31/07/2016
Has P**n Become a Public Health Crisis?
Therapists Speak out on Whether P**n is Killing Intimacy
There’s no question that today’s p**n is a far cry from the heyday of girlie magazines, back-alley strip clubs, and curtained-off rooms in the local video store. With p**n accounting for more than one-third of all web traffic, once risqué publications like Pl***oy have become the equivalent of the horse and buggy.
But is p**n’s unprecedented ubiquity and accessibility affecting our mental health? Inside and outside of psychotherapy circles, there’s an increasingly heated debate about the degree to which p**n is having harmful effects on our emotions, brains, and s*xual performance. In the April issue of Skeptic magazine, psychologist and Stanford professor Philip Zimbardo penned “How P**n Is Messing with Your Manhood,” in which he claims that p**nography is negatively affecting young men in particular, who, “hijacked by watching copious amounts of online p**n,” now suffer from “s*xual anorexia,” in which they struggle to have satisfying s*x with a real-life partner.
Several days after Zimbardo’s post was published, s*x therapist Marty Klein wrote a rebuttal, “Skeptical of the P**n Skeptics,” arguing that while it’s concerning that so many men seem to get their s*x education from p**n, Zimbardo’s claims aren’t conclusive, nor are they supported by neuroscience. Instead, Klein says, they’re based on a few isolated studies with small sample sizes. Refuting Zimbardo’s claim that “young p**n addicts exhibit brain responses that are comparable to [those of] drug addicts,” he adds that many reports that analyze the fMRI scans of p**n users mislead those who are easily impressed by neuroscientific hype. According to Klein, the brain lights up in the same observable way whether we’re watching p**n, cuddling a grandchild, or witnessing a sunset. “The brain is a reward machine,” he says. “If your brain didn’t light up looking at p**n, why would you be looking at it in the first place?”
Even as the debate intensifies about whether p**n is a healthy s*xual outlet or an erection-killing relationship death knell, consensus on the matter is lacking, both within the mental health field and beyond it. In fact, when the DSM-5 was being crafted in the run-up to its 2013 publication, committee members from the American Psychological Association considered adding a category for “hypers*xual disorder,” to include a subdiagnosis for p**nography users. But evidence for the necessity of such a classification came up short, and the idea was scrapped. Likewise, the American Academy of Psychiatry has found insufficient evidence to categorize excessive p**n use as a mental disorder.
Recently, the p**n debate has gained momentum in the mainstream media as well as in the political realm. In March, The New York Times ran an op-ed titled “When Did P**n Become S*x Ed?” portraying college students as accepting p**n as a type of s*xual instruction manual. And in April, Utah governor Gary Herbert signed a resolution declaring p**nography a “public health hazard” that “perpetuates a s*xually toxic environment.” Passages in the bill note p**n’s addictive potential, claim it promotes violence and abuse of women and children, and link p**n use to “lessening desire in young men to marry, dissatisfaction in marriage, and infidelity.”
So what position should ordinary clinicians take in this debate? Are we really in the midst of a public health crisis? What does good therapy with someone who regularly watches p**n look like?
Many leading s*x therapists argue that p**n and its effects have been woefully understudied, leaving clinicians vulnerable to hearsay, personal bias, and misinformation that risks driving clients from therapy, should they feel judged or misunderstood. According to therapist and s*x counselor Ian Kerner, current clinical training in s*xuality has been largely based on applying the addiction model to unfamiliar or taboo s*xual behavior, as outlined in Patrick Carnes’s 1983 Out of the Shadows: Understanding S*xual Addiction, which made s*x addiction a household term. “But frankly,” Kerner adds, “the addiction model is outdated, lacks compassion, and doesn’t provide much in the way of a treatment plan.” There’s a big difference between s*x addiction and regular p**n consumption, he says, adding, “If I’m treating a 40-year-old man who’s in a relationship where there’s not enough s*xual intimacy, and he’s ma********ng a lot to p**nography, I don’t automatically assume that’s a p**n issue.”
Another mistake clinicians make in evaluating the impact of p**n, according to Klein, is that they focus on its explicit content, rather than the motivation for viewing it. “Whether it’s a matter of helping a couple negotiate how to discipline a kid, or how to spend money,” he says, “therapists should able to see beyond content and comprehend the psychological dynamics of the couple they’re working with.”
According to psychotherapist Wendy Maltz, however, p**n in the pre-internet age was a fringe tool for complementing your s*x life. That was before it became a highly addictive runaway pleasure she calls “the high-fructose corn syrup of s*xual media” and “a high-octane espresso shot for s*xuality.” While p**n may not be dangerous in itself, she adds, harm comes from the way it portrays aggression against women. “Maybe it’s just some slapping or calling a woman ‘bitch,’ but this has become a part of mainstream p**nography,” she says. “And it’s only becoming more extreme,” she continues, as viewers habituate to it and seek even greater adrenaline-packed s*x scenes. Maltz says that while she withholds judgment if couples choose to watch p**n to spice up their s*x lives, it can be easy for one partner to feel pressured into watching something that makes them uncomfortable. She maintains that “you don’t hear many people proudly say that today’s p**n is genuinely enhancing their lives and s*xual relationships.”
Whether p**n constitutes a public health crisis remains a subject of debate, but it’s forcing therapists to confront their own biases about what constitutes healthy s*xuality more fully, and to become clearer about their therapeutic role. Thus, regardless of how an individual therapist might feel about p**n, most clinicians agree that it’s still crucial to refrain from snap judgments, be an empathic listener, and take a thorough assessment of s*xual history and habits. If you accept that premise, then most therapists are already equipped to deal with the issue of p**n when it arises in sessions, as long as they’re trained in tackling issues like s*xual desire, fantasy, anxiety, and shame. “The real question facing therapists today is whether they’re equipped to see an interest in p**nography as a legitimate desire,” says Klein. “Everybody’s views deserve respect. If we don’t give the p**n consumer a voice, we’re not acknowledging the full spectrum of human s*xuality.”
This blog is excerpted from "Has P**n Become a Public Health Crisis?" by Chris Lyford.
