Pornography addiction: A neuroscience perspective

Pornography addiction: A neuroscience perspective

( this is a great resource for launching a more thorough study to increase understanding and awareness ! Please, go to the link above and see the many references and links provided in the original article ! Share this information with as many people as you can…)

A significant postulate of this commentary is that all addictions create, in addition to chemical changes in the brain, anatomical and pathological changes which result in various manifestations of cerebral dysfunction collectively labeled hypofrontal syndromes. In these syndromes, the underlying defect, reduced to its simplest description, is damage to the “braking system” of the brain. They are well known to clinical neuroscientists, especially neurologists and neurosurgeons, for they are also seen with tumors, strokes, and trauma. Indeed, anatomically, loss of these frontal control systems is most apparent following trauma, exemplified by progressive atrophy of the frontal lobes seen in serial MRI scans over time.

Although the key elements of hypofrontal syndromes—impulsivity, compulsivity, emotional lability, impaired judgment—are well described, much of the process is still unknown. One emerging aspect of these hypofrontal states is their similarity to findings in addictive patients. Addressing hypofrontality, Fowler et al. noted, “studies of addicts show reduced cellular activity in the orbitofrontal cortex, a brain area…[relied upon]…to make strategic, rather than impulsive, decisions. Patients with traumatic injuries to this area of the brain display problems–aggressiveness, poor judgment of future consequences, inability to inhibit inappropriate responses that are similar to those observed in substance abusers.”[8] (emphasis added).

In 2002, a study on cocaine addiction demonstrated measurable volume loss in several areas of the brain, including the frontal lobes.[9] The study technique was an MRI-based protocol, voxel-based morphometry (VBM), where 1 mm cubes of brain are quantified and compared. Another VBM study was published in 2004 on methamphetamine, with very similar findings.[27] While interesting, these findings may not be surprising to either the scientist or the layperson, as these are “real drugs” used illicitly. Nevertheless, it was noteworthy that addiction could produce measurable, anatomical change in the brain.

Even more instructive are similar findings seen with the abuse of a normal biological behavior, eating, leading to addiction and obesity. In 2006, a VBM study was published looking specifically at obesity, and the results were very similar to the cocaine and methamphetamine studies.[20] The obesity study demonstrated multiple areas of volume loss, particularly in the frontal lobes, areas associated with judgment and control. This study is significant in demonstrating visible damage in a natural endogenous addiction, as opposed to an exogenous drug addiction. Furthermore, it is easy to accept intuitively because the effects of overeating can be seen in the obese person.

Eating, of course, is essential to individual survival, necessary for survival of the species. Another activity necessary for survival of the species is sex, an observation which leads to a series of logical questions derived from the work on obesity. Would the findings seen in eating addiction be seen in excessive sexual behavior? Can sex be addictive in the neurological sense? If so, are there associated with the addiction anatomical changes in the brain seen with other addictions?A recent study supports growing evidence that compulsive sexuality can indeed be addictive. In 2007, a VBM study out of Germany looked specifically at pedophilia, and demonstrated almost identical finding to the cocaine, methamphetamine, and obesity studies.[25] It concludes for the first time that a sexual compulsion can cause physical, anatomic change in the brain, the hallmark of brain addiction. A preliminary study showed frontal dysfunction specifically in patients unable to control their sexual behavior.[16] This study used diffusion MRI to evaluate function of nerve transmission through white matter. It demonstrated abnormality in the superior frontal region, an area associated with compulsivity.

A decade ago Dr. Howard Shaffer at Harvard wrote, “I had great difficulty with my own colleagues when I suggested that a lot of addiction is the result of experience … repetitive, high-emotion, high-frequency experience. But it’s become clear that neuroadaptation—that is, changes in neural circuitry that help perpetuate the behavior—occurs even in the absence of drug-taking.”[13] More recently he wrote, “Although it is possible to debate whether we should include substance or process addictions within the kingdom of addiction, technically there is little choice. Just as the use of exogenous substances precipitate impostor molecules vying for receptor sites within the brain, human activities stimulate naturally occurring neurotransmitters. The activity of these naturally occurring psychoactive substances likely will be determined as important mediators of many process addictions.”[24]

In 2005, Dr. Eric Nestler wrote a landmark paper describing all addiction as a dysfunction of the mesolimbic reward centers of the brain. Addiction occurs when pleasure/reward pathways are hijacked by exogenous drugs such as cocaine or opioids, or by natural processes essential and inherent to survival such as food and sex. The same dopaminergic systems include the ventral tegmental area with its projections to the nucleus accumbens and other striatal salience centers. He wrote, “Growing evidence indicates that the VTA-NAc pathway and the other limbic regions cited above similarly mediate, at least in part, the acute positive emotional effects of natural rewards, such as food, sex and social interactions. These same regions have also been implicated in the so-called ‘natural addictions’ (that is, compulsive consumption for natural rewards) such as pathological overeating, pathological gambling, and sexual addictions. Preliminary findings suggest that shared pathways may be involved: (an example is) cross-sensitization that occurs between natural rewards and drugs of abuse.”[18]

This attention to process (or natural) addictions requires focus on metabolic dysfunction in the mesolimbic salience pathways. Just as exogenously administered drugs cause downgrading of dopamine receptors in the nucleus accumbens in addiction, evidence supports endogenously functioning neurotransmitters causing similar pathology.

