Pornography Addiction: Science Fact or Science Fiction?
By: Robert V. Dindinger, PhD.
Recently there has been an increase of attention to the idea that the viewing of pornography is addictive and could cause significant harm to people. This has generated significant debate around whether or not pornography is actually addictive and whether it should be considered an actual disorder. Though this is a hot topic as of late, the debate has been going on for some time amongst professional psychologists and therapists for some time.
This debate really heated up for professionals in 2015 when the Fifth Edition of the Diagnostic Statistical Manual for Psychiatric Disorders (DSM-V) for therapists did not include sexual addiction (which includes pornography addiction) as a clinical diagnosis. Since this time many have pointed to the fact that pornography addiction is not recognized and have jumped to the conclusion that it therefore is not addictive.
For many, it is hard to accept that pornography is addictive because you do not take any substance into your body like drugs and alcohol. How can just looking at something lead to addiction. Others express that the viewing of pornography is a natural expression done by so many that it should be considered normal and not a disorder. As for professional psychologists, they want to see the research that backs up the assertion that pornography is addictive and until recently the research behind sexual addiction was largely nonexistent.
From this point forward, I will explain the process of pornography exposure from a researched scientific perspective to expose whether the assertion that pornography is addictive is science fact or science fiction.
1. What is Addiction?
There are many definitions of addiction. For the purposes of this article, addiction is defined as the misattribution of important processes in the brain (attributing specific non-survival stimulus to be important for survival) which reduces an individual’s ability to disengage from seeking and engaging with the stimulus. For example, the brain may start to recognize such things as drugs, alcohol, videogames, gambling, Facebook, texting, pornography, and other manufactured sources of stimulation as being important to survival.
When our brains tell us that some source of stimulation is important for survival, our focus on that source supersedes wants and desires that are not important for survival. We spend a considerable amount of time thinking about, obtaining, and maintaining this important resource that our biology believes we need. Important key mechanisms in the brain become activated to ensure that this important survival need is acquired. These mechanisms include the reward system, sensitization, desensitization, and hypofrontality.
2. The Reward System: The Brain’s Survival Mechanism
The reward system (Figure 1) is a part of our brain that responds to important survival resources. One of its main components is the neurotransmitter/hormone dopamine. This important chemical in the brain becomes activated when we encounter such things as food, social resources, achievements and intimate relationships to name a few. The more important the resource the more dopamine is released.
3. How Does the Brain Responds to Pornography?
The value that is assigned to an addictive stimulus depends on how much dopamine is released when the stimulus is encountered. As you can see in Figure 2, food increases dopamine output to 150% of normal production. The widely accepted addictive drug nicotine, found in cigarettes, increases dopamine production to 200%. Sexual intercourse increases dopamine to 250%. The use of pornography increases dopamine output even higher than sex and maintains that output for far longer. Even an extremely addictive drug like cocaine, which has an initially higher spike of dopamine, starts decreasing in output much faster than pornography. As shown in Figure 2, the brain interprets pornography to be extremely valuable and essential for survival, thus important to maintain. This results in biological processes that activate to maintain this resource. These processes result in addiction.
The first biological process, sensitization, begins when a stimulation source is associated with high levels of dopamine. The brain becomes hypersensitive to this resource. Everything about it becomes magnified. In the case of pornography, the images become seared into memory creating super memories that the brain recalls regularly to stimulate the desire to seek for the resource. Other things associated with pornography use, including technology, places of use, being alone, emotional states, relationship problems, and so forth become triggers that indicate the resource is near. When a trigger is recognized our body creates stimulation, excitement, and motivation to seek and use the stimulus.
The next process, desensitization, refers to a general dialing down of responsiveness to all pleasure. This process happens due to increased and prolonged dopamine production (Volkow, Wang, Fowler, Tomasi, Telang, & Baler, 2010). This process is illustrated in Figures 3-5. In Stage 1, normal functioning, dopamine is released into the synapse and received by receptor sites (see Figure 3).
When dopamine is received by the receptor sites it creates the feeling of pleasure. When high dopamine resources such as pornography are encountered, dopamine output increases dramatically as seen in Stage 2: over-stimulation (see Figure 4).
Our brains do not like over-stimulation. As with most biological processes, our brain seeks a state of homeostasis or normality. In an effort to prevent damage and reduce stimulation our brains retaliate by reducing the ability to receive stimulation. This is done by changing how the neuron functions by removing receptor sites as illustrated in Stage 3, desensitization (see Figure 5).
Food, friends, family, work/school achievements, social activities, and dating are our major sources of pleasure and stimulation. These important activities drive us to form healthy relationships and learn social skills. We rely on such relationships to help us solve problems, regulate our emotions and gain other needed resources.
The loss of receptor sites during desensitization changes how a person experiences normal sources of pleasure. As seen in Figures 6 & 7,
when desensitization occurs it changes the dopamine baseline or set point for the sources of stimulation we use to rely on. These important and healthy survival resources become weaker and less enjoyable. We then need higher sources of dopamine, such as pornography, to help us feel normal levels of pleasure. Over time, individuals addicted to porn spend less time with family, friends, intimate partners and seeking achievements. Sources that used to bring pleasure are no longer sufficient and are replaced by pornography.
