Mental Health
Neurofeedback as an Adjunct to Cognitive Behavior Therapy in Pornography Addiction Management’
Open Access: Yes.
Abstract
Pornography addiction, often conceptualized as a form of compulsive sexual behavior disorder, is increasingly recognized as a public health concern with significant impacts on social and occupational functioning. Despite its prevalence, there is a lack of intervention protocols. This case report explores the integration of cognitive behavior therapy (CBT) and neurofeedback. A 22-year-old male presented with compulsive pornography use, depressive symptoms, suicidal ideations, and intense guilt. Psychological assessments indicated pornography as a maladaptive coping mechanism rooted in trauma, abuse, bullying, and shame. Intervention followed 32 sessions in 4 phases. CBT addressed maladaptive schemas, while neurofeedback served as an adjunct addressing urges and arousal. The patient showed improvement in his porn usage frequency and depressive and suicidal symptoms. This combined approach offered a promising framework for treating behavioral addictions.
Relevance
“Pornography addiction is debated as a compulsive sexual disorder that shares features with substance use disorders. This case study aimed to identify the predispositions associated with pornography addiction, demonstrating that it is not merely a habit but rather a consequence of traumatic events and abuse, and to explore how the integration of CBT [cognitive behavioral therapy] and neurofeedback can help alleviate distress by addressing both psychological pain and brain reward systems.”
“Cognitive models have emphasised maladaptive schemas related to rejection and shame, and that sustaining compulsive behaviours can be addressed through cognitive restructuring, which works on core schemas to help develop adaptive coping strategies. Alpha–theta neurofeedback has empirical support for its effectiveness in modulating cortical arousal and reward processing, especially in the context of addictions and trauma-related disorders.”
“In this case, although the patient’s subjective experience of improvement was limited, objective behavioural regulation and therapeutic engagement improved, suggesting that neurofeedback may enhance readiness for cognitive work by stabilising neural activity.”
Citation
Maheshwari, S., Das, S., Sadik, T. M. M., & Khanra, S. (2026). Neurofeedback as an Adjunct to Cognitive Behavior Therapy in Pornography Addiction Management. Annals of Indian Psychiatry, 20(20). https://doi.org/10.4103/aip.aip_194_26
