I was staring at an inbox overflowing with emails about porn. Not spam, but hundreds of personal emails from people I'd never met, detailing their relationships with Internet pornography.
The emails were in response to a piece I wrote for Salon, in which I described the history of my Internet porn use. It began in pre-pubescence and continues to infect my intimacies today, despite an ongoing four-year boycott. Through the honesty of my digital pen pals, I found out I wasn't alone in having problems with porn or being disoriented about what that said about me. I mean, I'm not really a porn "addict" or anything, right? But if I'm not, then what am I?
Fortunately, some of my readers felt like they had discovered resources to understand, if not resolve, their porn-related tensions. This cadre of anonymous porn veterans pointed me towards a cache of research, which launched me on a rather academic investigation with some of the world's leading experts on "porn addiction," to find out what's been going on inside my head and what it says about who I am.
What Happened to my Brain?
There's not a consensus on the science of how porn affects the brain, but there is a lot of information on the topic. So much that it can be difficult to sift through.
Marnia Robinson and Gary Wilson, a science writer and science teacher who are married and the founders of YourBrainOnPorn, are leading voices in the space. They admit that they don't have the academic credentials, but think they've compiled some reliable information from years of following the research.
I sat down to watch Wilson's TED talk -- now viewed over 900,000 times -- with the proud skepticism of a recent university graduate. Wilson laid out his hypothesis: "natural addictions" arising from needs like food and sex have essentially the same neurochemical effect on the brain as drug-related addictions by hijacking evolutionarily useful mechanisms.
Wilson cites one such evolutionary mechanism called the "Coolidge Effect." This describes how male sheep typically take longer to ejaculate when having sex with the same ewe, but can ejaculate with a new partner in about two minutes every time. Wilson says that mammals developed tools designed for binging on natural rewards in case they needed to pack away food after a hefty kill or got their moment as Alpha male.
According to Wilson's theory, Internet porn perverted this evolutionary mechanism. It tricked my brain into thinking that I had the opportunity to procreate with limitless new mates, prompting repeated "hits" of dopamine, a neurotransmitter associated with reward and motivation. These persistent spikes of dopamine triggered the release of another chemical -- ΔFosB -- that's necessary for binging on rewards like sex and food.
With a reward like food I would eventually get full and my brain would cease its excitement for new bites. But the continuous stream of new sexual mates in Internet porn overrode my normal satiation mechanisms for sex, causing ΔFosB to accumulate in my brain. The accumulated ΔFosB ultimately led to physiological changes -- a numbed pleasure response, hyper-reactivity to porn, and an erosion of willpower -- that resulted in my cravings and addiction-like symptoms.
According to Wilson, Internet porn's power to sustain arousal with mass numbers of novel mates at-a-click has sensitized many people's brains to porn sex rather than real sex, leading to a wave of porn-induced brain-based sexual dysfunction. This is distinct from past pornography, because even fiends flipping through magazines could only fool their brain into thinking that there were a dozen or so different partners at a time with whom they could copulate.
Wilson contends that these new Internet porn "addicts" tend to exhibit specific symptoms related to these new conditions of porn, like compulsive novelty seeking and mutable (shifting) sexual tastes. This can further exacerbate stress if users' porn-based sexual fantasies morph to the point where they clash with their self-identified sexual desires or orientation.
Wilson's theory resonated with me, as did the trove of candid narratives of porn addiction and recovery hosted on YourBrainOnPorn.com that color the portrait of a user I can understand -- who can't get it up or can never cum, who watches gay porn or fetishes like "scat" despite having no real-world interest in those scenarios, and who spends hours a day masturbating with a tight-squeeze "death grip" that just can't be matched by vaginal sex.
While I was tempted to run with these corroborating accounts, I recognized that anecdotes were just that, and I wanted to see more rigorous investigations before drawing any conclusions.
The critics of YourBrainOnPorn.com feel the same way. They point out that there has never been a study that specifically examines the brain changes of Internet porn users with the scientific robustness of a randomized control trial, so the brain changes that Wilson and Robinson speculate are occurring in heavy porn-users have not actually been observed.
It's true, but that standard might not be feasible here. In 2009, University of Montreal professor Simon Lajeuness tried to set up such a study, but was thwarted because he "could not find any adult men who had never viewed sexually explicit material."
In lieu of such a study, Wilson and Robinson link to a slew of studies that show how the underlying brain changes observed in all addicts have already been seen in the brains of overeaters, compulsive gamblers, video gamers, and more recently in "Internet addicts" (including porn-watchers).
These changes include desensitization (reduced responsiveness to pleasure), sensitization (hyper-reactivity to addiction-related cues), abnormal white matter (a weakening of the communication between reward circuits and the frontal cortex) and hypofrontality (a decrease in frontal-lobe gray matter that is involved in impulse control and decision-making).
Still, the lack of scientifically rigorous research that isolates Internet porn users from other "Internet addicts" has forced Wilson and Robinson to cite testimonials -- and is why the couple's detractors cry "anecdotal pseudoscience!" and "mass hypochondria!" Sometimes, Wilson and Robinson do seem to get carried away, like by claiming that ex-Internet porn addicts are a valid, albeit "informal," control group to study this phenomenon (but, of course, they're not randomly selected, so there may be a common trait among these folks that made them use and stop using that could affect their results).
If the duo comes off as overzealous in their defense of the legitimacy of porn addiction, it may be because their counterparts are so dogmatically dismissive. Well-known sex therapist Dr. Marty Klein argues in The Humanist that these "addictions" are likely secondary to other root causes like bipolar disorder, OCD, borderline personality disorder, or just masturbating too much, and that focusing on porn masks the problem -- and the individual's responsibility to deal with his own immature decision-making. Dr. Klein categorically refutes the addiction model, stressing that most people who watch porn have no problem with it. He declares, "[U]sing porn does NOT cause brain damage, erectile dysfunction, or loss of sexual interest in one's mate."
Klein elaborated on his perspective on a January episode of the Savage Love Podcast with the celebrated sex advice columnist Dan Savage (who backs him up):
When a lot of people who label themselves as sex addicts or porn addicts say, "I'm out of control," what they're really mean is "You know, it would be really uncomfortable to make different decisions about sex than the ones that I'm making. When I'm lonely it would be really uncomfortable to not look at porn."
On air, Dr. Klein constructed a straw man of a porn addict who is too undisciplined "to stop looking at porn for five minutes," too unwilling to address the emotional roots of his behavior, and too socially inhibited to have a "decent" relationship alternative. I was feeling exhausted at the thought of contorting myself to fit this description, but gave up even trying when Dr. Klein informed me by email that I was more alone than I thought: "[I] do NOT see the epidemic of young men with porn-created erection problems that Robinson wants to help ... she's probably making a sampling error."
However, Dr. Klein's critics note that he has been defending pornography against censorship since the 1980s (apparently to the adoration of the industry; he is listed as a "porn star" on Adult Video News' website) and assert that he has not adequately taken into account just how different Internet porn is from its antecedents.
In academic circles too, the debate on the primacy of porn's role in problematic sexual behavior (as opposed to a secondary symptom or coping mechanism) is paramount.
Dr. Jim Pfaus of Concordia University, a leading researcher in the science of porn, claims that Internet porn can lead to chronic masturbation, but that the masturbation itself is the primary issue. Author Naomi Wolf quotes Dr. Pfaus in her book Vagina: A New Biography:
With each ejaculation, as with orgasm, you are turning on refractoriness. With each successive ejaculation, for chronic masturbators, the inhibition gets stronger -- because of the increased serotonin -- making it less likely for these men to achieve another erection, much less another ejaculation ... It's not the porn per se but its use in chronic and obsessive masturbation. The addiction is not actually to the porn but to the orgasm and the predictability of reward.
But this only makes sense if "porn addicts" are all chronic masturbators, using Internet porn to jerk off twice in a half hour or however long their post-ejaculatory refractory period is, which would override their natural sedation. I did not do this. And most testimonials I've read do not include this feature. I got in touch with Dr. Pfaus to get a more detailed explanation, but found that his theory rests completely on refractoriness.
Once again, the seeming disconnect between "experts" and the qualitative experience of my readers (and me) was leading me back to Wilson and Robinson. So were they right -- was I suffering from a physiologically based addiction? I wanted to hear it from the physicians and diagnosticians themselves.
In 2011, after a four-year process, the
American Society of Addiction Medicine (ASAM) released
a sweeping new definition
of addiction as a primary illness, not just a coping mechanism for something like depression. The definition also states that all addictions imply
the same fundamental brain changes, sexual behavior addictions included.
Since then, the American Psychiatric Association has at least partially followed suit, determining that addiction no longer applies only to substances like alcohol, but also to behaviors like pathological gambling -- adding the newly-codified "behavioral addiction" category
to the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders
(DSM).
While the DSM committee is still far more conservative in its approach to behavioral addictions than the ASAM, this new category does create room for a variety of behavioral addictions to eventually be recognized by psychiatrists. Some argue that this is precisely the intention of creating the new category, especially since sex addiction and Internet addiction were placed in the appendix of the DSM-IV, pending further research.
Furthermore, labeling behavioral addiction as a disease in the DSM-IV is significant in and of itself because it implies that conscious choice plays little or no role in the state of such compulsive behavior, which gets at one of the ASAM's primary goals --extinguishing the moral stigma around addiction.
And the more I read, the more I felt myself letting go of my own self-stigma. Maybe this wasn't really all my fault. Maybe I deserved treatment. Maybe I shouldn't be so scared to tell people about it for fear of moral retribution. But the copious criticism refilled me with doubts.
I worried: was this new definition really just a slippery slope towards diagnosing anything we like to do a lot as a mental disorder, as some critics were saying? Could pathologizing sexual behavior lead to legitimizing "conversion therapy" for sexual deviants, as people like Dr. David Ley, the author of The Myth of Sex Addiction, feared?
But as I did more research, these fears seemed increasingly unfounded. In fact, the long history of politics around definitions of sex addiction made it seem, if anything, sex addiction (and perhaps porn addiction) would have been recognized much earlier if various vested interests hadn't dragged the debate.