The prestigious Royal Society of London, founded in the 1660s, publishes the longest running scientific journal in the world. In a recent issue of the Philosophical Transactions of the Royal Society, the current state of the understanding of addiction was reported as it was discussed by some of the world’s leading addiction scientists at a meeting of the Society. The title of the journal issue reporting the meeting was “The neurobiology of addiction—new vistas.” Interestingly, of the 17 articles, two were specifically concerned with evidence for natural addiction: pathologic gambling[23] and overeating.[28] A third paper, addressing animal models of drug and natural addiction, related to DeltaFosB.[19] DeltaFosB is a protein studied by Nestler that appears to be over-expressed in the neurons of addicted subjects. It was first found in the neurons of animals studied in drug addiction[17] but has now been found in the nucleus accumbens related to over-consumption of natural rewards.[18] A recent paper investigating DeltaFosB and its role in over-consumption of two natural rewards, eating, and sexuality, concludes: …the work presented here provides evidence that, in addition to drugs of abuse, natural rewards induce ∆FosB levels in the Nac…our results raise the possibility that ∆FosB induction in the NAc may mediate not only key aspects of drug addiction, but also aspects of so-called natural addictions involving compulsive consumption of natural rewards.[29]

Even more pertinent are recent papers published in 2010 describing the effect of sexuality on neuroplasticity. In one study, sexual experience has been shown to induce alterations in medium spiny neurons in the nucleus accumbens similar to those seen with drugs of abuse.[21] Another study found that sexuality specifically increases DeltaFosB in the nucleus accumbens, and serves a role as a mediator in natural reward memory. This study also found that overexpression of DeltaFosB induced a hypersexual syndrome.[22] As Dr. Nestler said, DeltaFosB may thus become a “biomarker to assess the state of activation of an individual’s reward circuitry, as well as the degree to which an individual is ‘addicted’, both during the development of an addiction and its gradual waning during extended withdrawal or treatment.”[22]

Dr. Nora Volkow, Head of the National Institute on Drug Abuse (NIDA), and one of the most published and respected scientists in the field of addiction is, in recognition of the change in the understanding of natural addiction, advocating changing the name of the NIDA to the National Institute on Diseases of Addiction, as quoted in the journal Science: “NIDA Director Nora Volkow also felt that her institute’s name should encompass addictions such as pornography, gambling, and food, says NIDA adviser Glen Hanson. ‘She would like to send the message that [we should] look at the whole field.’”[7] (emphasis added).

With the increasing evidence that overeating can be an actual addiction as defined by measurable, verifiable changes in the limbic salience centers, our attention to this problem is appropriately increasing. Yet sexuality, with its moral ties, is handled much less objectively in scientific debate. This was apparent in the aftermath of the Hogg study published in 1997, which demonstrated a 20-year decrease in life expectancy for male homosexuals.[12] The authors, apparently feeling social pressure, issued a clarification to avoid being labeled what they called “homophobic.”[11] That a science journal would publish such an apology of sorts is also noteworthy. We believe, however, with the preceding foundation it is time to begin serious discussions of sexual addiction and its components such as pornography.

The proposed DSM-5, slated to publish in May of 2014, contains in this new addition the diagnosis of Hypersexual Disorder, which includes problematic, compulsive pornography use.[1] Bostwick and Bucci, in their report out of the Mayo Clinic on treating Internet pornography addiction with naltrexone, wrote “…cellular adaptations in the (pornography) addict’s PFC result in increased salience of drug-associated stimuli, decreased salience of non-drug stimuli, and decreased interest in pursuing goal-directed activities central to survival.”[3]

In 2006 world pornography revenue was 97 billion dollars, more than Microsoft, Google, Amazon, eBay, Yahoo, Apple, and Netflix combined.[14] This is no casual, inconsequential phenomenon, yet there is a tendency to trivialize the possible social and biologic effects of pornography. The sex industry has successfully characterized any objection to pornography as being from the religious/moral perspective; they then dismiss these objections as First Amendment infringements. If pornography addiction is viewed objectively, evidence indicates that it does indeed cause harm in humans with regard to pair-bonding.[2] The correlation (85%) between viewing child pornography and participating in actual sexual relations with children was demonstrated by Bourke and Hernandez.[4] The difficulty in objective peer-reviewed discussion of this topic is again illustrated by the attempted suppression of this data on social grounds.[15] The recent meta-analysis by Hald et al. strongly supports and clarifies previous data demonstrating correlation with regard to pornography inducing violence attitudes against women.[10] With such strong correlative data, it is irresponsible not to address the likely possibility of causation in these regards. Reviewing this data in the context of current usage patterns is particularly concerning; 87% of college age men view pornography, 50% weekly and 20 daily or every other day, with 31% of women viewing as well.[5] The predictive effect of pornography on sexual behavior in adolescents has also been demonstrated.[6]

