1. Pornography Therapeutic Interventions
COPING.US Training Program on Pornography #4 from Pornography Intervention at:
Prepared and Presented by:
Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T

2. Pornography Therapeutic Interventions (4th of 4 Programs on Pornography Intervention) Resource on Coping.us: and and and and Description of the Program: This program takes an intervention orientation to an emerging epidemic of internet pornography which threatens communities in which youth, adults and marital spouses who have become addicted compulsive pornography users. There is a need to train mental health professionals in specific treatments strategies on how to assist youth, adults and spouses who are dealing with the grips of compulsive pornography use in their lives Therapists need to use tools which are easily accessible to develop their intervention strategies. Also, therapists need to learn how to conduct community wide education programming to awaken citizens to this crisis and to help them develop strategies on how to deal with it in their communities. Helping all community members to grapple with this new challenge to their mental health and happiness can result in renewed commitment and conviction to fight this issue so that the community can support those addicted to compulsive pornography use gain complete recovery and wellness in their lives. Therapists need help on what to say, how to say it and how not to use shame, guilting and outing to get the compulsive pornography users to come to grips with this issue in their lives. Learning Objectives 1. To learn about the impact of Compulsive pornography use on Youth, Adults and Married Couples in America today with an exploration of what types of pornography are out there and on what platforms they are present. 2 To learn about the neuroscience of watching pornography by Youth and Adults which leads to the compulsive need for more pornography to satisfy the mesolimbic reward centers of the brain. 3. To learn therapeutic techniques which clients can use to lessen the impact of compulsive pornography in their lives and to help them learn how to grow stronger committed to strengthened personal growth and recovery despite what challenges that come their way. 4. To learn about the resources to supplement the treatment of youth, adults and couples coping with compulsive pornography use, which can be incorporated and used in to all types of institutions in the community, churches, civic organizations and social media.

3. Impact of Pornography on Children & Youth

4. Why Now?
In 2006 with the introduction of High Speed Internet systems the world has been turned upside down when it come to Pornography and the ease of its accessibility
No one dreamed of this problem which is now at epidemic proportions
In 2010 the Professional Literature began to be crowded with research on the impact of internet pornography or cybersex
Today there is enough documentation to convince mental health professionals, pastoral leaders, school officials and governmental agencies that there is a whole new study out there about the prevention of compulsive pornography use by children, teens, young adults, adults, and married partners
The time has come to deal with this issue seriously and for this reason Coping.US Training Programs has 4 distinct programs on Pornography Intervention
They are:
Pornography Prevention Program Strategies for parents with children and teens
Pornography Intervention for Couples
Pornography Intervention for Adults
Pornography Therapeutic Interventions for Mental Health Professionals

5. Impact of Pornography on Youth in America
The concern about the use and impact of pornography falls within the responsibility of how each family transmits sexual values and expectations. As a number of experts have cautioned, if the first conversation about sex that you have with your children is the result of discovering their Internet use, then you have not done your job as a parent.
Pornography is value laden and as such should be viewed through the lens of each family’s value structure, just as we raise our children to deal with the many other challenges they will confront. It is at this point that our role as religious leaders and mental health professionals takes on greater clarity; not to stem the tide of pornography – we simply cannot, but to help families prepare their children for the endless stream of sexual messages which permeate our world, some more invasive than others. As we seek to help families avoid or cope with this abuse, so we must help them raise children in a world that seems to change with unprecedented regularity. We then have the gift of preventing problems and not just treating them
(from: The Pornography Question by David S. Ribner, 2014)

6. What is the Current View of Porn by Youth?
In a 2016 study the Barna Group found the following:
What is Porn? The study found that the most significant factor for considering an image as porn was if the image involved sexual intercourse and that sexual plays an important factor in a person considering an image as porn
Teens and young adults consider more types of images as porn than do adults
Teens and young adults consider not recycling more immoral than viewing porn
Young Adults ages are least likely to say that porn is bad for society
More than half of teens and young adults speak of porn in a way that is completely accepting and only a small percentage talk about porn in a disagreeable way
Only child pornography and "painful sex" are considered "always wrong" by a majority of people
Two thirds of teens and young adults have received a sexually explicit image from their girl/boyfriend or friend
This 2016 study was done by the Barna Group for Covenant Eyes, Inc. The Report is called: The Porn Phenomenon: Survey of US Teens and Adults at

7. What are Pornography Websites?
In 2008, the company Hitwise catalogued 40,634 websites that distributed pornography (Tancer, 2008).
According to the research by two neuroscientists in 2010, out of the one million most trafficked websites in the world, 42,337 are sex-related sites (Ogasa & Gaddam, 2011).
Free websites comprise between 70-80% of the adult material online, typically used as “bait” for pay websites, guiding viewers to premium pay services (Zook, 2007).
A conservative estimate places 32% of adult membership websites and 58% of free adult websites outside the United States (Zook, 2007).
90% of free porn websites and nearly 100% of pay porn websites buy their material rather than create it themselves (Zook, 2007).

8. What are Pornography Websites?
In 2009, the Media Research Center (MRC) examined the most popular YouTube searches for the word “porn,” yielding 330,000 results. The study reported on the top 157 videos, all with one million views or more.
Two-thirds of the videos advertise themselves as being actual pornography.
Many videos feature clips from actual porn movies, interviews with porn stars, advertisements for porn sites, and phone sex lines.
Profanity is commonplace in the titles and comments for the videos.
There are suggestions of sex with computers, virtual reality sex, sex in multiplayer online video games and the merging of pornography with independent cinema are thing of the future. Perhaps two decades from now the seemingly immovable Internet as the go-to porn distribution tool will be as dead and buried as VHS (Nielsen & Kiss, 2015).

9. Numbers of Youth Viewing Pornography
A 2016 review of the research in the field reported that:
About 46% of US men and 16% of women watch porn in a given week
Between 6% and 28% of male porn users describe their habit as "problematic"
Many ex-­users report impressive benefits like better sleep, clearer skin and more confidence
Boys are starting to regularly use porn at an increasingly earlier age of 8 for the youngest in one survey thus it is vital to educate children and teens explaining that pornography may not accurately depict sex and relationships
Study after study shows that self-­identified porn addicts are not watching more porn than other people, but have moral values that conflict with their use (Wilson, 2016).
A 2017 study found the following:
Adolescents aged years, especially male adolescents, are the most prone to the development of Internet (pornography)addiction
Adolescents aged years show the lowest level of Internet (Pornography) addiction (Karacic & Oreskovic, 2017).

10. Pornography Has Gone Mobile
When 1,521 smartphone owners in the UK. ages 18 and older were surveyed, 24% admitted to having pornographic material on their mobile handset. Of these, 84% of those who were involved in a romantic relationship said their partner did not know about the porn on their handset (CovenantEyes, 2015).
In 2012, 43.8% of adult industry executives and stakeholders believed mobile devices would become consumers’ primary porn-viewing devices (XBIZ Research, 2012).
According to Juniper Research, by 2017, a quarter of a billion people are expected to be accessing mobile adult content from their phones or tablets, an increase of more than 30% from Mobile adult videochat alone will have a compound annual growth rate of 25% (Juniper Research, 2013).
Nearly 1 in 5 searches made from mobile devices are for pornography. Furthermore, 24% of smartphone owners have porn on their handset, and of these, 84% said their romantic partners did not know about it (Eldred, 2012).
Teens and young adults in particular, use smartphones, and are therefore at a higher risk of Internet misuse on their mobile devices. One study found that 51% of year-olds own smartphones. Meanwhile, 49% of teens use the Internet on a mobile device (Eldred, 2012).

11. Impact of Pornography on aDULTS

12. Impact of Pornography on Adults in America
A 2016 study identified that men’s sexual difficulties and the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40 is directly related to overuse of internet pornography. The study concluded that alterations to the brain's motivational system are the etiology underlying pornography-related sexual dysfunctions (Park et al., 2016). Their explanation is that the characteristics of internet pornography may be potent enough to condition sexual arousal that do not readily transition to real life partners. These characteristics include:
Limitless novelty
Potential for easy escalation to more extreme material
Video formats
The result of the impact of internet pornography is that
sex with desired partners may not register as meeting expectation and arousal declines.
Clinical reports suggest:
Terminating internet pornography use is sometimes sufficient to reverse negative effects. (Park et al., 2016).

