Porn Addiction Is Not Sex Addiction--And Why It Matters (our latest PT post)

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Sex addiction requires real people; porn addiction requires a screen

Grouping 'Internet porn addiction' and 'sex addiction' under the Sex Addiction Umbrella makes the former less visible because classic sex addiction is so rare. As a consequence, healthcare providers tend to misdiagnose those with porn addiction symptoms, which in turn leads to ineffective treatment. For example, young, otherwise healthy porn addicts with erectile dysfunction are given drugs instead of advice to lay off the porn. Others are treated for depression, procrastination or concentration problems instead of the addiction that may lie at the root of their symptoms.

The differences between porn addiction and sex addiction are considerable, as reflected in these self-reports:

Sex addict (age 35): I was feeling tired and low from the previous night's looking for anonymous sex. So I get back online. A woman is looking to hook up anonymously. She tells me to come over, so I grab some condoms. On my way, she texts me and tells me to pick up a pizza. WTF? This is weird, but the prospect of anonymous and novel sex is just too much at this point. However, fearing I might get robbed, I tell her that I would like to meet her first. The door opens up and it's very dark inside except for the light of a computer screen. I can't really see her, but I walk in anyways. She says, "Look at what I am wearing. Sexy isn't it?" But in a deep's a dude! And SHe says, "This is okay isn't it?" I'm thinking that I should just buy her a pizza out of kindness and get the fuck out of there. Then I hear someone moving in the back bedroom. I get super scared and bolt home, somewhat happy to not be dealing with any more drama and to have some money left. I just use porn and go to sleep.

Porn addict: I'm 23. I first tried to have sex when I was 18, but I couldn't get it up. I had been masturbating almost daily for 6 years, generally with tight grip and erotic visuals, often multiple times a day. I've had sex with four partners in my life and I never reached orgasm with any of them. In short, my sex life has been disappointing. Indeed, my last relationship ended because of erection problems. She accused me of being gay. I knew that wasn't true and yet how was she to believe me if my body didn't seem interested in her?

Porn addict (age 25): Is it possible to be porn addict but not a sex addict? I know I cannot control my porn use, nor masturbation with fantasy. But after sex I'm more satisfied. I sometimes survive a week or so without porn. I also wasn't subject to childhood abuse, so I don't think I'm escaping from past memories. Quite a lot of sex addicts I know from SLAA meeting are also substance abusers. I have never had cravings for alcohol or drugs, even though I drink too much once in a while. I have no shame about my porn use and never did. Also, Patrick Carnes says that the main belief of sex addicts is "No one would love me if they knew me as I am". I know it's not true because my partners and friends know about my addiction and I've never experienced any negative reaction from them because of that. Yes I do have problems around people and I'm not very confident, but I believe it's due to overwanking and too much time in front of computer vs. interaction with real people. Porn for me is just a way of escaping from reality and coping with stress—the most effective and most exciting vehicle to disconnect with reality. I honestly don't think that I'm a 'sex addict.'

Here are some ways porn addiction differs from sex addiction:

1.     Sex addiction involves real people; Internet porn addiction involves a screen. Porn addicts are hooked on pixels/searching/constant visual novelty. In contrast, sex addicts are hooked on novel partners, voyeurism, frottage, flashing, risky sex, and so forth; porn may or may not supplement other behaviors.

2.     Internet porn addiction is more akin to video-game addiction than sex addiction. It often does not spill over into other sexual activity. In fact, many heavy porn users cannot become aroused by real women—even women they find sexually attractive. Comparing a porn addict to a sex addict is like comparing a World of Warcraft enthusiast to a Las Vegas high-roller.

3.     Internet porn addicts often comment that they would like a steady girlfriend, or, if they have a mate, that they want to respond sexually to her. Sex addicts want a variety of partners. They are hooked on novel people rather than novel pixels.

4.     Sexual performance woes are a common complaint among Internet porn addicts. We typically don't hear about severe sexual performance problems among sex addicts.

5.     Porn addiction appears to be increasing as access to high-speed porn during teen years increases, although some older guys also report developing the addiction after switching to high-speed Internet.

In sum, a sex addict's pursuit of living people is over the top, while a porn addict is largely missing out on 3-D action. In effect, porn proves "sex negative" for many users.  How could such a bizarre situation arise?

Internet porn: a most unnatural natural reinforcer

In recent decades, innocuous natural rewards like food and sex have been joined by some very unnatural kin. These imposters trip the same neural triggers as the natural rewards our brains evolved to pursue. Our limbic brains love them—and are inclined to overlook their drawbacks.

