Is Pornography a problem?

We received the following comment from a recent visitor to our site.  We asked Don Hilton JR, MD a leading neurosurgeon and author of “He Restoreth My Soul” to provide his input and feedback.  Many in the world share the same attitude and belief towards Pornography / Sexual Addiction as our recent visitor.



The assertion of this website is that pornography and the addiction that it causes, creates great havoc. In what way?   Removing religion and long held beliefs regarding marriage and sexuality (neither of which are in accordance with our nature), I don't understand how pornography in any way harms sexually healthy adults. Drugs by definition will take a perfectly healthy person and kill them, or at best seriously damage their bodies. I have not found evidence that pornography does this in any way. I believe that what I am seeing is a way to make money off of people who don't really need treatment or providing marginal benefits to someone who should be seeing a psychiatrist for serious psychological issues that manifest themselves through sexual "addiction". Like treating the symptom instead of the cause, it is of marginal value. Much of your funding could come from churches and right wing moralists if it doesn't already. "Financial tip of the day."

Don Hilton's response:

Your questions and assertions require more space and time than a simple blog permit, but I provide references for you to explore if you truly desire to learn more about this.  As you appear to discount any religious input to this discussion, we will examine this issue from a purely secular perspective.

The assertion of this website is that pornography and the addiction that it causes, creates great havoc. In what way? Removing religion and long held beliefs regarding marriage and sexuality (neither of which are in accordance with our nature), I don't understand how pornography in any way harms sexually healthy adults.

I will defer the brunt of this question to Dan Gray with regard to the social and emotional pathology pornography causes, but  I would suggest you read New York Time’s journalist Pamela Paul’s book Pornified.  It is written from a secular perspective, and also you might find Columbia neurologist Norman Doidge’s book The Brain that Changes Itself, particularly Chapter 4, enlightening.  Porn impotence is a growing phenomenon, and Pamela Paul interviewed many men who found themselves preferring masturbation to porn preferable to real women.  Certainly these men aren’t interested in marrying and having children, at least not in demographically sustainable numbers.  You might say “So what?”  From natural selection’s vantage, your viewpoint is not sound.  Countries and cultures which eschew marriage evaporate.  It makes sense; why have kids if sex is purely recreational as you opine, and spend money to educate and feed them in a progressively urbanized society?  Every country in Europe is below the 2.1 fertility rate needed to sustain population, and several are at 1.3, which is demographically unrecoverable.  I won’t argue causation here, but correlation is very strong with regard to crashing fertility rates and marital dissolution, particularly in the EU and Japan.  Who will pay the future pensions of those who aren’t having today’s children?

Drugs by definition will take a perfectly healthy person and kill them, or at best seriously damage their bodies. I have not found evidence that pornography does this in any way

Your premise is based on now outdated views of the scientific literature.  I would suggest you review the articles I will reference.  You are saying that compulsively used drugs change your brain, but compulsively used natural rewards don’t.  The current literature on addiction contradicts you on several fronts.  For instance, look at cortical hypofrontality, or brain shrinkage.  That drugs such as cocaine[1] and methamphetamine[2] cause shrinkage in the frontal lobes would not surprise you, but you would probably be interested to find that recent studies show shrinkage in natural addictions such as overeating leading to obesity[3] and sexual addictions such as pedophilia,[4] which, by the way, is intimately associated with pornography.

You would not be surprised to learn that with regard to the mesolimbic dopaminergic reward systems targeting the nucleus accumbens, receptor downgrading and decreased presynaptic vesicular stores associated with a conditioned hypometabolic state are par for cocaine,[5] but you probably would be surprised to know that overeating leading to obesity[6] and even pathologic gambling[7] produce similar changes.

Indeed, the leading addiction scientists in the world, both from the basic science camp and from the clinical imaging perspective now believe that natural and drug addiction are one and the same with regard to structural and metabolic brain changes.  Dr. Eric Nestler, director of Neuroscience at Mount Cedar Sinai in New York stated,

"Growing evidence indicates that the VTA-NAc pathway and the other limbic regions cited above similarly mediate, at least in part, the acute positive emotional effects of natural rewards, such as food, sex and social interactions. These same regions have also been implicated in the so-called 'natural addictions' (that is, compulsive consumption of natural rewards) such as pathological overeating, pathological gambling and sexual addictions. Preliminary findings suggest that shared pathways may be involved: [an example is] cross-sensitization that occurs between natural rewards and drugs of abuse."[8]

Equally compelling is Dr. Nestler’s recent work with DFosB, which he presented at the Royal Society in England last year.[9] This marker has been found only in addicted neurons, initially demonstrated in drug addiction.  Now, rats conditioned to overeat and “hypersexual” rats also show this marker, whereas rats which consume natural rewards in ‘normal’ frequencies found in nature do not show this chemical.  I know you may be thinking “What is hypersexual?”, but I am merely pointing out the evidence you say you have not found.

Also, at this same meeting Nora Volkow, director of the National Institute for Drug Abuse (NIDA) and one of the most published addiction scientists in the world spoke on obesity and correlates with drug addiction.[10]

Your skeptical use of the term “sexual addiction” is not shared by Dr. Volkow, who used the term addiction to encompass pornography, gambling, and food compulsion.  In fact, she recommended that a Senate panel change the name of the NIDA to the National Institute of Diseases of Addiction.  Her advisor Glen Hanson said “She would like to send the message that we should look at the whole field.” This appeared in the journal Science.[11]

As you can see, the evidence you refer to is actually very supportive of the addictive nature of natural rewards.  To disregard this evidence and say that a powerful natural reward such as pornography is not addictive could make you as biased as you feel the religious right are.


Donald Hilton


Dan Gray's response:

We also asked Dan Gray, LCSW to also respond to this questions.  Dan is a licensed clinical social worker specializing in addictions counseling. He has a master's degree in social work and is a CSAT (Certified Sexual Addiction Therapist). He is also certified as an addictions counselor with the National Association of Forensic Counselors. He maintains a busy private practice, lecturing regularly and providing training and consultation to numerous civic, religious, and professional organizations throughout the country. In addition, he is the clinical director of the LifeSTAR Network program, which provides help for individuals and couples from around the country who are dealing with problems related to sexual addictions and compulsive behaviors. He recently co-authored the book, Discussing Pornography Problems with a Spouse: Confronting and Disclosing Secret Behaviors.

I believe Dr. Hilton thoroughly addressed your question regarding the addictive nature of pornography and the effects it has upon the functioning of the brain. These effects impact a person's ability to perform and function in everyday life as well. The research and studies are consistent in reflecting this fact. The thousands of anecdotal and personal reports also support this research. Ask the employers of those that view pornography on the job site or stay up late looking at porn and come to work wasted and fatigued. They will tell you that once productive employees have become lethargic, non-productive and present an increased risk for sexual harrassment law suits. Ask the men who have lost their jobs, careers, income, homes, etc., if there are any negative effects of looking at pornography.

Intimate relationships are also impacted. Spouses and partners of those viewing porn consistently report feeling unloved, undesired, distant emotionally and physically. Trust in the relationship is destroyed and feelings of betrayal, "not being enough" and low self worth ensue. Many who have viewed porn for long periods report developing an unrealistic view of sexuality and the opposite sex. Their expectations of a "healthy" sexual relationship are distorted as they have bought into these fake, staged sexual acts and tried to impose them onto their spouse or sexual partner, resulting in disappointment and disatisfaction for both partners. By the way, these reports come from a wide cross section of individuals, including those who are religious and those who are not.

Your comment regarding the deeper psychological factors that should not be neglected in lieu of treatment for the addicts is a point well taken. Any treatment program that does not appropriately diagnose and provide intervention for these conditions that require psychiatric care in tandom with addiction treatment would be considered negligent.

Finally, your point that "sexually healthy adults" are not negatively impacted by pornography may actually have some merit. I have not seen any studies supporting or disproving that notion. My guess is that may be a difficult population to study because our experience indicates that typically healthy sexual adults do not consistently view pornography. Of thousands of clients that have come to our clinic, I doubt that few, if any of them, would have described themselves as being sexually healthy while they were looking at pornography. What is reported by a majority of our clients is that as they progress in their recovery work and become increasingly healthy sexually, their craving, desire and need for pornography gradually lessens and becomes irrelevant and/or non existent. These factors may lead to a hypothesis that in general, "sexually healthy adults" are not typically drawn to pornography. It would be very interesting to see the results of a study addressing that issue.

[1] Teresa R. Franklin, Paul D. Acton, Joseph A Maldjian, Jason D. Gray, Jason R. Croft, Charles A. Dackis, Charles P. O’Brien, and Anna Rose Childress, “Decreased Gray Matter Concentration in the Insular, Orbitofrontal, Cingulate, and Temporal Cortices of Cocaine Patients,” Biological Psychiatry (51)2, January 15, 2002, 134-142.

[2] Paul M. Thompson, Kikralee M. Hayashi, Sara L. Simon, Jennifer A. Geaga, Michael S. Hong, Yihong Sui, Jessica Y. Lee, Arthur W. Toga, Walter Ling, and Edythe D. London, “Structural Abnormalities in the Brains of Human Subjects Who Use Methamphetamine,”The Journal of Neuroscience, 24(26) June 30 2004;6028-6036.

[3] Nicola Pannacciulli, Angelo Del Parigi, Kewei Chen, Dec Son N.T. Le, Eric M. Reiman and Pietro A. Tataranni, “Brain abnormalities in human obesity: A voxel-based morphometry study.” Neuroimage 31(4) July 15 2006, 1419-1425.

[4] Boris Schiffer, Thomas Peschel, Thomas Paul, Elke Gizewshi, Michael Forshing, Norbert Leygraf, Manfred Schedlowske, and Tillmann H.C. Krueger, “Structural Brain Abnormalities in the Frontostriatal System and Cerebellum in Pedophilia,” Journal of Psychiatric Research (41)9, November 2007, 754-762.

[5] Bruce E. Wexler, Christopher H. Gottschalk, Robert K. Fulbright, Isak Prohovnik, Cheryl M. Lacadie, Bruce J. Rounsaville, and John C. Gore, “Functional Magnetic Resonance Imaging of Cocaine Craving,” American Journal of Psychiatry, 158, 2001, 86-95.

[6] Gene-Jack Wang, Nora D. Volkow, Jean Logan, Naomi R. Pappas, Christopher T. Wong, Wei Zhu, Noelwah Netusil, Joanna S Fowler, “Brain dopamine and obesity,” Lancet357(9253) February 3 2001, 354-357.

[7] Marc N. Potenza, “The neurobiology of pathologic gambling and drug addiction: an overview and new findings,” Philosophical Transactions of the Royal Society, 363, 2008, 3181-3190

[8] Eric J. Nestler, “Is There a Common Molecular Pathway for Addiction?” Nature Neuroscience. 8(11), Nov 2005, 1445-9.

[9] Eric J. Nestler, “Transcriptional mechanisms of addiction: role of DFosB,”Philosophical Transactions of the Royal Society, 363, 2008, 3245-3256.

[10] Nora D. Volkow, Gene-Jack Wang, Joanna S. Fowler, Frank Telang, “Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology,” Philosophical Transactions of the Royal Society, 363, 2008, 3191-3200.

[11] “Officially a disease now? Science 6 July 2007, Vol. 317, no. 5834, pg 23.