Oprah Winfrey explores revolutionary approach to childhood trauma

Oprah Winfrey is shifting her perspective on how childhood trauma impacts people’s lives. For Sunday’s “60 Minutes,” Winfrey traveled to Milwaukee, where she grew up, to learn about a revolutionary approach in the city to early trauma. She spoke to Dr. Bruce Perry, a world-renowned expert in the field who has treated survivors of high-profile events like the Columbine shooting. He said a child’s brain gets wired “differently” when they’re raised in a chaotic or violent environment.

“If you have developmental trauma, the truth is you’re going to be at risk for almost any kind of physical health, mental health, social health problem that you can think of,” Perry told Winfrey.

Winfrey said she believes the conversation could be a “game changer.”

“This story is so important to me and I believe to our culture that if I could dance on the tabletops right now to get people to pay attention to it, I would. It is definitively changed the way I see people in the world, and it has definitively changed the way I will now be operating my school in South Africa and going forward any philanthropic efforts that I’m engaged in,” she said Tuesday on “CBS This Morning.”

“What I recognize is is that a lot of NGOs, a lot of people working in philanthropic world, who are trying to help disadvantaged, challenged people from backgrounds that have been disenfranchised, are working on the wrong thing,” Winfrey added.

While there have been plenty of job and training programs to help the disadvantaged, Winfrey said, “If you don’t fix the hole in the soul, the thing that is where the wounds started, you’re working at the wrong thing.”

The shift in perspective comes down to what Winfrey calls a “life-changing question.”

“See, we go through life and we see kids who are misbehaving. ‘You juvenile delinquents,’ we label them. And really the question that we should be asking is not ‘what’s wrong with that child’ but ‘what happened to that child?’ And then having the resources to be able to address what happened to you. The most important question you can ask of anybody which is what I now say even for the Parkland [school] shooting – instead of what’s the matter with that kid, I say what happened to that child?”

As a result of her reporting, she said she went back to her school board and said, “Hey, we’ve been doing it all wrong. We need to be a trauma-informed care institution.”

“CBS This Morning” co-host Gayle King pointed out that this was a personal story for Winfrey herself.

“Number one, it’s in Milwaukee where you were raised. You certainly suffered trauma there. You weren’t physically abused in your home, but you talk very candidly about –” King started.

“I got enough whippings to call it – we just didn’t call it physical abuse at the time,” Winfrey said. “Today I would have to report my mama.”

“Today it would be. But you’ve certainly been very candid about the sexual abuse. And a lot of these kids suffer from PTSD. I marvel, Oprah, that the environment you grew up in, that you don’t seem to have suffered from PTSD. Are you rethinking that?” King asked.

“No, I – I definitely do not have PTSD,” Winfrey responded. She said she asked Perry why some people like herself, “raised in chaotic environments,” turned out OK.

“It’s directly proportional to the relationships. So he was saying for me, for instance, it was school. I found my refuge in school,” Winfrey said. “I found my place in school from teachers. So everybody needs somebody growing up that says, ‘I believe in you, you’re OK, things are going to be all right.’ And that can be a teacher, that can be a coach, that can be somebody in Sunday school.”



Prodependence: Moving Beyond Codependency

Dot is the wife of an alcoholic. When she and her husband met and married, she knew that he drank, but she didn’t know how much, because he kept much of this behavior hidden. As their marriage progressed, she became more aware of his drinking, and she started to find empty pill bottles in the trash — prescription opioids that didn’t belong to her or her husband.

Dot loves her husband and has no interest in leaving him, so she’s done what anyone who loves her partner would do — she’s tried to manage the problem by controlling his drinking and pill abuse and prevent him from driving while intoxicated. Sadly, life for Dot has become less about her needs and more about “managing the situation.”

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Despite Dot’s best efforts, her husband recently got arrested for driving while impaired. His attorney encouraged him to get treatment. At the same time, Dot decided to see a therapist for advice on how to help her husband. The therapist heard Dot’s story and immediately said, “Wow, you’re a classic co-addict. You’re an enabler and a caretaker, and you need to go to CoDA (Codependent’s Anonymous) to deal with your problem.”

Guess what? Dot never went back to therapy, and she never went to a CoDA meeting. Instead, she feels hurt, angry, ashamed, and confused about why the therapist blamed her for her husband’s addiction. So instead of seeking support that could help her walk through a difficult time, she has retreated to her marriage, and she now speaks only to her husband about her feelings. Of course, as an addict who is (understandably) keen to maintain the status quo, he is of little help.

Moving Beyond the Codependency Label

Prodependence is a term I have created for use in a forthcoming (2018) book, co-written with Dr. Stefanie Carnes, to help loved ones of addicts. I use this term to describe healthy interdependence in the modern world. Essentially, prodependence occurs when attachment relationships are mutually beneficial — with one person’s strengths filling in the weak points of the other, and vice versa — and this mutual support occurs automatically and without question.

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The term prodependence is, rather obviously, a play on an older term with which most readers will probably be familiar — codependence. Codependence occurs when one person tries to control the actions of another, in the guise of helping. so that he or she can feel better about himself or herself and the relationship with that other person.

The codependency concept came into vogue in the mid-1980s, mostly with the publication of three specific books: Janet Woititz’s Adult Children of Alcoholics(1983)1; Robin Norwood’s Women Who Love Too Much (1985)2; and Melody Beattie‘s Codependent No More (1986)3. Based on these works, the 12-step fellowship Codependents Anonymous was born, with its first meeting taking place on October 22, 1986.4

One of the best explanations of the early codependency movement, especially in relation to addictions, appears in the foreword of the 2003 edition of Pia Mellody’s book, Facing Codependence. There, Andrea Wells Miller and J. Keith Miller write:

“It was actually the families of alcoholics and other chemically dependent people who brought [codependency] to the attention of therapists in treatment centers. These family members all seemed to be plagued with intensified feelings of shamefearanger, and pain in their relationships with the alcoholic or addict who was the focal point of their family. … One irrational aspect was that most of the family members had a deluded hope that if they could only be perfect in their ‘relating to’ and “helping” the alcoholic, he or she would become sober — and they, the family members, would be free of their awful shame, pain, fear, and anger.”5

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This statement recognizes and summarizes the feelings that many loved ones of addicts experience. They mistakenly think, “If I can just control the other person’s addiction in some way, everything will turn out the way I’d like.” That belief is the crux of codependence in its purest form.

Unfortunately, the concept of codependence has morphed into a negative, pathological-sounding label, indiscriminately applied to almost any person who tries to help an addicted loved one. So instead of being encouraged to care for yourself as well as your addicted loved one, you are encouraged to care for yourself instead of your addicted loved one. Basically, there seems to be a consensus that you really can love and care for someone too much. That is not what the progenitors of the codependence concept intended. But it’s what we’ve got.

Today, if you are the spouse, parentsibling, or friend of an addict, you’ve almost certainly had perfectly loving people tell you to step away from the relationship, to stop rescuing, to stop enabling, to “detach with love,” and to “stop being so codependent.” If you’ve experienced this, you’ve likely asked, “How can I possibly abandon a person I love, especially in his or her time of need?”

Still, plenty of people — family, friends, clergy, and even therapists — will try to convince you that caring about a person you’ve been close to for a very long time (perhaps his or her entire life, if you’re a parent or a sibling) is somehow irrational on your part, and counterproductive for both you and the challenged individual. Very probably, these well-meaning folks have suggested therapy, interventions, and participation in support groups like Al-Anon and CoDA as a way for you to fully and completely detach from what they think is a bad situation that’s taking you away from your own needs, goals, and personal fulfillment, while keeping your loved one mired in the problem.

As an addiction and mental-health treatment specialist who has worked for decades with addicts and their families, I admit that in the past I have espoused this outdated and potentially harmful opinion. This is the stance I was taught to take, both in school and in my continuing professional education. In trainings I was told, “If a loved one cannot emotionally detach from an active addict, that person will be dragged down into the murky depths of despair. Thus, loved ones must be coached to let go.” So when I saw spouses, family members, and friends refuse to distance themselves from an active addict, I told them they were enmeshed and codependent, and encouraged them to detach.

Unfortunately, this tactic ignores the ways in which human beings are wired for survival.


Human beings are meant to work together, not to go it alone. Think back to prehistoric times when people lived in tribes. If we went hunting, we went in a group; otherwise, we were as likely to be eaten as to eat. And hunting trips could take a very long time, so other members of our tribe stayed behind in the cave and tanned hides to keep the group warm, gathered nuts and berries to eat, collected sticks for fire, and maybe even did some rudimentary farming.

For thousands of years, this type of communal living was our standard for survival and our brains evolved in ways that encourage interpersonal bonding. Thus, we are evolutionarily wired to be dependent upon others. We enter the world reliant on others for shelter, nutrition, and emotional support, and these core requirements do not change as we grow older. What keeps us healthy as infants and children also keeps us healthy as adults.

Yet somehow, as we move into adulthood, our intrinsic need for emotional connection (i.e., love) gets discounted, despite the fact that people who spend their lives “apart from” rather than “a part of” do not function as well as those who feel emotionally connected. In fact, an immense amount of mental and physical health research shows that isolated/separated individuals suffer both emotionally and physically.6 Conversely, people who place a high value on developing and maintaining meaningful connections tend to be happier, more resilient, and more successful.7 They even tend to live longer.8 So, emotionally intimate connections are as essential as more obvious needs like food, water, clean air, and shelter. Without healthy dependency and connection, we may survive physically (for a while), but we won’t be as healthy or as happy as we could be.

Importantly, this deeply ingrained need for emotional connection does not abate simply because a person with whom we feel an intimate bond is challenged with an addiction or some other serious issue.

I think about it this way: If your spouse, child, sibling, or best friend was diagnosed with cancer and needed your help with doctor’s appointments, household chores, and maybe even his or her finances, would you walk away from that person? Most likely not. And nobody would blame you or label you or try to pathologize you for temporarily pushing your own needs to the side. But when you try to help an addict in a similar fashion, people will label you in all sorts of ways—and tell you to stop.

That is the wrong approach. Instead of being confrontational with spouses and others who love and care for addicts, we need to be invitational. We need to meet them where they are and teach them not to walk away, but to support in healthier, more prodependent ways. Rather than preaching detachment and distance over continued bonding and assistance, as so many therapists, self-help books, and 12-step groups do, we should celebrate the human need for and the pursuit of intimate connection, using that as a positive force for change.