For example, presented with endless varieties of cheap, tasty, high-calorie food, 79 percent of adult Americans are overweight, and some thirty percent of us are addicted to these goodies (obesity), despite negative physical, social and psychological consequences. "Addicted" is a medical term here, not a metaphor. It means the consumer's brain has changed in the same fundamental ways a substance addict's does.

Sexual stimuli have morphed too. For at least half a dozen years, those with high-speed Web access have been able to consume free, ever-novel online erotica. Like today's junk-food, it is uniquely stimulating in the annals of human history. Result? In young males, porn use nearly equates with online access. Indeed research data collected some 5 years ago already revealed that 9 of 10 college-age men (and about one third of the women) were using Internet porn. Old models of addiction risk are based on substances, not on today's supernormal versions of food and sex, so most experts are still taught that all sex addictions are rare.

Alas, if online forums are any indication, today's porn users are increasingly complaining that (1) they can't stop viewing, and (2) it is interfering with their development of normal dating and mating abilities. Just how many of today's online erotica users are becoming addicted no one actually knows, but Internet addiction rates in adolescents are jumping. A Hungarian study recently reported that one in five adolescents are already hooked. (Adolescent brains are showing corresponding addition-related changes.)

I realized I could bring myself literally to the brink of orgasm solely with visual stimulation—without using my hand at all. My mind was rewired into relying on the extreme images fed to it by my eyes to produce arousal.—Internet porn user

Dopamine levels - food, sex

Will Internet porn addiction rates surpass obesity rates in some population groups now that Internet porn is more pervasive than any other natural reinforcer except junkfood? Quite possibly. After all, brains naturally release far more dopamine for sex than they do for food. (Dopamine release during Internet porn use hasn't been measured, for a variety of technical and other reasons.) Moreover, there are limits to food consumption, but none to porn viewing. Also, although no one wants to be fat, porn use is becoming more socially acceptable every day.

Why isn't porn addition just "sex addiction?"

"Sex addiction" appears to be uncommon. Dr. Carnes has studied it for decades. His work reveals that those who, as children, were neglected, abused, molested, raped, or otherwise exposed to violence and/or sexuality at a young age are at risk for developing sex addiction (that is addiction to reckless sex/flashing/voyeurism). They use sex as a way to self-medicate to escape, to numb their psychological pain from feeling unsafe and insufficiently loved.

Porn users who visit our website often do not fit this profile, even though they self-identify as addicts. In Carnes's model, sex addicts who recover need three to five years, and a lot of support to restore healthy intimacy to their lives. In contrast, the majority of our visitors recover, even from severe symptoms like porn-induced impotence, in a matter of two to four months. Withdrawal symptoms can be acute, but eventually most guys bounce back to their pre-porn personalities and charisma levels.

Sex addicts have to work hard and often risk arrest or disease to act out. Porn users have only to tap their ever-present screens to get a fix. Not surprisingly, most guys below a certain age are using Internet porn, many quite heavily, irrespective of childhood-trauma profile. Perfectly healthy adolescent (and older) brains are naturally attracted to Internet porn's hyperstimulating combination of surprise, novelty, sexiness, and non-stop free availability.

Despite the fact that the typical heavy porn user no longer fits Carnes' classic sex addict description, porn addiction continues to be casually lumped in with sex addiction by experts and the journalists who rely on them. Thinking of Internet porn addiction as a "subset" of sex addiction (quite rare) decreases its visibility. One expert assured us that since sex addiction is rare, the incidence of the subset Internet porn addiction, is "vanishingly small." Huh?

We've also heard experts claim that Internet porn users who don't fit the childhood-development profile of sex addicts can't be addicts, even if the users themselves believe they are. These experts insist that porn addiction can only arise as a consequence of some other pathology (such as sex addiction, ADHD, depression or social anxiety). It is like trying to cram video-game addiction under board-game addiction, or smoking under drug addiction. This obscures reality and leaves people who are "just" porn addicts out in the cold.

Here's a video of a psychiatrist determined to shoehorn porn addiction into the sex addiction model, insisting the issue for young heavy porn users with mysterious erectile dysfunction isn't dopamine dysregulation from overstimulation of the brain's reward circuitry, but rather problems with intimacy. 

How could "intimacy issues" explain porn addiction among teens with very little relationship experience? Many of these youthful porn users attract sweethearts. They are baffled by the fact that their penises respond only to porn and not to real mates. In short, they don't fit the 'sexual addiction-intimacy issues' model.

