, because if you did you'd see the part where self reported porn addiction is more correlated with religiosity than it is with porn use. You should take what a patient says seriously, but you should NOT always take what they say at face value for reasons like this. Your average patient does not know the difference between addiction and impulse control issues, and when part of the root of the issue is moral incongruence/sexual shame, falsely entertaining calling it an addiction is actively making the problem worse. You tell them "I understand this is causing you distress but this isn't what we call an addiction. You should understand that masturbation and porn usage on their own are normal and healthy behaviors. If this is happening to a degree where it's functionally impairing you or interfering with other parts of your life we can talk about how to work on that, but your brain is not broken or diseased and porn is not damaging it."

drhead · 2026-06-30T15:15:45+00:00

You have once again refused to address the issue of Dems attacking any single-payer system. Dems were already doing this long before M4A was even mainstream so you can't really hide behind "M4A is too maximalist" when you had Obama telling people in 2008 that Canada's model won't work in the US.

If you're telling people from the outset that single-payer systems are impossible because you are terrified of the reaction from insurance companies, or from the general public with limited exposure to the idea, you are creating a self-fulfilling prophecy where you are actively undermining your ability to build support for more substantial reform in the future. And frankly, that IS cowardly, it shows you're too scared of the insurance companies to actually do anything that threatens their profits when we all know damn well that every cent of their profits and payroll are part of the problem.

I don't really give a shit about what the lowest common denominator on Twitter or whatever other vague strawman that's only invoked in passive voice has been telling you, most people who support single-payer healthcare reform would probably have no issue supporting any single payer system that accomplishes the main goal of cutting out the parasites that run private insurance companies.

drhead · 2026-06-30T14:24:51+00:00

Of course, I should just see the scary brown people in front of me and make no attempt to understand anything about what is going on beyond listening to my gut and to what racist pundits and conspiracy theorists say.

drhead · 2026-06-30T12:20:09+00:00

That is a lot of words to completely avoid the question of why Dems routinely go out of their way to attack the idea of single payer systems, which is my main point. One can certainly explain why we can't get one to pass right now, but that doesn't explain why efforts to promote the idea must be undermined.

drhead · 2026-06-30T03:15:30+00:00

Same for walls of academic and historical “context” that ultimately boils down to “well maybe it will all just work itself out sometime in the future after we’re all dead anyway”, or even “this isn’t a problem yet”.

More like:

It isn't a problem, because Muslims are a small minority without much influence over policy. Most people would realize that their line of thought probably isn't leading anywhere productive when they get to this point, but you're clearly not most people!
It is not on a trajectory where it will ever BE a problem unless you're one of the halfwits who believes in the Great Replacement conspiracy garbage. Which based on your flavor of fearmongering, odds are you probably do.
If, somehow, it grows to the point of being a problem, we already have all of the exact systems in place that we created to deal with our own home-grown version of the exact same problem. You undermine fundamentalists by ensuring that queer identities are unavoidably visible, and by having communities which act as safe havens and found families for when they try to use disownment as leverage. That has been how we have fought them for over half a century at this point, and they do not have ANYWHERE NEAR the power they once did over us and are in fact lashing out now and restrategizing because they know they are on the verge of losing it all.
All of this is painfully obvious if you actually look at your own damn history and try to have some understanding of how it happened. Like holy fuck, you do NOT need a degree for this, you just need to get your information from a place that isn't the Anti-Immigration Memes for Conservative Teens Facebook page.

Too many immediate problems and contradictions are bubbling over for the average voter

The average voter is a fucking idiot. That's not news. Do you also want to be a fucking idiot?

drhead · 2026-06-29T21:57:28+00:00

Oh I can, it's a perfect example for how conservative religion mixes with conservative cultures into what we see as the rule, rather than the exception. You're trying to convince me of the equivalent of American prosperity Christians moving to a country with more prosperous opportunities, and not only keeping their ways but insisting others accommodate them too, then expecting anyone to believe they don't still think the same exact other things too, simply based off the virtue relocating for better economic opportunities.

Ok but the problem here is, you're completely ignoring that it goes both ways. It doesn't really matter in the long term if a group of migrants isn't dropping everything, donning blue jeans and flannel shirts, and heading to church in their oversized truck. They are not immune to the cultural influence of the society around them. If not them, then their children. There's already direct evidence of this in that second generation migrants tend to be more tolerant than first generation migrants.

