And it's mostly men, at least in her practice. "Here's me as a sex therapist afraid to sound uncool, but the truth about what I'm seeing is what guys are saying to me in confidence: 'I look at it a lot and I prefer it to my wife or girlfriend. It's just better.'" Obviously not all porn-watching is unhealthy, but when it's interfering with their IRL sex life or their ability to get off without it, that's usually when people bring it up in Engler's office.
"Some of it is neurological, the way porn affects the brain and body. Some of it is that the guy started using it at a young age to go to sleep or reduce stress and now is kind of dependent on it. But it also helps guys to not feel self-conscious," says Engler. "They feel pressure to be good in bed and to perform, and they can avoid all that with porn." It’s not that women don’t watch porn — she’s just seeing a lot more men who are struggling with how much they depend on it. “Guys are totally aware when porn is a problem. It’s not like they come in and this female sex therapist is judging them. They’re loath to give it up, but they’re aware.”