Brain scans of porn addicts: what's wrong with this picture?

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?".