13. Self-Perceived Pornography Addiction
By 2016, an estimated 40 million adults in the U.S. regularly view Internet pornography
10 percent of whom admit to having an addiction to Internet pornography
Self-perceived pornography addiction (SPPA) has increasingly emerged as a concept in research & popular culture.
“Pornography or porn addiction” is not a formally recognized disorder & there is disagreement among researchers regarding its definition or even its existence however there are reliable findings about its impact
How Compulsive Pornography Use is operationalized often varies & this influences conclusions made about the impact of Compulsive Pornography Use
Compulsive Pornography Use is most frequently operationalized as excessive pornography use with negative consequences
Compulsive Pornography Use is reported to affect users & their partners in similar ways, such as increased feelings of isolation & relationship breakdowns
There still exist a debate regarding the definition & etiology of Self-Perceived Pornography Addiction as distinct from self-perceived sex addiction (Health & Medicine, 2016).

14. Psychological Distress Directly Related to Compulsive Pornography Use
A 2015 study examined how the notion of perceived addiction to Internet pornography might be related to other domains of psychological functioning
The study demonstrated that:
The notion of perceived addiction to Internet pornography is very robustly related to various measures of psychological distress
The relation between psychological distress & perceived addiction to Internet pornography persisted, even when other potential contributors (neuroticism, self- control, amount of time, spent viewing pornography) were controlled for statistically (Grubbs, Volk, Exline & Pargament, 2015).

15. Impact Exposure of Pornography on Young Adult Development
In 2012 a study of the role of exposure to pornography during adolescence in predicting intimacy among young adults was conducted with college students (aged 18–25 years) who were surveyed online. Respondents provided information about:
pornography use at ages 14 & 17
perceived realism of pornographic depictions of sexual activities
attitudes towards recreational sex & relationship intimacy
significant gender differences in pornography exposure
perceived realism of pornographic contents
attitudes towards recreational sex
No direct relationship was found between adolescent exposure to pornography & relationship intimacy in young adulthood
The realism of pornography was related both to exposure & intimacy, but only among female participants
The association between the appraisal of pornographic realism & intimacy was shown to be mediated by attitudes towards recreational sex (Štulhofera, Buškob & Schmidtc, 2012)

16. Impact of Pornography on Couples & Marriages

17. Impact of Pornography on Marriages in America
A 2016 study identified that men’s sexual difficulties and the sharp rise in erectile dysfunction, delayed ejaculation, decreased sexual satisfaction, and diminished libido during partnered sex in men under 40 is directly related to overuse of internet pornography. The study concluded that alterations to the brain's motivational system are the etiology underlying pornography-related sexual dysfunctions (Park et al., 2016). Their explanation is that the characteristics of internet pornography may be potent enough to condition sexual arousal that do not readily transition to real life partners. These characteristics include:
Limitless novelty
Potential for easy escalation to more extreme material
Video formats
The result of the impact of internet pornography is that
sex with desired partners may not register as meeting expectation and arousal declines.
Clinical reports suggest:
Terminating internet pornography use is sometimes sufficient to reverse negative effects. (Park et al., 2016).

18. Impact of Compulsive Pornography Use on Marital Partners
A survey of women in 2015, found that their reports of their male partners’ pornography use were related:
to less relationship satisfaction
more psychological distress.
In addition, relationship trust mediated the links between male partners’ perceived pornography use & relationship satisfaction & psychological distress
Results from the moderation analyses indicated that:
the direct effect of male partners’ perceived pornography use & relationship trust & the conditional indirect effects of male partners’ perceived pornography use on both relationship satisfaction & psychological distress were contingent on relationship investment
These findings indicated that when male partners’ perceived pornography use is high, women who have low or mean levels of relationship investment have less relationship trust
The survey revealed that the relationship between male partners’ perceived pornography use & relational & psychological outcomes exist regardless of women’s own attitudes toward pornography (Szymanski, Feltman & Dunn, 2015).

19. Pornography Leads to FWB Which Impacts Relationship Commitments
Friends with benefits (FWB) relationships integrate two types of relationship: 1. friendship & relationship that includes sexual intimacy but without an expectation of commitment
These relationships are often seen as less risky than other casual sexual behaviors, but they still pose a high risk of contracting a Sexually Transmitted Infection (STI)
Pornography consumption has been connected to increases in risky sexual behavior in casual sex
A 2015 study into pornography use influencing FWB behaviors, specifically through the mechanism of sexual scripts demonstrated that more frequent viewing of pornography is associated with:
A higher incidence of FWB relationships
A higher number of unique FWB partners
Engagement in all types of risky sexual behaviors during FWB relationships
More permissive sexual scripts mediated the association between frequency of pornography use & FWB behaviors
A need for mitigating public health risks among emerging adults was established (Braithwaite, Aaron, Dowdle, Spjut & Fincham, 2015)

20. Impact of Pornography on Commitment to Relationships
A 2014 study investigated female participants in committed relationships concerning honesty regarding pornography use & mutual consumption between partners, along with honesty & mutual use as predictors of satisfaction
Participants reporting more honesty showed higher satisfaction & lower levels of distress
Participants disclosing mutual use showed lower levels of distress, although no differences were reported in satisfaction
Honesty regarding pornography use significantly predicted relationship dissatisfaction (Resch & Alderson, 2014).

21. Impact of Online Pornography on Sexist Attitudes of Males
In 2014 a study investigated how the sexist attitudes of young adult males were affected when they were inadvertently exposed to online pornography & the role of the sense of anonymity in subsequent selection by these individuals of sexually explicit material
Results of this study showed that:
Participants were more likely to pursue extreme pornography when they felt anonymous, as compared with situations in which they did not feel anonymous
This tendency was especially apparent for those exposed for 10 seconds to sexual online pop- up commercials that include pornographic content
The results also showed that inadvertent exposure to such sexual online pop-up commercials, coupled with feelings of anonymity, could increase participants’ sexist attitudes toward women (Shim & Paul, 2014).

22. Impact on Gender Role & Attachment Styles from Compulsive Male Porn Use
A 2014 study examined, gender role conflict & attachment styles & consequences of poorer relationship quality & sexual satisfaction of men’s pornography use among adult heterosexual men - Findings revealed that:
Both frequency of pornography use & problematic pornography use were related to:
greater gender role conflict
more avoidant & anxious attachment styles
poorer relationship quality
less sexual satisfaction
In addition, the findings provided support for a theorized mediated model in which gender role conflict was linked to relational outcomes both directly & indirectly via attachment styles & pornography use (Szymanski & Stewart-Richardson, 2014).

23. Pornography’s Use Impact on Relationships
A 2013 study examined:
associations among pornography use
the meaning people attach to its use
sexual quality
relationship satisfaction
factors that discriminate between those who use pornography & those who do not
Participants were couples who were either married or cohabiting at the time the data were gathered. Overall results from this study indicated substantial gender differences in terms of use profiles, as well as pornography’s association with relationship factors. Findings:
male pornography use was negatively associated with both male & female sexual quality
Female pornography use was positively associated with female sexual quality
Meaning explained a relatively small part of the relationship between pornography use & sexual quality (Poulsen, Busby & Galovan, 2013).

24. Impact on the Mental Health of Female Partners of Compulsive Porn Users
A report in 2012 found that:
Women’s reports of their male partner’s frequency of pornography use were negatively associated with their relationship quality
More perceptions of problematic use of pornography were negatively correlated with the women’s self-esteem, relationship quality & sexual satisfaction
Due to the lowered self-esteem issues, women would continue in the relationship even with the perceptions of partner’s problematic pornography use & relationship quality
Relationship length moderated the relationship between perceptions of partner’s problematic pornography use & sexual satisfaction, with significant dissatisfaction being associated with longer relationship length (Stewart & Szymanski, 2012).

25. Pornography Use Weakens Commitment in Relationships
A 2012 analysis of five different studies examined the correction between pornography consumption & commitment to romantic relationships with the expectation that higher levels of pornography consumption would correspond to weakened commitment in young adult romantic relationships.
Study 1: found that higher pornography consumption was related to lower commitment
Study 2: replicated this finding using observational data
Study 3: participants were randomly assigned to either refrain from viewing pornography or to a self-control task. those who continued using pornography reported lower levels of commitment than control participants
Study 4: participants consuming higher levels of pornography flirted more with an extradyadic partner during an online chat
Study 5: found that pornography consumption was positively related to infidelity & this association was mediated by commitment.
Overall: a consistent pattern of results was found using a variety of approaches with the conclusion that more pornography consumption is associated with a more weakened commitment to one’s relationship partner (Lambert, Negash, Stillman, Olmstead & Fincham, ).

26. Differences from Male & Female Use of Pornography
In studying the differences between male and female use of pornography researchers found that males indicated:
a younger age of first exposure to pornography
higher total number of times pornography was viewed
more frequently viewing pornography within the last year compared to female participants
Although men viewed more pornography more frequently than women, both male & female participants reported similar reasons for viewing pornography
“Wanted the sexual excitement" was frequently indicated as a reason for viewing pornography
However, a higher percentage of women reported "never looking for pornography on purpose" than did men
The difference between "wanted the sexual excitement" and "never looking at pornography on purpose" was only 3%, suggesting that there is great discrepancy within reasons for viewing pornography among female participants. The discrepancy suggests that there is not a "typical" relation between women & pornography (Butler, Holm & Ferraro, 2011).

27. Wives of Sexual Addicts Give us a Hint to Wives Views of Pornography Addicts
A study of wives of sexual addicts in 2006 found that they experience distressing symptoms in response to the disclosure of their husbands’ compulsive sexual behaviors & often describe the disclosure event as traumatic
A majority of wives of sexual addicts respond to disclosure with significant trauma-related distress
The data also reveal that years married at the time of disclosure &number of previous traumatic event exposures best predicted total trauma symptom severity scores (Stefens & Rennie, 2006)
In the survey the finding were:
70% met most criteria for a diagnosis of post-traumatic stress disorder
75% discovered evidence of compulsive or addictive sexual behaviors themselves (as opposed to a planned disclosure on the part of a husband)
71% demonstrated a severe level of functional impairment in major areas of their lives
Length of marriage at disclosure & number of prior traumatic event exposures were the best predictors increased trauma symptoms (Stefens & Rennie, 2006).

28. Early Signs of Online Pornography’s Impact on Marital & Couple Relationships
Research from 2005, indicated pornography consumption was associated with the following six trends, among others:
Increased marital distress & risk of separation & divorce
Decreased marital intimacy & sexual satisfaction
Infidelity
Increased appetite for more graphic types of pornography & sexual activity associated with abusive, illegal or unsafe practices
Devaluation of monogamy, marriage & child rearing
An increasing number of people struggling with compulsive & addictive sexual behavior (Manning, ).

29. Neuroscience of Pornography

30. Mesolimbic System: Pleasure/Reward Pathways Impacted by Pornography
Addiction occurs when pleasure/reward pathways are hijacked by exogenous drugs such as cocaine or opioids, or by natural processes essential and inherent to survival such as food and sex in the mesolimbic reward centers of the brain.
The pleasure/reward pathways and the other limbic regions 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 for 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 (Hilton & Watts, 2011).

31. Ventral Striatal Reward Pathway This circuit starts and ends in the brainstem with the release of dopamine. Activating these “reward cells” with stimulation (e.g., pornography, sex, drugs, food, etc., causes them to transmit dopamine to other regions in the cortex and subcortex such as the striatum. This reinforces the drive for future reward seeking behaviors. These signals converge to a set of cells in the nucleus accumbens, which is essential for determining the motivational significance of the reward stimulus, causing the person to think, “Mmmmm that was fun; I’ll do that again.” In cases of extreme compulsive pornography use, simply showing still pictures to the compulsive pornography user will engage this reward circuit. The same is true for people addicted to eating: showing them pictures of food can reengage the same (Hilton & Watts, 2011).

32. Impact of Pornography Use on Brain Matter
In 2014 the first-ever brain-scan study of online porn users, was conducted at the Max Planck Institute for Human Development in Berlin, researchers found that the hours and years of porn use were correlated with decreased grey matter in regions of the brain associated with reward sensitivity, as well as reduced responsiveness to erotic still photos with:
Significant negative association between reported pornography hours per week & gray matter volume in the right caudate
Reduced functional activity during a sexual cue–reactivity paradigm in the left putamen
Functional connectivity of the right caudate to the left dorsolateral prefrontal cortex was negatively associated with hours of pornography consumption
The negative association of self-reported pornography consumption with the right striatum (caudate) volume, left striatum (putamen) activation during cue reactivity, and lower functional connectivity of the right caudate to the left dorsolateral prefrontal cortex could reflect change in neural plasticity as a consequence of an intense stimulation of the reward system, together with a lower top-down modulation of prefrontal cortical areas
Alternatively, it could be a precondition that makes pornography consumption more rewarding (Kuhn & Gallinat, 2014)

33. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use A Summary from Covenant Eye’s: The Porn Circuit: Understand Your Brain and Break Porn Habits in 90 Days by Sam Black, 2013.
Dopamine:
Focuses one’s attention on whatever task is at hand
Motivates person forward
Activates or enhances rewards circuitry that makes one feel good
Plays a major role in memory
Helps people recall what is important in environment & remember appropriate response to the stimulus
Fuels the tension & craving for meeting a need
Is released in response to all drugs of addiction & plays a role in many disorders affecting motivation & attention such as obsessive-compulsive disorder & behavioral addictions.
Helps brain remember what is interesting & how to respond to it.
Focuses the mind on a specific task while other concerns are ignored
Provides a neurological reward that feels good & assists in cravings for more of the activity.

34. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use
DeltaFosB
Has been implicated as a critical factor in the development of virtually all forms of behavioral & drug addictions
In the nucleus accumbens, DeltaFosB functions as a "sustained molecular switch" & "master control protein" in the development of an addiction
Once "turned on" (sufficiently overexpressed) DeltaFosB triggers a series of events that ultimately produce an addictive state (i.e., compulsive reward-seeking involving a particular stimulus)
This state is sustained for months after cessation of drug of choice use (including pornography) due to the abnormal & exceptionally long half-life of DeltaFosB
DeltaFosB in the nucleus accumbens medium spiny neurons directly & positively regulates drug self-administration & reward sensitization through positive reinforcement while decreasing sensitivity to aversion.

35. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use
Norepinephrine
A neurotransmitter often associated with stress & the fight-or-flight response, helping people to be more alert
Acts as a hormone for sexual arousal & sexual memory
Helps people burn emotional experiences in their minds
Whether it’s a wonderful sexual experience with one’s spouse or a provocative sexual image, the information is stored for easy recall with the help of norepinephrine.

36. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use
Oxytocin
Often referred to as the bonding hormone because big releases arrive when mothers & fathers hold their newborn babies
Often called the cuddle hormone because oxytocin levels rise when a couple snuggles, hold hands, or express other forms of intimacy
Is one reason a kiss is so powerful
Plays a big role in sexual bonding to one’s partner and triggers the contractions during male orgasm
It is for this reason that married couples are encouraged to enjoy face-to-face sex that provides as much skin contact as possible for the greatest release of the bonding chemical
Because oxytocin is also released in climax, it can have a negative impact for the porn user: Instead of bonding to a real mate, the porn viewer’s brain bonds to the image, video, or situation, especially when the activity is reinforced through repetition

37. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use
Vasopressin
Working in concert with oxytocin, encourages the feelings of bonding and is slowly released during sexual activity and at climax
The release of vasopressin during porn viewing and masturbation works to cement a person’s attachment to this behavior
Endogenous Opiates
People were designed to have an amazing sexual experience. The body produces natural or endogenous opiates, which during climax provide pain relief and a sense of transcendence and euphoria-It is for this reason that many say Pornography Addiction is PMO: Pornography leads to Masturbation which leads to Organism which produces these addictive endogenous opioids
This is an opium like substance, naturally produced by the body
Serotonin
Serotonin is released after climax and brings feelings of calm, wellbeing, and satisfaction.
High serotonin levels also decrease sexual motivation: These factors help explain why men are often accused of being ready for a nap after sex

38. The Brain’s Neurochemicals Impacted by Compulsive Pornography Use
Testosterone
Often cited as the male hormone (although women have it in lesser amounts), testosterone dramatically increases sexual arousal and desire
Is released in men throughout the day, but when sexual cues are picked up by the brain the testes increase production
Pornography (and the mental fantasizing that it enables) crafts a brain that constantly generates testosterone and heightens sexual desire. With this ever-present sexual desire, the brain is ready to interpret any signal (external or internal) and ramp up the perceived need for sexual activity.
Men with strong feelings of commitment to their spouse tend to have lower testosterone levels. This may be a reason why these men may be less likely to commit adultery.
Because testosterone is slow to dissipate, men who habitually view pornography cause their own chemical imbalance.
This high testosterone level increases their sexual awareness far above normal
Sexual fantasies are sparked by everyday objects & even modestly dressed women are seen as provocative.

