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When Pornography Became and Addiction: Its History and Evolution; Clinical Implications for Assessment, Diagnosis and Treatment. Dr. Matthew Hedelius Institute for Research and Treatment of Addictive Disorders www.addictions-healing.com. Pornography Definition.
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When Pornography Became and Addiction: Its History and Evolution; Clinical Implications for Assessment, Diagnosis and Treatment. Dr. Matthew HedeliusInstitute for Research and Treatment of Addictive Disorderswww.addictions-healing.com
Pornography Definition • The depiction of erotic behavior (as in pictures or writing) intended to cause sexual excitement. • Material ( as books or a photograph) that depicts erotic behavior and is intended to cause sexual excitement. • The depiction of acts in a sensational manner so as to arouse a quick intense emotional reaction.
Origins of Pornography • Comes from the Greek word “porne” which means prostitute and “pornea” which means prostitution. • Graphein which means to write or record.
Pornography Time Line • 1656 – In Boston, a Captain Kemble came home from a long trip and kissed his wife in public on Sunday. As a result he was sentenced to the stocks. • 1660 – Publick Occurrences was published by Benjamin Harris in Boston. It contained a story about a French King sleeping with his daughter in law. Was immediately suppressed by the Massachusetts Bay Colony.
Pornography Time Line • 1810 – First American edition of Fanny Hill. A collection of erotic letters written by a fictional character (Fanny) to an unknown woman. Primary author was John Cleland.
Pornography Time Line • 1849 – First erotic novel published in US. • 1904 – First American Pinup calendar in St. Paul, Minnesota. • 1912 – First issue of “Snappy Stories” a magazine of pulp fiction. Advertised as “entertaining fiction” . Consisted of flirtatious and sexually oriented stories as well as sexually oriented art and photographs including female nudity. Paved the way for (girlie magazines) in the 1930’s.
Pornography Time Line 1920’s – Pornographic comic books called “Tijuana Bibles” published in US. ( 8 pages – 4X6 inches, stapled together. • 1942 – Betty Grable poses for most famous pinup of WWII and gets legs insured for 1 million dollars.
Pornography Time Line • 1947 - 1st publication of American published lesbian magazine “Vice Versa”. • 1949 – John Kelly shoots pinup of Marilyn Monroe in the nude. • 1953 – 1st issue of Playboy published. • 1950’s – Focus shifted from “pinup” shots to breasts. • 1960’s – Focus went to semi-nude shots, sometimes showing buttocks but no pubic areas.
Pornography Time Line • 1970’s – Shift towards full nudity including pubic hair. Penthouse first to show this. • 1973 – First issue of Playgirl released. • 1980’s – 90’s – Pornography produced including photographs of sexual penetration, lesbianism, homosexuality, and fetishes. • 2000’s – Hard core magazines experience a decline in sales partially due to Internet access and “lad mags”.
Hyper-Stimulation and Pornography Addiction • What has changed about pornography over time? • Availability • Quantity • Novelty • Variety • Intensity
Availability/Quantity • One magazine per month (55-60 pictures) • Up to over a thousand of images per hour or more if desired. • Additional websites added daily to Internet (upwards of 250) • Internet Porn – Any time any place
Novelty & Variety • Numerous genres of pornography at the present time. • Something for every sexual template. • Something for virtually every paraphilia. • Plays into the brains desire for novel stimuli. • Enhances the brains desire for surprise. • All age ranges available.
Sub Genres of Pornography • Mature Porn – Over 40, 50, 60, 70 etc. • MILF – Mothers I’d Like to !$*# • Hair Color – blonde, red head, brunette, etc. • Body Features • Big/small breasts • Big/Small Penises • Big Butts • Hairy • Puffy Nipples
Sub Genres of Pornography • Race • Sub Cultures • Punk • Gothic • Skin Head • Rave
Sub Genres of Pornography • Fetishes • Bondage/Discipline • Gore –Blood or disfigurement • Face Sitting • Necrophilia • Europhilia • Corpophilia • Rape
Sub Genres of Pornography • Scat – Feces • Menstrual • Golden Showers - Urination • Squirt – Women ejaculation • Crying – Engaging in sexual acts while crying. • Ematophilia – Involving vomiting.
Illegal Pornography • Child pornography. • Adolescent/Under 18 pornography • Lime Wire • Frost Wire • File Sharing Programs
Hyper-Stimulation and Pornography Addiction • What has changed about pornography over time? • Availability • Quantity • Novelty • Variety • Intensity
Overstimulation of Young Brains • Increase in TV viewing of children. • Children between 2 – 5 years of age watch an average of 32 hours of TV per week (med.umich.edu).
Overstimulation of young brains • The brains of children are very plastic. • Young brains presented with intense stimuli are more likely to be impacted long term than those brains that are less plastic. • Environmental factors may set increase the vulnerability of young children becoming addicted to sexually oriented material.
Neural Circuit Development • Recognizing certain stimuli is accomplished by changes in synaptic connections of the inferior temporal cortex that help to establish new neural circuits. • Once this is accomplished, circuits become active again when similar activity is detected in the extrastriate cortex (Fuster & Jervey, 1981).
The Visual Cortex • Visual memories are stored in the inferior temporal cortex. • When fields of color-sensitive cells are stimulated with certain color patterns (i.e. yellow o blue; blue on yellow; red on green; and green on red) the cells rate of firing increases. • The more a neuron within a circuit fires, the more likely there is that a pathway will be developed.
Intensity • The brain responds more to intense stimuli. • Color scheme. • Poses. • Words. • Page lay out. • Props. • Quality of photography. • Quality of paper.
Technology and the Addiction • Advances in photography technology. • Transformation from pulp paper to glossy paper. • Photoshop technology. • The use of digital photography. • The use of color and brightness of colors. • Multiple colors. • Lighting and air brushing.
Quote from an Addict • "There's a difference between today's online porn and that of just a couple decades ago. Now, you can go to a variety of websites and find more free porn than you could watch if you quit your job and dedicated your life to it—all in living color. You can even pick your favorite fetish, whatever you find the most intense, and just watch video after video of it. If the intensity wanes for a few seconds, or you get bored with watching the same bodies for two
Quote from an Addict • minutes straight, you can jump to a new set doing new things. It has the potential to be far more destructive to your appreciation for the real thing than ever before.“ (Robison & Wilson, 2011).
Overstimulation of Old Brains • With each presentation of novel stimuli, the brain receives less of a dopamine reward. • Habituation increases over time when exposed to the same stimuli. • Level of psychological absorption decreases as stimuli becomes less novel and more familiar. • Penile tumescence decreases as stimuli becomes less novel (Koukounas & Over, 2000).
Overstimulation of Old Brains • Intense sexual stimuli increases the amount of dopamine released in D2 receptors. • This in turn, causes D2 receptors to shut down and the reward circuitry in the brain to experience a shortage of dopamine. • This leads to feelings of cravings that are not able to be satisfied (Robinson, 2010). • Overstimulation leads to a decrease in sensitivity.
Displayed are the horizontal (left), sagittal (middle), and coronal (right) sections through the voxel with maximal current source differences. There were significant decreases in absolute power beta3 (20-24 Hz) in Brodmann’s area 37 shown in blue.
Displayed are the horizontal (left), sagittal (middle), and coronal (right) sections through the voxel with maximal current source differences. There were significant decreases in absolute power beta5 (28-32 Hz) in Brodmann’s area 29 shown in blue.
Displayed are the horizontal (left), sagittal (middle), and coronal (right) sections through the voxel with maximal current source differences. There were significant decreases in absolute power beta4 (24-28 Hz) in Brodmann’s area 30 shown in blue.
Prolactin • Prolactin is a hormone that impacts milk production and appears to play a role in sexual satiation and the refractory period. • It is thought to be associated with the feeling of “turning off” of sexual desire for a while after sexual activity. • This allows the body to return to homeostasis and for the male to replenish the body with adequate sperm.
Masturbation vs. Intercourse • Prolactin is released from the pituitary gland. • Allows person to focus on other activities rather than pursue sex at the expense of all else. • Prolactin increases close to 400% more following intercourse than it does masturbation (Kruger, 2006).
Assessment Questions • How old were you when you started? • The more plastic the brain, the greater the impact? • Assess: Consistency, frequency and duration factors? • Is there a history of trauma and if so, how does the trauma and addiction interact? • What are you looking at?
Assessment Questions • Can you experience pleasure in simple things? • If you have a sexual relationship with a partner, do you experience a satisfying sense of pleasure and can you experience organic orgasm? • Have you ever used pornography to help increase arousal as part of sex with a partner?
Treatment Considerations • Establish a plan to help the patient successfully detox. • Individual and group therapy. • Support group. • Recovery education. • Establish a core of healthy, yet moderately stimulating pleasures. • Establish exercise routine (4-5 times per week of cardio of 30-45 minutes).
Treatment Considerations • Get adequate sleep. • Eat for the right reasons. • Practice self care. • Establish and strengthen relationships. This provides a social buffering against stress. • Re-establish a healthy sense of laughter.
Treatment Considerations • Establish Accountability process. • Help patient establish healthy ways of self soothing. • Train in emotional and psychophysiological self regulation. • Help patient to learn to tolerate anxiety and discomfort. • Educate patient on what is happening in the brain.
Treatment Considerations • Give the patient hope. • Help the patient identify through scripting what life will be like when they have achieved sobriety for a long period of time (i.e. several months).
References • Brody, S. & Kruger, TH. (2006). The post-orgasmic Prolactin increase following intercourse is greater than following masturbation and suggests greater satiety. Biological Psychology. Mar; 71(3) 312-315. • Carlson, N.R. (1994). Physiology of Behavior. Allyn and Bacon. • Lester, GL. & Gorzalka BB. (1988). Effect of novel and familiar mating partners on the duration of sexual receptivity in the female hamster. Behavior and Neurological Biology. May; 49 (3) 398-405. • Koukounas , E. & Over, R. (2000). Changes in the magnitude of the eyelink startle response during habituation of sexual arousal. Behaviour Research and Therapy. Vol. 38, 573-584. • Robinson, M. (2004). Pulling Away after sex. www.entelechyjournal.com. • Robinson, M. & Wilson, G. (2011). Porn Then and Now: Welcome to Brain Training. www.psychologytoday.com.