The enormous global proliferation of online pornography has made a vast array of sexually explicit material available to a large teen audience on laptops, tablets and smart phones. And if smart accessories catch on, you will soon be able to wear your pornography.

Online pornography accounts for such an overwhelming proportion of internet traffic that a new search engine has been created specifically for adult content. It was designed by two former Google employees and searches only for pre-screened adult content that is free of illicit or malevolent intent. It is also designed to protect the user from cookies and other forms of identity tracking. The site was launched on September 15th and according to the founders has “taken off like a rocket.”

Internet porn has long been seen as more readily accessible than riskier and more costly habits like prostitutes, massage parlors or anonymous hook-ups. This in turn makes it more easily available to youth, with the typical first exposure being in the pre-teen years.

Effects of porn on teens and young adults

A study published this summer in the by the UK’s Institute for Public Policy Research surveyed 500 18-year-olds about the impact of porn on their lives. Most of the respondents reported that accessing pornography was common throughout their school years, began in their early teens and had a damaging effect on their sexual and relationship lives.

Dr. Anthony Jack, a researcher and neuroscience professor at Case Western Reserve University stated that recent studies show “…widespread rates of sexual dysfunction… such that approximately 50% of late adolescents of both sexes report sexual dysfunction of clinical severity”. (See “Your Brain on Porn” by Gary Wilson)

Another study published this month by researchers in the US found that among a sample of over 900 emerging adults in college more frequent porn viewing was correlated with a greater number of sexual hook-ups and one night stands.

Other recent studies of the brain activity of chronic porn users have begun to show detrimental effects such as:

Less gray matter and reduced reward center activity while viewing sexually explicit imagery, i.e. desensitization.

A weakening of nerve connections between the reward centers and the higher brain centers thus increasing impulsiveness and impairing decision making.

Porn induced erectile dysfunction

As one of the researchers put it, “…regular consumption of pornography more or less wears out your reward system.” And clinicians here and abroad are seeing many more young adults and teens who can achieve erection and ejaculation with porn but not with a real person.

Treating the young porn addict: three models

The current crop of very young addicts have some special characteristics. The pre-teen brain is not fully mature and their emerging sexuality programs them to react powerfully to sexual stimuli. Getting hooked on porn at an early age can be damaging in at least three different ways. These in turn require interventions very different from the years of addiction treatment and relapse prevention that are appropriate for most adult addicts.

I. The drug-driven model

Jeff’s addiction appears to have come about through the habit-forming nature of porn itself in the absence of any other obvious psychopathology.

At first I thought Jeff was just like any other sex addict client, only younger. He had been watching porn on his computer since he was 13, and at age 18 he realized he had begun to fixate on child porn. Fortunately this scared him enough that he came clean to his parents who put him in a 6 week residential program for sex addiction.

After the residential program Jeff saw me for therapy for about a year. He also attended weekly Sex Addicts Anonymous meetings. He was an attractive, sophisticated kid with a sunny disposition, but at 20 he was still a virgin who had never dated a girl. While he was seeing me he began dating a very appropriate same-age young woman and eventually began a robust sexual relationship with her. Although that relationship ended he never returned to porn use that I know of. I am as certain as I can be that he had no residual attraction to children.

What is striking is that although Jeff went along with the usual program of sex addiction recovery, what seems to have worked for him was just getting away from porn! With abstinence, it seems his young brain rebalanced and in a period of months he was able to resume normal sexual development. He became more outgoing and began college with the ambition to become a filmmaker. Jeff needed a structure that would allow him to stay away from porn along with some outside support to get his life back on a normal track.

II. The trauma model

Brad discovered internet porn at 12 and became instantly hooked. He reports that his use escalated very rapidly as did his sexual tastes. He was binging on porn very heavily every day. While still in his teens he says that he quit, primarily out of exhaustion. His sexual interest diminished to zero and as of his mid 20’s he reported that his libido seemed to be permanently gone. He attributes this result to a kind of virtual sexual trauma.

There is some research that would support the idea that very early exposure to sexually explicit material can have effects on the developing psyche similar to actual sexual assault. The young mind is not ready to deal with the shock, adrenaline and stress of the hyper-arousal caused by porn. It thus constitutes a violation which can leave lasting sexual scars. Brad correctly sought out treatment with a specialist in sexual trauma rather than sex addiction.

III. The hybrid model

Ken is a happily married man in his late 20’s. He entered treatment for an addiction to porn and masturbation dating from childhood. He had no other sexually addictive behaviors but he had significant early trauma. His father died of a cocaine overdose when Ken was a toddler. Ken became the “man of the house” at age 3 and soon after had a serious illness requiring months of hospitalization. He had an unhealthy relationship with his narcissistic, demanding mother. Also as a child he witnessed his teenage sisters being molested by an older cousin.

After about 8 months of abstinence from porn and with the support of group therapy Ken has shifted gears. His relationship with his wife whom he adores is going well and he is comfortable with a new-found intimacy with her. In fact Ken no longer presents as an addict; he does however have issues that he knows he needs to work on. In particular he knows he has never fully understood or worked through his early childhood experiences and he is working his way out of his enmeshed relationship with his mother. He is appropriately seeking help for these problems and appears to be at zero risk of relapse into porn addiction.

So the good news is that the youthful porn addict’s brain can recover and resume a more normal developmental trajectory. And given that their only addictive behavior is internet porn and that their total time of usage relatively short, they do not have to overcome addiction as a pervasive and deeply entrenched coping style. They can get cured and stay cured. The bad news is that there is as yet so little awareness of the risks to children and teens on the part of the medical profession, the academic community, schools and the public at large. As with so many public health issues, prevention and education are sorely needed.

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