In the beginning of a forming addiction, sensitization and desensitization are the driving force in establishing an addiction, such as pornography, as a new, highly rewarding stimulus that is important to survival. Once established, hypofrontality then acts in ways to ensure that the new resource is maintained. In some ways, hypofrontality is more damaging as it removes a person’s ability to override pornography seeking and engaging behavior (Hilton & Watts, 2011; Fowler, Volkow, Tomasi & Baler, 2007; Volkow et al., 2010).
Two areas of the brain, the anterior cingulate and the orbital frontal cortex, function to override the reward system’s desire to increase dopamine. These areas help us to avoid activities that could cause us harm. For example, a person may want to blow off going to school or work so they can hang out with friends instead. While this type of social behavior increases dopamine levels and activates the reward system, our frontal cortex and the anterior cingulate act to suppress the reward system to avoid adverse consequences (see Figure 8).
The result is the decision to go to school/work even though we would rather blow it off. This is how the brain helps us reach our goals and not just seek immediate rewards all the time.
When exposed to pornography, we may initially have the ability to resist seeking after it, but with repeated exposure our brains determine that pornography is so valuable that it should be obtained even at the expense of serious consequences. The result is hypofrontality.
Hypofrontality is the rewiring of the brain so that when the impulse to engage in pornography is activated, the brain shuts down the ability to override the reward system (see Figure 9; Hilton & Watts, 2011; Volkow et al., 2010).
Many who reach this stage find that they are seeking and engaging in pornography even when they really do not want to. Individuals who are trying to quit viewing and engaging in pornography often report that they are unable to stop themselves and feel like they are on autopilot. In some ways, their ability to choose is gone. When these areas of the brain are shut down, other damaging activities occur. For example, people at this stage tend to make more risky decisions and engage in increasingly risky behaviors (Nestler & Malenka, 2004). Some move from pornography into sexually deviant and/or even illegal behavior, such as voyeurism or pushing potential sexual partners without consent (Hilton & Watts, 2011). Morals begin to change. This is a result of the anxiety felt when one believes they can no longer avoid unacceptable behaviors. In these situations people tend to change their moral structure to include pornography as an acceptable behavior. The end result is that all actions that support the view that pornography is bad are then judged to be irrelevant and wrong. Many people turn away from monogamous relationships, marriage, religious activities, family, “judgmental friends” and other former sources of pleasure in favor of pornography. Other things such as pornography supporting peer groups, being alone, technology, people with supportive philosophies, etc. are then designated as good.
7. Altered Stress System
Another process that takes place in tandem to the development of the other biological changes during the formation of a pornography addiction is an alteration of the body’s normal stress responses. This system normally promotes worrying about taking care of family, school, social and other personal responsibilities. Prolonged exposure to pornography hijacks the body’s stress responses to promote pornography seeking and engaging behavior (Macmillan, 2009). When the body senses that triggers related to pornography are not being acted on, the body starts releasing stress hormones. These hormones have a significant effect on heart rate, blood pressure, digestion and other systems. In order to end the stress response, the individual must engage in pornography seeking behavior. This is analogous to the seatbelt alarms that are now in most cars. The alarm keeps ringing in an attempt to promote enough discomfort for you to decide to put your seatbelt on. For pornography addicts, the stress and discomfort felt from the altered stress system makes avoiding pornography very difficult (Macmillan, 2009).
8. The Role of Development in Pornography Addiction
It is also important to understand how developmental age impacts addiction. Our brains have different abilities depending on our age. At some stages, we are more susceptible to pornography addiction and have fewer abilities to overcome it. While our brain structures are in place relatively early in development, the process of fully activating these structures is a long process that starts before birth and is not completed until about the age of 25 (Crews & Boettiger, 2009). This process starts from the back of the brain to the front as depicted in Figure 10.
Early in life, the reward system reigns supreme, it being fully developed at a very young age. The areas of the brain that are meant to prevent the reward system from getting out of control are a very long way from being effective for young children. This is where parents come in to inhibit the developing child’s reward system until the frontal cortex/reasoning area of the brain is ready to take on that role. The closer to age 25 a person is, the better they are at recognizing the consequences of their actions.
Many people are surprised to learn that the average first viewing of pornography is around the age of 10. One reason for this is that this is when children start to become more autonomous. They are now able to access the internet on their own, they go to a friend’s house where there may be less supervision, they start hearing more sexualized talk at school, and they start to see images in popular media differently at this time. This is the age where some girls in school start to develop breasts and curiosity develops about sexuality. This is also a time when they have a fully functioning reward system that tells them that pornography is highly desirable and important. In a way, they exist in a hypofrontality-like state because the anterior cingulate and the orbital frontal cortex parts of their brain are not well-developed and are not able to override their reward system (Crews & Boettiger, 2009). It is imperative that parents take measures to protect their children from pornography at this time. Once pornography has a hold on a child’s mind it becomes challenging to overcome. Make sure you look at the end of this workbook for tips on how to pornography proof your house to protect your children.
