New Treatment Models for Teen Porn Addiction

The enormous global proliferation of online pornography has made a vast array of sexually explicit material available to a large teen audience on laptops, tablets and smart phones. And if smart accessories catch on, you will soon be able to wear your pornography.

Online pornography accounts for such an overwhelming proportion of internet traffic that a new search engine has been created specifically for adult content. It was designed by two former Google employees and searches only for pre-screened adult content that is free of illicit or malevolent intent. It is also designed to protect the user from cookies and other forms of identity tracking. The site was launched on September 15th and according to the founders has “taken off like a rocket.”

Internet porn has long been seen as more readily accessible than riskier and more costly habits like prostitutes, massage parlors or anonymous hook-ups. This in turn makes it more easily available to youth, with the typical first exposure being in the pre-teen years.

Effects of porn on teens and young adults

A study published this summer in the by the UK’s Institute for Public Policy Research surveyed 500 18-year-olds about the impact of porn on their lives. Most of the respondents reported that accessing pornography was common throughout their school years, began in their early teens and had a damaging effect on their sexual and relationship lives.

Dr. Anthony Jack, a researcher and neuroscience professor at Case Western Reserve University stated that recent studies show “…widespread rates of sexual dysfunction… such that approximately 50% of late adolescents of both sexes report sexual dysfunction of clinical severity”.  (See “Your Brain on Porn” by Gary Wilson)

Another study published this month by researchers in the US found that among a sample of over 900 emerging adults in college more frequent porn viewing was correlated with a greater number of sexual hook-ups and one night stands.

Other recent studies of the brain activity of chronic porn users have begun to show detrimental effects such as:

• Less gray matter and reduced reward center activity while viewing sexually explicit imagery, i.e. desensitization.

• A weakening of nerve connections between the reward centers and the higher brain centers thus increasing impulsiveness and impairing decision making.

• Porn induced erectile dysfunction

As one of the researchers put it, “…regular consumption of pornography more or less wears out your reward system.” And clinicians here and abroad are seeing many more young adults and teens who can achieve erection and ejaculation with porn but not with a real person.

Treating the young porn addict: three models

The current crop of very young addicts have some special characteristics. The pre-teen brain is not fully mature and their emerging sexuality programs them to react powerfully to sexual stimuli. Getting hooked on porn at an early age can be damaging in at least three different ways. These in turn require interventions very different from the years of addiction treatment and relapse prevention that are appropriate for most adult addicts.

I. The drug-driven model

Jeff’s addiction appears to have come about through the habit-forming nature of porn itself in the absence of any other obvious psychopathology.

At first I thought Jeff was just like any other sex addict client, only younger. He had been watching porn on his computer since he was 13, and at age 18 he realized he had begun to fixate on child porn. Fortunately this scared him enough that he came clean to his parents who put him in a 6 week residential program for sex addiction.

After the residential program Jeff saw me for therapy for about a year. He also attended weekly Sex Addicts Anonymous meetings. He was an attractive, sophisticated kid with a sunny disposition, but at 20 he was still a virgin who had never dated a girl. While he was seeing me he began dating a very appropriate same-age young woman and eventually began a robust sexual relationship with her. Although that relationship ended he never returned to porn use that I know of. I am as certain as I can be that he had no residual attraction to children.

What is striking is that although Jeff went along with the usual program of sex addiction recovery, what seems to have worked for him was just getting away from porn! With abstinence, it seems his young brain rebalanced and in a period of months he was able to resume normal sexual development. He became more outgoing and began college with the ambition to become a filmmaker. Jeff needed a structure that would allow him to stay away from porn along with some outside support to get his life back on a normal track.

II. The trauma model

Brad discovered internet porn at 12 and became instantly hooked. He reports that his use escalated very rapidly as did his sexual tastes. He was binging on porn very heavily every day. While still in his teens he says that he quit, primarily out of exhaustion. His sexual interest diminished to zero and as of his mid 20’s he reported that his libido seemed to be permanently gone. He attributes this result to a kind of virtual sexual trauma.

There is some research that would support the idea that very early exposure to sexually explicit material can have effects on the developing psyche similar to actual sexual assault. The young mind is not ready to deal with the shock, adrenaline and stress of the hyper-arousal caused by porn. It thus constitutes a violation which can leave lasting sexual scars. Brad correctly sought out treatment with a specialist in sexual trauma rather than sex addiction.

