Narcissism & Porn Addiction: What the Latest Research Means for Healing

If you’re worried that pornography is taking up too much space in your life or relationship, you’re not alone—and you’re not broken. At CARE Counseling, Inc., we take a compassionate, research-supported approach to concerns around porn use, shame, and relationship strain. Below is a plain-language overview of what current research says about narcissism and problematic pornography use, plus practical next steps you can start today.

First, a quick reality check on diagnosis

In everyday conversation, people often say “porn addiction.” Clinically, the term that’s actually recognized worldwide is Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11 (the World Health Organization’s diagnostic system). CSBD focuses on loss of control, persistence over time (6+ months), and life impairment—and it explicitly warns against diagnosing someone whose distress is only due to moral disapproval or shame. In other words, a high sex drive alone—or feeling guilty—doesn’t equal a disorder.

In the U.S., the DSM-5-TR (the American Psychiatric Association’s manual) does not list “porn addiction” as a diagnosis. Many clinicians still treat porn-related distress, but it’s important to know the current taxonomy differs across systems.

What do we mean by “narcissism”?

“Narcissism” describes a personality trait (not always a full disorder) that can show up as grandiosity (needing admiration, entitlement) or more vulnerable forms (sensitivity to criticism, shame). One particularly important facet is antagonism—patterns like hostility, entitlement, or exploitation.

A 2023 study found that antagonistic narcissism (more than other facets) was linked to identifying as “addicted” to pornography—not necessarily to higher frequency of porn use itself. The authors suggest that certain narcissistic styles may influence how people interpret their behavior and distress. That doesn’t make the distress any less real; it simply highlights that personality style can color self-labels and help-seeking. Related research shows that self-perceived porn addiction is shaped by multiple factors—like difficulty with self-regulation, habits of use, and moral incongruence (when behavior clashes with one’s values). Religiosity and value conflicts can amplify distress even at lower levels of use.

Takeaway: two people can watch the same amount of porn and feel very different about it—based on values, coping skills, and personality style.

How narcissism and PPU can interact in real life

• Shame–avoidance loop: Antagonistic traits can make it hard to tolerate shame or criticism. If porn becomes a quick regulator for stress or shame, it can create a relief → shame → more relief cycle. Over time, this feels “out of control,” even if frequency fluctuates.

• Meaning-making: People high in antagonistic narcissism may be more likely to interpret struggles with strong, global labels (“I’m addicted,” “I’m hopeless”), which can increase hopelessness and conflict with partners.

• Moral incongruence: When personal or spiritual values conflict with use, distress and “problem” labels rise—regardless of minutes/hours watched. That distress is valid and treatable.

What actually helps? (Evidence-based options)

1) Cognitive-behavioral and third-wave therapies (CBT, ACT, mindfulness)
A 2024 systematic review finds the strongest (though still limited-quality) evidence for CBT-style approaches: identifying triggers, building replacement behaviors, skills for urges/emotions, and value-aligned action. Online/self-help formats can help—but adherence is a common challenge.

2) Low-threshold self-help: “imaginal retraining”
A 2024 randomized trial tested a brief, at-home technique that practices mentally “pushing away” porn cues and “pulling toward” valued alternatives. Results were mixed overall (adherence mattered), but per-protocol analyses showed reductions for a subset of participants—suggesting it can be a helpful add-on for some.

3) Medication (case-by-case)
The evidence base is small. Some case reports/series and small trials have explored naltrexone or antidepressants alongside therapy, particularly when urges feel compulsive or co-occur with other conditions. Medication decisions are individualized and should be made with a prescriber who understands CSBD/PPU.

4) Couples work
When secrecy, conflict, or trust injuries are part of the picture, couples therapy can help move from blame to collaborative boundaries, rebuilding safety and honest communication. (This is a clinical best practice even though RCTs are limited.)

5) Address the drivers
Treatment is more effective when it also targets mood issues, anxiety, trauma, ADHD, sleep, loneliness, and relationship stress—things that often fuel the cycle. (These co-occurring factors are frequently noted across reviews.)

When is it time to get help?

Reach out if any of the following fit:

• You’ve tried to cut back for months with little change.

• Use is causing relationship conflict, missed responsibilities, or legal/occupational issues.

• You feel stuck in shame, secrecy, or escalating behaviors that don’t fit your values.

• Co-occurring concerns (depression, anxiety, ADHD, trauma) are present.

Good news: People can get better—with skills, support, and a compassionate plan tailored to you.

How CARE Counseling, Inc. can help?

We specialize in evidence-based, non-shaming care for individuals and couples. Your clinician can help you:

• Clarify whether what you’re facing fits CSBD/PPU, a values conflict, or another pattern;

• Build a skills-first plan (CBT/ACT/mindfulness), optionally test low-threshold tools like imaginal retraining;

• Address relationship repair and honest communication;

• Coordinate with your physician if a medication consult makes sense.

If you’re in crisis or feel unsafe, call/text 988 (Suicide & Crisis Lifeline) in the U.S. right now.

You deserve care that respects your values, reduces shame, and grows real skills. If this resonates, reach out to schedule with a CARE clinician. Compassionate care. Research-supported strategies.