Perhaps as a consequence of such imperfect logic, research on the effects of Internet porn use is lagging well behind the exploding reality of the phenomenon itself. Yet already, "arousal addiction" is common enough to merit a TED talk by Psychologist Philip Zimbardo: "The Demise of Guys."

Fortunately for humanity's future wellbeing, the American Society of Addiction Medicine recently confirmed that addiction can be a primary disease. It's a function of brain changes-regardless of childhood development, and whether or not the addict engages in behavior that society finds acceptable/unacceptable.

Bottom line: The etiology of sex addiction is not related to the etiology of most Internet porn addiction (although some sex addicts certainly use porn to excess, and some porn addicts have childhood issues). Porn addicts can develop for the same reasons food addicts develop: (1) over-consumption of abnormally stimulating goodies, (2) brains that naturally perceive supernormal stimuli as irresistible, and/or (3) beginning use during adolescence, when the brain is especially plastic and most bent on seeking thrills and novelty.

Conflating "masturbation" and "porn use" obscures porn addiction

Both experts and young Internet porn users fail to distinguish "Internet porn use" from "masturbation." The experts (older generations) think of Internet porn as just another aid for normal masturbation. In contrast, the younger generations have no idea that porn-free masturbation is even possible. They're wired to the Web's extreme novelty and often shocking visuals. Many have never masturbated any other way. Consider this young man's surprising experiment:

Two weeks after quitting porn, I tried something completely different—masturbation to orgasm without porn—something I've never considered (always used Internet porn). Two days later, I added the porn on a whim and relapsed.

The two experiences were vastly different. Just masturbation to orgasm was almost startling at the finale, because I had no buzz, no shift of perception. It turned out to be a sweet, invigorating feeling.

But it may have triggered the full porn/masturbation session, which felt like I was totally on a DRUG. Every picture turned my body into a searing blast of tension, each new one more powerful than the last. I felt that familiar "dope surge" run from my brain through my body. I could hear and feel EVERYTHING more intensely. At orgasm, it was like a cloud of idiocy swept over me, and everything went numb. That numb last feeling lasted at least two days.

Conflating masturbation and Internet porn use results in a dangerous communication gap. We hear the following scenario repeatedly on our forum: A young man suffering from an inability to have normal erections consults a urologist. If he even thinks to ask whether his masturbation (subtext "hours of daily Internet porn use") is causing the problem, the urologist answers, "Masturbation (subtext "good old fashioned solo sex") simply cannot cause ED (or your other addiction-like symptoms), so something else is causing your problems. Here are some trial Cialis tablets and a referral to a sex therapist." The guy leaves, persuaded that his affliction has no cure, and continues to make his problem worse for fear that if he doesn't use it he'll lose it.

The experts are right in one sense: Masturbation addiction would be rare without Internet porn. Today's porn is more than a masturbation aid. It replaces imagination with multiple tabs, constant searching, fast forwarding to the perfect scene, a voyeur's perspective and so forth. It's a different, and far more neurochemically seductive, reinforcer than mere solo sex.

Today's porn use extends beyond the reward of orgasm. Guys don't necessarily masturbate to climax when watching at work, sharing clips on their phones, flying in aircraft, or during hours of edging while surfing. 

Much of the mainstream confusion about porn appears to arise from flawed logic, which overlooks a key fact. It starts with the correct assumption that orgasm is natural and people don't generally get addicted to it. It proceeds to the further assumption that Internet porn use can't produce anything with more neurochemical punch than an orgasm. It concludes that porn use therefore could not possibly be addictive.

Here's the error: Addictiveness is actually not tied to magnitude of dopamine impact. Cigarettes, for example, hook nearly 80% of those who try them, while heroin hooks only a rather small minority of users. Obviously, the dopamine impact of a cigarette is tiny compared with the dopamine impact of shooting heroin. The seductiveness of cigarettes lies in their ability to train the brain with each puff (hit of dopamine). Because of this, their power to rewire the brain for addiction cannot be measured by their relative neurochemical impact. This point is made in David Linden's book The Compass of Pleasure.

Sex addiction is likely analogous to a heroin addiction in that there's a limit to how often one can get a fix, and the addict generally needs a ritualized neurochemical build-up. Internet porn, on the other hand, seems more akin to smoking. Each easily obtained, novel image offers a small, rewarding dopamine burst, which trains the brain to repeat the behavior, not unlike each puff.