III. The hybrid model

Ken is a happily married man in his late 20’s. He entered treatment for an addiction to porn and masturbation dating from childhood. He had no other sexually addictive behaviors but he had significant early trauma. His father died of a cocaine overdose when Ken was a toddler. Ken became the “man of the house” at age 3 and soon after had a serious illness requiring months of hospitalization. He had an unhealthy relationship with his narcissistic, demanding mother. Also as a child he witnessed his teenage sisters being molested by an older cousin.

After about 8 months of abstinence from porn and with the support of group therapy Ken has shifted gears. His relationship with his wife whom he adores is going well and he is comfortable with a new-found intimacy with her. In fact Ken no longer presents as an addict; he does however have issues that he knows he needs to work on. In particular he knows he has never fully understood or worked through his early childhood experiences and he is working his way out of his enmeshed relationship with his mother. He is appropriately seeking help for these problems and appears to be at zero risk of relapse into porn addiction.

So the good news is that the youthful porn addict’s brain can recover and resume a more normal developmental trajectory. And given that their only addictive behavior is internet porn and that their total time of usage relatively short, they do not have to overcome addiction as a pervasive and deeply entrenched coping style. They can get cured and stay cured. The bad news is that there is as yet so little awareness of the risks to children and teens on the part of the medical profession, the academic community, schools and the public at large. As with so many public health issues, prevention and education are sorely needed.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Signs of a Porn or Sex Addiction Relapse

When a client who is trying to avoid a sex addiction relapse has had a slip I can often tell before they say anything about it.

At first I wasn’t sure what it was that I was seeing; whether it was just intuition or whether they were actually doing something different.  And with some clients I could tell right away and with others I couldn’t.  So what was the difference?

Signs of a relapse

When I see clients who have had a slip since the last time I saw them I can sometimes spot the following signs:

A difference of style.  The addict who is coming in laden with the knowledge that he has had a slip will likely be thinking about the fact that they have to discuss it with me.  This often results in their seeming to be superficially jocular or casual.  They seem to be tap dancing, probably because they feel embarrassed or ashamed about having let themselves and me down.

A difference in cognition.  To a greater or lesser extent, a sex addict who has had a slip or a relapse will be suffering from the aftereffects of their drug.  In order to go into the slip in the first place, the addict will have had to let go of part of their rational thinking, the part that has to do with weighing consequences, and thinking logically about the decision they are about to make.  This suspension of higher order thinking, being in the “bubble” as it is called, may have residual effects on their apparent ability to think clearly and communicate clearly.

Lack of focus.  The addict who has had a slip may seem scattered in the aftermath.  They are not completely able to integrate what they know they have done to endanger their recovery and part of them doesn’t want to think about it or about anything else.  They may deflect or divert the conversation and go off on tangents.  They may even be questioning their interest in recovery, their need to change or the appropriateness of the program.

When are these signs missing?

Why is it sometimes easier for me as a therapist to spot a client who has relapsed than it might be for other people in their life, even their partner?  And when are they able to fool me as well?

I think the answer has to do with the level of commitment to recovery that the addict has achieved.  Most of my clients are trying to be honest with me.  When they have something to say that they would previously have lied through their teeth about, they have an automatic high level of cognitive dissonance about it which causes some visible distress symptoms.

Likewise when the addict is still somewhat on the fence about whether and how much of their sexual acting out they really want to give up, then they will be better able to lie to themselves and therefore their deception will be more impenetrable.

It follows that the more someone has become committed to recovery the more difficult it will be for them to conceal the truth from someone they are close to.  When an addict has not really given up the need for secrecy as a way of life, they will more readily adopt a false persona that may be hard to see through.

An addict who has lied to his wife for years and then gotten into recovery may be better able to slip into old deceitful habits with her than with a new person such as a therapist.  The addict may have been doing well in recovery so far but when it comes to intimate relationships, recovery is more than just avoiding sex  addiction relapse. Relationship recovery and the building of honesty and trust is a long term process that involves revamping the entire basis of the relationship.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Relapses and Slips in Porn and Sex Addiction

It is accepted among those of us who work with porn and sex addiction that there will be relapses or “slips” at some point in the first year or so of recovery.  Internet pornography in particular is notoriously hard to quit.