Certainly our role as healers suggests we can do more to investigate and treat human pathology related to this new entity of process or natural addiction, particularly given the growing weight of evidence supporting the neural basis of all addictive processes. Just as we consider food addiction as having a biologic basis, with no moral overlay or value-laden terminology, it is time we looked at pornography and other forms of sexual addiction with the same objective eye. Currently, social pressures relegate the management of pornography primarily to proceedings in civil or in criminal judicial venues.[26] This commentary is not a plea to change those practices any time soon. It is a statement that seeks to encourage an examination by medicine in general and the clinical neuroscience specialties specifically of the role for medical treatment in the management of the addictive nature of the pathology of pornography.

In concluding this thought, a Public Health profile of pornography might be useful. Any such profile by its nature will be somewhat primitive because of the current status of the knowledge of the addiction and the environment in which it occurs. Table 1 is an attempt to provide such a profile of the case of pornography, using as a model the investigation of an outbreak of cholera in London in 1854, when the understanding of the Public Health implications of cholera by medicine was perhaps as primitive as that of pornography today. While noting the huge contribution by the industry of the physical material of pornography that will need to be addressed through nonmedical resources, it also suggests a place for medicine in management of the addiction.
Table 1

Table 1 is submitted to help launch the debate of these questions: what are the medical implications of pornography given current evidence supporting an addictive model?, how should they be addressed relative to the major nonmedical resources required for a comprehensive societal response to this problem?, how may the experience of clinical neuroscientists with hypofrontal syndromes be brought collaboratively in support of those scientists experienced in addiction?

Toil, toil, never recoil…


Be encouraged: There is some surprisingly good news about porn

Written by: Jonathon van Maren


April 13, 2016 (LifeSiteNews) – I’ve written hundreds of pages on the porn crisis, and the number one complaint I get from readers is that my columns are too depressing. This is a fair accusation, since I cover a lot of depressing topics. But today, I’d like to share good news with you: There is light at the end of the tunnel.

For starters, The Washington Post just published a full exposé of the porn industry, titling their article, “Is porn immoral? That doesn’t matter: It’s a public health crisis.” This is perhaps one of the most resoundingly anti-porn pieces published in a mainstream newspaper in years, replete with quotes like this:

The thing is, no matter what you think of pornography (whether it’s harmful or harmless fantasy), the science is there. After 40 years of peer-reviewed research, scholars can say with confidence that porn is an industrial product that shapes how we think about gender, sexuality, relationships, intimacy, sexual violence and gender equality — for the worse.…

Extensive scientific research reveals that exposure to and consumption of porn threaten the social, emotional and physical health of individuals, families and communities, and highlights the degree to which porn is a public health crisis rather than a private matter. But just as the tobacco industry argued for decades that there was no proof of a connection between smoking and lung cancer, so, too, has the porn industry, with the help of a well-oiled public relations machine, denied the existence of empirical research on the impact of its products.

The Post is not the only mainstream publication finally acknowledging the scientific consensus on pornography. TIME Magazine, too, published a front page story called “Porn and the threat to virility,” detailing the widespread evidence that compulsive porn use can lean to erectile dysfunction. “Porn,” the cover of the magazine announces, “Why young men who grew up with Internet porn are becoming advocates for turning it off.”

It is encouraging to see that increasingly, pornography is not being treated as a “free speech” issue or a “sexual freedom” issue, but a health crisis. It is a very positive sign that publications which generally cheer on any new manifestation of the Sexual Revolution are beginning to recognize pornography for the cultural cancer it is. I was shocked when Utah recently decided to declare compulsive porn use a “health crisis,” and much of the media coverage was not scornful. Some was even thoughtful.

From FOX13, for example:

Sen. Todd Weiler, R-Woods Cross, filed Senate Concurrent Resolution 9, which declares that pornography is creating a “public health crisis.” The resolution states that pornography is leading to hypersexualization of teens, addiction, prostitution and other problems.

“WHEREAS, because pornography treats women as objects and commodities for the viewer’s use, it teaches girls they are to be used and teaches boys to be users,” Weiler wrote. “Pornography normalizes violence and abuse of women and children; WHEREAS, pornography treats women and children as objects and often depicts rape and abuse as if they are harmless.”

“Whereas pornography use is linked to lessening desire in young men to marry, dissatisfaction in marriage, and infidelity,” the resolution states.

SCR9 asks the “Legislature and the Governor recognize the need for education, prevention, research, and policy change at the community and societal level in order to address the pornography epidemic that is harming the people of our state and nation.”

It’s not just Utah, either. Canadian Member of Parliament Arnold Viersen recently put forward Motion M-47, which would ask the House of Commons standing committee “to examine the public health effects of the ease of access and viewing of online violent and degrading sexually explicit material on children, women, and men.”

The Toronto Sun reported:

Statistics suggest the average age of first exposure to Internet porn is between 10 and 12 in Canada. This makes Peace River-Westlock MP Arnold Viersen worry about how it could affect his children. “They are growing up in a world that’s completely different than the one I grew up in,” he said…

Health professionals have been warning about the harmful effects of violent media on children and adolescents for decades. According to the American Academy of Pediatrics, thousands of studies have “associated exposure to media violence with a variety of physical and mental health problems for children and adolescents, including aggressive and violent behaviour, bullying (and) desensitization.”

And before you scoff and point out that Canada has a Liberal government that is sure to ignore such a motion, remember that when he was asked about violence women, even Justin Trudeau pointed a finger at pornography, noting, “I think there’s probably an awful lot of factors that come together to shape societal behaviour — whether it’s certain types of music? There’s a lot of misogyny in, you know, certain types of music. There’s issues around pornography and its prevalence now and its accessibility, which is something I’m really wrapping my head around as a father of kids who are approaching their teen years. And there’s also just the shifting parental roles as well. There’s a lot of communities in which fathers are less present than they have been or they might be in the past, and there’s more need to have engaged positive role models.”

Great Britain has made moves against pornography, too, with some sources accusing Prime Minister David Cameron of a “war on porn.” From Fight the New Drug:

The UK government is proposing new legislation that will require all sites containing pornographic content to request age verification of visitors to their sites. Rather than porn sites putting an “18+ to enter” button that can be clicked just as easily by an 8-year old as a 28-year old, internet providers will access public information that will help to identify the age of the visitor. This is a huge step forward in protecting kids from the harmful effects of pornography.

The motivation behind this effort, led by Prime Minister David Cameron, is to keep children safe on the internet, preventing them from viewing material which is proven to be damaging to children. A press release from the Prime Minister’s Office states, “Viewing pornography at a young age can cause distress and can have a harmful effect on sexual development, beliefs, and relationships.”

A “war on porn”? Bring it on!

So to those readers who review the statistics on porn use and despair, take heart. There are some in our culture who are waking up to the reality of what pornography has done to our culture, and how many have been swept away by the avalanche of sleaze that the Internet has unleashed. There are now editors and journalists willing to cover this health crisis, and even politicians willing to call it that. We have a long way to go, but for today, at least, be encouraged.


This is a post taken from an article scheduled to be printed in TIME magazine this month…

