Brain scans of porn addicts: what's wrong with this picture?
Scan images show that watching online 'adult' sites can alter our grey matter, which may lead to a change in sexual tastes
A doctor looks at a heroin addict's brain scans. New research shows men who say they are addicted to porn … develop changes in the same area – the reward centre – that changes in drug addicts.' Photograph: Don McPhee for the Guardian
The Cambridge University neuropsychiatrist Dr Valerie Voon has recently shown that men who describe themselves as addicted to porn (and who lost relationships because of it) develop changes in the same brain area – the reward centre – that changes in drug addicts. The study, not yet published, is featured next week in the Channel 4 TV show Porn on the Brain. Neurosceptics may argue that pictures of the brain lighting up in addicts tell us nothing new – we already know they are addicted. But they do help: knowing the reward centre is changed explains some porn paradoxes.
In the mid-1990s I, and other psychiatrists, began to notice the following. An adult male, in a happy relationship, being seen for some non-romantic issue, might describe getting curious about porn on the burgeoning internet. Most sites bored him, but he soon noticed several that fascinated him to the point he was craving them. The more he used the porn, the more he wanted to.
Yet, though he craved it, he didn't like it (porn paradox 1). The cravings were so intense, he might feel them while thinking about his computer (paradox 2). The patient would also report that, far from getting more turned on by the idea of sex with his partner, he was less attracted to her (paradox 3). Through porn he acquired new sexual tastes.
We often talk about addicts as though they simply have "quantitative problems". They "use too much", and should "cut back". But porn addictions also have a qualitative component: they change sexual taste. Here's how.
Until recently, scientists believed our brains were fixed, their circuits formed and finalised in childhood, or "hardwired". Now we know the brain is "neuroplastic", and not only can it change, but that it works by changing its structure in response to repeated mental experience.
One key driver of plastic change is the reward centre, which normally fires as we accomplish a goal. A brain chemical, dopamine, is released, giving us the thrill that goes with accomplishment. It also consolidates the connections between neurons in the brain that helped us accomplish that goal. As well, dopamine is secreted at moments of sexual excitement and novelty. Porn scenes, filled with novel sexual "partners", fire the reward centre. The images get reinforced, altering the user's sexual tastes.
Many abused substances directly trigger dopamine secretion – without us having to work to accomplish a goal. This can damage the dopamine reward system. In porn, we get "sex" without the work of courtship. Now, scans show that porn can alter the reward centre too.
Once the reward centre is altered, a person will compulsively seek out the activity or place that triggered the dopamine discharge. (Like addicts who get excited passing the alley where they first tried cocaine, the patients got excited thinking about their computers.) They crave despite negative consequences. (This is why those patients could crave porn without liking it.) Worse, over time, a damaged dopamine system makes one more "tolerant" to the activity and needing more stimulation, to get the rush and quiet the craving. "Tolerance" drives a search for ramped-up stimulation, and this can drive the change in sexual tastes towards the extreme.
The most obvious change in porn is how sex is so laced with aggression and sadomasochism. As tolerance to sexual excitement develops, it no longer satisfies; only by releasing a second drive, the aggressive drive, can the addict be excited. And so – for people psychologically predisposed – there are scenes of angry sex, men ejaculating insultingly on women's faces, angry anal penetration, etc. Porn sites are also filled with the complexes Freud described: "Milf" ("mothers I'd like to fuck") sites show us the Oedipus complex is alive; spanking sites sexualise a childhood trauma; and many other oral and anal fixations. All these features indicate that porn's dirty little secret is that what distinguishes "adult sites" is how "infantile," they are, in terms of how much power they derive from our infantile complexes and forms of sexuality and aggression. Porn doesn't "cause" these complexes, but it can strengthen them, by wiring them into the reward system. The porn triggers a "neo-sexuality" – an interplay between the pornographer's fantasies, and the viewer's.
Of all our instincts, sexuality is perhaps the most plastic, appearing to have broken free of its primary evolutionary aim, reproduction, even though a certain naive biological narrative depicts our sexual tastes as hardwired and unchanging, and insists we are all always drawn to the same, biologically fit, symmetrical features and attributes which indicate "this person will produce fit offspring". But clearly we are not all attracted to the same type, or person.
Sexual tastes change from era to era: the sexual goddesses painted by Rubens are corpulent by modern standards. Sexual tastes also change from individual to individual: different people have different romantic "types". Types tend to be caricatures: the free spirit, the artistic type, the bad boy, the strong silent type, the devoted woman, and so on. We learn that types are related to plasticity, when we discover the individual's history. The woman attracted to "the unavailable man", often lost her father in childhood; the man attracted to the "ice queen" had a distant critical mother. There is little hardwired about the specifics of these attractions. But the ultimate sign that sexual desire need not be hardwired into reproduction is the fetishist, more attracted to a shoe than its wearer.
Sexual tastes change over the course of our individual lives; not all love is love at first sight, based on looks; we may not notice someone as especially attractive, until we fall in love with them and feel such pleasure in their presence, that we soon "awaken" to their charms. And successfully monogamous couples, who love and feel attraction to each other over decades, slowly change their sexual tastes, as their partners age and look different. Sometimes change comes quickly, but no changes are as rapid or radical as those occurring in teenagers, who go from having limited, to all consuming attractions.
Teenagers' brains are especially plastic. Now, 24/7 access to internet porn is laying the foundation of their sexual tastes. In Beeban Kidron's InRealLife, a gripping film about the effects of the internet on teenagers, a 15-year-old boy of extraordinary honesty and courage articulates what is going on in the lives of millions of teen boys. He shows her the porn images that excite him and his friends, and describes how they have moulded their "real life" sexual activity. He says: "You'd try out a girl and get a perfect image of what you've watched on the internet … you'd want her to be exactly like the one you saw on the internet … I'm highly thankful to whoever made these websites, and that they're free, but in other senses it's ruined the whole sense of love. It hurts me because I find now it's so hard for me to actually find a connection to a girl."
The sexual tastes and the romantic longings of these boys have become dissociated from each other. Meanwhile, the girls have "downloaded" on to them the expectation that they play roles written by pornographers. Once, porn was used by teens to explore, prepare and relieve sexual tension, in anticipation of a real sexual relationship. Today, it supplants it.
In her book, Bunny Tales: Behind Closed Doors at the Playboy Mansion, Izabella St James, who was one of Hugh Hefner's former "official girlfriends", described sex with Hef. Hef, in his late 70s, would have sex twice a week, sometimes with four or more of his girlfriends at once, St James among them. He had novelty, variety, multiplicity and women willing to do what he pleased. At the end of the happy orgy, wrote St James, came "the grand finale: he masturbated while watching porn".
Here, the man who could actually live out the ultimate porn fantasy, with real porn stars, instead turned from their real flesh and touch, to the image on the screen. Now, I ask you, "what is wrong with this picture?".
• This article was corrected on 27 September. The Channel 4 programme Porn on the Brain was incorrectly called Porn and the Teenage Brain
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