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The threat that internet pornography poses can be traced to the effects it has on the reward circuitry of the brain. This reward circuitry comprises a remarkable and complex system. It learns and changes with experience, and it is sensitive to many different sorts of rewards. The central nexus of this reward circuitry is a set of subcortical structures that lie just above and behind the eyes. These structures are usually referred to collectively as the ventral striatum, and activity in these structures indexes the degree to which a stimulus or behavior is rewarding to the individual. Some rewards are very concrete. You won’t be surprised to learn that the ventral striatum fires when people eat chocolate and when they look at pictures of attractive scantily clad people. These are obvious atavistic rewards. Evolution shaped us to desire calorie-rich foods and fit mates –we wouldn’t be here if our ancestors hadn’t been motivated to seek those things. Similarly, it isn’t very surprising that cocaine activates the ventral striatum – cocaine would never have become a popular drug of abuse if it didn’t. However, the ventral striatum is not merely activated by drugs of abuse or stimuli whose associations with reward were hard wired into our brains long ago by evolution. The ventral striatum is strongly connected to and modulated by regions involved in social processing, and it is strongly triggered by rewards that depend on social context. For instance, stimuli that signal financial gains and an increase in social status also activate the ventral striatum. It is very important to appreciate that the ventral striatum is not just associated with self-serving rewards, but also motivates prosocial behavior such as charitable giving. The ventral striatum is highly sensitive to genuine empathetic social connection, including looking at a photograph of a family member, falling in love, altruistic acts, and even the simple feeling that someone has listened to you. Great care needs to be taken when we move from talking about the reward to addiction. When addiction is being discussed in a clinical context, for instance relating to substance abuse or dependency, then by definition it means a tuning of the reward system that is dysfunctional. That is, the medical phenomenon of addiction occurs when the reward system loses its balance and becomes over-tuned to prefer a type of reward that is demonstrably detrimental to our wellbeing. But the mere fact the reward system of an individual has become very strongly tuned to the particular type of reward does not mean any dysfunction is present. In ordinary language, we recognize this fact. We might say that a friend is addicted to exercise, addicted to nature, addicted to reading literature, or addicted to charitable service work. Such ‘addictions’ can certainly exist, in the sense that people can have reward systems that are very strongly tuned to the rewards associated with these activities. Provided the tuning is not so strong that other important behaviors are completely displaced, these ‘addictions’ are far more likely to be healthy and functional, rather than unhealthy and dysfunctional. In particular, a great deal of recent research suggests that the more that people’s reward systems are tuned to forming social connections with others, the more likely they are to be both more physically healthy and more psychologically well balanced. This is what makes internet pornography addiction so troubling. It represents a turning of the reward system from a very healthy type of reward, that of forming a genuine and intimate connection with another, into a type of reward that removes the user from social contact, and often leaves them feeling lonely and ashamed rather than connected and supported. It is a basic assumption of addiction research that when people describe themselves as experiencing the detrimental effects associated with pathological addictions, there is good reason to think that they really are addicted (in the more troubling clinical sense of the term). Few people will endure the humiliation of confessing to a pathological addiction that is not real. It is the reverse strategy, of denying an addiction that is obvious to loved ones, which is much more common. It is very clear, from the reports of the large number of individuals who suffer from it, that internet porn addiction is a real phenomenon. It is also clear that, in at least some cases, it takes a very severe and debilitating form. The first-person accounts you will read in this book and collected on Gary’s website of the same name will, and should, trouble you deeply. It is truly frightening to learn the degree to which internet pornography can damage and alienate individuals who have become badly addicted to watching it. At the same time, one of the most striking features of these reports is how they reflect a reversal of the damaging effects of internet porn addiction. It is truly beautiful to see people who have lost themselves in this addiction turn their lives around. Instead of compulsively masturbating in private, they have come to find meaning and genuine social connection through selfless attempts to help others caught in a similar trap. It all happens on the internet, both good and bad. Within this same technological medium, a medium which often threatens to make us impersonal, this group has found a way to move from an activity which is completely solitary and detached to something that is deeply altruistic, brave, personal and meaningful. It is time that the rest of us took note of what they are saying. Many physicians and researchers have dismissed and undermined these reports. However, that strategy is simply not ethical. We must respect the wisdom of their experience and the humility they show by sharing it. Anyone who pretends to care about the social and sexual health of others has a duty to better understand this phenomenon and find creative ways to reduce the damage it is doing. Dr. Anthony Jack Professor of Philosophy, Psychology, Neurology, and Neuroscience and Research Director at the Inamori International Center for Ethics and Excellence, Case Western Reserve University Introduction I count him braver who overcomes his desires than him who conquers his enemies; for the hardest victory is over self. Aristotle You might be reading this book because you're curious why hundreds of thousands of porn users around the globe are experimenting with giving it up.[2] But more likely you're reading it because you are engaging with pornographic material in a way that you find troubling. Maybe you have been spending more time online seeking out graphic material than you want to, despite a settled determination to cut back. Maybe you are finding it difficult to climax during sex, or you're plagued by unreliable erections. Maybe you're noticing that real partners just don't excite you while the online sirens beckon constantly. Maybe you've escalated to fetish material that you find disturbing or out of alignment with your values or even your sexual orientation. If you’re anything like the thousands of other people who have realized that they have a problem, it has probably taken you a while to connect your troubles with your porn use. You might have thought you were struggling with some other disorder. Perhaps thought you had developed unaccustomed depression or social anxiety or, as one man feared, premature dementia. Or maybe you believed that you had low testosterone or were simply getting older. You might even have been prescribed drugs from a well-meaning doctor. Perhaps your physician assured you that you were wrong to worry about your use of pornography. There are plenty of authoritative voices out there who will tell you that interest in graphic imagery is perfectly normal and that therefore internet porn is harmless. While the first claim is true, the second, as we shall see, is not. Although not all porn users develop problems, some do. At the moment, mainstream culture tends to assume that pornography use cannot cause severe symptoms. And, as high-profile criticisms of pornography often come from religious and socially conservative organizations, it's easy for liberally minded people to dismiss them without examination. But for the last seven years, I have been paying attention to what people say about their experiences with pornography. For even longer, I've been studying what scientists are learning about how our brains work. I am here to tell you that this isn’t about liberals and conservatives. It isn’t about religious shame or sexual freedom. This is about the nature of our brains and how they respond to cues from a radically changed environment. This is about the effects of chronic overconsumption of sexual novelty, delivered on-demand in endless supply. Until about half a dozen years ago I had no opinion about internet porn. I thought that two-dimensional images of women were a poor substitute for actual three-dimensional women. But I've never been in favor of banning porn. I grew up in a non-religious family in Seattle, the liberal Northwest. ‘Live and let live was my motto. However, when men began showing up in my wife's website forum claiming to be addicted to porn it became clear that something serious was going on. A long-time anatomy and physiology teacher, I am particularly interested in neuroplasticity (how experiences alter the brain), the appetite mechanisms of the brain, and by extension, addiction. I'd been keeping up with the biological research in this area, intrigued by discoveries about the physiological underpinnings of our appetites and how they can become dysregulated.