Also, I wondered, if people are so afraid of calling my condition an "addiction," then what do they call it? And how are they defining it?
Well, one of the main alternatives that critics have used to describe my porn habits is "compulsion." But Gary Wilson of YourBrainOnPorn.com argues that compulsion implies the same fundamental constellation of brain events that promotes persistent overconsumption initiated by ΔFosB -- just to a lesser degree. He cites several studies that demonstrate how the level of ΔFosB in the brain correlate with the profundity of addiction-related brain changes. So, true compulsive behavior is addictive behavior.
Still, many continue to believe that this is a bottomless debate. That just like every other politicized question, there are two entrenched sides with
endless arguments and counter arguments, definitions and redefinitions, shifting proofs and truths, and so we throw our hands up and say: I guess we just
can't know.
But defaulting to agnosticism in the face of complicated evidence isn't neutral; it reaffirms of the status quo. And those troubled by their relationship with porn will continue to suffer without support, unsure of how to feel about themselves or how best to seek treatment.
Neurosurgeon Dr. Donald Hilton, the author of Understanding Pornography and Sexual Addiction, gets this. He makes an incisive comparison in a paper for the Society for the Advancement of Sexual Health to illustrate how the absence of randomized trials should not stop us from having a declarative opinion on porn addiction:
Where is the comparative prospective study with tobacco in children? The one that divides the kids, gives half cigarettes, protects the others, and follows them? It doesn't exist, of course, and never will, and therefore those so biased will still say that smoking is not addictive, even now.
Hilton argues that even though tobacco executives still tell Congress that smoking is not addictive, a "tapestry of research over the decades" has
convinced virtually everyone that it is.
Personally, I do see a "tapestry" of evidence that porn addiction exists. Others may not. But I think that in a few decades, it's likely that most people will think of it as similar to eating disorders or gambling addictions -- yes, I have "chosen" to do destructive things, but it's because I have a condition, an illness, and it should be treated as such.
***
Rich qualitative data and physiological evidence may never be enough to "prove" the existence or non-existence of porn addiction as was true with tobacco, so it's worth asking: would the consequences of formally recognizing "porn addiction" be good or bad?
In the aforementioned episode of Savage Love, Klein is upfront about his consequentialist bias, which is quite sympathetic:
I think a lot of the whole sex addiction movement is simply an attempt to pathologize sexual expression that somebody doesn't like. It's pretty easy nowadays to use that expression, "sex addiction," to say this person has a disease and with the addiction industry being so popular in this country, the infrastructure of handling that "disease" of sex addiction is all set up.
This is not a porn addiction model I would stand behind. We should stand guard against a hegemonic addiction industry and the over-pathologizing of sexual expression. But the prominent pro-porn addiction model folk don't advocate for this. Just about everyone in that camp prescribes therapy and a regimen of behavior change, targeting the emotional-psychological roots of the user's decision making while simultaneously curbing problematic behaviors.
Furthermore, addictions are often intertwined with other emotional and behavioral issues (which perhaps renders the "primary illness" debate a bit inane). But by denying the possibility that porn could be a primary factor in such troublesome behavior, we fail to support people who would benefit from targeting porn directly with cognitive behavior therapy or twelve step treatment programs to complement psychotherapy.
Tellingly, Marnia Robinson and Gary Wilson also take a consequentialist perspective, and it's exactly why they push so hard for the addiction model:
We don't necessarily think everyone having symptoms from overconsumption of porn is "an addict," but we think the addiction model is still the best one for helping guys understand how they could have conditioned their sexuality in unwanted ways.
What Robinson and Wilson understand that Klein doesn't is that there are profound psychological effects of being unrecognized -- suffering, and being told it's either your fault, you're making excuses for yourself, or you're making it up altogether.
If we codify the category of "porn addiction," everyone will more accurately appreciate the potential power of porn to condition sexuality (brains are most plastic as teens, so be careful) and perhaps most importantly, porn users will be more precisely differentiated under the porn addiction umbrella.
If we know how different types of Internet porn use interact with various emotional conditions and stages of development, we can provide a rigorous conception of who fits this category and who might be better suited by another model.
Like Violet.
Violet is a reader I really connected with who wrote that although she is not addicted to watching porn, "I've been brainwashed so that anytime I experience erotic feelings they channel through mainstream hetero porn images" (she identifies as lesbian). She didn't experience "the involuntary impulse to watch or read porn," which is how she conceived of addiction, but instead she experienced "the involuntary internal hijacking of erotic expression, which I don't have a short term for at the moment."
Addictive behaviors are often classified as recreational use, abuse, and dependence. The earlier the use, the more profound the effects and the more difficult to treat. Maybe if this is officially recognized, I'll know if I'm a recovered porn addict, a porn abuser, or an early-stage recreational user experiencing an internalization of porn-based eroticism that has profoundly impacted what sexual stimuli I find salient (still searching for that shorter term). But for now, I'm allying myself with addiction.
I am not advocating for victimhood or pathologizing sexuality, I just want to have my struggle recognized. I've been battling this for a long time alone. To get past it, I need to find affinity and support. To find that, I need this to have a name.