Those who have been struggling with a pornography addiction from a young age often grow up thinking they are weak when they are unable to break the addiction. As discussed above, children are susceptible to pornography addiction if not protected from it by the adults in their lives and they have a limited ability to fight against such an addiction on their own. To those who formed an addiction to pornography during their youth: During the rest of this course you will learn the skills needed to fight this addiction, skills you did not have as a youth. Make the choice to start today. You can beat pornography addiction.
9. How Do I Know if I am Addicted?
Below are a list of questions to ask yourself about pornography. These are the type of questions you would be asked from a medical or psychological professional to determine if you are addicted to pornography. Answering yes to 2 or more of these questions puts you at risk for pornography abuse. Answering yes to 4 or more puts you at risk of pornography addiction.
- Do you at times feel powerless to resist the urge to view pornography?
- Do you frequently spend more time or money on pornography than you initially intended?
- Have you tried without success to limit or stop viewing pornography?
- Do you spend a significant portion of your time viewing pornography, thinking about pornography or engaging in activities that will enable you to access pornography?
- Do you neglect family, social or work/school obligations to view pornography?
- Do you continue to use pornography despite the potential for negative consequences?
- Have you had a reduction in satisfaction from pornography, or the need to increase the riskiness or frequency of pornography use over time?
- Have you passed up social opportunities, or have considered passing up social opportunities, so that you have more time to use or view pornography?
- Do you become anxious, stressed or irritable if you are unable to access pornography?
- Do you keep all or part of your pornography use secret from loved ones?
- Do you feel as though you live a double or secret life because of your pornography use?
- Have you lost track of large chunks of time because you’ve been absorbed in pornography use?
10. Summing Up Pornography Addiction
The key thing to understand concerning pornography addiction is that normal survival processes in the brain are activated by artificial sources of stimulation resulting in the brain designating pornography to be an essential need that is important to a person’s survival. Alterations in the brain’s neuro-pathways are then created to ensure that pornography is obtained. This alteration decreases the desire to obtain other sources of stimulation, such as social relationships, achievements, and activities where pornography is viewed negatively. When the addicted individual attempts to refrain from pornography, stress hormones are released increasing agitation, emotional dysregulation, sleep disturbances, and other negative outcomes to promote the seeking of pornography to reduce stress. Individuals who are addicted to pornography often find themselves feeling frustrated and hopeless. Fortunately, with help many are able to overcome this challenge and regain their freedom. Through the rest of this workbook, you will learn important steps to removing the biological roadblocks of your addiction.
The Future of Pornography Addiction
With many studies completed and many more underway, the science of pornography addiction is becoming firmed up. It is likely that pornography addiction will be legitimized in the next printing of the Diagnostic Statistical Manual for Psychiatric Disorders (DSM-VI)
The proposed criteria for Hypersexual Disorder (which includes pornography addiction):
Over a period of at least 6 months, recurrent or intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following 5 criteria:
- Time consumed by sexual fantasies, urges, or behaviors repetitively interferes with other important (non-sexual) goals, activities, and obligations.
- Repetitively engaging in sexual fantasies, urges, or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
- Repetitively engaging in sexual fantasies, urges, or behaviors in response to stressful life events.
- Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, or behaviors.
- Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.
- There is clinically significant personal distress or impairment in social, occupational, or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, or behaviors.
- These sexual fantasies, urges, or behaviors are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication). Specify if: Masturbation
About the Author
Robert V. Dindinger, Ph.d
Dr. Dindinger has over 20 years experience working with children, adolescents, and their families. As a cognitive behavioral therapist Dr. Dindinger is an expert in helping individuals regain control of their thoughts, feelings, and behaviors. He works with his clients to help them improve their ability to function and gain satisfaction from the many environments (home, school, work, community) in which they interact with. He is keenly aware of development and recognize the need to fit treatment to the stage of life and circumstances of the individual. He is competent in many modalities of therapy to fit his client’s needs.
Dr. Dindinger received his Doctorate in Clinical Psychology from Brigham Young University. He also received specialized training treating children and adolescents at Primary Children’s Medical Center. He prides himself in keeping informed and using evidenced based mental health practices to ensure success in meeting client needs. He has authored workbooks on anxiety, depression, pornography addiction, and psychosis. He often states that he feels it is a privileged to help others and sees the work he does helping others as sacred duty.
Dr. Dindinger enjoys spending time with his wife and three children and is an avid outdoor enthusiast and sports fan. He was born and raised in Alaska where he worked for the family business as a whitewater rafting guide in his youth and young adult years. He served as an army medic during operation Desert Storm and spent two years as a missionary in Scotland.
Dr. Dindinger is the author of the workbook “Pornography Addiction Breaking the Chains: A Workbook of Essential Tools for Recovery” His book can be found on amazon at: