Introduction to pornography addiction and the impact on couples. Introduction to treatment for the user and spouses/partners.

1. Pornography Addiction
(Compulsive Pornography Use):
Identification, Treatment and
Couples Recovery
Earl Ledford, MSW, LCSW, CST, CET, CAP
earl@earlledfordlcsw.c0m

2. • Launched in September 2012
• Combat problem of pornography
addiction and sexual addiction.
• Individuals over 30 years old and
couples of all ages.
• Launched in January 2012
• Star Guides for Youths serves ages of
12 to 18 and is a resource for parents.
• Star Guides for Young Adults assists
young adults between the ages of 18
to 30.

3. Pornography Addiction: Identifying,
Treating and Recovery
Objectives
 Participants will be able to identify the signs of pornography
abuse/compulsive use (addiction).
 Participants will be able to distinguish between use of pornography
and compulsive use of pornography.
 Participants will know the effect on the brain as the result use and
abuse of pornography.
 Participants will gain an understanding of the recovery process for
the individual and, if appropriate, the spouse.

4. What Is Pornography?

5. Definition of PORNOGRAPHY
1: the depiction of erotic behavior (as in pictures or
writing) intended to cause sexual excitement
2: material (as books or a photograph) that depicts erotic
behavior and is intended to cause sexual excitement
3: the depiction of acts in a sensational manner so as to
arouse a quick intense emotional reaction <the
pornography of violence>
Source: Merriam-Webster

6. Porn Then and Now

7. Porn………Just A Click Away

8. • Living a double or secret life related to pornography
use.
• Tendency to isolate self and stay up late at night on the
internet.
• Hiding or attempting to keep secret the viewing of
pornography.
• An inability to stop viewing pornography despite
previous attempts to do so.
• Denial and anger when asked to stop.
• Continuing to view pornography despite the known
consequences of continued viewing.
• Depression, irritability, anger.
• Hypersexual attitude, vocabulary and behavior.
• Overprotective of their technology (cell phone, I-pod,
lap top, etc.)
Signs of Pornography Addiction

9. Dr. Oz Show – Erectile Dysfunction and Porn
Key Symptoms of Porn-Induced Sexual Erectile Dysfunction
• Erectile Dysfunction
• Desensitization to porn
• Preferring porn to sex with live partner
• No spontaneous erections
• Not aroused by static porn
• Decreased penile sensitivity
• Delayed ejaculation
• Copulatory impotence with real person major complaint
• ED drugs losing effect
• ED difficulty even with extreme porn use
• Study in France– 20 % of men have lost interest in “real” sex
• Study in Japan – (2011) over 1/3 of men aged 16 to 19 had no
interest in sex with another live person; double the figure in
2008 – 40% of married men in study were sex less for more
than a month

10. “Addiction is a relationship -
a pathological relationship in which
sexual obsession replaces people.”
—Patrick Carnes, Ph.D.

11. Among 932 sex addicts studied, 90 percent
of men and 77 percent of women said
pornography was significant to their
addictions.
– Patrick Carnes, Ph.D.

12. Almost half of rapists used porn depicting
consenting sex to arouse
themselves before seeking out a victim.
— W.L. Marshall, Ph.D.

13. “For the first time in human
history, the images’ power and
allure have supplanted that of
real naked women. Today,
naked women are just bad porn.”
Wolfe (2003)…....

14. Describing porn’s effect to a U.S.
Senate committee, Dr. Jeffrey
Satinover of Princeton University
said, “It is as though we have
devised a form of heroin 100 times
more powerful than before, usable
in the privacy of one’s own home
and injected directly to the brain
through the eyes.”

15. Only 3% of pornographic websites require age
verification.
The most popular day of the week for viewing
pornography is Sunday.
10% of pornography users report being addicted.
The average age a child first sees internet pornography
is 11.
NSPCC poll found one-in-ten 12 to 13-year-olds worried
about porn addiction
70% of young men ages 18-24 visit pornographic
websites on at least a monthly basis.

16. Cosmopolitan Survey
31 per cent of the women said they watched porn every week
and another 30 per cent said they did so a few times a
month.
Asked what kind of porn they gravitated towards, they
answered the following: 63% Heterosexual, 44% Lesbian,
31% It's a mixed bag, 28% Hard-core, 26% Soft-core/"arty“,
13% Gay male, and 13% Not listed here
But these viewing figures are still low when compared with
men's habits. A Cosmopolitan survey from 2014 found that
32.5 per cent of males said they watched it on a daily basis,
compared with just 3.8 per cent of women.

17. Porn has grown into one of the largest forms of
entertainment in the world. In fact, it brings in
more money than professional basketball, baseball
and football combined.
Porn has a higher revenue than CBS, NBC and ABC
combined as well.
With this sort of power and money, it is able to
reach every corner of the globe. This includes the
Internet and your home. Sometimes it can
seemingly be difficult to completely avoid porn.

18. Porn and Anonymity
86% of men are likely to click on porn sites
if no-one else will know
Pornography and Aggression
88% of scenes in porn films contain acts of physical aggression.
49% of scenes in porn films contain verbal aggression.
Porn Decreases sexual satisfaction10
58% of men say they view porn once a week or more, and the more frequently men view
it, the more they are likely to say they are less satisfied with sex and relationships.
Porn and Anonymity, Aggression and Sexual Satisfaction

19. Can pornography use become compulsive
(addictive)?

20. Skinner’s Seven Levels of Pornography Addiction
Level 1
• Just recently been exposed
• Look at once or twice a year
• Can count times have been seen nudity on one hand
• Thoughts and everyday actions not focused on porn
Level 2
• Some porn magazines or Internet porn sites
• Episodes of involvement no more than six
• Time spent thinking about is still limited
• Not compulsive

21. Level 3
• Episodes about once a month
• Try to restrain and often followed 1 or 2 day binge
• Borderline growing problem/compulsion
• Fantasizing becomes part of the struggle
• Spend extra time/energy fighting off thoughts
Level 4
• Begin to wonder why it occupies thoughts so much
• May be impacting focus in other areas of life
• Viewing a few time a month/more hard-core porn
• Fantasizing most likely increased
• Getting high off thinking about
• Don’t feel as bad because not looking at porn
• Tried to cut back/experience withdrawal symptoms

22. Level 5
• Impacting day-to-day living/thoughts of significant
• Not a day goes by when think or give in
• Viewing 3 to 5 times a week & “higher octane” porn
• Porn/sexual behavior in top seven thoughts
• Often individuals are dealing with some type of loss
• May be limiting personal growth/development
• Fantasies and viewing begin to feel overwhelmed
• More intense withdrawal symptoms the longer
• Borderline compulsive

23. Level 6
• Begins to dominate life – has become compulsive
• Compulsive behaviors and actions common
• Many viewing porn daily
• Often lie about what and how doing things
• Common to be caught
• Strong desire to stop or have given up
• Likely to have lost job, wife, etc
• Other lose spirituality and sexuality

24. Level 7
• Viewing porn and sexually acting out almost daily
• Deep seeded compulsive feeling to act out
• Feeling of powerlessness and hopelessness
• Images hardcore and may be filled with violence, rape,
incest, bestiality, etc
• Spend hours each day looking for and finding porn or
sex or engaging in fantasies
• Lying is frequent each and every day
• Inpatient treatment is indicated

25. More than 4,000 people who had sought help because pornography
had a negative impact on their personal lives or relationships have
completed an online survey. What are these people telling us?
First, individuals who want to stop viewing pornography are
having a difficult time doing so. Their frequency of viewing
pornography (3-5 times a week or more) is related to elevated
depression, anxiety, and loneliness.
Those who view it frequently also experience less overall
happiness and life satisfaction. These are the results of research
on more than 3,000 married and single men and women.

26. Science of Pornography “Addiction”
The Impact on the Brain

27. The body’s natural reward chemical for life
sustaining activities

28. Neurons, Synapses, and Receptors

38. Amygdala and Hypothalamus
• Plays a key role in the processing of
emotions and memory
• Sets a “pleasure thermostat”

39. Frontal Lobe
“Break pads worn out”

42. Pathway to Authorization
Option to Exit Option to Exit
Option to Exit Option to Exit
HALT/BLAST

43. How the Brain is Designed to Work in a
Healthy Sexual Relationship

44. Comparison and Effect of Drugs Released
During Normal Healthy Sex and Viewing of
Pornography
Normal Healthy Sex
(Normal sexual desire + Selflessness = Intimacy
Engaging in Pornography
(Normal sexual desire + Selfishness = Lust)
Dopamine: Elevated levels of
dopamine in the brain produce
extremely focused attention on each
other.
Dopamine: Elevated levels of dopamine
in the brain produce extremely focused
attention on the pornographic
images.
Norepinephrine: This chemical
generates exhilaration and increased
energy by giving the body a shot of
natural adrenaline. Norepinephrine has
also been linked to raising memory
capacity. Whatever stimulus is being
experienced in the presence of this
chemical is “seared” in the
brain…..couple in love can
remember the smallest details of
their beloved’s features.
Norepinephrine: This chemical induces
feelings of exhilaration and increased
energy by giving the body a shot of
natural adrenaline. Norepinephrine also
increases memory capacity. This
explains why porn addicts can recall
viewed images with vivid clarity
years later.

45. Testosterone: Testosterone is
known as the hormone of sexual
desire in both men and women. For
men, however, it is the key
hormone of desire, triggering
feelings of positive energy and
well-being(and desire for) toward
the other.
Testosterone: Pornography
triggers the release of
testosterone which in turn
increases the desire for more
pornography.
Oxytocin: The flood of oxytocin at
climax acts as a natural tranquilizer,
lowering blood pressure, blunting
sensitivity to pain and stress, and
inducing sleep. Bonding takes place
between each other.
Oxytocin: Oxytocin acts as a
natural tranquilizer. The individual
seeks an Oxytocin rush to cope with
the stress and pressure of life.
Bonding takes place with the
images on the screen.
Serotonin: This natural chemical
decreases during sex is released right
after climax bringing on a deep feeling
of calmness, satisfaction and release
from stress and vulnerability.
Sometimes people get hooked on
using sex to self medicate.
Serotonin: The quick release of this
natural chemical intensifies the
orgasm and then evokes a deep
feeling of calmness. Individuals
turn to porn to self-medicate and
escape vulnerability.

46. The Experience is More Than Just
Physical: As lovers move down the
funnel together, there is more to the
experience than just chemicals
released in the physical body… the
mind, heart and spirit are all joined
together…
The Experience is More Than Just
Sexual: There is a lot more going on
in the Pornography Funnel than
sexual arousal. In fact, if you
remove sexual arousal from the
process, any similarities to sexual
intimacy in a healthy marriage
would cease.
A tidal wave of conflicting and
confusing images and messages
wash over the viewer.
This is why many
neuropsychologists refer to
pornography as “visual crack
cocaine”.

47. A Climax of Many Things: The final
crescendo is a culmination of all the
things the lovers have shared –
doing the dishes, paying the bills,
raising the children, all that make
up a marriage.
An Explosive Climax (zone or
bubble): The brain desensitizes to the
images, habituates to them, and
eventually becomes bored. An
increase in the variety of images
and/or time spent on the Internet is
required to maintain stimulation
levels… (more octane is needed)
In a healthy marriage relationship,
sexual intimacy is only a part of
everything else going on in the couple’s
life. So when the couple “brings all of
that into the bedroom,” it is highly
unlikely that the brain will habituate to
the sexual process

48. When Reality Returns – the Hopeless Dialogue: When the
porn viewer emerges from the narrowest part of the
funnel back to a wide perspective, the heartless
“zone/bubble” of pornography and climax quickly
dissipate….elevated level of dopamine continues for
extended period.
Rational thinking returns and the hopeless dialogue
begins: “What have I done? What was I thinking?” He
wasn’t thinking; that was the problem!

49. Assessments Used
Assessing Pornography Addiction Test
www.growthclimate.com
Sexual Addiction Screening Test
www.recoveryzone.com/tests/sex-
addiction/SAST/index.php
Youth Pornography Screening Test
PDF Download
www.ypacenter.com/youth-ages-12-18/

50. • Assess Current Internet Use
• Practices Make Measurable Changes in
Internet Behavior
• Computer Restructuring
• Set Clear Limits/Accountability
• Practice the Opposite
• Abstinence from Internet Porn and Sex
• Identify Triggers for Abuse
• Address Emotional States, Maladaptive
Cognitions, Life Events
• Address How to Deal With Abstinence
Treating/Recovery
Pornography Addiction

51. Treating/Recovery
Pornography Addiction
• Cognitive Restructuring
• Electronic Restructuring
• Covenant Eyes/Accountability Partner
• Attend Sexaholics Anonymous (SA)
• Individual Sessions/Couples Sessions
• 90 days of no porn, masturbating, fantasizing or
sexually acting out.
30 Tasks (Facing the Shadow, Internal, External, and Creating
Family Recovery)

52. THREE-SECOND RULE
First skill in recovery involves three steps done within three seconds:
1. Alert: Realize that something seen is inappropriate or thought of porn
becomes a primary focus.
2. Avert: Close eyes or look away/Change primary focus. Step 1 and 2 should be
instantaneous.
3. Affirm: Give self a mental high-five! Say to self, “I saw that by mistake, and I
quickly looked away. I’ve been clean for ____ days
and I am going to stay that way.”
Bouncing Eyes

53. Internet Sex Addiction Treated With Naltrexone
VIVITROL®

54. FAPSTRONAUTS
A fast-growing online community of people who call
themselves “Fapstronauts” complain that porn is the
root of their problems with ED and premature
ejaculation.
“Fapping,” slang for masturbating to Internet porn, is
causing these people so many troubles they banded
together for support.
One online community claims 50,000 members, and
their goal is to encourage each other to avoid
pornography and masturbation for 90 days in the hope
of never going back.

55. Is Porn Bad for Relationships?
• Patrick Carnes’s research shows that sexual addiction affects three to five
percent of adults, suggesting that porn use isn’t about to turn us into a country
of addicts glued to their computer screens.
• To be sure, porn use is permeated with a sense of the forbidden that triggers
intense emotion, but as therapists, we need to understand it on a case-by-case
basis and be careful to separate our own biases from our clients’ needs.
• To begin to see porn in a more normalizing light, it can be helpful to
understand the ways in which porn can be incorporated into a relationship
without secretiveness or shame
• Many couples have described the shame and secretiveness of one partner’s
involvement with porn. Time and again, I have worked with people for whom
viewing porn has become a compulsion and who’ve come to prefer it to being
with a partner (about 30% of my case load).

56. Gottman Says….research has shown when one person (in
a relationship) frequently watches porn it can hurt the
relationship. Other factors:
• Supernormal Stimuli (Nikko Tinbergen)
• Turning away from intimate interaction
• User in total control of the sexual experience
• Expect partner will always be immediately ready
(typical foreplay 10%/59%)
• Some argue it is ok if it does not involve partnered
sexual acts ……relationship goal of intimate
connection lost
Source Gottman’s blog An Open Letter on Porn, April 6, 2016

57. We are led to unconditionally
conclude that for many reasons, porn
poses a serious threat to couple
intimacy and relationship harmony.
This moment calls for public
discussion, and we want our readers
around the world to understand what
is at stake.
Source Gottman’s blog An Open Letter on Porn, April 6, 2016

58. Reference:
1. Manning J., Senate Testimony 2004, referencing: Dedmon, J., "Is the Internet bad for your
marriage? Online affairs, pornographic sites playing greater role in divorces," 2002, press
release from The Dilenschneider Group, Inc.
In a 2004 testimony before the United States Senate, Dr. Jill
Manning shared some interesting data regarding pornography and
relationships. In her research she found that 56 percent of divorce
cases involved one party having an obsessive interest in
pornographic websites.1
Another source, the American Academy of Matrimonial Lawyers,
polled 350 divorce attorneys in 2003 where two thirds of them
reported that the Internet played a significant role in the divorces,
with excessive interest in online porn contributing to more
than half such cases.

59. Trauma of Discovery:
Impact on the Relationship
Traumatic events such as natural disasters and criminal attacks
shatter our assumptions about our sense of safety in the world.
In a similar way, the discovery of infidelity is devastating because
it shatters every basic assumptions about the security we expect
in committed relationships and destroys the very fiber of trust.
Everyday I see individuals so badly traumatized by the discovery
of a spouse engaged in pornography (and affairs) that they are
barely able to get through a day.
Most helpful thing I can initially do is validate their pain and
suffering resulting from betrayal and insure them their reaction
to a betrayal of this magnitude is not at all unusual and, many
ways, to be expected.

60. Second, women who discover their partner's involvement in pornography report
experiencing tremendous amounts of fear and anxiety. Here are four specific statements to
which this group responded:
1. I experience intense feelings of indescribable fear since discovering my partner's sexual
behaviors. 75 percent of women (791 of 1,062 respondents) answer that at least half of
the time they experience intense feelings of fear.
2. Since discovering my partner's behavior, when I see sexually suggestive images I feel
anxious. 80 percent of the women (833 of 1,062 respondents) answer that at least half
of the time or more they are anxious when they see sexually suggestive images.
3. When I am in social settings I don't feel like I belong anymore. 62 percent of the women
(607 of 1,062 respondents) answer that at least half of the time they don't feel like
they belong in social settings.
4. I feel like I am emotionally on edge more now than I used to be before all this happened. 84
percent of the women (889 of 1,062 respondents) report that at least half of the time
they are emotionally on edge in contrast to what they felt before they discovered
their partner's behaviors.
Psychology Today Online Survey posted 08/05/2014

61. In a survey of 63 wives of self-identified sex addicts:15
70% met most criteria for a diagnosis of post-traumatic stress disorder.
71% demonstrated a severe level of functional impairment in major areas of their lives.
Cybersex and Relationships
In a survey of women (and some men) who experienced serious adverse consequences from
their partner’s cybersex involvement
In 68% of the couples, one or both lost interest in relational sex. Partners commonly
reported feeling hurt, betrayed, rejected, abandoned, lonely, isolated, humiliated, jealous,
and angry. Partners often compared themselves unfavorably to online images. Partners
overwhelmingly felt that cyber affairs were as emotionally painful as offline affairs.
Porn and Marriage
Those who are happily married are 61% less likely to look at porn.
A growing percentage of people attending “sex addiction” programs seek help with
pornography rather than a problem with real partners. (my observation)

62. Trauma of Discovery:
Impact on the Relationship
 Severity of the traumatic reaction is determined by (1) how the discovery was
made, (2) extent of shattered assumptions, (3) individual and situation
vulnerabilities, (4) the nature of the betrayal, and (5) whether the betrayal
continues.
 Traumatized spouses questions everything they trusted and depended on.
 Shock
 Grief
 Emotional Chaos
 Stay or Go
 They no longer know who they are married to or what their marriage stands for.
 The most severely traumatized are generally the ones who had the greatest trust
and were the most unsuspecting.
 Someone who is suspicious and is initially relieved to learn that they weren't
paranoid, has difficulty accepting the reality of a partner's deception and
generally suffer significant trauma.

63. Trauma of Discovery
Betrayed Partners Unfaithful Partner
 24% were severely anxious
 18% were extremely anxious
 30% were clinically depressed
 Every potential irritation is
magnified
 Throwing objects/pounding
fists
 Numbness
 Obsessing
 Interrogating (ambushing)
 Grief
 32% of unfaithful wives
severely/extremely anxious
 10% of unfaithful husbands
severely/extremely anxious
 27% of unfaithful wives were
clinically depressed
 14% of unfaithful husbands
were clinically depressed
 Resentment
 Impatience
 Grief
Source; Not “Just Friends” Shirley Glass, PhD

64. Trauma of Discovery
Disclosure process goes through stages: the first stage of
truth-seeking often feels like the inquisition of a detective
and a criminal.
Betrayed Spouse want to know
Why?
Questions can come at any time (Ambushing)
Second stage of information-seeking is a neutral process like a
reporter and an interviewee.
Betrayed spouse wants to know
that it is over and will never happen again.

65. Trauma of Discovery
Final stage of mutual understanding is an empathic search for the
meaning of the affair.
Betrayed spouse wants know that
there is an understanding and appreciation of their
pain (personal apologies)

66. Trauma of Discovery
Three questions being asked by the unfaithful spouse.
• How can I ever be trusted again?
• How can you still say that you love me?
• Feels like *%#@* for what they have done?
Does not believe they are not authorized to have feelings!

67. Spouse Recovery
Pornography (affair recovery) therapy followed by
couples/marriage counseling/therapy can help couples create
a healing process of disclosure.
 Honesty (Transparency)
 Knowing what is going on (Being in the know
 Honesty + Knowing = Safety
 Only when there is safety can true healing start
 Spouse is a Rebuilder
 Support Groups

68. Groups
SA – Sexaholics Anonymous has four meetings each week on
Sunday (Titusville), Monday, Wednesday and Thursday
(Melbourne)– google SA meetings in Brevard County
SAA – Sex Addicts Anonymous has one meeting each week
Local Contact - e-mail: SAASPACECOAST@GMAIL.COM
Peter L - phone: 321-242-2950
SANON – One meeting each week
(melbourneSANON@gmail.com)
RCA – Recovering Couples Anonymous – One meeting each
week at Church on the Rock on Tuesday at 7:00 PM.
Foundations for Recovery –
Tiffanie Trudeau (321-323-7900)

69. Therapist Impact
Online study 57% of betrayed spouses felt
discounted and frustrated because therapist
focused on ______?
General Marital
Issues

70. Teen Pornography Addiction
ABC News Nightline on Teen Pornography Addiction

71. Eight Motives of Cybersex
1. Disease free
2. Intensifies self-stimulation and masturbation
3. Provides instant gratification
4. Provides an escape from mental stress and
tension
5. Normalizes sexual fantasies
6. Provides approval and affirmation
7. Alleviates performance anxiety
8. Helps cope with the pain of childhood sexual
abuse

72. Treatment
Having a specific, goal-orientated plan that
modifies computer behavior for healthy
computer use is necessary in the early stage of
recovery.
• Must address client’s behavior related to the
computer
• Must address the underlying reasons driving
the behavior
• Must Address Spousal Issues, Addiction/Co-
Addiction, Affair

73. -Not interested in people or
activities you used to enjoy
because you fear others will
discover the “secret.”
-Do not want to discuss the
problem with your spouse
because you fear the outcome.
-Suddenly become angry or
irritable.
-Have a hard time sleeping.
-Have trouble concentrating.
-Irregular eating patterns.
-Fearful and always feel on
guard.
-Anxiety attacks, physical
symptoms for no reason.
-Feelings of shame, despair, or
hopelessness.
-Difficulty controlling your
emotions.
-Impulsive or self-destructive
behavior.
-Changed beliefs or faith is
challenged.