Rather than labeling and pathologizing the supporters of challenged individuals when they refuse to abandon their caregiving roles, we should encourage them to continue their pursuit of love and emotional intimacy as best they can. At the same time, we can provide an outline for developing and maintaining healthy, prodependent boundaries — margins within which caregivers can love unconditionally, while not enabling or doing things their loved one could and should be doing for himself or herself. In so doing, we will create a fresh paradigm for useful and healthy support, an evolved prism through which caregivers can examine, evaluate, and improve their daily lives despite the oftentimes debilitating presence of an addiction.

Robert Weiss LCSW


What Teenagers Are Learning From Online Porn

Drew was 8 years old when he was flipping through TV channels at home and landed on “Girls Gone Wild.” A few years later, he came across HBO’s late-night soft-core pornography. Then in ninth grade, he found online porn sites on his phone. The videos were good for getting off, he said, but also sources for ideas for future sex positions with future girlfriends. From porn, he learned that guys need to be buff and dominant in bed, doing things like flipping girls over on their stomach during sex. Girls moan a lot and are turned on by pretty much everything a confident guy does. One particular porn scene stuck with him: A woman was bored by a man who approached sex gently but became ecstatic with a far more aggressive guy.

But around 10th grade, it began bothering Drew, an honor-roll student who loves baseball and writing rap lyrics and still confides in his mom, that porn influenced how he thought about girls at school. Were their breasts, he wondered, like the ones in porn? Would girls look at him the way women do in porn when they had sex? Would they give him blow jobs and do the other stuff he saw?

Drew, who asked me to use one of his nicknames, was a junior when I first met him in late 2016, and he told me some of this one Thursday afternoon, as we sat in a small conference room with several other high school boys, eating chips and drinking soda and waiting for an after-school program to begin. Next to Drew was Q., who asked me to identify him by the first initial of his nickname. He was 15, a good student and a baseball fan, too, and pretty perplexed about how porn translated into real life. Q. hadn’t had sex — he liked older, out-of-reach girls, and the last time he had a girlfriend was in sixth grade, and they just fooled around a bit. So he wasn’t exactly in a good position to ask girls directly what they liked. But as he told me over several conversations, it wasn’t just porn but rough images on Snapchat, Facebook and other social media that confused him. Like the GIF he saw of a man pushing a woman against a wall with a girl commenting: “I want a guy like this.” And the one Drew mentioned of the “pain room” in “Fifty Shades of Grey” with a caption by a girl: “This is awesome!”

Watching porn also heightened Q.’s performance anxiety. “You are looking at an adult,” he told me. “The guys are built and dominant and have a big penis, and they last a long time.” And if you don’t do it like the guys in porn, Drew added, “you fear she’s not going to like you.”

Leaning back in his chair, Drew said some girls acted as if they wanted some thug rather than a smart, sensitive guy. But was it true desire? Was it posturing? Was it what girls thought they were supposed to want? Neither Q. nor Drew knew. A couple of seats away, a sophomore who had been quiet until then added that maybe the girls didn’t know either. “I think social media makes girls think they want something,” he said, noting he hadn’t seen porn more than a handful of times and disliked it. “But I think some of the girls are afraid.”

“It gets in your head,” Q. said. “If this girl wants it, then maybe the majority of girls want it.” He’d heard about the importance of consent in sex, but it felt pretty abstract, and it didn’t seem as if it would always be realistic in the heat of the moment. Out of nowhere was he supposed to say: Can I pull your hair? Or could he try something and see how a girl responded? He knew that there were certain things — “big things, like sex toys or anal” — that he would not try without asking.

“I would just do it,” said another boy, in jeans and a sweatshirt. When I asked what he meant, he said anal sex. He assumed that girls like it, because the women in porn do.

“I would never do something that looked uncomfortable,” Drew said, jumping back into the conversation. “I might say, ‘I’ve seen this in porn — do you want to try it?’ ”

It was almost 4 p.m., and the boys started to gather their backpacks to head to a class known as Porn Literacy. The course, with the official title The Truth About Pornography: A Pornography-Literacy Curriculum for High School Students Designed to Reduce Sexual and Dating Violence, is a recent addition to Start Strong, a peer-leadership program for teenagers headquartered in Boston’s South End and funded by the city’s public-health agency. About two dozen selected high school students attend every year, most of them black or Latino, along with a few Asian students, from Boston public high schools, including the city’s competitive exam schools, and a couple of parochial schools. During most of the year, the teenagers learn about healthy relationships, dating violence and L.G.B.T. issues, often through group discussions, role-playing and other exercises.

But for around two hours each week, for five weeks, the students — sophomores, juniors and seniors — take part in Porn Literacy, which aims to make them savvier, more critical consumers of porn by examining how gender, sexuality, aggression, consent, race, queer sex, relationships and body images are portrayed (or, in the case of consent, not portrayed) in porn.

On average, boys are around 13, and girls are around 14, when they first see pornography, says Bryant Paul, an associate professor at Indiana University’s Media School and the author of studies on porn content and adolescent and adult viewing habits. In a 2008 University of New Hampshire survey, 93 percent of male college students and 62 percent of female students said they saw online porn before they were 18. Many females, in particular, weren’t seeking it out. Thirty-five percent of males said they had watched it 10 or more times during adolescence.

Porn Literacy, which began in 2016 and is the focus of a pilot study, was created in part by Emily Rothman, an associate professor at Boston University’s School of Public Health who has conducted several studies on dating violence, as well as on porn use by adolescents. She told me that the curriculum isn’t designed to scare kids into believing porn is addictive, or that it will ruin their lives and relationships and warp their libidos. Instead it is grounded in the reality that most adolescents do see porn and takes the approach that teaching them to analyze its messages is far more effective than simply wishing our children could live in a porn-free world.

Imagine that you are a 14-year-old today. A friend might show you a short porn clip on his phone during the bus ride to school or after soccer practice. A pornographic GIF appears on Snapchat. Or you mistype the word “fishing” and end up with a bunch of links to “fisting” videos. Like most 14-year-olds, you haven’t had sex, but you’re curious, so maybe you start searching and land on one of the many porn sites that work much like YouTube — XVideos.com, Xnxx.com, BongaCams.com, all of them among the 100 most-frequented websites in the world, according to Alexa Top Sites. Or you find Pornhub, the most popular of the group, with 80 million visitors a day and more traffic than Pinterest, Tumblr or PayPal. The mainstream websites aren’t verifying your age, and your phone allows you to watch porn away from the scrutinizing eyes of adults. If you still have parental-control filters, you probably have ways around them.

Besides, there’s a decent chance your parents don’t think you are watching porn. Preliminary analysis of data from a 2016 Indiana University survey of more than 600 pairs of children and their parents reveals a parental naïveté gap: Half as many parents thought their 14- and 18-year-olds had seen porn as had in fact watched it. And depending on the sex act, parents underestimated what their kids saw by as much as 10 times.

What teenagers see on Pornhub depends partly on algorithms and the clips they’ve clicked on in the past. Along with stacks of videos on the opening page, there are several dozen categories (“teen,” “anal,” “blonde,” “girl on girl,” “ebony,” “milf”) that can take them to more than six million videos. The clips tend to be short, low on production value, free and, though Pornhub tries to prevent it, sometimes pirated from paid sites. Many of the heterosexual videos are shot from the male point of view, as if the man were holding the camera while he has sex with a woman whose main job, via oral sex, intercourse or anal sex, is to make him orgasm. Plot lines are thin to nonexistent as the camera zooms in for up-close shots of genitals and penetration that are repetitive, pounding and — though perhaps not through the eyes of a 14-year-old — banal. (There are alternative narratives in L.G.B.T. and feminist porn, and studies show that for gay and bisexual youth, porn can provide affirmation that they are not alone in their sexual desires.)

We don’t have many specifics on what kids actually view, in large part because it’s extremely difficult to get federal funding for research on children and pornography. A few years ago, frustrated by the dearth of large, recent United States studies, Rashida Jones, Jill Bauer and Ronna Gradus, creators of the 2017 Netflix documentary series “Hot Girls Wanted: Turned On,” about technology and porn, paired with several foundations and philanthropists to fund a national survey about porn viewing, sexual attitudes and behaviors. As part of the survey, led by Debby Herbenick, a professor at the Indiana University School of Public Health and director of the university’s Center for Sexual Health Promotion, along with her colleague Bryant Paul, 614 teenagers ages 14 to 18 reported what their experiences were with porn. In preliminary data analysis from the study (Herbenick is submitting an academic paper for publication this year), of the roughly 300 who did watch porn, one-quarter of the girls and 36 percent of the boys said they had seen videos of men ejaculating on women’s faces (known as “facials”), Paul says. Almost one-third of both sexes saw B.D.S.M. (bondage, domination, sadism, masochism), and 26 percent of males and 20 percent of females watched videos with double penetration, described in the study as one or more penises or objects in a woman’s anus and/or in her vagina. Also, 31 percent of boys said they had seen “gang bangs,” or group sex, and “rough oral sex” (a man aggressively thrusting his penis in and out of a mouth); less than half as many girls had.

It’s hard to know if, and how, this translates into behavior. While some studies show a small number of teens who watch higher rates of pornengage in earlier sex as well as gender stereotyping and sexual relationships that are less affectionate than their peers, these only indicate correlations, not cause and effect. But surveys do suggest that the kinds of sex some teenagers have may be shifting. The percentage of 18-to-24-year-old women who reported trying anal sex rose to 40 percent in 2009 from 16 percent in 1992, according to the largest survey on American sexual behavior in decades, co-authored by Herbenick and published in The Journal of Sexual Medicine. In data from that same survey, 20 percent of 18-to-19 year old females had tried anal sex; about 6 percent of 14-to-17-year-old females had. And in a 2016 Swedish study of nearly 400 16-year-old girls, the percentage of girls who had tried anal sex doubled if they watched pornography. Like other studies about sex and porn, it only showed a correlation, and girls who are more sexually curious may also be drawn to porn. In addition, some girls may view anal sex as a “safer” alternative to vaginal sex, as there’s little risk of pregnancy.

The Indiana University national survey of teenagers asked about other sex behaviors as well. Though the data have not been fully analyzed, preliminary findings suggest that of the teenagers who had had sex, around one-sixth of boys said they had ejaculated on someone’s face or choked a sex partner. The survey didn’t define choking, but the high school and college-age students I spoke to referred to it as anything from placing a hand gently on a partner’s neck to squeezing it.

We don’t have longitudinal data on the frequency of ejaculating on a girl’s face or choking among American teenagers to know whether either practice is more common now. And, as David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire, told me, fewer teenagers have early sex than in the past (in a recent study, 24 percent of American ninth graders had sex; in 1995 about 37 percent had), and arrests of teenagers for sexual assault are also down. But you don’t have to believe that porn leads to sexual assault or that it’s creating a generation of brutal men to wonder how it helps shape how teenagers talk and think about sex and, by extension, their ideas about masculinity, femininity, intimacy and power.

Over the year in which I spoke to dozens of older teenagers at Start Strong and around the country, many said that both porn and mainstream media — everything from the TV show “Family Guy” (which references choking and anal sex) to Nicki Minaj’s song “Truffle Butter” (with an apparent allusion to anal sex followed by vaginal sex) to the lyrics in Rihanna’s “S&M” (“Sticks and stones may break my bones, but chains and whips excite me”) — made anal and rough sex seem almost commonplace. Drew told me he got the sense that girls wanted to be dominated not only from reading a few pages of “Fifty Shades of Grey” but also from watching the movie “Mr. & Mrs. Smith,” with Brad Pitt and Angelina Jolie. “She’s on the table, and she’s getting pounded by him. That’s all I’ve seen growing up.”

These images confound many teenagers about the kinds of sex they want or think they should have. In part, that’s because they aren’t always sure what is fake and what is real in porn. Though some told me that porn was fantasy or exaggerated, others said that porn wasn’t real only insofar as it wasn’t typically two lovers having sex on film. Some of those same teenagers assumed the portrayal of how sex and pleasure worked was largely accurate. That seems to be in keeping with a 2016 survey of 1,001 11-to-16-year-olds in Britain. Of the roughly half who had seen pornography, 53 percent of boys and 39 percent of girls said it was “realistic.” And in the recent Indiana University national survey, only one in six boys and one in four girls believed that women in online porn were not actually experiencing pleasure: As one suburban high school senior boy told me recently, “I’ve never seen a girl in porn who doesn’t look like she’s having a good time.”

It’s not surprising, then, that some adolescents use porn as a how-to guide. In a study that Rothman carried out in 2016 of 72 high schoolers ages 16 and 17, teenagers reported that porn was their primary source for information about sex — more than friends, siblings, schools or parents.

“There’s nowhere else to learn about sex,” the suburban boy told me. “And porn stars know what they are doing.” His words reflect a paradox about sex and pornography in this country. Even as smartphones have made it easier for teenagers to watch porn, sex education in the United States — where abstinence-based sex education remains the norm — is meager. Massachusetts is among 26 states that do not mandate sex ed. And a mere 13 require that the material be medically and scientifically accurate. After some gains by the Obama administration to promote more comprehensive sex ed, which includes pregnancy prevention, discussions of anatomy, birth control, disease prevention, abstinence and healthy relationships, the Trump administration did not include the program in its proposed 2018 budget; it also has requested increased funding for abstinence education. Easy-to-access online porn fills the vacuum, making porn the de facto sex educator for American youth.

One Thursday afternoon, about a dozen teenagers sat in a semicircle of North Face zip-ups, Jordans, combat boots, big hoop earrings and the slumped shoulders of late afternoon. It was the third week of Porn Literacy, and everyone already knew the rules: You don’t have to have watched porn to attend; no yucking someone else’s yum — no disparaging a student’s sexual tastes or sexuality. And avoid sharing personal stories about sex in class. Nicole Daley and Jess Alder, who wrote the curriculum with Emily Rothman and led most of the exercises and discussion, are in their 30s, warm and easygoing. Daley, who until last month was the director of Start Strong, played the slightly more serious favorite-aunt role, while Alder, who runs Start Strong’s classes for teenagers, was the goofier, ask-me-anything big sister. Rothman also attended most of the classes, offering information about pornography studies and explaining to them, for example, that there is no scientific evidence that porn is addictive, but that people can become compulsive about it.

In the first class, Daley led an exercise in which the group defined porn terms (B.D.S.M., kink, soft-core, hard-core), so that, as she put it, “everyone is on the same page” and “you can avoid clicking on things you don’t want to see.” The students also “values voted” — agreeing or disagreeing about whether the legal viewing age of 18 for porn is too high, if working in the porn industry is a good way to make money and if pornography should be illegal. Later, Daley held up images of a 1940s pinup girl, a Japanese geisha and Kim Kardashian, to talk about how cultural values about beauty and bodies change over time. In future classes, they would talk about types of intimacy not depicted in porn and nonsexist pickup lines. Finally, Daley would offer a lesson about sexting and sexting laws and the risks of so-called revenge porn (in which, say, a teenager circulates a naked selfie of an ex without consent). And to the teenagers’ surprise, they learned that receiving or sending consensual naked photos, even to your boyfriend or girlfriend, can be against the law if the person in the photo is a minor.

Now, in the third week of class, Daley’s goal was to undercut porn’s allure for teenagers by exposing the underbelly of the business. “When you understand it’s not just two people on the screen but an industry,” she told me, “it’s not as sexy.”

To that end, Daley started class by detailing a midlevel female performer’s salary (taken from the 2008 documentary “The Price of Pleasure”): “Blow job: $300,” Daley read from a list. “Anal: $1,000. Double penetration: $1,200. Gang bang: $1,300 for three guys. $100 for each additional guy.”

“Wow,” Drew muttered. “That makes it nasty now.”

“That’s nothing for being penetrated on camera,” another boy said.

Then, as if they had been given a green light to ask about a world that grown-ups rarely acknowledge, they began peppering Daley, Rothman and Alder with questions.

CreditPhoto illustration by Sara Cwynar

“How much do men get paid?” one girl asked. It is the one of the few professions in which men are paid less, Rothman explained, but they also typically have longer careers. How long do women stay in their jobs? On average, six to 18 months. How do guys get erections if they aren’t turned on? Often Viagra, Rothman offered, and sometimes a “fluffer,” as an offscreen human stimulator is known.

Daley then asked the teenagers to pretend they were contestants on a reality-TV show, in which they had to decide if they were willing to participate in certain challenges (your parents might be watching) and for how much money. In one scenario, she said, you would kneel on the ground while someone poured a goopy substance over your face. In another, you’d lick a spoon that had touched fecal matter. The kids debated the fecal-matter challenge — most wouldn’t to do it for less than $2 million. One wanted to know if the goop smelled. “Can we find out what it is?” asked another.

Then Daley explained that each was in fact a simulation of a porn act. The goopy substance was what’s called a “baker’s dozen,” in which 13 men ejaculate on a woman’s face, breasts and mouth.

“What?” a girl named Tiffany protested.

The second scenario — licking the spoon with fecal matter — was from a porn act known as A.T.M., in which a man puts his penis in a woman’s anus and then immediately follows by sticking it in her mouth.

“No way,” a 15-year-old boy said. “Can’t you wash in between?”

Nope, Daley said.

“We don’t question it when we see it in porn, right?” Daley went on. “There’s no judgment here, but some of you guys are squeamish about it.”

“I never knew any of this,” Drew said, sounding a bit glum.

Daley went on to detail a 2010 study that coded incidents of aggression in best-selling 2004 and 2005 porn videos. She noted that 88 percent of scenes showed verbal or physical aggression, mostly spanking, slapping and gagging. (A more recent content analysis of more than 6,000 mainstream online heterosexual porn scenes by Bryant Paul and his colleagues defined aggression specifically as any purposeful action appearing to cause physical or psychological harm to another person and found that 33 percent of scenes met that criteria. In each study, women were on the receiving end of the aggression more than 90 percent of the time.)

“Do you think,” Daley said, standing in front of the students, “watching porn leads to violence against women? There’s no right or wrong here. It’s a debate.”

Kyrah, a 10th-grade feminist with an athlete’s compact body and a tendency to speak her opinions, didn’t hesitate. “In porn they glamorize calling women a slut or a whore, and younger kids think this is how it is. Or when they have those weird porn scenes and the woman is saying, ‘Stop touching me,’ and then she ends up enjoying it!”

Tiffany, her best friend, snapped her fingers in approval.

“Yes and no,” one guy interjected. “When a man is choking a woman in porn, people know it is not real, and they aren’t supposed to do it, because it’s violence.” He was the same teenager who told me he would just “do” anal sex without asking a girl, because the women in porn like it.

Pornography didn’t create the narrative that male pleasure should be first and foremost. But that idea is certainly reinforced by “a male-dominated porn industry shot through a male lens,” as Cindy Gallop puts it. Gallop is the creator of an online platform called MakeLoveNotPorn, where users can submit videos of their sexual encounters — which she describes as “real world,” consensual sex with “good values” — and pay to watch videos of others.

For years, Gallop has been a one-woman laboratory witnessing how easy-to-access mainstream porn influences sex. Now in her 50s, she has spent more than a decade dating 20-something men. She finds them through “cougar” dating sites — where older women connect with younger men — and her main criterion is that they are “nice.” Even so, she told me, during sex with these significantly younger nice men, she repeatedly encounters porn memes: facials, “jackhammering” intercourse, more frequent requests for anal sex and men who seem less focused on female orgasms than men were when she was younger. Gallop takes it upon herself to “re-educate,” as she half-jokingly puts it, men raised on porn. Some people, of course, do enjoy these acts. But speaking of teenagers in particular, she told me she worries that hard-core porn leads many girls to think, for example, that “all boys love coming on girls’ faces, and all girls love having their faces come on. And therefore, girls feel they must let boys come on their face and pretend to like it.”

Though none of the boys I spoke to at Start Strong told me they had ejaculated on a girl’s face, Gallop’s words reminded me of conversations I had with some older high-schoolers in various cities. One senior said that ejaculating on a woman’s face was in a majority of porn scenes he had watched, and that he had done it with a girlfriend. “I brought it up, or she would say, ‘Come on my face.’ It was an aspect I liked — and she did, too.”

Another noted that the act is “talked about a lot” among guys, but said that “a girl’s got to be down with it” before he’d ever consider doing it. “There is something that’s appealing for guys. The dominance and intimacy and that whole opportunity for eye contact. Guys are obsessed with their come displayed on a girl.”

Many girls at Start Strong were decidedly less enthusiastic. One senior told me a boyfriend asked to ejaculate on her face; she said no. And during a conversation I had with three girls, one senior wondered aloud: “What if you don’t want a facial? What are you supposed to do? Friends say a boy cleans it with a napkin. A lot of girls my age like facials.” But a few moments later, she reversed course. “I actually don’t think they like it. They do it because their partner likes it.” Next to her, a sophomore added that when older girls talk among themselves, many say it’s gross. “But they say you gotta do what you gotta do.” And if you don’t, the first girl added, “then someone else will.”

These are not new power dynamics between girls and boys. In a 2014 British study about anal sex and teenagers, girls expressed a similar lack of sexual agency and experienced physical pain. In the survey, of 130 heterosexual teenagers age 16 to 18, teenagers often said they believed porn was a motivating factor for why males wanted anal sex. And among the guys who reported trying it, many said friends encouraged them, or they felt competitive with other guys to do it. At the same time, a majority of girls who had tried anal sex said they didn’t actually want to; their partners persuaded or coerced them. Some males took a “try it and see” approach, as researchers called it, attempting to put their finger or penis in a girl’s anus and hoping she didn’t stop them. Sometimes, one teenager reported, you “just keep going till they just get fed up and let you do it anyway.” Both boys and girls blamed the girls for pain they felt during anal sex and some told researchers the girls needed to “relax” more or “get used to it.” Only one girl said she enjoyed it, and only a few boys did. Teenagers may not know that even while porn makes it seem commonplace, in the 2009 national survey of American sex habits, most men and women who tried anal sex didn’t make it a regular part of their sex lives. And in another study, by Indiana University’s Debby Herbenick and others in 2015, about 70 percent of women who had anal sex said they experienced pain.

Drew had firsthand experience with what he had seen in porn not translating into actual pleasure. The first time he had sex, he thought he was supposed to exert some physical control over his girlfriend. But the whole thing felt awkward, too rough and not all that fun. And things that looked easy in porn, like sex while taking a shower or mutual oral sex, didn’t go so well.

CreditPhoto illustration by Sara Cwynar

At one point during sex, Drew’s girlfriend at the time, who was a year older and more experienced, asked him to put his hand around her neck during sex. He did it, without squeezing, and though it didn’t exactly bother him, it felt uncomfortable. Drew never asked if she got the idea from porn, but it made him wonder. Had she also picked up other ways of acting? “Like, how do you really know a girl has had a good time?” he said one afternoon, musing aloud while sitting with some friends before Porn Literacy class. “My girlfriend said she had a good time,” he went on. “She was moaning. But that’s the thing: Is it fake moaning?”

Even if you know porn isn’t realistic, it still sets up expectations, one senior told me. In porn, he said, “the clothes are off, and the girl goes down on the guy, he gets hard and he starts having sex with her. It’s all very simple and well lit.” Before he had sex, porn had supplied his images of oral sex, including scenes in which a woman is on her knees as a man stands over her. At one point, he thought that’s how it might go one day when he had sex. But when he talked with his girlfriend, they realized they didn’t want to re-enact that power dynamic.

I spent a couple of hours on a Wednesday afternoon at Start Strong with a senior girl who took the first Porn Literacy class in the summer of 2016. Looking back over the last several years of middle and high school, A., who asked me to identify her by the first initial of her middle name, said she wished she had had someplace — home, school, a community sex-ed program — to learn about sex. Instead, she learned about it from porn. She saw it for the first time by accident, after a group of sixth-grade boys cajoled her to look at tube8.com, which she didn’t know was a porn site. She was fascinated. She had never seen a penis before, “not a drawing of one, nothing.” A few years later, she searched online for porn again after listening to girls in the high school locker room talk about masturbation. A.’s parents, whom she describes as conservative about sex, hadn’t talked to her about female anatomy or sex, and her school didn’t offer any sex education before ninth grade; even then, it focused mostly on the dangers — sexually transmitted infections and diseases and pregnancy.

Aside from some private schools and innovative community programs, relatively few sex-ed classes in middle and high school delve in detail into anatomy (female, especially), intimacy, healthy relationships, sexual diversity. Even more rare are discussions of female desire and pleasure. Porn taught A. the basics of masturbation. And porn served as her study guide when she was 16 and was the first among her friends to have sex. She clicked through videos to watch women giving oral sex. She focused on how they moved during sex and listened to how they moaned. She began shaving her vulva (“I’ve never seen anyone in porn have sex with hair on it”).

Porn is “not all bad,” said A., who was frank and funny, with a slew of advanced-placement classes on her transcript and a self-assured manner that impresses adults. “I got my sexual ways from porn, and I like the way I am.” But what she learned from porn had downsides too. Because she assumed women’s pleasure in porn was real, when she first had intercourse and didn’t have an orgasm, she figured that was just how it went.

For A., it wasn’t enough to know that porn was fake sex. She wanted to understand how real sex worked. Rothman and her team did consult a sex educator while they were writing the Porn Literacy curriculum but decided to include only some basic information about safe sex. It came in the form of a “Porn Jeopardy” game during one class. The teenagers, clustered in teams, chose from four categories: S.T.D./S.T.I.s, Birth Control, Teen Violence/Sexual Assault and Porn on the Brain.

“I never learned this before,” Drew announced to the class after it was mentioned that lubrication decreased friction, increased pleasure and could reduce the risk of tearing and therefore of S.T.I.s and S.T.D.s. Drew’s only sliver of sex ed was in sixth grade with the school gym teacher, who sweated as he talked about sex, “and it was all about it being bad and we shouldn’t do it.”

As if to rectify that, Alder offered a quick anatomy lesson, drawing a vulva on the whiteboard and pointing out the clitoris, the vagina, the urethra. “This is called a vulva,” she said. Alder repeated the word slowly and loudly, as if instructing the students in a foreign language. It was both for humor and to normalize a word that some of them may have been hearing for the first time. “This is the clitoris,” Alder went on. “This is where women get most pleasure. Most women do not have a G spot. If you want to know how to give a woman pleasure, it’s the clitoris.”

“Let’s move on,” Rothman said quietly. Alder had just inched across a line in which anatomy rested on one side and female desire and pleasure on the other. It was a reminder that as controversial as it is to teach kids about pornography, it can be more taboo to teach them how their bodies work sexually. “The class is about critically analyzing sexually explicit media,” Rothman told me later, “not how to have sex. We want to stay in our narrow lane and not be seen as promoting anything parents are uncomfortable with.” Daley added: “I wish it were different, but we have to be aware of the limitations of where we are as a society.”

Porn education is such new territory that no one knows the best practices, what material should be included and where to teach it. (Few people are optimistic that it will be taught anytime soon in public schools.) Several years ago, L. Kris Gowen, a sexuality educator and author of the 2017 book “Sexual Decisions: The Ultimate Teen Guide,” wrote extensive guidelines for teaching teenagers to critique “sexually explicit media” (she avoided the more provocative term “porn literacy”). Even though Oregon, where Gowen lives, has one of the most comprehensive sex-ed programs in the country, Gowen said that teachers felt unequipped to talk about porn. And though the guidelines have been circulated at education conferences and made publicly available, Gowen doesn’t know of a single educator who has implemented them. In part, she says, people may be waiting for a better sense of what’s effective. But also, many schools and teachers are nervous about anything that risks them being “accused of promoting porn.”

The most recent sex-education guidelines from the World Health Organization’s European office note that educators should include discussions about the influence of pornography on sexuality starting with late elementary school and through high school. The guidelines don’t, however, provide specific ideas on how to have those conversations.

In Britain, nonprofit organizations and a teachers’ union, along with members of Parliament, have recommended that schools include discussions about the influence of porn on how children view sex and relationships. Magdalena Mattebo, a researcher at Uppsala University in Sweden who studies pornography and adolescents, would like porn literacy mandated in her country. “We are a little lost in how to handle this,” Mattebo told me.

More than 300 schools, youth and community groups and government agencies in Australia and New Zealand use components of a porn-education resource called “In the Picture” that includes statistics, studies and exercises primarily for teenagers. It was created by Maree Crabbe, an expert on sexual violence and pornography education, who lives near Melbourne, Australia. As she put it during a United States training program for educators and social workers that I attended in 2016: “We want to be positive about sex, positive about masturbation and critical of pornography.” One key component of the program is often neglected in porn literacy: providing training to help parents understand and talk about these issues.

 Last year, a feminist porn producer, Erika Lust, in consultation with sex educators, created a porn-education website for parents. The Porn Conversation links to research and articles and provides practical tips for parents, including talking to kids about the ways mainstream porn doesn’t represent typical bodies or mutually satisfying sex and avoiding accusatory questions about why your kid is watching porn and who showed it to them. “We can’t just say, ‘I don’t like mainstream porn because it’s chauvinistic,’ ” says Lust, whose films feature female-centered pleasure. “We have given our children technology, so we need to teach them how to handle it.” But she takes it a step further by suggesting that parents of middle- and high-schoolers talk to their teenagers about “healthy porn,” which she says includes showing female desire and pleasure and being made under fair working conditions. I asked Lust if she would steer her daughters in that direction when they are older (they are 7 and 10). “I would recommend good sites to my daughters at age 15, when I think they are mature enough. We are so curious to find out about sex. People have doubts and insecurities about themselves sexually. ‘Is it O.K. that I like that, or this?’ I think porn can be a good thing to have as an outlet. I’m not scared by explicit sex per se. I’m afraid of the bad values.”

Tristan Taormino, another feminist porn filmmaker and author, speaks frequently on college campuses and produces explicit sex-ed videos for adults. “The party line is we don’t want teenagers watching our videos,” she says, noting they are rated XXX. “But do I wish teenagers had access to some of the elements of it?” In addition to seeing consent, she said, “they would see people talking to each other, and they’d see a lot of warm-up. We show lube, we show sex toys.”

That may be more than most parents, even of older teenagers, can bear. But even if parents decided to help their teenagers find these sites, not only is it illegal to show any kind of porn — good or bad — to anyone under 18, but, really, do teenagers want their parents to do so? And which ones would parents recommend for teenagers? “Unlike organic food, there’s no coding system for ethical or feminist porn,” Crabbe notes. “They might use condoms and dental dams and still convey the same gender and aggression dynamics.” Also, “good porn” isn’t typically free or nearly as accessible as the millions of videos streaming on mainstream sites.

Al Vernacchio, a nationally known sexuality educator who teaches progressive sex ed at a private Quaker school outside Philadelphia, believes the better solution is to make porn literacy part of the larger umbrella of comprehensive sex education. Vernacchio, who is the author of the 2014 book “For Goodness Sex: Changing the Way We Talk to Teens About Sexuality, Values, and Health,” is one of those rare teenage-sex educators who talks directly to his high school students about sexual pleasure and mutuality, along with the ingredients for healthy relationships. The problem with porn “is not just that it often shows misogynistic, unhealthy representations of relationships,” Vernacchio says. “You can’t learn relationship skills from porn, and if you are looking for pleasure and connection, porn can’t teach you how to have those.”

Crabbe notes one effective way to get young men to take fewer lessons from porn: “Tell them if you want to be a lazy, selfish lover, look at porn. If you want to be a lover where your partner says, ‘That was great,’ you won’t learn it from porn.” And parents should want their teenagers to be generous lovers, Cindy Gallop argues. “Our parents bring us up to have good manners, a work ethic. But nobody brings us up to behave well in bed.”

To prepare his students to be comfortable and respectful in sexual situations, Vernacchio shows photos, not just drawings, of genitalia to his high-schoolers. “Most people are having sex with real people, not porn stars, and real bodies are highly variable. I would much rather my students have that moment of asking questions or confusion or even laughter in my classroom rather than when they see their partner’s naked body for the first time.” He, along with Debby Herbenick, who is also the author of the 2012 book “Sex Made Easy: Your Awkward Questions Answered for Better, Smarter Amazing Sex,” advocate that adolescents should understand that most females don’t have orgasms by penetration alone, and that clitoral stimulation often requires oral sex, fingers and sex toys. As she notes: “It’s part of human life, and you teach it in smart, sensitive ways.”

As the students from the first Porn Literacy classes moved through their lives in the year after their courses ended, some things from the discussions stayed with them. In surveys from the first three sets of classes, one-third of the students still said they would agree to do things from porn if their partner asked them to. Several also wanted to try things they saw in porn. They were, after all, normal, sexually curious, experimenting teenagers. But only a tiny number of students agreed in the postclass survey that “most people like to be slapped, spanked or have their hair pulled during sex,” compared with 27 percent at the start of class. And while at the beginning, 45 percent said that porn was a good way for young people to learn about sex, now only 18 percent agreed. By the end of the class, no one said pornography was realistic; just over one-quarter had believed that at the outset. The survey didn’t reveal the catalyst for the changes. Was it the curriculum itself? Was it something about Daley and Alder’s teaching style? It’s possible the students created the changes themselves, teaching one another through their in-class debates and discussions.

A., the young woman who said she had never seen an image of a penis until she watched porn, resisted the idea that porn was uniformly bad for teenagers. “At least kids are watching porn and not going out and getting pregnant,” she said. But recently, she told me that she’d given up watching it altogether. She disliked looking at women’s expressions now, believing that they probably weren’t experiencing pleasure and might be in pain. When Drew watched porn, he found himself wondering if women were having sex against their will. As another student said with a sigh: “Nicole and Jess ruined porn for us.”


In the months after the class, A. had created a new mission for herself: She was going to always have orgasms during sex. “And I did it!” she told me. It helped that she had been in a relationship with a guy who was open and asked what she liked. But even if Porn Literacy didn’t go into as many details about sex as she would have liked, “in this indirect way, the class shows what you deserve and don’t deserve,” she said. “In porn, the guy cares only about himself. I used to think more about ‘Am I doing something right or wrong?’ ” Porn may neglect women’s orgasms, but A. wasn’t going to anymore.

Drew, who had once used porn as his main sex educator, was now thinking about sex differently. “Some things need to come to us naturally, not by watching it and seeing what turns you on,” he told me. The discussions about anatomy and fake displays of pleasure made him realize that girls didn’t always respond as they did in porn and that they didn’t all want the same things. And guys didn’t, either. Maybe that porn clip in which the nice, tender guy didn’t excite the girl was wrong. What Drew needed was a girl who was open and honest, as he was, and with whom he could start to figure out how to have good sex. It would take some time and most likely involve some fumbling. But Drew was O.K. with that. He was just starting out.

A Few Research-Based FACTS About Pornography – Sex and Relationship Healing

If you search the internet for information about porn and its effects, you’re going to find a whole lot of opinions. Unfortunately, hardly any of those opinions will be based on verifiable information. This can be frustrating to those interested in the truth (as opposed to grandstanding and fear-mongering). Recognizing this, we have collected the latest research about pornography, presenting it below so those who are interested in the truth can know it.

How much porn is out there? A lot.

  • There are more than 2.5 million porn websites.[i]
  • Approximately 12% of all websites offer pornographic content.[ii]
  • The preceding numbers do not consider erotic content on social media, dating and hookup websites/apps, video chat services, etc.

Who is looking at porn? Men, women, and children.

  • A study of 434 adult men found that 99% of study participants looked at porn at least occasionally.[iii]
  • Research conducted in 2017 by PornHub.com (one of the world’s largest porn providers) found a 359% increase in “porn for women” searches.[iv]
  • Porn use among adolescent boys is ubiquitous. When a Canadian researcher tried to study the effects of porn usage on young males, he couldn’t, because he was unable to find any potential study participants who weren’t already looking at porn. No control group = no experiment.[v]
  • Research tells us that that nearly all boys and most girls use porn, though boys tend to look at it earlier and view it more often.[vi]
  • In a study of 16-year-old Swedish boys, 96% admitted they were porn users, with 10% saying they looked at porn every day. Importantly, approximately 1/3 of the daily users said they sometimes watched more porn than they wanted—a common indicator of porn addiction.[vii]
  • Current estimates place the average age of first porn use at 11.[viii]

Why do people look at porn, and does that matter? Motivations for porn use vary widely, and they often overlap. And yes, those reasons do matter.

  • One study found that porn users go online for a variety of reasons: sexual satisfaction (94.4%), to feel arousal (87.2%), to achieve orgasm (86.5%), to alleviate stress (73.8%), to relieve boredom (70.8%), to forget daily problems (53%), to deal with loneliness (44.9%), and to fight depression (38.1%).[ix]
  • Research shows that people who use porn primarily to self-soothe and self-regulate their emotions are significantly more likely to experience problems (like porn addiction) than people who go online primarily to find sexual satisfaction, achieve arousal, and experience orgasm.[x]

How much porn are people looking at? Sometimes a little, sometimes a lot.

  • One study found that adult male porn users spend an average of 3 hours per week with porn, with answers ranging from 5 minutes per week to 33 hours per week.[xi]
  • A study analyzing more than 400 million worldwide internet searches (representing more than 2 million users) found that approximately 13% of all internet searches are looking for porn.[xii]
  • Approximately 35% of all internet downloads are pornographic in nature.[xiii]
  • Research suggests that porn addicts typically spend at least 11 or 12 hours per week using pornography, with many devoting double or even triple that amount of time to porn.[xiv]

Is there a downside to porn? For some people, yes.

  • Porn use is correlated with decreased marital satisfaction in both the short-term and long-term. This link is stronger with male porn use than with female porn use.[xv]
  • Porn use almost doubles the likelihood of getting divorced in the next four years, increasing the probability from 6% to 11%.[xvi]
  • Heavy porn use among boys is correlated with higher levels of risky sexual behaviors, truancy, relationship problems, smoking, drinking, and illicit drug use.[xvii]
  • Not all porn users feel good about their behavior. One study found that 61.7% felt shame about their porn use, 49% searched for sexual content that did not previously interest them or that they considered disgusting, and 27.6% self-assessed their porn use as problematic.[xviii]
  • Research consistently shows that sex/porn addicts often struggle with real-world sexuality, with the most common issues being porn-induced erectile dysfunction (PIED), delayed ejaculation, and anorgasmia (inability to reach orgasm).[xix] One study of 350 sex/porn addicts found that 26.7% report issues with sexual dysfunction.[xx] A more recent study of sex/porn addicts identified sexual dysfunction in 58% of test subjects.[xxi] An even more recent study of adult men found that approximately 28% of participants self-assessed their porn use as problematic, with PIED listed as a primary consequence.[xxii]

[i] Ogas, O. & Gaddam, S. (2012). A billion wicked thoughts: What the Internet tells us about sexual relationships, p 8. New York, NY: Plume.

[ii] Damania, D. (2014). “Internet pornography statistics,” thedinfographics.com/2011/12/23/internet-pornography-statistics/, accessed May 28, 2014.

[iii] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.

[v] Liew, J. (2009). All men watch porn, scientists find. The Telegraph. Retrieved Jan 16, 2015 from telegraph.co.uk/women/sex/6709646/All-men-watch-porn-scientists-find.html.

[vi] Sabina, C., Wolak, J., & Finkelhor, D. (2008). The nature and dynamics of Internet pornography exposure for youth. CyberPsychology & Behavior, 11(6), 691-693.

[vii] Mattebo, M., Tyden, T., Haggstrom-Nordin, E., Nilsson, K.S., & Larsson M. (2013). Pornography consumption, sexual experiences, lifestyles, and self-rated health among male adolescents in Sweden. Journal of Developmental & Behavioral Pediatrics 34(7):460-468.

[viii] Wolak, J., Mitchell, K., & Finkelhor, D. (2007). Unwanted and wanted exposure to online pornography in a national sample of youth Internet users. Pediatrics, 119(2), 247-257.

[ix] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.

[x] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.

[xi] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.

[xii] Ogas, O. & Gaddam, S. (2012). A billion wicked thoughts: What the Internet tells us about sexual relationships, p 15. New York, NY: Plume.

[xiii] Damania, D. (2014). “Internet pornography statistics,” thedinfographics.com/2011/12/23/internet-pornography-statistics/, accessed May 28, 2014.

[xiv] Cooper, A. Putnam D.E., Planchon, A. & Boies, S.C. (1999). Online Sexual Compulsivity: Getting Tangled in the Net. Sexual Addiction and Compulsivity 6(2):79–104.

[xv] Perry, S. L. (2017). Does viewing pornography reduce marital quality over time? Evidence from longitudinal data. Archives of sexual behavior, 46(2), 549-559.

[xvi] Perry, S. L. (2017). Does viewing pornography reduce marital quality over time? Evidence from longitudinal data. Archives of sexual behavior, 46(2), 549-559.

[xvii] Mattebo, M., Tyden, T., Haggstrom-Nordin, E., Nilsson, K.S., & Larsson M. (2013). Pornography consumption, sexual experiences, lifestyles, and self-rated health among male adolescents in Sweden. Journal of Developmental & Behavioral Pediatrics 34(7):460-468.

[xviii] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.

[xix] Rosenberg, K. P., Carnes, P., & O’Connor, S. (2014). Evaluation and treatment of sex addiction. Journal of sex & marital therapy, 40(2), 77-91.