In short, it's not the neurochemical blast of orgasm that hooks Internet porn addicts, although orgasm also reinforces porn use. The more potent hook is the ever-available novelty of Internet porn. Not surprisingly, when a guy attempts to "reboot" his brain, this experience is common:

Even though I have had some strong urges for porn during this reboot, I have never had a strong desire to masturbate. Perhaps that is the most concerning thing, that my brain misses the porn more than it misses the masturbation/orgasm.

Today's porn addict has more in common with an Internet videogame addict, because he (or she) relies on constant mini-dopamine hits from exciting, ever-novel visuals. Like video games, Internet porn is effortless entertainment. No need to seek a real partner. He's also more like a food addict because Internet porn hijacks our most compelling natural urge (to reproduce) using a superstimulating delivery that also taps into our programmed proclivities for novelty and seeking.

Stranded in a virtual world

Porn addicts are not hooked on sex; they're hooked on Internet porn. They have not been training for sex, but for virtual stimulation. Here are comments of three:

I knew I was in trouble when in real life girls standing naked in front of me barely got me erect, but as soon I jumped on a computer and looked up some crazy porn I was excited and rock hard.

[Weeks after stopping porn] I have felt physically attracted to real women for the first time in a long time. It's strange, but I was basically asexual when I was on pornography.

I'm hoping to break 30-year of porn use that has, in part, made me a 40-year old virgin. I started porn use at age 12-13, ejaculated to images of fantasy women only (fit/muscular women and/or big boobs), never ejaculated without porn, and used it frequently. I've had opportunities with several women, but was a complete dud. Earlier this year, I had another failure to perform with a woman I liked quite a bit, and after 30 years I decided to do something about it. Trouble is, I think I never even developed "proper" brain pathways for what actual intercourse with a real partner is like. There isn't even an old, overgrown path to go back to; it never existed. I'm 33 days porn/masturbation free. But having closed my current road, I feel like I'm surrounded by dense jungle where a foot has never before been set. And me without even a machete, when I feel like I really need a chainsaw and a bulldozer.

For as long as porn addiction remains virtually invisible, users who develop symptoms are in a precarious position. They have to figure things out for themselves, and it's not easy to connect the dots between porn-induced sexual dysfunction problems (or porn-related anxiety, depression or concentration problems) and viewing porn. After all, Internet porn is a powerful aphrodisiac. It also makes the user feel better while viewing. Not surprisingly, users eagerly ascribe their symptoms to any other suggested cause, or simply conclude, "This is who I am."

Right now, experts' protocols and well-meaning journalists are making the journeys of many of those at risk for Internet porn addiction unnecessarily long. Moreover, those who need more substantial help, because they are self-medicating due to childhood issues are also being caught in the "porn is harmless" net. Furthermore, adolescent porn users are wiring their sexual response to pixels, not humans—and some receive rude awakenings when they can't successfully have, or enjoy, real sex. Do these users have to wait until they become full-fledged addicts to begin rewiring their brains?

I've suffered from anxiety and self confidence issues for years. I had suspected part of it was due to PMO but always felt it was difficult to stop. Several years ago I quit for about 3 months and was happier than I had been all my life. I socialized with people, went on dates with women, and was more confident than ever. However...for whatever reason out boredom...or habit...I relapsed. I went down a spiral of depression and even contemplated suicide. Since then it has been a struggle...until now! I am on day 21 being PMO free and I'm not looking back!

After I got past the 2 weeks stage I started to see diminished anxiety, more confidence, and even better vocal tonality. I feel like I am becoming normal again—like the person I am supposed to be. Women are noticing me again and I can genuinely have a conversation with them. I feel like I'm connecting with people in general better. I am even performing better athletically. I feel stronger, faster and sharper. It is as though the fog has been lifted! I'm 29 years old and now I feel like I have the energy that I had in my teens. My goal is to be PMO free for the rest of my life. The momentum I feel is stronger than a cheap thrill that PMO brings. I look forward to living and not hiding anymore. Taking back control is the most liberating thing I've felt in a long time.


Nice job with good points

Nice job with good points even for those that might have read them in other contexts. It can be good to have these ideas hit one repeatedly, often, and from many angles.

What do the addiction professionals say, generally in a non-porn context, about the social divide between addicts and non-addicts as a barrier to treating addiction?

Perhaps this would make an interesting new thread. Excluding some who might have gained significant muscle, what percentage of us have gained/lost weight while reducing porn use?

This perfectly describes

and makes sense of my experiences with porn and masturbation. I'm eight days into my reboot. More than anything, I just feel really lucky and grateful that I found and then this site. It would have been great to have known about all this sooner (I've been looking at online porn for about 12 years) but, hey, better late than never =)