“The first generation of men who grew up with unlimited online porn sound the alarm
Noah Church is a 26-year-old part-time wildland firefighter in Portland, Ore. When he was 9, he found naked pictures on the Internet. He learned how to download explicit videos. When he was 15, streaming videos arrived, and he watched those. Often. Several times a day, doing that which people often do while watching that genre by themselves.
After a while, he says, those videos did not arouse him as much, so he moved on to different configurations, sometimes involving just women, sometimes one woman and several guys, sometimes even an unwilling woman. “I could find anything I imagined and a lot of stuff I couldn’t imagine,” he says. After the appeal of those waned, he moved on to the next level, more intense, often more violent.
In his senior year of high school, he had an opportunity to have actual sex, with a real partner. He was attracted to her and she to him, as demonstrated by the fact that she was naked in her bedroom in front of him. But his body didn’t seem to be interested. “There was a disconnect between what I wanted in my mind and how my body reacted,” he says. He simply couldn’t get the necessary hydraulics going.
He put it down to first-timers’ nerves, but six years went by, and no matter which woman he was with, his body was no more cooperative. It responded only to the sight of porn. Church came to believe that his adolescent Internet indulgence had somehow caused his problems and that he had what some are calling porn-induced erectile dysfunction (PIED).
A growing number of young men are convinced that their sexual responses have been sabotaged because their brains were virtually marinated in porn when they were adolescents. Their generation has consumed explicit content in quantities and varieties never before possible, on devices designed to deliver content swiftly and privately, all at an age when their brains were more plastic–more prone to permanent change–than in later life. These young men feel like unwitting guinea pigs in a largely unmonitored decade-long experiment in sexual conditioning. The results of the experiment, they claim, are literally a downer.
So they’re beginning to push back, creating online community groups, smartphone apps and educational videos to help men quit porn. They have started blogs and podcasts and take all the public-speaking gigs they can get. Porn has always faced criticism among the faithful and the feminist. But now, for the first time, some of the most strident alarms are coming from the same demographic as its most enthusiastic customers.
Of course there are much broader concerns about porn’s effect on society that go beyond the potential for sexual dysfunction, including the fact that it often celebrates the degradation of women and normalizes sexual aggression. In February, these issues led British Prime Minister David Cameron’s government, which had previously asked Internet service providers to filter adult content unless a user opted in, to begin the process of requiring porn sites to verify the age of their users or face a fine. Shortly afterward, the Utah legislature unanimously passed a resolution to treat pornography as a public-health crisis. And compelling new research on visual stimuli is offering some support to the young men’s theories, suggesting the combination of computer access, sexual pleasure and the brain’s mechanisms for learning could make online porn acutely habit forming, with potential psychological effects.
For Gabe Deem, 28, porn was as much a part of adolescence as homework or acne. “It was normal and it was everywhere,” he says. He grew up in an era when what used to be considered X-rated was becoming mainstream, and he and his friends used to watch explicit videos constantly, he says, even during class, on their school-issued laptops. “It wasn’t something we were ashamed of.” Deem, who lives in Irving, Texas, is the founder of Reboot Nation, a forum and online video channel that offers advice and support for young people who believe they are addicted to pornography, have sexual dysfunctions as a result and wish to quit.
He’s a little different from many of the porn activists, because he was sexually active at a young age and consumed porn only as a side dish. But it came to dominate his diet, and some years after high school, “I got with a gorgeous girl and we went to have sex and my body had no response at all,” he says. “I was freaked because I was young and fit and I was super attracted to the girl.” He went to his doctor. “I said, I might have low T,” Deem says, using slang for a testosterone deficiency. “He laughed.”
Many of the details of his story are confirmed by his girlfriend at the time, who would prefer to remain anonymous. “He would try to start something, and then in the middle he would say, ‘I think we should wait,’” she recalls. “I was just really confused and I would think, Does he not like me? What’s going on?” It took nine months after he told her about his problem for him to be able to perform with her.
Having a partner with ED isn’t the primary problem most young women face with porn, and only a fraction of women report feeling addicted, yet they are not immune to the effects of growing up in a culture rife with this content. Teen girls increasingly report that guys are expecting them to behave like porn starlets, encumbered by neither body hair nor sexual needs of their own.
In April 2015, Alexander Rhodes left a good job with Google to develop counseling and community-support sites for those who are struggling with a porn habit. He had started the NoFap subreddit–a list of posts on one subject–on the popular website Reddit and a companion website called in 2011, but it’s now a full-time endeavor. (The name derives from fap, Internet-speak for masturbation.) The 26-year-old says his first exposure to porn was a pop-up ad–no, really, he swears!–when he was about 11. His father was a software engineer in Pennsylvania, and he had been encouraged to play with computers since he was a 3-year-old. “For as long as there had been an Internet, I had relatively unfiltered access,” says Rhodes. The ad was for a site that showed rape, but he says he only understood there was a naked lady. Pretty soon he was printing out thumbnails of his image-search results for “women’s tummies” or “pretty girls’ boobies.” By the time he was 14, he says, he was pleasuring himself to porn 10 times a day. “That’s not an exaggeration,” he insists. “That, and play video games, was all I did.”
In his late teens, when he got a girlfriend, things did not go well. “I really hurt her [emotionally],” says Rhodes. “I thought it was normal to fantasize about porn while having sex with another person.” If he stopped thinking about porn to focus on the girl, his body lost interest, he says. He quit porn a couple of times before finally swearing off it for good in late 2013. His two sites have about 200,000 members, and he says they get about a million unique users a month.
These men, and the thousands of others who populate their websites with stories of sexual dysfunction, are all at pains to make it clear that they are not antisex. “The reason I quit watching porn is to have more sex,” says Deem. “Quitting porn is one of the most sex-positive things people can do,” says Rhodes. One online commenter, sirrifo, put it more simply: “I just want to enjoy sex again and feel the desire for another person.”
Do their claims of porn-induced ED have any merit? Recent statistics suggest some correlation. In 1992, about 5% of men experienced ED at age 40, according to the U.S. National Institutes of Health (NIH). A study in the July 2013 Journal of Sexual Medicine found that 26% of adult men seeking help for ED were under 40. In a 2014 study of 367 U.S. military personnel younger than 40, a third reported ED. And a 2012 Swiss study found the condition among a third of even younger men: 18 to 25.
Of course, there could be any number of reasons for these findings. Since the advent of Viagra and similar medications, awareness and acceptance of erectile dysfunction is much higher, and thanks to all those TV commercials, the stigma is correspondingly lower, so more people may be admitting to it. Diabetes, obesity, social anxiety or depression can also cause the condition, as can drug or alcohol abuse. As these have risen among the young, so may have instances of ED. But urologists aren’t willing to rule out that pornography could be partly to blame. “I think it’s possible,” says Dr. Ajay Nangia, former president of the Society for Male Reproduction and Urology. “There’s a kind of desensitization of these men, and they only reach the point of feeling stimulated when sex is like it is on a movie.”
If the causes of the spike in ED are up for debate, the unprecedented access to porn via streaming video in the past decade is not. The advent of video sites that, like YouTube (which launched in 2005), allow users to upload, aggregate and organize videos has transformed the way people encounter porn. There’s a staggeringly diverse array of free explicit content that’s constantly expanding because anyone, from amateurs to professionals, can put a video online. One independent web-tracking company clocked 58 million monthly U.S. visitors to adult sites in February 2006. Ten years later the number was 107 million. One of the world’s largest adult sites, Pornhub, an explicit-video-sharing site, says that it gets 2.4 million visitors per hour and that in 2015 alone, people around the globe watched 4,392,486,580 hours of its content, which is more than twice as long as Homo sapiens has spent on earth. Porn is so ubiquitous, it has spun off memes, including Rule 34, which says, “If it exists, there is porn of it.” (Leprechauns? Check. Pterodactyls? Check. Pandas? Check.) The Internet is like a 24-hour all-you-can-eat buffet restaurant that serves every type of sex snack.
And the young are devouring it. Almost 40% of British boys ages 14 to 17 said they regularly watch, according to a February 2015 study by the University of Bristol. Chyng Sun, an associate professor of media studies at New York University, says nearly half of the 487 men she surveyed in one study had been exposed to porn before they’d turned 13. A study in the Journal of Sex Research puts first exposure at, on average, 12 years old for young men.
A massive social shift involving the health of young people usually prompts a robust round of research to assess what’s really going on. But in this case, not so much. It’s hard even to get funding to study how widespread porn use is, says Janis Whitlock, a former sex educator who is now a researcher in mental health at Cornell University. NIH staff reportedly advise researchers against using the word sexual in their funding applications if possible. Neuroscientist Simone Kühn, whose study on porn watching and brain structure was published in the esteemed JAMA Psychiatry, says her employers at the Max Planck Institute were unhappy to be associated with it.
The lack of research is exacerbating a bitter fight in the academic community about the effects of excessive porn use. And there’s not a lot of hard science to decide the outcome.
The young porn abstainers do have an unlikely guru:

Book   Gary Wilson, 59, a former part-time adjunct biology professor at Southern Oregon University and various vocational schools and the author of Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. His website,, or more commonly YBOP, is a clearinghouse for information that supports the link between heavy adolescent pornography use and sexual dysfunction. Many people find him through his 2012 TEDx talk, which has more than 6 million views.

YBOP contends that watching too much onanistic material in adolescence affects the brain in multiple ways. “Porn trains your brain to need everything associated with porn to get aroused,” Wilson says. That includes not only the content but also the delivery method. Because porn videos are limitless, free and fast, users can click to a whole new scene or genre as soon as their arousal ebbs and thereby, says Wilson, “condition their arousal patterns to ongoing, ever changing novelty.”
A heavy porn schedule and the resulting sustained high levels of dopamine reinforces these patterns. “The result in some Internet porn users is higher brain activation to internet porn, and less arousal to sex with a real person,” Wilson argues. And then there’s habituation: the need for more to get the same hit. “Extreme novelty, certain fetishes, shock and surprise and anxiety–all those elevate dopamine,” he says. “So they need those to be sexually aroused.”
Other researchers are dismissive of any link between porn and erectile dysfunction.”In the absence of supporting scientific data, the strength of [these young men’s] belief that porn causes ED is not evidence for the validity of their belief,” says David J. Ley, a clinical psychologist and the author of The Myth of Sex Addiction. “The overwhelming majority of porn users report no ill effects. A very, very small minority are reporting these concerns about ED.”
Ley points to recent studies of young men who use porn, like a 2015 paper in the Journal of Sexual Medicine, in which researchers from the University of Zagreb in Croatia analyzed studies of about 4,000 sexually active heterosexual young men in three European countries and found only a very slight correlation between pornography use and erectile problems. (And only in Croatia.) Another found that porn users who were religious were more likely to think they were addicted. Nicole Prause, a psychologist and neuroscientist, also believes PIED is a myth: “An overwhelming number of studies have shown that the strongest predictors of ED continue to be depression and drug use.”
For the young male activists, however, Exhibit A is always their own physiology. “If you can get a boner with porn and you can’t get a boner without porn, that’s about as hard as evidence gets in my opinion,” says Deem of Reboot Nation. He crosses off every other reason for his sexual dysfunction. Inexperience? “I’ve been a sexually confident and experienced guy since the age of 14,” he says. Obesity? He’s a certified personal trainer with, he says, under 10% body fat. Drug use? He claims to have smoked about five joints in his life. And his ED couldn’t have been due to performance anxiety, because he says he couldn’t get aroused even when masturbating offline on a relaxed Sunday afternoon. “I ran back to my computer to double-check. I turned on porn and bam!”
Beyond the issues facing these young men, there’s emerging research that should give every porn user pause. A 2014 fMRI study from the Max Planck Institute found that habitual porn use may have an effect on the brain. “The more pornography men consumed, the smaller the brain striatum, the reward center of the brain,” says Kühn, the author. “And those who watched more pornography showed less response to pornographic pictures in the same area.” Another study showed that more-frequent porn users were more impulsive and had less ability to delay gratification. And a brain-scan study out of the University of Cambridge in 2014 showed that men with compulsive sexual behavior responded to explicit clips in the same way users of drugs respond to drugs; they craved them, even if they didn’t like them.
The lead researcher in that study, neuroscientist and neuropsychiatrist Valerie Voon, says many of her heavy-porn-using subjects report having erectile issues. But she and Kühn both note that none of this is proof that porn shrinks brains; it could be that people who have smaller reward centers have to watch more porn to get the same thrill. “I would be cautious about using a single imaging study to imply that there has been ‘damage’ to the brain,” says Voon. “We just need more studies.”
The porn-addiction debate is a rancorous subset of a disagreement in the medical and scientific communities about whether it’s possible to classify so-called behavioral addictions, like those to gambling and eating, in the same category as substance addictions, like those to alcohol or prescription drugs. Prause argues that using the word addiction to describe what could simply be a high sexual appetite is unhelpful and may be worsening the problem by stigmatizing it.
But to Voon, who studies addictions, compulsive porn watching sure looks like one, even though it has different properties, including a higher appetite for novelty than other addictions. “It’s possible that the combination of pornographic stimuli being highly rewarding in addition to the novelty might have some kind of greater effect,” she says.
Brian Anderson, a cognitive neuroscientist at Johns Hopkins University, has an intriguing theory. His specialty is habit formation; in February his team released a study showing that visual stimuli that are linked to a reward are harder to ignore when they are encountered again. When the brain detects evidence of the enjoyable stimulus, it pays more attention and blocks out other stimuli. “Your brain is wired to develop those patterns, and when you tie them to something like porn it can be very disruptive and difficult to break,” says Anderson.
He hypothesizes that the visual nature of porn makes it particularly appealing for the brain. “It lends itself to a strong and quick attention bias,” he says. “The brain is going to learn that association very quickly.” And because people’s modern lives are very computer-heavy, there are reminders of porn everywhere. “There probably comes a point in time,” he says, “where you open up your browser and you just start thinking about porn.” (And that’s before virtual-reality tech takes things to a whole new level.)
Since the teenagers guzzling all that porn are digesting it in a brain that is still developing, it’s possible they are particularly susceptible. Philip Zimbardo, emeritus professor of psychology at Stanford University (and the guy who did the famous Stanford prison experiment), notes that porn often goes hand in hand with video games and is similarly finely tuned to be as habit-forming as possible.
“Porn embeds you in what I call present hedonistic time zone,” he says. “You seek pleasure and novelty and live for the moment.” While not chemically addictive, he says, porn has the same effect on behavior as a drug addiction does: some people stop doing much else in favor of pursuing it. “And then the problem is, as you do this more and more, the reward centers of your brain lose the capacity for arousal,” he says. At a time when young men are at their physical peak, he says, all the inactivity may be contributing to the unexpected sexual dysfunction.
Noah Church devotes about 20 hours a week to trying to help others eliminate porn from their lives, or at least to cut out the habit known as PMO (porn, masturbation, orgasm). He has written a free book about it, Wack, runs and counsels people via Skype for a $100 fee. Rhodes, meanwhile, tries to help guys get their mojo back by arranging “challenges,” during which young people try to abstain from PMO for a certain span of time. There are different levels of abstinence: the most extreme (known, ironically, as “hard mode”) is keeping away from any sexual activity, and the least extreme is having all the sexual encounters that present themselves, including those that occur alone, but without visual aids. Deem’s site offers similar strategies, along with a lot of community support and educational materials. He makes money from speaking fees. A group of young men from Utah have started an organization called Fight the New Drug, which has a free recovery program for teens called Fortify.
The young men who wish to reboot their brains describe similar consequences as they titrate off the habit. Some of them have withdrawal-like symptoms such as headaches and sleeplessness. Many of them talk about “flatlining,” a period of joylessness, zero libido and even shrunken genitalia that can last several weeks. “I felt like a zombie,” says Deem. Older guys have reported similar symptoms, but they generally recover faster, possibly because they had more sexual experiences in real life. Football player turned actor Terry Crews recently posted a series of Facebook videos about the damage his porn habit did to his marriage, and his life, though not his virility. He went to rehab. Others report bouncing back more quickly. “I felt more focused, awake, socially confident, connected to others, more interested in daily activities and more emotionally sensitive,” says Church. “I started feeling these changes very soon after quitting.”
Because consuming porn is often done on impulse, NoFap’s newest product is an online emergency button, which when clicked takes users to a motivational picture, video, story or advice, like this: “PMO is not even an option. The way eating yellow snow is not an option. It doesn’t even factor into the decisionmaking process.” The Brainbuddy app, which was developed after a young Australian named David Endacott noticed how difficult it was for him to give up porn, offers a series of alternatives–an activity or an inspiring video. Not watching porn is only half the battle, he says. The brain has to develop new and different pleasurable associations with the computer. Like a Fitbit, the app also tracks how many days users have gone without resorting to the habit. It has had more than 300,000 downloads so far.
The one thing that these young men are not suggesting is an end to porn, even if that were possible. “I don’t think that pornography should be legislated or banned or restricted,” says Rhodes. In any case, legislating porn has always been fraught, and today that’s not just because of the First Amendment but also because of technology. One challenge facing the British proposal to force porn sites to verify the age of their consumers is figuring out how to make that work without invading adult privacy and despite the ease with which most teenagers can subvert online filters. (Reports showed that 1.4 million unique visitors to adult sites in Britain were under the age of 18 in May 2015, after Internet providers’ opt-in filters were in place.) Although one U.S.-based site, Pornhub, has pledged to adhere to the new British rules, the industry is dubious about the health claims. “My No. 1 gripe with the porn industry is that they have been generally unaccepting of the whole porn-addiction recovery movement,” says Rhodes. “They really trivialize it.” (Pornhub declined to answer any questions about legislation or health concerns for this story.)
“As an industry we have seen a lot of moral panics,” says Mike Stabile, communications director for the Free Speech Coalition, the adult-entertainment industry’s trade association. “There doesn’t seem to be a whole lot of reputable science. Should something emerge it might spur discussions.” The industry is not in favor of the British approach that makes Internet users opt in to adult content rather than opting out, says Stabile: “Those filters can block access to LGBTQ groups and sex-education sites.” But that’s exactly the model that state senator Todd Weiler is hoping will be used in Utah. “We’ve changed how we’ve approached tobacco, not by banning it but by putting reasonable restrictions in place,” says Weiler. He’d like places like McDonald’s and Starbucks–and even libraries–to filter their wi-fi so that they would be porn-free.
Providing a counternarrative for teens about the porn they’ll inevitably encounter, despite whatever filters are put in place, is a key goal of the young activists. “Thirteen- and 14-year-olds have access to unrestricted and endlessly novel Internet porn way before they discover that it could potentially have harmful side effects,” says Rhodes. Deem points out that he stayed away from cocaine because he was taught it would harm him. He’d like to see porn treated the same way, with schools teaching about the possible side effects of pornography during sex ed. “I would tell my son, I’ll be straight up with you, all superstimulating things, like Internet porn, junk food and drugs, can be fun and pleasurable, temporarily,” says Deem. “However, they also have the potential to desensitize you to normal, natural things and ultimately rob you of the one thing you thought they would give you, the ability to experience pleasure.”
Introducing porn to sex ed at school would seem a quixotic quest. Sex education is already the source of much conflict, and schools do not wish to be accused of introducing kids to pornography, even if the science of its effects were settled. Parents too are wary of broaching the subject, afraid of what questions might be asked. But curiosity abhors a vacuum; online porn is becoming de facto sex ed for many young people.
Whitlock, the former sex educator, says she has been surprised by how reluctant her erstwhile colleagues are to speak up about porn. She believes that because sex educators were fighting a negative image of sex for so long during the years of abstinence-only education, they’re allergic to anything that questions sexual appetites. She has found that even asking students to reflect on what their watching habits are doing to their mental health is met with pushback. “It makes no sense to me,” she says. “It’s like saying if you question the value of eating Dunkin’ Donuts all the time that you’re ‘food negative.’”
An ideal way to deliver the message might be online, but ironically, many of these efforts are thwarted by porn blockers. That’s a problem for Brainbuddy. Its creator feels it’s important to get it to the 12-and-older crowd, but users must be over 17 to download it.
The shame around a compulsive porn habit makes asking for help difficult, even though neuroscientists say it could happen to anyone. Then there’s the reverse stigma for young men who speak against the genre in a culture that celebrates sexuality. Deem and other advocates know they are walking into a headwind of apathy, antagonism and ridicule. But they’re not dissuaded. “If anything is going to change,” says Deem, “it’s going to have to come through the guys who went through the trenches, who were actually clicking the tabs and watching the hardcore porn when we were 12.”
One of the newer NoFap members (known as Fapstronauts), a 30-something gay man just starting a 30-day challenge, puts it this way: “When I think about it,” he writes, “I’ve wasted years of my life looking for a computer or mobile phone to provide something it is not capable of providing.”
This appears in the April 11, 2016 issue of TIME. Tap to read full story