39. Neuroplasticity Impacted by Pornography
Brain plasticity or neuroplasticity:
Lifelong ability of the brain to wire and rewire its neurocircuitry
Brain can increase or decrease the strength and number of synapses that communicate an emotion or feeling allowing information or memories to flow more or less quickly
Operates under a dynamic of “use it or lose it” - Do an activity more often and the brain will create neural pathways that make an activity easier to think about and complete. In creating neural pathways of porn use, repetition matters
Sexual activity launches major excitation in peoples’ brains, so it takes less repetition to build these porn pathways than it would to engrain cravings for other activities
Because porn provides a state of arousal, the brain also creates pathways that make initial arousal easier
Suddenly, porn & sex with a partner aren’t the only experiences that are arousing: Since as porn pathways deepen, people in everyday life become objects of sexualized fantasy & inanimate objects, clothing & situations not designed for sex become sexually charged

40. The Processes involved in the Neuroplasticity of the Brain A Summary from Covenant Eye’s, The Porn Circuit: Understand Your Brain and Break Porn Habits in 90 Days by Sam Black, 2013
Sensitization
A person who uses a pornographic image or story and masturbates for the first time begins a learning process of how to respond to porn in the future
With repetition the brain responds not only to the initial stimulus, but also to related stimuli.
After a person becomes sensitized, very little is needed to trigger a response
A superhighway is connected to the rewards circuitry
This superhighway has many entrance ramps
Sexual cues are seen everywhere and sexual fantasizing comes easy.

41. The Processes involved in the Neuroplasticity of the Brain
Triggers:
Cigarette smokers can name a list of activities that spark a physical & mental desire for a smoke: drinking a cup of coffee, finishing a meal, sipping alcohol. These cues are called triggers & when presented the brain gets a shot of dopamine that motivates a person to smoke, ingest nicotine & fire the rewards circuitry of the brain
Triggers also surface for porn & masturbation & these sensitization cues can vary greatly from person to person depending on their gender, marital status, & types of porn & activities they use:
Simply being home alone is enough to prompt many people to rush to their computer in search of porn
Some people lie awake at night, taunted with thoughts of getting up to view porn online & masturbate while the family sleeps. Why? Because they hold not only memories of using the computer for porn, but also of opportunities of secrecy & even of getting up or staying up for a late- night fix.
These compulsive feelings are engrained from repetitive & powerful experiences: Dopamine flows easily in response to the learned pornographic trigger driving a person to act out & the sensitized neural pathway leads easily to the rewards circuitry where opiates fire.

42. The Processes involved in the Neuroplasticity of the Brain
Desensitization
Though not true for everyone, many porn users find they need a greater amount or more intense porn to activate a state of arousal
Their brains had decided after multiple porn excursions that this amount of dopamine is excessive. So, it had reduced the amount of dopamine in response to porn, and it had reduced the number of dopamine receptors for the neural circuits associated with porn use.
To escape this desensitization, people & men especially, expand their pornographic tastes to more novel stimuli: What was once considered hardcore — a heterosexual couple engaged in intercourse — is now considered mundane, and varied forms of sex mixed with force, violence, and humiliation are now fused into today’s pornographic scripts
Hypofrontality:
Compulsiveness is a good descriptor of hypofrontality
Many porn users feel focused on getting to porn and masturbating even when a big part of them is saying, “Don’t do this”
Even when negative consequences seem imminent, impulse control is too weak to battle the cravings.

43. Summary of Neuroplasticity Processes
When a man sees his partner or pornography and is sexually stimulated, including imagination, his arousal is increased &h is thoughts are focused through dopamine, testosterone & norepinephrine.
If sex or self-sex is pursued, these chemicals further focus his brain’s attention & narrow his thoughts on the sexual experience
These and other chemicals are also active in women during arousal, but in addition, perceptions, feelings, lengthy memories & cognitive choices play a larger role
During sex or masturbation, people get the sexual version of tunnel vision as more of these initial chemicals are combined with the slow release of oxytocin and vasopressin
Worries & concerns often fall away & the mind focuses on sexual release
The contractions of orgasm are connected to the brain’s release of endogenous opiates
These opiates & dopamine shut off the portions of the brain responsible for anxiety, adding to the euphoria & the removal of fear
Then the brain receives serotonin, adding feelings of wellbeing & satisfaction
All of those hormones and neurotransmitters are actually interacting with the physical brain & its neural connections.

44. Summary of Neuroplasticity Processes
Through this process of learning, the neural circuits for a porn habit are sensitized, becoming broad superhighways with multiple on-ramps
These on-ramps are the direct result of a sensitivity to sexual cues that are seen in a growing variety of stimuli
The pornographic brain sees cues for arousal everywhere & because porn is part of the regular diet, testosterone keeps men especially on high alert
When sexual cues are strong enough, dopamine spurs the pornography user to act out, which releases more of the neural chemicals that focus attention
In men, the neural pathway for masturbation leads to a quick release of opiates during ejaculation.
Meanwhile, as this highway grows more engrained, often people become desensitized to the pornography they have been using and seek more images or porn that are more novel
As this tolerance expands, people often become disgusted with their own pornographic pursuits…but do it anyway, broadening the cues that lead to arousal.
When pornography users boast they are pushing the envelope by introducing new, harder themes, what they don’t say is they must, because they have been building up tolerance to their usual content, So when temporary escape has passed, many look at themselves & see widening & higher banks of their pornographic stream & their lives, both sexually & non-sexually, seem shallow & covered with algae. The dam has long been broken & so many once beautiful things are uprooted (Black, 2013)

45. How Compulsive Pornography Use Mimics Other Addictions in the Brain
Video on How Compulsive Pornography Use Mimics Other Addictions in the Brain
Here is a Ted Talk Video which explains this process:
The great porn experiment (2012) | Gary Wilson | TEDxGlasgo

46. Is Compulsive Pornography Use an Addiction?
The American Society of Addiction Medicine (ASAM) formally expanded their definition of addiction in 2011 to include both behaviors and substances:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. There is a Three Stage Model of Addiction which includes:
Binge/intoxication
Withdrawal/negative affect
Preoccupation/anticipation
(Love, Laier, Brand, Hatch & Hajela, 2015)

47. Three Stage Model of Addiction
Stage 1: Binge/intoxication
Different classes of drugs activate the reward system through different means, however, the universal result is a flood of dopamine in the Mesolimbic System: Pleasure/Reward Pathways
This results in acute positive reinforcement of the behavior that initiated the flood
In this impulsive stage, this positive reinforcement results in addictive related learning associations
Neuroplastic changes begin to occur, however, as the continued release of dopamine in the Pleasure/Reward Pathways leads to an increase in dynorphin levels
Dynorphin, in turn, decreases the dopaminergic function of the reward system, resulting in a decrease of the reward threshold and an increase in tolerance.

