Psychotherapists working with couples or individuals involved in intimate relationships often receive questions or need to respond to issues related to the use of pornography. These can emerge as a primary or secondary focus of treatment. One specific area where substantial misinformation exists is in the connection between the use of pornography and sexual response/dysfunction during partnered sex. It is important for psychotherapists to base their assessments and interventions on an accurate understanding of the existing empirical data.

Rowland and Cooper (2024) had four goals in their narrative review: 1) Identify and review methodological issues that affect confidence in the extant literature; 2) Briefly summarize recent review papers on the topic; 3) Encapsulate and update the literature, examining the issue in two groups: the general population and specific subpopulations of problematic pornography users; and 4) Provide an evaluation and discussion of the state of research on this topic.

Their article is divided into several sections, starting with an introduction that not only clearly defines the issue but also identifies and defines the two variables of interest, sexual response/dysfunction and pornography use. The paper then presented the review methodology employed to identify high quality research articles published post 2016. This was followed by a synthesis of those articles within the two populations of interest: the general population and specific problematic pornographic users.

Rowland and Cooper (2024) drew several conclusions from their review. They demonstrated that claims of a strong impact of Frequency of Pornography Use (FPU) and/or Problematic Pornography Use (PPU) on sexual functioning during partnered sex are unfounded both by the findings of studies and/or by misinterpretations of them. Additionally, they found significant diversity of outcomes of pornography use, including how they currently play out differently for women and men and for problematic and non-problematic users. Importantly, Rowland and Cooper (2024) concluded that a relatively small percentage of men—perhaps younger, sexually inexperienced, and/or residing in sexually restrictive environments—might (even in the absence of pornography use) struggle with sexual performance during partnered sex, and this situation may be exacerbated by excessive or problematic pornography use. Equally important, they further noted that studies based on community samples do not support the notion that pornography use is widely and strongly associated with impaired sexual functioning during partnered sex.

Rowland and Cooper (2024) sought to advance the field via specific suggestions. They expressed the hope that a proximal outcome of this review would be the advancement of research in this field, achieved via two pathways. First is the inclusion of more relevant covariates directly associated with PPU and also with the particular sexual dysfunctions being assessed. It was their premise that these covariates may be accounting for much of any observed correlation between pornography use and the development of problematic outcomes. Second is the development of more intricate and detailed models that supplant concepts such as PPU and compulsive use with their component pieces, enabling retention or discarding of common and/or specific elements of PPU/addiction.

As a final note, Rowland and Cooper (2024) highlight that while pornography has been a part of human culture over the millennia, the development of technology has had a profound impact on the nature, amount, and availability of cybersexual activity, from viewing pornographic material to online sexual activities, both in-person and with robotic partners. They challenge thought leaders in this field to envision the future of human sexuality in an environment where such (once unimaginable) disruptive interfaces are likely to affect the nature and definition of sexuality in future generations.

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Stewart E. Cooper, PhD, ABPP

My diverse professional background in psychotherapy practice, education, supervision, and research have worked synergistically with each element enhancing the others. For many years, I served as the Director of Counseling Services (which eventually included a Counseling Center plus separate Substance Abuse, Sexual Assault and Suicide Prevention units) at Valparaiso University in NW Indiana. During this time, I was also a faculty member in the Department of Psychology teaching in their accredited master’s mental health counseling program where I served two stints as its Program Chair. Based on my teaching, service, and scholarship, I was promoted to Full Professor. I have authored/edited 5 books, 10 book chapters, and 80 refereed journal articles. Within APA Governance, I have served as the Chair of the Board of Professional Affairs, Chair of the Membership Board, a member of its Policy and Planning Board and as co-creator and member of its Committee for the Advancement of General Applied Psychology. I also served two terms on its Council of Representatives and was an At-Large Member of the APA Board of Directors. Additionally, I was President of the Society for Consulting Psychology (APA Division 13) and am President-Elect for the Society for the Advancement of Psychotherapy (APA Division 29). Licensed as a HSPP in Arizona and in Indiana with Board Certification in both Counseling and Organizational Psychology, I am currently expanding Life Enrichment Associates, a solo clinical and consultation practice which I developed in 1982.