Sex addiction is  clever and devious.  It wants to find a way to come out and play.  So even when the addict is totally abstinent from his or her “bottom line” behaviors (behaviors that the addict has identified as the ones that need to be out of bounds) the addict may engage in other watered down kinds of behavior to get a “hit.”  For example, the addict who wants to quit internet pornography may find himself watching movies that have a significant amount of sexual content or looking at YouTube or Facebook videos that are suggestive or outright sexual.

But in early recovery addicts are likely to repeat even their bottom line sexually addictive behavior at some point.  So when is this something to be concerned about? When should it be called a slip and when should it be seen as an out-and-out relapse?

When is it just a slip?

What is counted as a slip is doing the addictive behavior (e.g. going to a strip club, watching porn, engaging in cybersex, having a sexual hook-up with a stranger, or getting together with an old affair partner).  It is not doing the things that lead up to the bottom line behavior but it is actually doing something that is what you have decided not to do any more.  (Slips will usually count as sexual acting out and will mean changing your sobriety date.)  What I believe makes it a “slip” rather than a relapse is:

  • You perform the sexually addictive behavior without planning to.  You did not enter the situation consciously intending to do the behavior.  It “just happened” and you may feel a certain shock at finding yourself in the situation.
  • You do the behavior only once.  You realize immediately what you have done and you get out of the situation before you do it again.  You turn off the computer, you hang up the phone, you get rid of the person’s contact information etc.
  • You talk about it with someone like a sponsor, counselor or recovery partner and you describe it in your regular 12-step meeting right away.  You do not attempt to hide it or minimize it.
  • You figure out what you need to learn from the slip. This means that you use the slip to gain a better understanding of the circumstances that can lead up to you slipping.  Do you have to plan your day or evening more carefully? Should you be more aware of slippery situations like business trips?  You will need to anticipate known stressors or other things that constitute your “relapse scenario” as it is called.
  • You may change your recovery plan in response to the slip.  You might decide to put additional behaviors, people or activities, such as browsing singles ads, into your list of bottom line behaviors so that you see them as relevant to your staying abstinent.   You may also consider whether other addictions such as alcohol or drug use have played a role in your slip and consider addressing them more strenuously.  And you may want to consult with a doctor if appropriate when you believe you may have psychological issues or need medication to stay emotionally stable enough.

Avoiding Relapse

If you respond to the incident of sexual acting out in the way described above you will have gone a long way to avoiding a full on relapse in which you continue the acting out behavior.  Often people have a slip and decide that it is a relapse.  They therefore feel “What the heck! I’ve already blown it; I might as well go all the way.”  This is using the slip as an excuse to keep acting out.  But the fact is a slip does not mean that you have blown your program.  It is an opportunity to make your program better and to learn about yourself.  If you use it.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

How Much Porn Can You Watch Before it’s a Sexual Addiction?

Sexual AddictionThis is a very different question from the standpoint of the person using the porn versus the standpoint of a spouse, partner, boyfriend or girlfriend of the porn user.  Spouses and Partners may be worried about something the person is doing that makes them uncomfortable.  Porn users are worried about whether being a sex addict is something they need to worry about at all.

I know of no hard and fast rule about how much porn viewing makes you an addict.  And it is sometimes confusing because using internet pornography may be the addict’s primary and sometimes even their only behavior, but more often it is part of a pattern or set of behaviors.  Some porn addicts may have other sexually compulsive behaviors like seductiveness, affairs, online sexual hook-ups, use of prostitutes or visiting sexual massage parlors.  Viewing internet porn may exist along side one or more of these as a part of an overall sexual addiction.  Nevertheless is is possible to look at what factors do and don’t make porn an addiction.

It’s not the exact number of hours per week

If a person is a “recreational” porn user and has no other addictive sexual behaviors they may not have any problem at all.  However, this assumes that they can stop if they want to and that they can honor their partner’s feelings if their partner wants them to stop.  It also assumes that they are capable of being honest about what they are doing and are not leading a double life.  Further it assumes that the use of pornography is not interfering with their having a relationship life in the first place.

So searching for an exact number of hours of watching internet porn is difficult.  It is like the question “How many hairs do you have to lose before you are bald?”  But at the extreme end of the scale where the person is watching porn several hours a day or 20 hours a week it is clear that there is some kind of a problem.

