Your Brain on Porn (12 page)

In analysing the Max Planck results, the Cambridge team hypothesised that the brain responses to

porn might differ between non-addicts and addicts. True. Yet might the visual stimuli used in the two studies go far in explaining the differences? The Max Planck researchers employed half-second exposure to still porn images, which may strike today's porn viewer as ordinary, while the 9-second video clips the Cambridge team used would arouse most porn viewers, addicted or not. In short, perhaps the video clips were proper
cues
for today's users of streaming HD hardcore porn while brief stills were a closer representation of everyday erotic visuals.

In any case, both hyper-reactivity to addiction cues (hardcore video) and reduced sexual responsiveness to tamer sexual visuals are not surprising in porn overconsumers.
Both cue-reactivity
and a reduced pleasure response are often seen in addicts of all kinds.

Readers interested in addiction science and its relevance to internet porn users may want to have a look at this peer-reviewed journal article: "Pornography addiction – a supranormal stimulus considered in the context of neuroplasticity"
.[97]

No doubt more brain studies on porn addicts are on the way, but already addiction specialists maintain that all
addiction is one condition.
It doesn't matter whether it entails sexual behaviour, gambling, alcohol, nicotine, heroin or crystal meth – many of which addiction neuroscientists have studied for decades. Hundreds of brain studies on behavioural and substance addiction confirm that all addictions modify the same fundamental brain mechanisms
[98]
and produce a recognized set of anatomical and chemical alterations.
[99]
(More on these in a moment.)

In 2011 the American Society of Addiction Medicine (doctors and researchers) confirmed the addiction-is-one-condition model by publishing an all-encompassing new definition of addiction.

[100]
This is from the related FAQs:

QUESTION: This new definition of addiction refers to addiction involving gambling,

food, and sexual behaviours. Does ASAM really believe that food and sex are addicting?

ANSWER: The new ASAM definition makes a departure from equating addiction with just

substance dependence, by describing how addiction is also related to behaviours that are
rewarding.
...
This definition says that addiction is about functioning and brain circuitry and
how the structure and function of the brains of persons with addiction differ from the
structure and function of the brains of persons who do not have addiction
. ...
Food and sexual
behaviours and gambling behaviours can be associated with the ‘pathological pursuit of
rewards’ described in this new definition of addiction.

Even the psychiatry profession's heavily criticised and obsolete bible, the
DSM-5,
has grudgingly begun to recognize the existence of behavioural addictions.
[101]
Charles O’Brien, MD, chair of the
DSM-5
Work Group on Substance-Related and Addictive Disorders said:
[102]

The idea of a non-substance-related addiction may be new to some people, but those of us

who are studying the mechanisms of addiction find strong evidence from animal and human

research that addiction is a disorder of the brain reward system, and it doesn’t matter whether
the system is repeatedly activated by gambling or alcohol or another substance.

Outside the addiction field, you can still find vocal addiction naysayers who insist that gambling addiction and porn addiction are not addictions but rather
compulsions.
This is a red herring. I have asked these naysayers, ‘how do the neural correlates for a compulsion to use something differ from the neural correlates for an addiction to something?’ (
Neural correlates
refer to the brain circuits, neurochemicals, receptors and genes underlying a disorder.)

The 'compulsion' advocates never answer because, in fact, there is no physical difference at the

brain level between a gambling addiction and a compulsion to gamble. There is only one reward centre and one reward circuit. Core brain changes seen in behavioural addictions occur equally with drug addictions – and compulsions to use. These are the brain changes associated with addictive behaviour. (Of course, specific addictions each have unique characteristics as well. For example, heroin addiction drastically reduces opioid receptors, which produces particularly severe withdrawal symptoms.)

Here are some brain changes that show up in all addictions, whether substance or behavioural:

1. Desensitisation
, or a numbed response to pleasure.
Reduced dopamine signallin
g[103]
and other changes
[104]
leave the addict less sensitive to everyday pleasures and ‘hungry’ for dopamine-raising activities and substances.
[105]
The addict may neglect other interests and activities that were once high priorities.

Desensitisation is probably the first addiction-related brain change porn users notice. They need greater and greater stimulation to achieve the same buzz (‘tolerance’). They may spend more time online, prolonging sessions through edging, watching when not masturbating, or searching for the perfect video to end with. But desensitisation can also take the form of escalating to new genres, sometimes harder and stranger, or even disturbing. Remember: shock, surprise and anxiety can jack up dopamine.

2. Sensitisation
, or an unconscious super-memory of pleasure that, when activated, triggers
powerful cravings
. Rewired nerve connections cause the reward circuit to buz
z[106]
in response to addiction-related cues or thoughts
[107]
– the ‘fire together wire together’ principle. This Pavlovian memory makes the addiction more compelling than other activities in the addict's life.

Cues, such as turning on the computer, seeing a pop-up, or being alone, trigger intense cravings

for porn. Are you suddenly much hornier (true libido) when your wife goes shopping? Unlikely. But perhaps you feel as if you are on autopilot, or someone else is controlling your brain. Some describe a sensitised porn response as ‘entering a tunnel that has only one escape: porn’. Maybe you feel a rush, rapid heartbeat, even trembling, and all you can think about is logging onto your favourite tube site. These are examples of sensitised addiction pathways activating your reward circuit, screaming, ‘Do it now!’

3. Hypofrontality
, or reduced brain activity in the prefrontal regions, which weakens willpower
in the face of strong subconscious cravings.
Alterations
[108]
in the prefrontal regions' grey matter
[109]
and white matter
[110]
correlate with reduced impulse control
[111]
and the weakened ability to foresee consequences.
[112]
A recent German review of brain and psychological studies concluded that reduced brain function in internet addicts may be related to their loss of control over their internet use
.[113]

Hypofrontality shows up as the feeling that two parts of your brain are engaged in a tug-of-war.

The sensitised addiction pathways are screaming ‘Yes!’ while your ‘higher brain’ is saying, ‘No, not again!’ While the executive-control portions of your brain are in a weakened condition the addiction pathways usually win.

4.
Dysfunctional stress circuits
,
[114]
which can make even minor stress lead to cravings
and relapse because they activate powerful sensitised pathways.

To sum up, if these neuroplastic changes could speak,
desensitisation
would be moaning, ‘I can't get no satisfaction’. At the same time,
sensitisation
would be poking you in the ribs saying, ‘hey, I’ve got just what you need’, which happens to be the very thing that caused the desensitisation.

Hypofrontality
would be shrugging and sighing, ‘bad idea, but I can't stop you’.
Dysfunctional stress
circuits
would be screaming, ‘I
NEED
something NOW to take the edge off!’

These phenomena are at the core of all addictions. One recovering porn addict summed them up:

‘I will never get enough of what doesn't satisfy me and it never, ever satisfies me’. Recovery reverses these changes. Slowly, the addict relearns how to 'want' normally.

Withdrawal
Many people believe that addiction always entails both tolerance (a need for more stimulation to get the same effect, caused by desensitisation) and brutal withdrawal symptoms. In fact, neither is a prerequisite for addiction – although today's porn users often report both. What all addiction assessment tests share is, ‘continued use despite negative consequences’. That is the most reliable evidence of addiction.

This book has already offered many accounts by porn users who sought more extreme porn as their brains grew less sensitive to pleasure (tolerance). What about withdrawal symptoms? First, as stated, a person can be addicted without experiencing severe withdrawal symptoms. For example, cigarette and cocaine addicts can be thoroughly hooked but will typically experience mild withdrawal symptoms compared with alcoholics or heroin addicts
.[115]

However, in the forums I monitor ex-porn users regularly report withdrawal symptoms that are reminiscent of drug withdrawals: insomnia, anxiety, irritability, mood swings, headaches, restlessness, fatigue, poor concentration, depression, social paralysis and cravings. Some also report more startling symptoms, such as shaking, flu-like symptoms, muscle cramps or the mysterious sudden loss of libido that guys call the flatline (apparently unique to porn withdrawal).

December and January were tough, and I mean tough! I had serious

depression...absolutely no libido at all. Distressing thoughts would run through my brain all

day and night and I found myself crying like a baby. My poor little man was a permanently

flaccid, useless addition to my body that simply didn't want or fancy real female attention.

Internet-porn withdrawal symptoms haven't been studied in isolation, but in 2013 Swansea and Milan universities reported that internet addicts suffer a form of cold turkey when they stop using the web, just like people coming off drugs
.[116]
Most of the addicts studied were accessing porn or gambling
.[117]

Not everyone who stops using pornography will suffer withdrawal symptoms, but some do:

My symptoms after quitting: extreme exhaustion, restless sleep, muscle aches, joint pains

and fever, mild disorientation, tension in the chest/tight breathing and anxiousness.

*

My withdrawal symptoms are restless legs. My legs won't stay still when I'm sitting in my

chair. Disrupted sleep. I'm having trouble sleeping, or I wake up in the middle of the night
with my heart beating fast and can't get back to sleep. Headaches. I have a sore throat and

feel generally run down.

To repeat, internet withdrawal symptoms sometimes resemble drug withdrawal symptoms

because all addictions share specific neurochemical and cellular changes (as well as producing additional, unique changes). Withdrawal initiates a cascade of neurochemical alterations, although brains experience them somewhat differently.
[118]

Overriding Normal Satisfaction

Excess consumption of food or sex signals the brain that you have hit the evolutionary jackpot.

[119]
This kind of powerful neurochemical incentive to grab more is an advantage in situations where survival is furthered by overriding normal satisfaction.
[120]
Think of wolves, which need to stow away up to twenty pounds of a single kill at one go. Or mating season
,[121]
when there was a harem to impregnate. In the past, such opportunities were rare and passed quickly.

Now, however, the internet offers endless 'mating opportunities', which a primitive part of the brain perceives as valuable because they are so arousing. As any good mammal would, viewers attempt to spread their genes far and wide, but there’s no end to a porn viewer's mating season. He can keep going indefinitely by pumping up his dopamine via anticipation as he surfs: viewing novelty, material that violates his expectations, and driving for sexual arousal – the natural reward that releases the highest surges of dopamine.

Click, click, click, masturbate, click, click, click, masturbate, click, click, click. Sessions can last for hours, day in and day out, sometimes kicking the viewer's evolved ‘binge mechanism’ into overdrive. Evolution has not prepared the brain for this kind of nonstop stimulation. Experts Riemersma and Sytsma warn that today's porn may cause ‘rapid onset’ addiction in some chronic users
.[122]

How the Brain Keeps Us Bingeing

You already know that dopamine sets off the neurochemical events that cause addiction-related brain changes
[123]
. But the actual molecular switch that initiates many of the lasting brain changes is the protein DeltaFosB.
[124]
Dopamine surges trigger DeltaFosB's production. It then accumulates slowly in the reward circuitry in proportion to the amount of dopamine released when we chronically indulge in natural rewards
[125]
(sex
,[126]
sugar
,[127]
high fat,
[128]
aerobic exercise
[129]
) or virtually any drug of abuse. DeltaFosB takes a month or two to dissipate, but the changes it causes can remain.