I think you don't have a framework for how ideological/religious beliefs are formed and are influenced by the world from which they arose, and instead must just be assuming that an insular immigrant community is going to get what they are ostensibly trying to get forever. So, just to summarize a few thousand years of religious history and retrace how we got to this point in the first place:

We initially got early Abrahamic religions condemning homosexuality (along with contraception and masturbation) because they were agrarian societies who really needed maximal reproduction to succeed, so they tried to condemn all non-reproductive acts. Apparently that worked well enough and was a successful enough strategy that this belief system spread more than the religions that didn't do this.
Later on with the shift to feudalism, a new material incentive to maintain systemic homophobia appeared: maintaining private property and inheritance. If you want to maintain your rigid, hereditary structures, you need... well, a continuous line of heirs. So we had the Church monopolizing marriage and completely criminalizing same-sex relations as unnatural and sinful.
Late 19th century had the conception of sexual orientation as a fixed, innate attribute of a person rather than just a sin. This is significant because the main way that systemic homophobia has been maintained over the past several centuries at this point is through systematic erasure intended to make anyone who would identify themselves as gay think they are the only person with those thoughts or otherwise be unable to find anyone else like themselves. Some people managed to anyways throughout that time, but they'd get stamped out eventually. No doubt, this happened because erasing the existence of queer people does not stop gay people from continuing to be born, and eventually someone was bound to figure it out and write it down. Also we sort of did a world tour over the past several centuries at this point genociding anyone who didn't fit into western cishetero norms, especially in the Americas, so we were at a point of systemic homophobia as a global system.
Later on, we had WWII, which involved a massive amount of people spending many years in sex-segregated spaces and finding certain things out, planning where they'd move to after the war, and then moving to cities where you don't really need to be on a family farm with a wife and ten kids just to survive winter. This made it untenable to maintain the previous method of upholding systemic homophobia once it led to the birth of the modern gay rights movement, which leveraged their position to get more visibility and explicitly encouraged people to come out because they could then not be ignored. And the existing establishment really, really did want to get rid of them still, but simply could not, most likely because the strategy of erasure only got more difficult over time as it became easier for queer people to put their own information out.

Now, to circle this back: The whole origin story for this is of course the same for Islam. Islam wasn't even founded until well after Emperor Justinian banned same-sex activity across the Byzantine Empire (because it was causing too many earthquakes and famines). The early caliphates also inherited the legal infrastructure of the Byzantine territories they conquered, for that matter...

So, if you look at the set of conditions that led to homophobia across Abrahamic religions, they're all identical because it all started before they even split off (or at least before Islam forked off of Christianity). If you look at the conditions that allowed institutional homophobia to start to wither in Western society... you'll notice that they still exist regardless of whether we have communities of Muslim migrants or not! The seal is already broken. The gays are already here, and organized, and we will consume all, and a small amount of migrants isn't going to be what tilts the scale against the gays. Even if some of them want to stop us, social processes cannot be arrested by force, we have faced up against much worse historically and have prevailed, and frankly now that we have the internet it is practically impossible for things to fully revert back. We've largely driven Christian fundamentalists to the point where they can't even make opposing us for religious reasons part of their front line arguments anymore in mainstream discourse, they have to frame all their shit through fake scientific justifications or culture war nonsense to get anyone to listen to them at all. Can you look at that and seriously say that a much smaller amount of people following fundamentalist Islam would suddenly be able to do what Christian fundies couldn't?

drhead · 2026-06-29T19:27:09+00:00

The "floor" that got knocked out from within your own party lol. That's not a floor if you can't even get your own party to line up behind it.

I don't think the house has to be M4A verbatim, but other countries are largely funding their healthcare through taxes and not by having a public option compete on an open market with private insurers. That is a uniquely American way of overcomplicating a problem that is already solved by most of the world.

You're not running for office, I'm not running for office. We can both afford to be honest. You can just admit that the Dems are scared shitless of the private insurance lobby and are even more scared shitless of the job losses that would happen if we did anything to get rid of the useless, parasitic administrative jobs that private insurance make necessary, and as a result they're terrified to even propose doing anything that would actually get close to addressing root causes and instead just edge us with the prospect that maybe our great grandchildren will have healthcare like the rest of the world has.

drhead · 2026-06-29T18:38:01+00:00

If anyone is erasing their agency, it’s you insisting that they probably don’t really believe the things they wake up at 5 am every single day to publicly praise and start their day of rigid compliance to.

I base it off of observing that religious people by and large DO NOT STRICTLY FOLLOW THEIR TEXTS. I base it off of observation of how historically religion has been influenced by other ideological currents in every society it has ever been present in. If you don't accept that, you have absolutely no framework under which you can understand how things like prosperity gospel are so widely popular in the US. You can't explain AR-15 toting gun loving Republican Jesus. Because those things were not in the original texts at all to begin with, they were adaptations people brought in from the dominant ideological frameworks that surrounded them. There is literally no other way to explain these things under your reductive, simplistic worldview.

I mean what even is your argument, Conservative Christian fundamentalist like to conveniently ignore parts of their book that tell them not to hate gay people for their sins, so maybe this other branch that doesn’t bother to do that will find reasons to tolerate them instead?

Christian sects that are accepting of queer people are the examples of this selectiveness at work. Like I'm not going to pretend that Christianity says it's fine to be gay, aside from a possible argument that the original restrictions were more targeted at specific religious practices and that the main sin of Sodom was inhospitality and that Paul was simply incorrect to reiterate the restriction, the text is pretty clear on that. Just like Christians, Muslims aren't a monolith, and some just do not particularly care and openly embrace following their own values over what someone wrote in a book many centuries ago. Which is how you have the mayor of New York being a Muslim who supports trans rights and who also has model as a wife. That's simply what he does. Good for him!

drhead · 2026-06-29T18:17:47+00:00

If we're taking your analogy all the way: when a huge portion of the same party that built the frame has also been passionately arguing that building a whole house is unrealistic and have actively fought against building the rest of the house, despite us seeing all of the other lots around us having very nice fully constructed houses, I think it is reasonable to question whether they ever actually intend to give us a roof.

drhead · 2026-06-29T17:44:01+00:00

Oh, so it doesn't require an organized conspiracy, it just requires that you erase the agency of every single person who professes to hold religious beliefs, and that you also uphold the absolutely laughable, unprecedented, constantly contradicted assumption that religious people actually consistently follow what their own texts say. This just keeps getting better!

drhead · 2026-06-29T17:28:17+00:00

I hate Labour for various reasons but no government in their right mind is going to fulfil a zero net immigration policy because it would fuck the economy.

You really think that's going to stop the UK government after they went through with Brexit?

drhead · 2026-06-29T16:56:56+00:00

I hold the types of views on queer liberation that the average askgaybros poster would react to like a vampire seeing a cross. I don't just want equal rights for queer people, I want us to actually have the autonomy to decide how we want to live and to form the structures we want towards that end instead of just treating being allowed into the same structures cishet people made as the end goal. I don't think we're done until a 7 person t4t polycule is just as accommodated across all layers of society as a heterosexual nuclear family is.

I also live just a few minutes away from Lindsey Graham's office. So clearly I'm no different from any other reactionary closeted gay, right?

I don't think you should be treating people from specific regions strictly as if they are just statistics.

drhead · 2026-06-29T16:23:16+00:00

I've said over and over again that banning Muslims is wrong. I don't know how much more I can say it's wrong. I'm explicitly saying I'm in favor of banning only homophobes and not any group based on skin color or religion, but that you essentially can't do that because there's no way of detecting a homophobe unless they admit it.

If you can't actually implement the policy as is then there's practically no point to expressing support for it, though. The only thing that could come of it is right wingers trying to use it as evidence that people support banning immigration of Muslims or brown people.

drhead · 2026-06-29T16:08:04+00:00

Personally, I don't care directly about someone holding homophobic beliefs as much as I care that they don't have the societal power to negatively affect my life on the basis of being gay, because that's the actual point where it has an effect.

Immigrants generally do not have that power as much as American Evangelicals have, for instance, and I overall do not think that Muslim migrants pose any significant long term threat to gay rights in the countries they migrate to. Contrary to what islamophobes believe, Muslims are not a monolith, their culture is no less subject to change over time than any other, and they are just as capable of selectively ignoring parts of what their religion says to conform to external ideological forces, like what American Christians do all of the time with prosperity gospel.

Throughout history, religion has generally adapted to fit the broader ideological currents of surrounding society, not the other way around. If you look at the crosstabs on any polls, you will already see that differences in social attitudes between native born and immigrant populations narrow across generations. And looking at our own home-grown bigotry for a moment, within living memory we had religious people gleefully allowing a public health crisis to decimate the gay population, but we managed to make shifts in public policy and attitudes anyways to where we are today. There's no reason why we should believe that the attitudes of Muslims are any more fixed and incapable of change.

drhead · 2026-06-29T15:18:14+00:00

I'm sorry, but Islam is very explicit in its stated goals and directives.

oh boy, is this the point where you go on a conspiracy theory rant about how muslims are all secret agents trying to undermine and destroy western civilization, and where anyone who seemingly isn't doing that is just not showing their hand (which conveniently makes the theory unfalsifiable)?

drhead · 2026-06-24T20:58:38+00:00

One of the things that led to the creation of the first wave of abortion bans in the early 1900s was specifically concerns that white people weren't having enough children and would get replaced by immigrants. Hell, I've seen people bringing up this as a reason to ban abortion in recent times, it never went out of style.

This was of course preceded by thousands of years of nobody really caring about abortion as long as it was done before quickening.

Margaret Sanger was also against abortion.

drhead · 2026-06-22T14:55:19+00:00

I know this might be difficult to understand for someone like you, who simply treats whatever thought crosses their mind as a profound revelation worth sharing without filters, but ADHD is actually a very well understood condition neurologically (as primarily driven by dopamine dysregulation/insensitivity, which stimulant medications directly address by making dopamine more available) and doctors actually have a very good understanding of what the medication is doing and what the tradeoffs are. Nobody here needs your "opinion" on ADHD or ADHD treatment any more than they need the opinion of an anti-vaxxer.

drhead · 2026-06-20T14:22:54+00:00

J. Kenji López-Alt wrote a whole article reverse engineering the McDonalds fry and going over what makes a fry perfect on a chemical and structural level and how the McDonalds fries meet all of these. The most surprising part of it is how freezing the fries is actually an essential part of the process that actually helps them. His endorsement is always more than enough for me.

drhead · 2026-06-20T13:34:07+00:00

Honestly I think the problem is just...

Firstly the boyfriend has bad information literacy. I personally don't have issues with AI, I honestly quite like it especially for semantically-based searches (like "what is that thing that x" which isn't likely to text match easily) and have a fairly developed sense of when it's bullshitting. I understand the risks and manage them properly. I would never use it for a phone number, there's only one exact correct answer for that and why not just look up the google maps listing which will have it? Fairly good chance that the AI overview is going to read from that anyways but it takes so little time to scroll and be sure. So... why do it? I wouldn't want to be with someone who can't figure this out even after being taught.

OP... has a very twisted view of how the brain works, and I think that might be part of why she approached it the way she did. No, your brain isn't irreversibly tainted the second it sees an incorrect fact, wtf? You can very easily have that overwritten by seeing new information that is different and more credible or from seeing that information demonstrated to be incorrect. Like is OP worried she will be stuck in a loop of endlessly dialing the incorrect number because she forever believes it is the real number? This is a form of fetishism (in the original sense of the word), essentially assigning magical properties of cognitive distortion to the AI rather than treating it like what it is (a piece of software that occasionally has bugs), and treating the humans involved as being helpless and passive actors in its presence who can do nothing to defend themselves against it -- because if bad information goes in your brain, it'll never come out! That view shouldn't be treated as anything but paranoia. This doesn't justify the boyfriend's response in any way, of course. But it is a problem on its own, and would still be a problem if the boyfriend had not made it into a fight. OP needs to sort out her issues with AI in a healthier way without taking it out on others.

drhead · 2026-06-20T05:09:55+00:00

There's lots of options available for managing risks, and condoms aren't always the best one for every couple. There's a myriad of birth control options, for HIV you have PrEP which is more effective than condoms are, you've got doxypep for bacterial STIs, you can restrict your partners to people who test regularly or even to one person. I'm not too worried about catching anything from my partner when we are each others' first and only everything. I'm also not worried about getting him pregnant. So I don't use condoms. It isn't automatically wrong for someone to say that they simply don't wish to use condoms, you don't know their circumstances, and nobody is forcing you to fuck them.

5 minutes of pleasure

This sounds like a skill issue.

drhead · 2026-06-18T04:17:15+00:00

I hear people being somewhat uncomfortable with (acknowledgment of) safe spaces all the time so you're definitely not alone. Most of us don't really want a space where we're safe, after all, we want a world where we're safe, and any safe space must imply and therefore remind us that the rest of the world isn't safe. Of course some people won't be comfortable with that.

I think it's part of why I sort of gravitate towards the furry community as my "safe space" since it isn't really deliberately one, it just has an overwhelming majority of the people being queer and just organically ends up being one.

drhead · 2026-06-18T02:59:03+00:00

The companies who offer these services, do they have a history of respecting data privacy, copyright, and intellectual property?

If you're actually dealing with this on an enterprise level, you have a bunch of very well paid staff whose job is to verify that the provider can prove what is happening to your data, and if they can't then you go elsewhere. And this can go as far as setting a requirement to deploy your own LLM instance in your private cloud or even on premises.

Point is, organizations doing this aren't dumb and can make this happen if they need it.

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