It’s not the content

Some people might think that if the content of the pornography being used is especially bizarre or violent or even illegal that this means the person is an addict.  Such people may have problems or fetishes but they may not act them out in an addictive way.  Likewise the fact that a porn addict only looks at “normal” heterosexual scenarios does not mean that he or she is not a sex addict.

It’s how you do it that makes it addiction

  • Addiction has been described as a pathological relationship with a mood altering experience.  The use of porn as an addiction involves the use of sexual arousal and gratification as a way to escape from unpleasant feelings in the same way that using alcohol and other drugs is a way to numb out or escape.
  • Another of the key features of porn as an addiction is that the addict continues to engage in the behavior even though it has negative consequence.  Like a drug addict, a porn addict will take extreme risks such as viewing porn on his work computer even though it may mean losing his job.  And the addict will not stop there but will continue to use porn despite what it costs in terms of the damage it does to his life or livelihood.
  • A distinguishing feature of porn or sex addiction is that it goes against the addict’s basic value system.  If there is no effective intervention the porn or sex addict continues in the addiction regardless of the harm to himself or others he is close to.  The addict does not like what he or she is doing and often feels very bad about it.  The fact that it continues is evidence that an addiction is present.
  • Porn addicts are also people who want to quit at various times and who have every intention of quitting.  Sometimes these are merely cynical ploys but very often they are real intentions.  And yet the fact of doing something despite the intention not to do it is a sign that addiction is present.
  • Lastly, any sex addiction including porn addiction is distinguished by the fact that it involves the avoidance of intimacy.  The addict removes part of himself from the relationship with a significant other and compartmentalizes it in a particular sexual activity.  This is the intimacy “disability” or intimacy avoidance that is present in some form for most sex and porn addicts.

So to sum up:  If the person is not using pornography to medicate anything, is feeling fine about it, is able to be honest and open about it with a partner, is able to maintain an intimate relationship in which he shares all parts of himself, is not taking risks, losing jobs, going into debt or otherwise ruining his life for the sake of porn and is able to make a decision to quit and stick to it when there is good reason to do so then the person is probably not a porn addict.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource

Fighting Porn Addiction: Should Porn be Against the Law?

Even if they do not talk about the problem in terms of porn addiction, many countries are concerned about the mushrooming consumption of porn and are making moves in the direction of criminalizing internet pornography.  A number of countries already have.  The concern is not only about child porn but all hardcore online porn.

Whether governments should ban porn or not is a complicated matter that is debated on many levels.  But there is also a debate about whether it is actually possible to stop the flow of porn onto the internet. 

Let’s look at these two questions separately.

Should countries prohibit hardcore adult porn?

A number of countries are either attempting to enforce existing laws against pornography by blocking internet porn sites and/or by prosecuting those responsible for the porn sites.  A number of other countries are in the process of trying to make online porn content illegal.

Hardcore pornographic content is already being blocked in China, Hong Kong, Singapore, Gaza Strip, Indonesia and Pakistan and there is a complicated regulatory structure in Australia.   (See the Wikipedia catalog of countries and their existing porn laws.)

In other countries there is heated debate and movement toward the banning of internet porn, such as India, Egypt and Iceland.  And in the UK and the US there is controversy about and resistance to making or enforcing laws that criminalize the posting or viewing of hardcore adult pornographic content.

Some of the main arguments for making anti-porn laws (or for enforcing laws that may be on the books) are:

-Porn is socially unjust in that it is oppressive toward women (Iceland),

-Porn is causing violence against women (India)

-Porn is socially and morally corrosive (China, Egypt and others)

-Porn addiction is a problem for many adults (US, UK)

-children can be inadvertently exposed to harmful content (US, UK, Iceland and others)

The arguments against criminalizing adult hardcore porn are mainly that such laws would violate freedom of expression, that porn is personal and is something that should not be controlled by governments and that there are legitimate positive uses for pornographic content.

Is it possible to outlaw internet porn?

A 2011 International Herald Tribune headline states: “Over 1,000 porn sites blocked in Pakistan.”  Although at that time Pakistan was continuing to find and block sites, the article goes on to say that there was a list of over 170,000 websites that might be banned.  The article says:

“Blocking 170,000 sites is not feasible for any operator.  The screening time on a per request basis will essentially slow the internet down to make it unusable.”