[xx] Hall, P. (2012). Understanding and treating sex addiction: A comprehensive guide for people who struggle with sex addiction and those who want to help them. Routledge.

[xxi] Voon, V., Mole, T. B., Banca, P., Porter, L., Morris, L., Mitchell, S., … & Irvine, M. (2014). Neural correlates of sexual cue reactivity in individuals with and without compulsive sexual behaviours. PloS one, 9(7), e102419.

[xxii] Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior, 56, 257-266.



Technology and Sexual Addiction – Sex and Relationship Healing

“I initially noticed tech-related sexual issues in the early 1990s, when online bulletin boards (BBS) and porn sites first hit the web. Prior to that, my clients were mostly hooked on real-world sexuality—serial affairs, prostitutes, sex clubs, and adult movie theaters, plus the occasional guy hooked on phone sex (the old-fashioned kind of phone that plugged into the wall). But when home computers and ubiquitous Internet connections came along, my clients were suddenly and primarily engaging in tech-driven sexuality. And this tech-sex trend continues unabated, with current-day sex addicts hooked on digital pornography, virtual sex games, webcam sex, hookup apps, teledildonics, and whatever else R&D departments can dream up.”

—Robert Weiss, Sex Addiction 101

The simple, sad truth is that with every advance in digital technology, more and more people are challenged by sexual addiction. Consider that researchconducted in the 1980s (pre-Internet) suggested that anywhere from 3 to 5% of the adult male population was sexually addicted. By 1999, which was still the very early days of Internet usage, research showed that percentage had approximately doubled, to 8.5%. Nineteen years later we don’t have an updated number, but anecdotal evidence strongly suggests the percentage is still climbing. Today, it would be difficult to find even a single sex addict who hasn’t been involved in some way with online sexuality.

Without doubt, porn is the “industry leader” when it comes to cybersex addiction. This is hardly a surprise, given the recent online porn explosion. And no, we’re not exaggerating when we use the word explosion. In their book, A Billion Wicked Thoughts, researchers Ogi Ogas and Sai Gaddam write:

In 1991, the year the World Wide Web went online, there were fewer than 90 different adult magazines published in America, and you’d have been hard-pressed to find a newsstand that carried more than a dozen. Just six years later, in 1997, there were about 900 pornography sites on the Web. Today, the filtering software CYBERsitter blocks 2.5 million adult Web sites.

Of course, pornography is just the tip of the sexnological iceberg. In today’s world, it is possible to meet someone on a dating site or a hookup app, to flirt with that person via text and sext, to have sex with that person via webcam and teledildonic devices, and to brag about this hot new relationship on social media. All without ever being in the same room (or even the same country).

Hookup apps are especially problematic for digital-era sex addicts, primarily because they present an entire universe of readily available potential sexual partners, helpfully arranged, thanks to geo-locating software, from nearest to furthest away. And a person’s marital status, hobbies, job, religion, goals, and worldview don’t matter on these apps, because they’re all about the quick encounter. No muss, no fuss, just the sex, thank you very much. Many sex addicts post profiles on multiple apps simultaneously, staying logged in to all of them 24/7 and checking them constantly. Sometimes they’re looking for the next sexual encounter before they’re even done with the current sexual encounter.

If you or someone you know is struggling with digital sexual activity, you may want to consider installing a filtering and accountability software on your digital devices. For information about which products work best, click here.



When Is Porn Use a Problem?

“We have a distorted view of our fantasies … because we don’t talk about them enough.” —Sasha Grey, actor and former porn performer

Pornography is becoming ubiquitous and ever more sophisticated. Long gone are the days of erotic wood carvings. Gone are the days of XXX cinemas in seedy neighborhoods with furtive and lurid shapes in the fog. Gone are the days of print magazines and pin-up girls. Pornography plus the internet equals a “sexplosion” of erotica — prerecorded, real-time, virtual reality, and more — confronting flesh-and-blood interpersonal relationships with compelling alternatives, which for some prove more desirable, ultimately superior, and equally, if not more, clandestine. I predict that by the end of the 21st century, sex will finally come out of the closet — and fundamentally change what being a human being means.

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Source: Stokkete/Shutterstock

In their recently published work, Daspe, Vaillancourt-Morel, Lussier, Sabourin, and Ferron (2018) investigate important questions regarding pornography use, which is going up in frequency and plays an increasingly significant and pervasive role in society. Setting aside questions of morality and direct and indirect harm, pornography use is seen by many relationship experts as being potentially healthy or potentially destructive to individuals and couples.

How Do Relationship Circumstances Shape Pornography’s Impact?

However, up until now the research on pornography has not looked at how overall relationship and sexual satisfaction affects the frequency of pornography use, or the extent to which pornography users experience distress associated with pornography use. More abusive and violent pornography also shapes attitudes about gender and sexuality, and can negatively affect relationships and contribute to harm, though men reporting both positive and negative effects from pornography attribute greater positive effects overall, and young men greater negative effects than older men (Miller et al., 2017). Studies have also shown that pornography use may mis-wire reward circuits, causing sexual dysfunction and reinforcing dependence on porn (Park et al., 2016).

Daspe and colleagues note many points which are now common knowledge. Pornography use is on the rise and diversifying. When it becomes destructive, it leads to distress and loss of control, and negatively impacts relationships. For some, internet pornography use becomes persistent. According to researchers, 17 percent of pornography users are compulsive (Cooper, Delmonico & Berg, 2000), leading to distress and dysfunction. In other work (Grubbs et al., 2015; Blais-Lecours et al., 2016), feeling out of control is only partly due to a higher frequency of use, with correlations between the two ranging from weak to strong.

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But we don’t know why that is, or what factors connect frequency and perceived loss of control. It’s easy to understand why someone who uses porn more than they want to, or who feels conflict about it or fears consequences, would perceive losing control even with relatively low levels of porn use. On the other hand, someone who doesn’t have any problem with pornography may be a frequent user and be as happy as can be. In the research review here, the role of relationship and sexual satisfaction for couples is examined as a factor in determining how frequency of use and perceived lack of control connect.

Zoom in on Pornography, and Relationship and Sexual Satisfaction

To better understand how these factors interact, Daspe and colleagues (2018) recruited people in relationships to complete an online survey about pornography use, relationship and sexual satisfaction, and other factors. They surveyed 1,036 people, about 50 percent women, mainly between the ages of 18 and 35. Most had been in a relationship over a year; 30 percent were going out, but did not live together; 54 percent lived together; and 15.6 percent were married. A third had children, and the majority were male-female couples.

They completed measures including: internet pornography use; frequency of use; type of pornography used; perceived lack of control over pornography use; relationship satisfaction; and sexual satisfaction. The data were analyzed first to look for significant correlations, and then in more detail to understand the complex moderating effects among factors of interest.

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In terms of basic results, they found that 73 percent of women and 98 percent of men reported internet porn use in the last six months, for a total of 85 percent of respondents. For porn use within the last week, the numbers were lower: 80 percent of men and 26 percent of women. Prerecorded videos were the most common type of online porn used. For both men and women, those who reported using porn more often noted a greater perceived lack of control.

For men, lower sexual satisfaction correlated with greater frequency of porn use, and perceived lack of control was associated with both lower relationship and sexual satisfaction. There were interesting correlations for relationship duration — for women, longer relationships were associated with less porn use. For men and women, longer relationships were associated with decreased relationship and sexual satisfaction. Importantly, men reported higher frequency of use, higher perceived lack of control, and lower relationship and sexual satisfaction. People who cohabited said they experienced both lower relationship and sexual satisfaction. Finally, people with kids also reported lower relationship and sexual satisfaction, but having children did not affect the relationship between frequency of porn use and feeling out of control.

When they dug into the data more deeply, there were several useful insights. In the presence of lower relationship satisfaction, frequency of use was more highly correlated with perceived lack of control. This suggests that using porn to compensate for relationship issues as a maladaptive coping strategy is more likely to become distressing. For men only, having no children enhanced perceived lack of control in the presence of both lower relationship and sexual satisfaction. This suggests that having children “protects” against excessive porn use, as accessing porn is usually more difficult with children in the household.

Good relationship satisfaction, for both men and women, reduced the connection between perceived lack of control and frequency of use, suggesting that porn use is not as likely to be destructive for satisfying relationships. Lower sexual satisfaction predicted more frequent porn use, as well as greater perceived lack of control.

Working with Pornography in Relationships

What can we do with research findings to improve relationship quality and sexual satisfaction and limit the damaging effects of pornography, while enhancing arguably constructive pornography use? When pornography use is problematic, it can damage relationship and sexual enjoyment for both partners, worsening problems already present. For both partners in a less satisfying relationship, pornography use is more likely to feel out of control, suggesting major relationship issues are being avoided. When children come into the picture, women may find satisfaction in providing care, as women are still more often the primary caregivers, and the couple’s relationship may suffer if additional steps are not taken to prevent that from happening. For many couples, children draw partners closer.

Women may end up having fewer resources available for the couple, expending more time and energy with children. Men may turn to pornography, further widening the intimacy gap and potentially causing sexual dysfunction (Park et al., 2016). Pornography may also stabilize unhappy relationships by providing an alternative to infidelity. Porn use tends to be kept secret, a source of fear and shame (perhaps echoing childhood attitudes about self-stimulation), making it even harder to talk about relationship and sexual issues. In addition to sexual frustration, pornography may also be used to cope with other stressors in life, both within and outside of intimate relationships.

When couples decide to work on their relationship issues, pornography needs to be approached thoughtfully. Couples need to understand each other’s beliefs and attitudes. If there are major gaps in how they view pornography, it is going to be difficult to discuss sexuality and the relationship in general without coming to some consensus about those conflicts; if there is an absolute moral prohibition, it may even be a non-starter. Partners may also differ in whether they see porn use as infidelity. One person may see themselves as being innocent of any transgression, while the other feels betrayed. That betrayal then becomes the main issue, especially if it is already a theme in the relationship or part of the either partner’s past (e.g., a personal history of cheating, or being cheated on, and/or a parental infidelity history).

Partners may also hold different views on the morality of pornography. One person, for instance, may believe that pornography actors are generally abused and coerced vulnerable young people who are possibly fleeing problematic home situations; women being taken advantage of in a male-dominated industry. The other may argue that porn actors are aware of their choices and able to give full informed consent. It varies from person to person, and people who make porn vary in how they select actors. The meaning of being viewed as complicit in abuseby virtue of pornography consumption is a recurring theme for many couples, a discussion which often doesn’t go well.

Being clear about what constitutes infidelity and betrayal is also at the heart of the conversation. To complicate matters, people may be unaware of how they really feel about something until it happens. We could agree in principle, for example, that it’s OK to use porn, and that it isn’t cheating — only to find out we feel very differently when we catch our partner with it. This can lead to confusion and conflict, as each sees the other as culpable in different ways.

Getting clear with one another about porn is part of a larger effort to improve relationship and sexual satisfaction. Talking through sexual issues improves both sexual and relationship quality, and can include a detailed discussion of partners’ sexual wishes, which is shown to enhance women’s pleasure. It can also help to include close other couples in relationship conversations as well. Individual factors, such as attachment style and sexual self-concept, are additional important factors to consider. When couples are avoidant and/or don’t have the tools, they should strongly consider whether they are ready to make a serious commitment to dealing with their issues and seek appropriate assistance.


Blais-Lecours, S., Vaillancourt-Morel, M.-P., Sabourin, S., & Godbout, N. (2016). Cyberpornography: Time use, perceived addiction, sexual functioning, and sexual satisfaction. Cyberpsychology, Behavior, and SocialNetworking, 19(11), 649–655. doi:10.1089/cyber.2016.0364

Cooper, A.,Delmonico,D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives:New findings and implications. Sexual Addiction & Compulsivity, 7(1–2), 5–29. doi:10.1080/10720160008400205

Daspe M, Vaillancourt-Morel M, Lussier Y, Sabourin S & Ferron A (2017): When Pornography Use Feels Out of Control: The Moderation Effect of Relationship and Sexual Satisfaction, Journal of Sex & Marital Therapy, DOI: 10.1080/0092623X.2017.1405301

Grubbs, J. B., Stauner, N., Exline, J. J., Pargament, K. I., & Lindberg, M. J. (2015). Perceived addiction to Internet pornography and psychological distress: Examining relationships concurrently and over time. Psychology of Addictive Behaviors, 29(4), 1056–1067. doi:10.1037/adb0000114

Miller D, Hald, J, Martin & Kidd G. (2017). Self-perceived effects of pornography consumption among heterosexual men. Psychology of Men & Masculinity. Psychology of Men & Masculinity, May 8. http://dx.doi.org/10.1037/men0000112

Park BY, Wilson G & Doan AP. (2016). Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behavioral Sciences, 2016 Sep; 6(3): 17.


What is Sex Addiction? – Sex and Relationship Healing

Sex addiction is a dysfunctional preoccupation with sex that continues for a period of at least six months, despite negative consequences and attempts to either quit or curtail the problem-causing behaviors. Or, stated more simply, sex addiction is an ongoing, out-of-control pattern of sexual fantasies and behaviors that causes problems in a person’s life.

Sex addiction is diagnosed based on three primary criteria:

  1. Preoccupation to the point of obsession. Sex addicts spend hours, sometimes even days, fantasizing about, planning for, pursuing, and eventually engaging in sexual acts (with self or others). They often “lose time” when floating around in their sexual obsession.
  2. Loss of control. Most sex addicts try, usually repeatedly, to either quit or cut back on their sexual behaviors. Sometimes they even succeed for a short while. But before they know it, they are back where they started, losing themselves in sexual obsession.
  3. Negative consequences. Sex addicts typically experience the same basic consequences as other addicts—problems at work or in school, relationship woes, financial issues, declining physical and/or emotional health, loss of interest in previously enjoyable activities, isolation, arrest, etc.

If you identify with these three criteria, it is quite possible that you are sexually addicted. If so, it’s likely that you are compulsively engaging in one or more of the following behaviors:

  • Hour after hour of porn and/or webcam use, with or without masturbation.
  • Losing oneself in hookup apps and similar technologies—dating sites, video chat, sexting, etc.
  • Constantly “hunting” for sex—cruising in the car for sex partners, surfing online for sex partners, hanging out in the steam room at the gym, etc.
  • An ongoing pattern of intense and highly sexualized affairs or brief “serial” relationships.
  • Consistently having casual and/or anonymous sex with people met online or in-person.
  • Consistently visiting strip clubs, adult bookstores/theatres, and other sex-driven environments.
  • Paying for (or being paid for) sex, sensual massage, eroticized domination, etc.
  • A pattern of unsafe sex—unprotected sex, sex with strangers, sex in public, etc.
  • Consistently seeking sex without regard to consequences—damaged relationships, financial issues, arrest, etc.

This listing of typical sex addict behaviors is wildly incomplete. That said, at least one or two of the activities listed above are nearly always among the behaviors that any sex addict struggles with.

Sex Addiction is Not About Sex

Interestingly, sex addiction is not about sex. It’s about “numbing out” and escaping from stress and other forms of emotional discomfort, such as depression, anxiety, low self-esteem, the pain of unresolved early-life trauma, etc. Sex addicts are hooked not on the sex act, but on the emotional intensity and escape produced by their sexual fantasies and patterns of behavior, including the endless search for the perfect video, the perfect sex partner, the perfect sexual encounter, etc. Often, sex addicts spend many hours, sometimes even days, in this elevated state—high on the goal/idea of having sex—without ever engaging in any concrete sexual act. They even have a name for this escapist, dissociated condition, referring to it as either “the bubble” or “the trance.”



The one thing dating apps will give you for sure? Addiction

A Chelsea-based physiotherapist I know saw a young woman complaining of persistent pain in her index finger. Puzzled, he tried to identify what could possibly be straining it. The patient finally admitted, slightly sheepishly, to using Tinder. A lot. The prescription? Switch hands. That will be £200 pounds please… Tinder finger treated, she’s back online for Valentine’s. But just how likely are modern-day lonely hearts to find the love, or even the sex, they seek on their smartphones?

The stats are grim: despite 26 million matches made each day on Tinder alone, Pew data reveal that only five per cent of committed relationships began online. For the vast majority of users, the game itself proves to be more arousing than the other players: fewer than 10 per cent of matches are consummated with even a half-assed “hey”, as users opt to “keep playing” instead of messaging the matches already made. Nearly half of millennials surveyed admitted to using dating apps as “ego-boosting procrastination” rather than to meet people. Perhaps no surprise, then, that – far from the image of a free-love fest at the fingertips propagated by the popular press – singles are having less sex than their counterparts a generation ago, a phenomenon the study’s author, San Diego State University psychology professor Jean Twenge, attributes to the apps.

What is it about caressing a touchscreen that has become more compelling than touching another human being? Dating apps have been shown to be pathologically addictive: according to Tinder – by far the market leader – the average user logs in 11 times per day, spending about 77 minutes daily in pursuit of the neurochemical cocktail dished out each time there’s a match. The dinglights up the same pleasure centers in the brain activated by eating chocolate, viewing erotic imagery, or snorting cocaine.

Like any interface in our attention economy, there are “a thousand people on the other side of the screen” whose job it is to keep you hooked, says “design ethicist” Tristan Harris, one of a growing band of ex-tech execs reckoning with the Frankensteins of their creation. Every last detail of the user experience is engineered to keep our hands and eyes glued to the smartphone – from the colours and sounds of notifications to the timing of their receipt. “Let’s admit it: We are all in the persuasion business,” writes gaming entrepreneur Nir Eyal in Hooked: How to Build Habit-Forming Productsa playbook of sorts for what has been dubbed “the dark arts of attentional design”. “We call these people users,” he writes. “And even if we don’t say it aloud, we secretly wish every one of them would become fiendishly hooked to whatever we’re making.”

Lesson one of Dark Arts 101? The irresistible pull of variable-schedule rewards. The brain releases dopamine not upon the receipt of a reward but in anticipation of it (think dogs salivating at the sound signaling supper). This effect is amplified when the reward – in this case, a match – is uncertain. Research has shown that pigeons presented with a button that produces goodies (pellets of food or doses of drugs) in an unpredictable pattern will peck the heck out of the button, nearly twice as much as when the reward arrives in a predictable manner. Natasha Dow Schüll, a cultural anthropologist who studies gambling addiction, has likened the deliberate design of dating apps to that of slot machines, with the same resultant risk of tumbling down the rabbit hole.

Dopamine was long thought to be the direct source of pleasure, until lab work led by University of Michigan neuroscientist Kent Berridge determined that dopamine is in fact only what motivates the movement toward pleasure – what he refers to as “wanting”. A dopamine-deficient rat won’t get off its metaphoric rat couch to eat if it’s hungry, but will lick its lips in rapture if fed a drop of sugar water on that couch.

Our brains, explains Dr Berridge, are “more stingy with mechanisms for pleasure than for desire.” Evolution favours go-getters. But this wiring leaves us susceptible to getting stuck in “wanting” for a long – and not particularly pleasant – time. The more we spend time seeking, whether in search of drugs, sex or dating app dings, “we get less and less pleasure out of it, and the less and less balanced life becomes,” Morten Kringelbach, a neuroscientist and Senior Research Fellow at The Queen’s College at Oxford, told me. “That’s the tragedy of addiction. We’re like an animal in a cage trapped in the same circus all the time.”

Online dating apps are truly evolutionarily novel environments,” David Buss, a professor of psychology at the University of Texas at Austin who specialises in the evolution of human sexuality, has said. “But we come to those environments with the same evolved psychologies.” While natural rewards contain built-in satiety signals at consummation (one can only eat/dance/make love for so long), when we’re deliberately kept in the “wanting” phase by persuasive design, there is no signal telling us when to stop. The “infinite scroll” mechanism used by most dating apps takes advantage of this vulnerability by automatically loading the next page so that users don’t have to pause, encouraging them to take just one more hit by swiping on just one more profile, and then another, ad infinitum.

Scientists have come to understand that the brain changes its physical structure as it performs various activities. Repetitive actions set grooves in neural pathways to make them the path of least resistance, allowing the brain to conserve energy. Digital daters get in the habit of automatically opening an app at certain times of the day or as the go-to solution to quell boredom or loneliness, whether or not they’re consciously aware of that feeling. Studies have yet to be conducted on the long-term effects of the dopaminergic excitation of dating apps on the brain (rats don’t have iPhones.) But even small doses of addictive drugs have been shown to lead to long-lasting or even permanent changes in neural circuitry, and behavioural cues are thought to work in much the same way as drugs. Like any addiction, it may not be so easy to walk away. (An acquaintance of mine had made it as far as a third date with a woman, only to be caught on a dating app when his date returned from the toilet.) He’s in good company: 22 per cent of men admit to the offence, according to the dating app company Hinge, although the dopamine hit was probably less powerful than the well-deserved whack he received with her handbag.)

Dating apps may seem harmless, or more efficient than attending an endless string of parties, but users may be sacrificing more satisfying long-term rewards. When singletons forgo face-to-face connection to scroll through avatars, they receive a short-term hit of validation but miss out on social interaction itself: indeed, a majority report feeling lonely after swiping. “There is pleasure in the seeking,” explains Dr Kringelbach. “But the problem is that the effect is drip, drip, drip. This only serves to sustain addiction, rather than leading to real pleasure or satiety.

“It is impossible to work with information technology without also engaging in social engineering,” warns Jaron Lanier, one of the founding fathers of virtual reality. “It takes only a tiny group of engineers to create technology that can shape the entire future of human experience with incredible speed.” We have gone to great lengths to free ourselves from societal and religious constraints on how and whom to love, only to outsource the most intimate of our endeavours to a handful of (predominantly) dudes in the Valley. And their interests lie not in our flourishing love lives, but in their bottom line.

by Mia Levitin


Love Versus Lust: Here’s What You Need To Know

In a general way, most people think of love as living in the heart. And why not, when being with a person you love causes your heart to beat faster, and breaking up with a person you love makes your chest hurt? Science, however, tells us that love lives not in the heart but in the brain. And when I say brain, I do, in fact, mean the blood-and-guts organ between our ears. In fact, thanks to functional magnetic resonance imaging (fMRI) techniques, we even know where in the brain this wonderful emotion resides.

One neurobiological study of people who said they were “intensely in love” compared test subjects’ brain activity as they viewed photos of their beloved interspersed with photos of familiar but not beloved individuals, to see how the brain reacts to love versus a neutral stimulus. Later, other scholars replicated that study, but they did so with pornographic imagery tossed into the mix. This research was done in an attempt to separate physical attraction (sexual arousal) from romantic connection (love). Taken together, these studies give three primary findings:

1. Sexual attraction/arousal consistently activates the dopamine-rich nucleus accumbens, which is sometimes referred to as the brain’s “pleasure center.”

2. Intense feelings of love also consistently activate the nucleus accumbens, creating a sensation of pleasure.

3. In addition to the brain’s pleasure center, intense feelings of love activate regions of the brain that “give value” to life-sustaining activities (to make sure we continue to engage in them). Sexual attraction/arousal without love does not activate these other parts of the brain.

This means that our brains view love not only as pleasurable but also as a life-sustaining necessity, while sexual arousal merely gives us pleasure. As such, people who are strongly in love feel a powerful desire to be with their beloved because it gives them pleasure and because their brains are actually telling them this is part of the human survival process. This is also why we can feel real, physical pain after a breakup with someone we truly love. Basically, the “value” parts of our brain cause our bodies to react to the loss of love in a way that reminds us how important it is.

So, how can we accurately define love? Perhaps we could state that love is a pleasurable feeling that our brain values more than most other pleasurable feelings. For instance, eating a chocolate ganache gives us pleasure, but our chests don’t ache when the treat is gone because our brain doesn’t place the same value on chocolate as on love. So perhaps the 1970s rock band Sweet got it right when they sang, “Love is like oxygen.” As with oxygen, without love, we ultimately can’t survive.



With Sex Addiction, Sobriety Looks Different for Every Addict

There is a lot of confusion and misinformation about sexual addiction, much of which centers around the way in which “sexual sobriety” is (and is not) defined. For starters, a lot of people, including some underinformed therapists, think that clinicians who treat sex addiction dictate to their clients what is and is not healthy, which would leave the definition of sexual sobriety open to the clinician’s personal, moral, and/or religious views about what sex should look like, with whom you should have it, and how often you should have it. This could include possible interpretations like, “If you’re not legally married to an opposite sex spouse, you should not be having sex with anyone, including yourself.”


Happily, after nearly three decades treating sex addicts and their families, and training other therapists to do the same, I can assure you that this is not the way in which sexual sobriety is defined. Certified sex addiction therapists are not the sex police, nor do we wish to be. In fact, as a rule we are incredibly sex positive, encouraging any and all forms of sexual expression, as long as they’re not obsessive, compulsive, and out of control in ways that harm self or others. Same-sex behaviors, fetishes, kinks, and all other forms of legal and consensual sexual activity are perfectly acceptable as far as we are concerned—even for recovering sex addicts. Anyone who says differently is either misinformed or lying.

A similar concern, generally expressed by sex addicts themselves, is that sexual sobriety requires long-term abstinence (as we typically see with recovery from substance and gambling addictions), or at least long-term abstinence from the types of behaviors that turn them on the most. In fact, one of the first questions I am likely to hear when starting work with a newly recovering sex addict is, “Will I ever have a healthy and enjoyable sex life, or do I have to give up hot sex forever?” Often, that is followed by a statement like, “If I have to give up sex permanently, or my favorite flavor of sex permanently, you can forget about me staying in recovery.”

I do not in any way fault my clients for this attitude. Instead, I tell them that unlike certain other forms of addiction sobriety, sexual sobriety is not defined by long-term deprivation. With sex addiction, we define sobriety as we do with eating disorders—another area where long-term abstinence is neither desired nor feasible. So, instead of permanently abstaining from all sexual activity or even certain types of sexual activity, recovering sex addicts define sexual sobriety in ways that help them be sexual in non-compulsive, non-problematic, life-affirming ways.

Individually Defining Sexual Sobriety

On the heels of the conversation described above, newly recovering sex addicts tend to ask, “If sexual sobriety doesn’t require lasting sexual abstinence, what does it require?” The good news (and maybe also the bad news, for those who like rigid rules) is there’s no cut-and-dried answer to this question. Each sex addict enters the process of recovery with a unique life history, a unique set of compulsive sexual behaviors that are causing problems, and a unique set of goals for the future. Based on this information, each sex addict is encouraged to craft a personalized definition of sobriety. This means each addict’s definition of sexual sobriety will be his or hers alone. Moreover, sexual behaviors that are highly problematic for one recovering sex addict might be perfectly fine for another. For example, sexual sobriety for 28-year-old single gay man could (and probably will) only loosely resemble sexual sobriety for a 48-year-old married father of three. The goal of sexual sobriety is not conformity; the goal is a non-compulsive, non-shaming, consequence-free sexual life.

Sexual Boundary Plans

Recovering sex addicts, after defining what sexual sobriety means to them, typically put this into effect through use of a sexual boundary plan. These plans define and set limits on which sexual behaviors are and are not acceptable for that addict.

Typically, the process of creating a sexual boundary plan begins with a statement of goals, where recovering sex addicts list the primary reasons they want to change their sexual behavior. A few commonly stated goals are as follows:

  • I don’t want to cheat on or keep secrets from my significant other.
  • I want to be present in the real world instead of living my life online.
  • I don’t want to “lose myself” in pornography ever again.
  • I don’t want to put my health and my self-esteem at risk through sexual behaviors.
  • I want to feel like a whole, integrated, healthy person, like I’m living my life with integrity.

Once a sex addict’s goals for recovery are clearly stated, he or she can move forward with the creation of a personalized plan for sobriety, using his or her pre-established goals as an overall guide. Sometimes sexual sobriety plans are simple, straightforward statements like, “I will not engage in sexual infidelity no matter what,” or, “I will not view pornography of any kind.” More often, sex addicts implement a more detailed, three-tiered set of guidelines constructed as follows:

The Inner Boundary: This boundary lists the specific sexual actions that lead to negative life consequences and incomprehensible demoralization for the addict. If the addict engages in these behaviors, he or she has “slipped” and will need to reset his or her sobriety clock (while also doing a thorough examination of what lead to the slip). A few common inner boundary behaviors are as follows:

  • Paying for sex.
  • Calling an ex for sex.
  • Going online for porn.
  • Masturbating to porn.
  • Engaging in webcam sex.
  • Getting sensual massages.
  • Hiring prostitutes.
  • Hooking up for casual and/or anonymous sex.
  • Having affairs.
  • Exhibiting oneself (online and/or real world).

The Middle Boundary: This boundary lists warning signs and slippery situations that might lead a sex addict back to inner boundary activities. Here, the addict lists the people, places, thoughts/fantasies, events, and experiences that might trigger his or her desire to engage in problematic (non-sober) sexual behaviors. In addition to obvious potential triggers (logging onto the Internet, driving through a neighborhood where prostitutes hang out, downloading a hookup app, etc.), this list includes things that might indirectly trigger a desire to act out (working long hours, arguing with a spouse or boss, keeping secrets, worrying about finances, etc.) A few common middle boundary items are as follows:

  • Skipping therapy and/or a support group meeting.
  • Lying (about anything), especially to a loved one.
  • Poor self-care—lack of sleep, eating poorly, forgoing exercise, etc.
  • Working more hours than usual.
  • Spending time with family of origin—holidays, reunions, etc.
  • Fighting and/or arguing with anyone, especially with loved ones.
  • Unstructured time alone.
  • Traveling alone (for any reason).
  • Feeling lonely.
  • Feeling bored.

The Outer Boundary: This boundary lists healthy behaviors and activities that can and hopefully will lead a sex addict toward his or her life goals—including but not even remotely limited to having a healthy, non-destructive sex life. These healthy pleasures are what addicts turn to as a replacement for sexual acting out. Outer boundary activities may be immediate and concrete, such as “working on my house,” or long-term and less tangible, such as “redefining my career goals.” In all cases, the list should reflect a healthy combination of work, recovery, and play. A few common outer boundary behaviors are as follows:

  • Spend more time with family, especially the kids.
  • Reconnect with old friends.
  • Rekindle an old hobby or develop a new one.
  • Get in shape.
  • Get regular sleep.
  • Work no more than eight hours per day.
  • Rejoin and become active in church.
  • Go back to school.
  • Work on the house and yard.
  • Do volunteer work.

Once again, and I can’t stress this enough, every sex addict is different. Each addict has a unique life history, singular goals, and specific problematic sexual behaviors. Therefore, every definition of sexual sobriety and every sexual boundary plan is different. Behaviors that are deeply troubling for one sex addict could be perfectly acceptable for another, and vice versa. As such, there is no set formula for defining and living sexual sobriety. Conformity is not the goal. Living a healthy and fulfilling life is what matters.

by Robert Weiss LCSW, CSAT-S