48. Three Stage Model of Addiction
Stage 2: Withdrawal/negative affect
The dopamine flood has run its course, and there is activation of the extended amygdala, an area associated with pain processing and fear conditioning
The resulting negative emotional state leads to activation of brain stress systems and dysregulation of anti-stress systems
This leads to a decreased sensitivity to rewards and an increase in the reward threshold, which is called tolerance
This further progresses to negative reinforcement as the individual continues to engage in the addictive behaviors to avoid the negative affect associated with withdrawal
A second component of the reward system comes into play here: the mesocortical dopamine pathway responsible for key components of cognition and executive function, inhibition & emotional response
Taken together, the mesocortical dopamine pathway affects the cognitive component of reward processing

49. Three Stage Model of Addiction
Stage 3: Preoccupation/anticipation (craving)
The neuroplastic impairments expand beyond the mesocortical dopamine pathway into other regions of the prefrontal cortex responsible for motivation, self-regulation/self-control, delayed reward discounting, and other cognitive and executive functions
This leaves the individual vulnerable to reinstatement of the behavior
Two primary mechanisms have been identified; cue-induced reinstatement and stress induced reinstatement
Numerous neuroimaging studies substantiate this model, and these impairments are the source behind the “chronic relapsing disorder” element of the medical definition of addiction
(Love, Laier, Brand, Hatch & Hajela, 2015)

50. Helping Parents Have “The Talk” with their Children

51. Help Parents Get Ready to have “The Talk” with their Kids!
Encourage discussions of parents with their children about porn when they are young enough to prevent its use & when they are older not to embarrass or shame them but to get them to recognize the negative impact that getting into porn can be
Help parents be well prepared to conduct these talks with their children have them read the following sections on coping.us Pornography Intervention site, to help them put together their outline for talks with their preschoolers, elementary, middle and high school aged children. Have them look at the following topics on this site to get themselves ready:
Introduction to the Issue of Pornography
The Neuroscience of Pornography
Impact of Pornography on Children and Teens
Impact of Pornography on Young Adults
Websites, Monitoring Sites and Videos To Be Used in Pornography Intervention
References on Impact of Pornography
References on Treatment for Compulsive Use of Pornography

52. Encourage Parent to make their Home Safe from Pornography & Other Negative Materials on Internet
Make homes safe from cybersex invasion through the use of Monitoring and Filtering systems such as Covenant Eyes which are listed below: Circle with Disney: Covenant Eyes: K9 Web Protection: McAfee Family Protection system: websites/ Mobicip Internet Filter: Net Nanny: Norton: Keep Your Family Safe: Qustodio Family System: Surfblocker: TVBO Blockit:

53. Help Parents Understand Stages of Kids’ Involvement with porn When Your Child is Looking at Porn by Luke Gilkerson (2013) a free Ebook from Covenant Eyes)
Stage 1: Experimentation & curiosity: Most initial porn viewing that happens in childhood, or even teen years, is born out of curiosity. Boys want to know what the girls look like with no clothes on & vice versa. Before puberty, it is natural for boys & girls to be curious about gender & sexual differences. During puberty, as sexual feelings grow, it is also common for boys & girls to be drawn by provocative images online, desiring to see more
Stage 2: Regular use of masturbation: In this stage the child has gone from curiosity to “using” porn or online chatting for sexual gratification & orgasm. While this stage is more common among teens, younger children can also enter this stage. In this stage, while there may be feelings of shame, the porn use is seen as recreational.
Stage 3: Risky use: What constitutes “risky use” is not the same for all children. The almost undetectable shift into this stage happens when kids start to seek porn despite the negative consequences. They might stay up late into the night binging on porn, losing sleep & the ability to focus during the daytime, only to return to porn the next night. They might start looking at porn in riskier settings (at school, with a parent’s smartphone, when someone could walk in at any moment, when they should be watching a younger sibling, etc.). Getting caught is less of a concern to them & fear of it becomes part of the “high” they get from the experience.
Stage 4: Dependence and Addiction: Masturbating to pornography taps into the neurocircuitry of the brain, signaling the release of dopamine, serotonin, opiates, oxytocin, and other hormones and neurotransmitters. This hormonal cocktail is part of the body’s natural response to sexual activity, but when combined with graphic porn, the brain experiences a sexual “high” at unnatural levels. Those who have developed an addictive relationship to pornography experience an overwhelming craving for porn, seemingly uncontrollable sexual fantasies & even withdrawal symptoms. The types of porn that used to satisfy no longer do; harder and more graphic pornography is sought

54. Realities of Pornography Parents Need to Face
Exposure to pornography is probably unavoidable as long as kids have access to the internet be it by computer, smart phones, ipads, iphones etc., but pornography problems are preventable
Recent accounts report that children as young as 8 years of age have been exposed to pornography online
As online pornography/sex materials expanded, a study in 2016 found links between Internet addiction, engagement in online erotica (including pornography usage & usage of sex-based Internet chat sites) & engagement in risky online sexual behaviors (sending sexually-explicit pictures to those known only online; sexting) & expecting to engage in offline sex with those known only online which has been exacerbated by the onslaught of Internet sex chat sites (Drouin & Miller, 2016).
Research has also demonstrated that Adolescents aged years, especially male adolescents, are the most prone to the development of Internet addiction, whereas adolescents aged years show the lowest level of Internet addiction (Karacic & Oreskovic, 2017).

55. Realities of Pornography Parents Need to Face
Research has shown that:
Pornography and related sexual media can influence sexual violence, sexual attitudes, moral values & sexual activity of children
Peer-to-peer-file-sharing leads to a tremendous amount of inadvertent & unintentional exposure of children to pornography & other adult sexual media & that these networks depend on these young people constructing their own sexualized media environment
But research has demonstrated that a warm and open parent-child relationship is the most important nontechnical means that parents can use to deal with the challenges of the sexualized media
That open parent-child channels for communicating about sexual and media experiences, sex education at home or school & parental participation with children on the Internet are constructive influences (Greenfield, 2004).

56. 10 Recommendations for Parents
Not give a smartphone to a child until age 14 or older
Not have computers or other electronic devices in their children's room but rather in public spaces and that bedrooms are to be used for school studying & sleep.
Check daily the log of site visitation on computers & electronic devices used by children
Talk with the parents of your children's friends & update them on the realities of internet pornography mass production
Recognize that up to 90% of pornography is not commercial but rather from amateur production & distribution-such as through sexting
Get to know the friends & colleagues their children associate with so as to monitor if these friends are engaging in pornography related behaviors
Arrange to monitor the computer & all electronic devices in the home
Be cautious about their children freely going to public libraries or other public facilities which have free access to the computers & the internet
Be cautious with their own smartphones, ipads, iphones, laptops, computers etc. so that their children are not utilizing them to get to undesirable websites
Work hard to improve the communications with their children to keep the lines of communications open so that their children can feel free & not be shamed if they bring to their parents' attention their encounters & use of pornography be it online or not.

57. Helping Parents Strengthen Their Relationship with Their Children to Weather the Cyber Storms
Pathfinder Parenting: Tools for Raising Responsible Children at: written well before the internet era, updated but unfortunately did not directly address the issue of Online Compulsive Pornography Use. However, its tools are very relevant to this issue & these principles will work well with parents dealing with their children’s potential or current use of pornography:
P - Principles of Pathfinder Parenting
A - Activating Children's Self-Esteem Over The Lifespan
T - Tracking Pathfinder Structures for Children
H - Hugging Children to Create a Healthy Bond
F - Formulating Behavioral Consequences to Encourage Personal Responsibility in Children
I - Intervening in Loss Issues Facing Children
N - Negotiating to Advocate for Children's Rights & Needs
D - Discussing Issues with Feelings Oriented Communication
E - Establishing Healthy Boundaries with Children - Releasing Ourselves of Shame and Guilt Through Self-Forgiveness
R - Releasing Ourselves of Shame and Guilt Through Self-Forgiveness

58. PATHFINDER Guide for Parents
P - Principles of Pathfinder Parenting: covers guidelines on how to relate to children in a responsible way so that there is never “yelling, screaming, ranting or raving” going on but rather rational calm & supportive communications which lead kids to accept personal responsibility for their own behaviors by use of natural & logical consequences A - Activating Children's Self-Esteem Over The Lifespan: covers guidelines to follow over children’s lifetime to encourage, support & enhance their self-esteem T - Tracking Pathfinder Structures for Children: give parents directions for the positive steps they can take at each stage of their children’s development to insure that by the time they are old enough to deal with the internet &its enticements that they will trust & respect their parents’ judgment as to what is best for them & to accept the natural & logical consequences established to maintain health boundaries & goal directed behaviors H - Hugging Children to Create a Healthy Bond: encourages parents to build an emotional bond with their children which can be relied upon when the need for parental support & guidance are needed especially when setting up family boundaries concerning use of the internet, mobile devices & other cyber activities F - Formulating Behavioral Consequences to Encourage Personal Responsibility in Children: provides parents with a better understanding of what it takes to use natural & logical consequences to help their children grow in personal responsibility taking