The International Business Times last month had an article on China’s anti-porn ban which reported that the creator of China’s biggest porn site was convicted and sentenced to life in prison in 2005, and that movie producers and film studios creating erotic films can potentially lose their licenses to make movies.

But the article goes on to state:

“Still, with constantly developing technology, and the demand for pornography, Internet users are still able to access pornographic material.”

Last month the L.A. Times reported that following anti-porn demonstrations, Egypt now has a plan to implement a court-ordered ban on porn websites.  The plan is to target each individual website and will cost about $4 million.  This is a big and controversial expense for a country that is under pressure economically.  This seems like a never ending if not impossible task for any government to attempt.  And if porn cannot be interdicted at the level of the website or the internet service provider it seems like a hard sell to prosecute individuals for watching the material that is currently flooding the web.

I am convinced that porn addiction is a growing problem and that the epidemic of porn consumption around the globe shows no sign of slowing.  The process of getting the product to the customer via the internet is extremely sophisticated and difficult to regulate.

Yet we do regulate some products that are addictive and/or damaging such as cigarettes, alcohol and even the sexual content of movies.  People need to find a way to agree on some basic ideas about what content should be regulated, especially as regards children.  The problem of implement regulations on internet content, like the problem of combating porn addiction, will probably be a long and difficult process combining the efforts of research, technology, public heath and advocacy.

The One Essential Key to Porn and Sex Addiction Recovery

Some people start recovery for sex addiction at a full gallop and never look back.  But for people who struggle with sex and porn addiction and who have multiple slips or periodic relapses there is one key thing they may be missing.

I’m not talking here about the spiritual enlightenment side of it, the so called “white light moment” or even just the daily spiritual practice.  Those are important elements but there is something much more mundane than that.

A simple idea with big ramifications

It sounds deceptively simple but the thing you need to get your head around in recovery is that your recovery comes first.  Deceptively simple because it is very hard to put this idea into practice.  For one thing although addicts may be selfish and narcissistic, that does not mean that they are any good at getting their priorities straight.

The idea that  recovery literally comes before anything else. 

You might say well what if I am having a heart attack?  Should I go to a Sex Addicts Anonymous meeting or to the emergency room?  Well of course you need to deal with really life threatening situations first.  But in day-to-day life it is important to take the commandment to put recovery first quite literally.

Why is this so important?  Because addicts find excuses to avoid getting sober.  The need for the “drug” leads to rationalizations for putting other things ahead of the addict’s own need to recover.  This is faulty logic.  And it is part of the “cunning baffling and insidious” nature of the addiction talked about in the 12-step literature.

Isn’t spending time with your kids more important than your own recovery?  My addict clients are surprised when I challenge this idea.  Off the top it seems selfish and harmful to their children to disappoint them and undermine the closeness.  But dropping the ball on your recovery work is more harmful in the long run to everyone concerned.

There is a saying in 12-step circles that “Anything you put ahead of your recovery you will lose”.

This is profound  The reason recovery comes first is that addiction is so destructive.  Over time, the un-sober addict will forfeit everything that ever mattered to him.  He will destroy relationships, jobs, money, health, and lose any chance to fulfill his potential in life.

Many addicts get stuck in a pattern of continual relapse even though they are quite diligent about going to treatment, going to meetings and so on.  Making recovery the center of your life, at least until you are well on your way (usually at least a year or two and often longer) means more than just going through the motions of getting help.

Recovering addicts may enter treatment for any number of reasons other than wanting to get over their addiction.  In fact few actually want to stop using porn or sexually addictive behaviors in the beginning.  Most likely they have come to get help because their spouse or partner threatened to leave them, because they lost their job, because they got in trouble with the law, or some other crisis situation.

The crisis motivates the addict to get into recovery in order to hold onto something else: the wife, the career, their freedom.  And yet in the long run the motivation needs to shift, the addict needs to put those things after his recovery or he will stay an addict.  He will lose the very things he came into recovery to keep.

Putting recovery first is very hard.  As if the siren song of sex addiction weren’t enough, life throws numerous other challenges our way.  We get temporarily derailed from what we need to do to stay sober.  But eventually the basic principle applies: be ruthless in your pursuit of your own need to recover.  If you think in this way nothing and no one can stop you.  Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource