We have written about the often contrary claims made by commentators about the current state of research on, and clinical understanding of, problematic internet pornography use (a.k.a. “pornography addiction”) and its effects. On one hand, a body of scientific literature appears to support the view that problematic pornography use qualifies as an addiction and often leads to sexual problems including, notably, erectile dysfunction. On the other hand, a vocal group of skeptics use words like “pseudo-science” and “moral panic” to dismiss research linking pornography to sexual dysfunction, and decry “porn addiction” as the invention of a treatment industry in search of a new and profitable problem to solve.
We at PornHelp overcame an addiction-like dependence on internet pornography, and as such tend to favor the former view. That said, we don’t claim to be able to vouch for the quality or reliability of scientific research that is beyond our learning. Often, we are only able to catch the general drift of articles in science journals, and compare the conclusions to our own admittedly anecdotal experiences in order to form a judgment. Still, regardless of how snowed we are by the technical minutiae, we take notice when an article captures the essence of what it was like for us to struggle with porn, particularly if it also makes tangible recommendations about ways to isolate and test factors that could contribute to internet porn becoming a source of distress and destruction in a person’s life, as it did in ours.
“Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports”, published earlier this month in the journal Behavioral Sciences, fits that bill. With seven United States Navy doctors among its co-authors, this new article pairs a review of the latest scientific research on internet porn use and sexual dysfunction with three case studies from the Navy authors’ clinical practices. It argues that current research supports the conclusion that internet pornography is a key contributor to the sharp rise in reports of sexual dysfunction among men under forty in the past decade. It also makes detailed and, we think, apt recommendations for future areas of study.
The article follows an analytical trajectory that will look familiar to anyone whose life has been consumed by problem porn use. The authors begin by proposing that research on internet pornography establishes it as a “super-normal” stimulus that is particularly effective in catching and retaining the brain’s attention, a quality known as “salience.” This is so, the authors contend, because internet porn is an “exaggerated imitation of something our brains evolved to pursue,” and because internet porn's near-infinite availability and variety feeds an equally hard-wired evolutionary preference for novelty. The authors next point to research that suggests “chronic Internet pornography use may become a self-reinforcing activity.” That is, the more you use, the more you want and need to use. If that sounds like an addiction process to you, it does to the authors also. Reviewing the symptoms reported by one of the authors’ patients, they draw a parallel between those symptoms and the criteria for internet gaming disorder, a widely accepted addiction diagnosis.
Finally, the authors review a large body of neuroscience research, including a study co-authored by one of the most prominent “skeptics” mentioned above, and posit that the findings support their hypothesis that sexual dysfunction results from “neuroadaptations” in internet pornography users’ brains. Things get a little complicated here, but the basic idea is that internet porn use can change the brain in two meaningful ways: it can make a user more sensitive to “cues” associated with using internet porn, while it also makes a user less sensitive to the “rewards” of normally rewarding activities, such as partnered sex. The authors propose that this combination of brain changes results in users’ desire to consume porn supplanting their desire to have partnered sex, and to a decline in sexual arousal from partnered sex.
People who struggle with problematic porn use know firsthand what these changes are all about. The first change is responsible for that sudden, insistent craving to use porn that arises after seeing a seemingly random image - say, an advertisement for a beach vacation. The second change is what builds up porn tolerance, prompting a need for more volume and variety to stay sexually excited and a loss of interest in real-life sexual situations. Now, as we’ve mentioned, we can’t speak to the specific evidence of “neuroadaptations” described in the research, much of which is, candidly, over our heads. But, we can say that hair-trigger cravings for porn (but not sex), an unquenchable thirst for more and different content, and a near complete loss of interest in and arousal from partnered sex, sums up the experiences of many former problem porn users pretty darn well. Ok, back to the article.
After reviewing the existing evidence, the authors suggest several avenues for future research that we think are well-tuned to advancing the discussion of how best to treat problematic porn use and associated sexual dysfunction. The authors push for more “intervention” studies, where a group of internet pornography users reporting sexual dysfunction have internet pornography removed from their lives for a period of time and are monitored to see if their sexual dysfunction dissipates. We find it surprising that only a few researchers have taken this approach, considering that widespread posts on internet forums such as NoFap.com and RebootNation.org report that refraining from internet pornography use restored sexual function and desire for partnered sex that had gone missing during a period of frequent porn use. The authors also suggest adding more nuance to correlative studies. Instead of simply using frequency of internet porn use as a variable (as many studies have thus far), the authors suggest evaluating more subtle and telling formulations, such as how many years a person has masturbated with porn compared to years masturbating without porn, the ratio of orgasms a user has with pornography to orgasms a user has in partnered sex over a given time period, and the age at which a user’s pornography use began.
We think these suggestions are on-target because they capture what many of us have experienced. Anecdotally, things take a turn toward the destructive when users isolate themselves from their lives and loved ones in order to find time to use internet porn. The variables the authors propose may help identify factors contributing to that turning point, and perhaps even prevent it.
“Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports” will not end the debate that continues to rage in the popular press about whether pornography addiction "exists" and whether pornography use can lead to problems like erectile dysfunction. But this article does make a sophisticated and hyperbole-free contribution to the discussion. For those who know firsthand the difficulty of struggling with a pornography use problem, and the frustration of trying to find useful information about their condition, that’s a welcome step in the right direction.
The internet has been a major contributor to the growth of problematic porn use, PIED, and similar issues. But, here at PornHelp, we think another factor has been equally, and perhaps even more, significant: virtually unlimited amounts of porn on the internet are available for free. As much as the internet made it possible to avoid the social stigma of being seen in public buying porn, free porn has enabled overuse and abuse by removing financial breakwaters to accessing vast oceans of porn videos. Speaking from personal experience, we believe there’s a direct correlation between the ever-expanding availability of free porn on the internet and the intensification of a porn use problem, particularly among people too young to have a credit card or PayPal account.
Still, we’ve always wondered: why is porn available for free? The bulk of porn (even so-called “amateur” porn) is produced as a commercial product. It costs money to make even a low quality porn video, and that cost has to be recouped somehow. So, how is it that enough porn is available to make it possible to binge on porn for years without ever spending a penny? And, is there any hope of that changing?
Two posts on Quora, here and here, provide fascinating responses to those questions. (Trigger warning: these Quora posts name porn sites and generally acknowledge the nature of porn content.) One, written by Garion Hall, the owner of a popular porn site, explains trends in the industry at large. The other, written by Sabrina Deep, a popular adult performer and writer, discusses what it really means for porn to be “free”. Their conclusion, to paraphrase Milton Friedman, is that there’s no such thing as free porn…almost.
To set the stage, we find it helpful to compare the porn industry to the music industry, which is in a period of massive transition brought on by internet connectivity and evolving methods of sharing digital media. The music business has been very aggressive in tackling digital copying and sharing. Yes, illegal sharing of music online continues to be a problem, but today it’s pretty hard to download a popular album from the internet “for free” without, at the very least, knowing you’re doing something you shouldn’t. The music industry’s clampdown on digital sharing has managed to be pretty effective among average consumers because music distribution has historically been concentrated in the hands of a few large, well-financed players. The same is also true of the tv and movie industries, which have also pursued aggressive anti-piracy campaigns.
In contrast, according to Hall and Deep, porn has historically been an industry of small producers who were not able, or willing, to mount an effective, coordinated response when digital sharing exploded and their content began appearing everywhere on the internet. The industry has started to consolidate, notably in the form of the most popular “tube” sites coming under the control of the company Mindgeek. But, says Hall, for the moment Mindgeek’s business model is itself based upon exploiting the weakness and lack of coordination among small porn producers A significant portion of Mindgeek’s “tube” content consists of stolen videos, which it takes down only when asked. Mindgeek’s idea, it seems, is to establish a dominant position as an online porn distributor, so that eventually any producer who wants adult content to reach a large market must pay Mindgeek for access to a “tube” site. Deep also points out that Mindgeek controls two large porn production houses, making it “vertically integrated" and allowing it to promote its own content. The upshot: someone is paying for that "free" porn, and it's probably the small-time porn producers whose videos are being pirated.
Ok, sure, you may be saying, that’s all well and good, but porn is still free for consumers, right? That depends on what you mean by free, says Deep. To begin with, pirating increases the costs of paid porn for anyone who opens their wallets to buy adult content. But that's not all. Porn sites - not just the “tubes,” all of them - earn revenues by bombarding users with advertising and mining users’ personal information. Sites install cookies on consumers’ computers, and sell the information to aggregators and advertisers. So, porn is “free” only in the sense that users are not forking over hard currency in exchange for pictures and videos. But, those consumers are still parting with substitute currencies - namely, their attention spans and information about their erotic tastes, viewing patterns and buying habits. The same goes for porn found on social media platforms (which, if anything, have far more advanced analytics available to them, and more well-heeled customers lining up to buy their data). And, of course, once porn users start moving away from “mainstream” porn and social media sites to more obscure corners of the internet, they risk malware infections and other nastiness. So, says Deep, porn isn’t as “free” as it appears.
Deep and Hall predict more changes in store for the porn industry as digital sharing and a cumbersome digital copyright enforcement system continue to decimate the business model for small producers. In time and in some ways, the porn industry seems likely to mature and come to resemble the music and film businesses. At that point, perhaps producers and large distributors like Mindgeek will find a reliable way to charge for porn and prevent most users' access to pirated "free" content. That development would certainly help prevent some problematic porn use, particularly in young people.
And yet, there is already an infinite catalog of porn out there, available for download by anyone comfortable with parting with their personal information and/or risking a malware infection (which is to say, just about any teenage boy alive). The digital rights to all that porn are so widely dispersed, and its commercial value is so minimal, that it seems impossible the porn industry will ever want, much less manage, to retake control of it. So, unfortunately, even if the porn industry installs effective controls on future porn videos, it seems unlikely the industry will ever rebuild financial barriers to accessing existing porn sufficient to make a meaningful dent in the growth of problematic porn use.
In our most recent post, we picked apart the dictionary definition of “addiction.” Our conclusion: people use the word “addiction” to say so many things in so many contexts that the word has become practically meaningless. The sentence “John is addicted to slot machines” could mean John really enjoys slot machines, or that John has a debilitating gambling problem, or both. Confusion reigns.
That seems, to us, like a problem worth addressing. “Addiction” is one of the most prominent concepts in social discourse today. Shouldn’t we all at least try to get on the same page about what it means?
In this post, we look at a definition of addiction that we all might rally around. It’s a definition of “addiction” developed by experts in the field of addiction medicine. And, it has some fascinating implications for coming to grips with how some of us used, and abused, porn.
The American Society of Addiction Medicine defines “addiction” this way:
"Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death."
Now, that’s a lot to chew on, so let’s break it down. First, and most prominently, addiction is called a “disease” (which, interestingly, is the same word 12-step programs have used to describe “addiction” for decades). It’s a disease that’s “primary” (meaning it arises spontaneously, not as a result of some other disease, injury or event) and “chronic” (meaning it’s long-lasting). And it’s a disease affecting the brain’s circuitry for “reward” (the brain telling you something feels good), “motivation” (the brain telling you to do something) and “memory.”
Next, according to the ASAM definition, this disease of addiction has certain characteristic “manifestations”, or traits, summed up with the mnemonic device “ABCDE”: “Inability to consistently Abstain, impairment in Behavioral control, Craving, Diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional Emotional response.”
Finally, this disease of addiction is reflected in behaviors, namely “pathologically pursuing reward and/or relief by substance use and other behaviors.” What’s so fascinating about this final element the ASAM definition of “addiction” is that these behaviors - doing drugs, binge drinking, etc. - are what we commonly think of as “being addicted.” But, according to the ASAM, that’s not quite accurate. The behaviors aren’t “addiction” themselves, but rather, they are actions signifying the presence of a brain disease called “addiction” - a disease that exists independent of those actions.
To put it another way, the ASAM definition of “addiction” suggests that the problem might not be that the sentence “John is addicted to slot machines” has multiple potential meanings. Instead, the problem could be that “John is addicted to slot machines” misuses the word “addiction” altogether. If the ASAM definition holds true, John isn’t addicted to anything. Instead, the accurate way to describe John’s condition would be “John has a brain disease called addiction. In John, that disease shows up in the way he can’t control himself around slot machines.” And, if that’s the case, then addiction could show up in lots of other ways, too, such as compulsively binging on porn.
The ASAM definition has the potential to change the way we use the word “addiction.” It also raises complex and challenging issues for another day, like “if addiction is a disease, how does a person contract it?” and “if my compulsive, destructive actions are the result of my having a brain disease called addiction, what responsibility do I have for them, and for seeking treatment?” It also bears noting that the “addiction as disease” concept does not enjoy universal acceptance. One commentator, for instance, recently posited that addiction isn’t a disease but, instead, it’s a learning disorder.
For our part, we find the ASAM definition of “addiction” somewhat comforting. For many of us, the awful experience of compulsively binging on porn, despising what it was doing to our lives, and trying to stop but repeatedly failing, led to enormous confusion. Why was this happening? What the hell was wrong with us? Perhaps the answer to those questions was “addiction” in the ASAM sense, a dysfunction in our brain’s reward, motivation and memory circuitry that led to the behavior we so hated, but could just as easily have led to some other equally destructive actions, like runaway drug use or problem gambling. Gaining that perspective on our porn use problem eased the shame we felt about our vexing, embarrassing failures, and offered us a tangible, identifiable problem to tackle once and for all.
Even so, it also occurs to us that perhaps we’re asking the term “addiction” to do too much work in the lives of people struggling with problematic behaviors. Maybe the many afflictions we refer to as “addiction” exhibit too many causes and variations to be captured in a single word. Instead, maybe it's better to focus on making sure people have access to resources for helping them stop destructive behaviors, whatever we call those behaviors. After all, for people stuck in a downward spiral of porn abuse, often the most important thing is simply knowing that they’re not alone and that there is hope for finding a way out.
Longer-form writing from the PornHelp team on current topics relating to problem porn use and recovery.