59. PATHFINDER Guide for Parents
I - Intervening in Loss Issues Facing Children: covers a variety of potential loss issues which parents need to help their children cope with during their lifetimes so as not to escape in self-destructive behaviors such as compulsive pornography use N - Negotiating to Advocate for Children's Rights & Needs: encourages parents with steps to take to get out there & negotiate with those who educate, train, coach, and preach to their children to support measures to insure safety & well-being of their children in this pornography epidemic D - Discussing Issues with Feelings Oriented Communication: which is a short course for parents on how to effectively communicate with their children to insure they are on board with the parents & to insure their children are safe and living their lives in a healthy responsible way when it comes to such things as internet, mobile devices and other cyber activities E - Establishing Healthy Boundaries with Children: Guidelines and Tools for parents to utilize to assist their children to establish healthy boundaries in their lives which speaks directly to the need to establish health boundaries in their use of the internet, mobile devices and other cyber activities. R - Releasing Ourselves of Shame and Guilt Through Self-Forgiveness: helps parents recognize that: “they can only do what they can do, given the nature of imperfect humans” & given that “life is not always fair.” Parent need to self-heal so that they can more appropriately confront and deal with the realities of pornography use by their children especially if they have been late in intervening with their children concerning this issue

60. Intervening with Adult Compulsive Pornography users

61. Immediately Have Adut Clients Make Their Homes Safe from Pornography & Other Negative Materials on Internet
Have Adult Clients make their home safe from cybersex invasion through the use of Monitoring & Filtering systems such as Covenant Eyes which are listed below: Circle with Disney: Covenant Eyes: K9 Web Protection: McAfee Family Protection system: websites/ Mobicip Internet Filter: Net Nanny: Norton: Keep Your Family Safe: Qustodio Family System: Surfblocker: TVBO Blockit:

62. Strategies When Working with Adults with Compulsive Pornography Use
In planning your Intervention with an Adult with Compulsive pornography/sex use you want to follow the steps recommend by Delboy (2015):
Step 1. Client Background and Case Conceptualization
Complete an Initial Clinical Assessment and Treatment Plan
Use of Self-Assessment or Professional Assessment Instruments to determine if the client is a compulsive pornography/sex user
Delineate the Symptoms which are signs of the problem
Do a complete Psychosocial History & include assessment of ACE Factors (Adverse Childhood Experiences)
Provide a complete diagnosis for the client including Principal, Provisional & Other Conditions That May Be a Focus of Clinical Attention
Step 2. Literature and Research Review
Step 3. Appraisal of Existing Literature
Step 4. Treatment Plan Development
Step 5. Implementation Considerations

63. Step 1. Client Background and Case Conceptualization
A. Complete an Initial Clinical Assessment and Treatment Plan
You want to be sure you complete an Initial Clinical Assessment and Treatment Plan
B. Assessments (
Self-Assessment for assessing Compulsive Pornography/Cybersex Use
Self-Assessment: Am I addicted to Internet Sex?
Cybersex Addiction Self-Assessment Screening
Am I a Sex Addict Self Assessment
PATHOS Screening Tool for Compulsive Pornography Use
Professional Assessments to Assess Compulsive Pornography/Cybersex Use
Hypersexual Behaviors Inventory (HBI) with Scoring
The Hypersexual Disorder Screening Inventory (HDSI)
Love Addiction Screening Test (LAST)
Sex Addiction Screening Test (SAST)
4-self-tests- Sexual Addiction, Sexual Anorexia, Binge-Purge, Collateral indicators
Sexual Compulsivity Scale

64. Step 1. Client Background and Case Conceptualization
C. Delineate the Symptoms which are signs of the problem
D. Do a complete Psychosocial History and include assessment of ACE Factors (Adverse Childhood Experiences) explained at: Adverse Childhood Experiences (ACE) Factors Assessment at:
E. Provide a complete diagnosis for the client including Principal, Provisional and Other Conditions That May Be a Focus of Clinical Attention. Remembering that hypersexual, compulsive pornography/sex use are not diagnosable, so utilize a mental health disorder Co-Morbidities of Depression (F34.1 Persistent Depressive Disorder (Dysthymia) (DSM-5, 2013, p.168) or Anxiety (F41.1 Generalized Anxiety Disorder (DSM-5, 2013, p.222)
Step 2. Literature and Research Review
Introduction to the Issue of Pornography at:
Neuroscience of Pornography at:
Impact of Pornography on Children and Teens at:
Impact of Pornography on Young Adults at:
Impact of Pornography on Marriage and Family Life at:

65. Step 3. Appraisal of Existing Literature
Read the following: Treatment of Compulsive Pornography Use by Adults at:
Step 4. Treatment Plan Development
Recognizing the treating of Compulsive pornography/sex use is similar to Addictions in the Alcohol and Substance Use Disorder Treatment Protocols so utilize the tools available for you in:
Tools for Coping Books at:
Marriage Workout: A Marital Enrichment Online Workbook at:
Tools for a Balanced Lifestyle: A Manual for a Guilt Free System of Healthy Living at:
Step 5. Implementation Considerations
Consider implementing an Alternative 12-Step Program which will not set up resistance due to the fear of stigmatization. A readily available program is The Self-Esteem Seekers Anonymous (SEA’s) Program at:
Feel free to utilize any and all of the units in the Online Books on Coping.us.

66. Addressing Adults' Specific Issues Related to Compulsive Pornography/Sex Use
Years of data have shown that individuals who are engaged in compulsive pornography/sex use are typically:
Victims of abuse (sexual, physical, emotional)
Come from rigidly disengaged families
See themselves as shameful, bad, unworthy persons
Are codependent & believe no one will love them as they are
See sexual activity as the most important way of taking care of their emotional needs
Engage in a variety of sexual behaviors
(Levert. 2007)

67. Addressing Adults' Specific Issues Related to Compulsive Pornography/Sex Use
“Shame-based” is self-message most often experienced by adults with sexual related addiction. Efforts in treatment to reduce this shame is a goal (Wilson, 2000).
Problematic Internet Use behaviors may lead to decreased offline social activities & increased depression and loneliness over the course of several years. (Brezing, Derevensky & Potenza, 2010)
A 2017 report demonstrated that both insecure attachment styles & shame based or punishment-based religious beliefs were related to college students’ addictive sexual behaviors (Giordano, Cashwell, Lankford, King & Henson, 2017)
Given these needs, therapists can utilize the REBT and CBT modules from six books on coping.us (Laying the Foundation, Tools for Personal Growth, Tools for Relationships, Tools for Anger Workout, Tools for Handling Control Issues and Growing Down: Tools for Healing the Inner Child) to help their clients address these needs

68. 1. Victims of abuse (sexual, physical, emotional) ACE Factors:
Adverse Childhood Experiences (ACE Factors) Assessment and Resilience Stress/ Questionnaire:
Laying the Foundation:
Understanding Self-Esteem:
“Little Child within”:
Inner Child Needing Growing Down:
Re-Parenting Your Inner Child:
Handling Resentment:
Overcoming Silent Withdrawal:
Stop Self-Destructive Anger Responses:

69. 2. Come from rigidly disengaged families:
Handling Insecurity:
Building Trust:
Getting in Touch With Feelings:
Handling the Need to Control:
Tempering Survival Behaviors:
Handling Depression:
Overcoming Pessimism and Negativity:

70. 3. See themselves as shameful, bad, unworthy persons
Letting Go of Shame and Guilt:
Self-Forgiveness:
Handling Guilt:
Unconditional Self-Acceptance and Self-Love:
Handling Irrational Beliefs:
Self-Affirmations that Work:
Handling Fear of Success:
Stop Jumping to Negative Assumptions:

71. 4. Are codependent and believe no one will love them as they are
Handling the Need for Approval:
Handling the Fear of Rejection:
Overcoming Fears:
Becoming Vulnerable:
On Becoming a Risk Taker:
Unconditional Acceptance and Love:
Overcoming Helplessness:
Handling Confrontation:

72. 5. See sexual activity as the most important way of taking care of their emotional needs
Accepting Powerlessness:
Handling Pride:
Overcoming Perfectionism:
Developing Patience:
Visualizations for Growing Down:
Developing Self-Control:
Eliminating Passive-Aggressiveness:

73. 6. Engage in a variety of sexual behaviors
Letting Go of the Uncontrollables and Unchangeables:
Accepting Personal Responsibility:
Spirituality:
Overcoming Invisibility:
Establishing Healthy Boundaries:
Eliminate Revenge:

74. Dealing with Relapse in Recovery from Compulsive Pornography/Sex Use
Relapse is a common experience among sex addicts, and the disclosure of relapse has a range of consequences for addicts and their relationships, however, voluntary disclosure of relapse (rather than the partner discovering relapses independently) has been found to be associated with positive relational outcomes (Corley, Pollard, Hook & Schneider, ).
Relapse is an everyday reality in recovery from any addiction and it is important for therapists to be armed with tools to share with their clients to help them get back on the way when relapse happens, figure out why it happened and do specific things to reducing the change of relapse in the future.

75. Tool Box for clients to use as they deal with Relapse
Time Management for Recovery:
Goal Setting in Recovery:
Handling Anti-Recovery Thinking:
Overcoming Perfectionism in Recovery:
The Emotional/Behavioral Connection in Recovery:
Social Support in Recovery:
Coping with Stress in Recovery:
Thought Stopping for Recovery:
Problem Solving in Recovery:
Cues for Anti-Recovery:
Use of Behavioral Chains in Recovery:
Handling Binging, Compulsive and Addictive Behaviors:
Handling Relapse-Inducing Factors:
Mental Imagery in Recovery:
Self-Image in Recovery:
Handling Feedback in Recovery:
Testing Motivation in Recovery:
Exercise Program in Recovery:
SEA's Tools for Recovery:

76. 12-Step Program for Adults with Compulsive Pornography/Sex Use
Supportive communication received through 12-step processes may enable pornography/sex addicts to change their behavior or motivated pornography/sex addicts who change their behavior diligently attend 12-step processes, either way such programs appear to be highly productive (Wright, 2010).
It is for this reason that we highly recommend that therapists initiate a 12 Step Program known as the Self-Esteem Anonymous-SEA’s Program which is non-stigmatizing since there is no mention of Pornography or Sex Addiction in the program’s Title or Programs:
Outline of Setting up SEA's Program and Meetings:
SEA's Tools for Recovery:
The SEA's 12 Steps Workbook:

77. Online Recovery Programs for Adult Compulsive Pornography Users
Reclaim Sexual Health: (An online recovery program to overcome pornography sponsored by the Catholic Church)
Exodus 90; Fight for Your Freedom Program from Those Catholic Men:
Porn Kills Love - Fight the New Drug:
The app from Fight the New Drug at: app/id
Fortify - A Step Toward Recovery - an online recovery program at:

78. Intervening with Couples Impacted by Pornography

79. Make Their Home Safe from Pornography and Other Negative Materials on Internet
Encourage Couples to make their homes safe from cybersex invasion through the use of Monitoring and Filtering systems such as Covenant Eyes which are listed below: Circle with Disney: Covenant Eyes: K9 Web Protection: McAfee Family Protection system: websites/ Mobicip Internet Filter: Net Nanny: Norton: Keep Your Family Safe: Qustodio Family System: Surfblocker: TVBO Blockit:

80. Addressing Couples’ Relationships Impacted by Compulsive Pornography/Sex Use
Understanding and treating compulsive sexual activity in marital therapy is a stepwise process:
careful history taking and diagnostics of both partners
identification of the mutually reinforcing relationship dynamics keeping destructive behaviors in play
processing of underlying psychological and developmental roots of such behaviors
cultivation of empathy and trust
revitalizing of the couple’s sexual relationship (Cohn, 2014).
In assessing status of the relationship, it is important to ask the couples to come clean about their use of social media since there could be covert relationships being built on these platforms (Cravens & Whiting, ).
Internet pornography’s unique properties (limitless novelty, potential for easy escalation to more extreme material, video format, etc.) may be potent enough to condition sexual arousal to aspects of Internet pornography use that do not readily transition to real-life partners, such that sex with desired partners may not register as meeting expectations & arousal declines which clearly points out the need to work along with partners of those experiencing this compulsive condition (Park, et al., 2016).

81. Step 1: Careful History Taking & Diagnosis of Both Partners
The Marital Check Up: Which includes five assessments:
Marital Status Inventory
Key Marital Behavioral Issues Inventory
Marital Symptom Checklist
What’s Bothering Us Recording Form
Marriage Work-out Plan of Action
Handling Relationship Barriers:
Helping Another Recognize the Need for Getting Help:

82. 2. Identify Mutually Reinforcing Relationship Dynamics Keeping Destructive Behaviors in Play
Fighting Fairly: : Seven tools: 1 Judging our Fights; 2 Fighting for Love; 3 Take a Risk; 4 Rules on Handling Marital Conflict; 5 Improving Marital Negotiations; 6 Let’s Have a Fight and 7. Follow-up Work-Out Plans for Fighting Fairly
Avoid Burnout: Five tools: 1 Marital Burn-Out Inventory; 2 A Short Course on Marital Burn-Out; 3 What’s Bugging You in the Marriage and a Debugging Plan; 4 A Self-Help Plan to Treat Burnout and 5 Follow-up Work-Out Plan for Marital Burnout
Financial Aerobics: Six tools: 1 An Inventory of the State of our Economy; 2 What are Our Attitudes about Money? 3 A Couple’s Scavenger Hunt; 4 What’s Blocking My Financial Aerobic Routines? 5 Budgeting – Tightening the Belt and 6 Follow-up Work-Plans for Financial Responsibility
Handling Conflict & Problem Solving & Overcoming Role of Victim or Martyr: in

83. 3. Processing Underlying Psychological & Developmental Roots of Such Behaviors
Function Analysis: Six tools: 1 A Couple’s Analysis of their Individual Personality Functioning; 2 A Couple’s Life Events Stress Analysis; 3 A Couple’s Assessment of What Type they Are; 4 Self-Image Checklist; 5 Increasing Personal Performance and 6 Follow-up Work-out Plans for My Personal Functioning Values on Track: Six tools: 1 A Value Conflict Assessment Inventory; 2 What Do We Value? 3 Determining Our Priorities; 4 How They Affect Us; 5 How are We Value-Programmed? and 6 Follow-up Work- Out Plans for Getting Our Values On Track Handling a Fantasy Relationship & Handling the Use of Power and Control & Handling Competition:

84. 4. Cultivation of Empathy and Trust
Communications Warmup: Six tools: 1 How Well Do I Communicate with My Partner; 2 Effective Listening; 3 Effective Responses; 4 Practicing Effective Responses; 5 Effective Problem Solving and 6 Follow-up Work- Out Plans for Improving Marital Communications Handling Forgiving and Forgetting & Handling Fear of Rejection & Handling The Need For Approval & Creating a Healing Environment & Improving Assertive Behavior: Shaping up Assertiveness: Six tools: 1 Do I Operate from Weakness or Strength; 2 A Marital Assertiveness Behaviors Exercise; 3 Ten Assertive Rights in Marriage; 4 Common Roadblocks and Myths Concerning Assertiveness in Marital Relationships; 5 Self-Assertive Training Exercise and 6. Follow-up Work-Out Plans for Mutual Assertiveness Marital Team Expansion: Five tools: 1 The Family Reunion Inventory; 2 My Parents: Myself; 3 An Overview of Pathfinder Parenting; 4 Family Councils: A Family Work-Out Model and 5 Follow-up Work-Out Plans for Family and Children

85. 5. Revitalizing of the Couple’s Sexual Relationship
Nurturing Sexuality: Six tools: 1 How Well Do We Know One Another Sexually? 2 Increasing Our Sexual Awareness; 3 Life Cycle Tasks For Healthy Sexuality; 4 Debunking Some Marital Sexual Myths and Fallacies; 5 What are Our Sexual Styles? And 6 Follow-up Work-Out Plans for Our Sexuality Handling Intimacy & Goal Setting in Relationships: Making Record Time: Seven Tools: 1 Why I Don’t Have Enough Time for You; 2 A Short Course in Time Management; 3 Things We Waste Our Time On; 4 Preparing a Family Time Budget; 5 Leisure/Free Time Analysis; 6 Shared Interests Exercise and 7 Follow-up Work-Out Plans for Making Record Time for Each Other

86. Resources to Use with Children

87. Parenting in the Internet Generation
Here is a "How to" Online Training Program for Parents to develop a parental action plan to address the pornography onslaught, developed by Covenant Eyes presented through a combination of their E-book: Parenting in the Internet Generation by Luke Gilkerson and Chris McKenna (2016) and through a series of videos related to each of the book’s chapters. To get the E-book go to: Introductory Video to Parenting the Internet Generation at:
Videos Related to each of the 9 Chapters:
A House in Ruins: How Porn is Harming Our Kids
The Blueprint: This is the House the Lord Built
The First Wall: A Godly Self-Identity
The Second Wall: Understanding Sexual Integrity
The Third Wall: Understanding the Sinful Impulse
The Fourth Wall: Understanding Sexual Shame
Windows to the World of Parental Controls and Media Literacy
The Roof of Protection: Supportive and Structured Parenting
The Foundation: The Security of the Gospel of Grace

88. Covenant Eyes E-Books for Parents
Free E-books to help Parents who are working to prevent their children becoming hooked on pornography at: The books include:
Equipped: Raising Godly Digital Natives by Luke Gilkerson & Christ McKenna. (2016). Owosso, MI: Covenant Eyes, Inc.
Parenting the Internet Generation-A Blueprint for Teaching Digital Discernment by Luke Gilkerson & Christ McKenna. (2016). Owosso, MI: Covenant Eyes, Inc.
When Your Child is Looking at Porn-a Step by Step Guide for Christian Parents by Luke Gilkerson. (2013). Owosso, MI: Covenant Eyes, Inc.
Protecting Your Family Online-A Parent’s How-To Guide. (2013). Owosso, MI: Covenant Eyes, Inc
A Parent’s Guide to Cyberbullying. (2013). Owosso, MI: Covenant Eyes, Inc

89. Books for Parent to Use With Their Children
Arterburn, S., Stoeker, F. & Yorkey, M. (2002). Every young man’s battle: Strategies for victory in the real world of sexual temptation. Colorado Springs, CO: Waterbrook Press Jenson, K.A., Poyner, G. & Fox, D. (2014). Good Pictures, Bad Pictures: Porn-Proofing Today's Young Kids. Richland, WA: Glen Cove Press Wilson, G. (2014). Your brain on porn: Internet pornography and the emerging science of addiction. London: Commonwealth Publishing.

90. YouTube Videos on Dealing with Pornography use by Children & Adolescents
Loving Our Children in a Pornified World:
How to Talk to Your Kids About Pornography at: OJ00
What Should I Do When I See Pornography? At:
How to Talk to Your Kids about Intimacy At:

91. Resources to Use with Adults

92. E-Books for Couples
Here is are 2 Covenant Eyes E-Books (Free) for Couples Working on overcoming compulsive pornography use at:
Porn and Your Husband – A Recovery Guide for Wives. (2015). Owosso, MI: Covenant Eyes, Inc.
Hope After Porn-4 Women Share Their Stories of Heartbreak…and How Their Marriages Were Saved. (2014). Owosso, MI: Covenant Eyes, Inc.

93. Videos for Couples
10 Signs Your Husband is Looking at Porn:
4 Ways Porn Warps the Male Brain:
Does Porn Impact the Brain?
What Are the Practical Steps to Quitting Porn?
Elevate Recovery: Get High on Life This site has a series of video’s which are self-help motivational presentations for Men or for Women who are suffering from addicted pornography use:
How Porn Destroys Your Manhood
10 Mistakes You Make When Quitting Porn
How To Stop Watching Porn by using other Addictions!
Overcoming Pornography Addiction: The Healing Power of Jesus Christ:
Pornography Addiction: Is There Hope? - His Grace:

94. Websites Specific For Compulsive Porn Users
Integrity Restored:
Fight the new drug:
Those Catholic Men:
Fight for Your Freedom Program from Those Catholic Men:
Reclaim Sexual Health: (An online recovery program to overcome pornography sponsored by the Catholic Church)
Freedom from Pornography of the Lincoln, Nebraska Diocese:
Overcoming Pornography A website of the Mormon Church:

95. A Video Series for Adults
Covenant Eyes – Porn Harms Your Heart and Soul at:
This organization which is related to Integrity Restored has developed a series of videos which are listed with organized topical play lists at:
The Topical Playlists are:
Accountable Lifestyle
Tutorials for installing and use of the Covenant Eye Internet Security System
Parenting for the Internet Generation
What is lust and pornography?
Recovery from porn
IProtect: App and Device Education

96. Videos: Scriptural Approach to Overcoming Compulsive Pornography Use from Covenant Eyes
The Catholic Church and Pornography: 4 Quick Insights from the U.S. Bishops: Is Pornography a Problem in the Church? Introduction to the Cycle of Pornography Series (2016): The Cycle of Porn Addiction (2016): How to Deal with Guilt and Shame After Looking at Pornography (2016): Idols of the Heart Part 1 (2016): Idols of the Heart Part 2 (2016): Reclaim Sexual Health Video Series

97. More Videos
5 Lies Culture Tells Christian Singles:
The Porn Effect: This site is a spinoff of Integrity Restored has loads of helpful ways to overcome use of pornography including excellent videos
5 Research Findings From University Porn Experiment- The Great Porn Experiment:
Men are quitting Internet Porn:
3 Reasons Anime Porn is Really Bad for You:
4 Ways Porn Warps the Male Brain:
Does Porn Impact the Brain?
What Are the Practical Steps to Quitting Porn?
Elevate Recovery: Get High on Life This site has a series of video’s which are self-help motivational presentations for Men or for Women who are suffering from addicted pornography use:
How Porn Destroys Your Manhood
10 Mistakes You Make When Quitting Porn
How To Stop Watching Porn by using other Addictions!
Overcoming Pornography Addiction: The Healing Power of Jesus Christ:
Pornography Addiction: Is There Hope? - His Grace:

98. TED Talks For Adults
The great porn experiment (2012) | Gary Wilson | TEDxGlasgo
Pornography Isn't Your Problem (2016) | Jason Mahr | TEDxCincinnati:
No Sex Marriage – Masturbation, Loneliness, Cheating and Shame (2016) | Maureen McGrath | TEDxStanleyPark:
The Sex-Starved Marriage (2013) | Michele Weiner-Davis | TEDxCU:

99. Bibliography on Treatment for Compulsive Pornography Use
Bradshaw, J. (2005). Healing the shame that binds you. Deerfield Beach, FL: Health Communications, Inc.
Brandenburg, B. (2013). Power over pornography: The breakthrough formula for overcoming pornography addiction. North Charleston, SC: CreateSpace Independent Publishing Platform.
Carnes, P. (1997). The betrayal bond: Breaking free of exploitive relationships. Deerfield Beach, FL: Health Communications, Inc.
Carnes, P. (2012). A gentle path through the twelve steps: The classic guide for all people in the process of recovery. Center City, MN: Hazelden.
Hall, P. (2013). Understanding and treating sex addiction: A comprehensive guide for people who struggle with sex addiction and those who want to help them. New York, NY: Routledge.
Hall, P. (2016), Sex addiction: The partner’s perspective: A comprehensive guide to understanding and surviving sex addiction for partners and those who want to help them. New York, NY: Routledge.

100. Bibliography on Treatment for Compulsive Pornography Use
Laaser, M.R. (2009). Healing the wounds of sexual addiction. Grand Rapids, MI: Zondervan.
Palmer, V.T. (2016). Moving beyond betrayal: The 5-step boundary solution for partners of sex addicts. Las Vegas, Nevada: Central Recovery Press.
Trotter, D.L. (2016). A different kind of strong. Salt Lake City, UT: Intellectual Reserve
Weiss, R. & Schneider. (2015). Always turned on: Sex addiction in the digital age. Carefree, Arizona: Gentle Path Press.
Williams, R.E. & Kraft, J.S. (2012). The mindfulness workbook for addiction: A guide to coping with grief, stress and anger that trigger addictive behaviors. Oakland, CA: New Harbinger Publications.
Wilson, G. (2014). Your brain on porn: Internet pornography and the emerging science of addiction. London: Commonwealth Publishing.

101. References (1):
Barna Group (2016) The Porn Phenomenon: Survey of US Teens and Adults retrieved at Black, S. (2013). The porn circuit: Understand your brain and break the porn habits in 90 days. Owosso, MI: Covenant Eyes, Inc. Braithwaite, S.R., Aaron, S.C., Dowdle, K.K., Spjut, K. & Fincham, F.D. (2015). Does pornography consumption increase participation in friends with benefits relationships? Sexuality & Culture, 19, DOI /s Butler, M.E., Holm, J.E. & Ferraro, F.R. (2011). Pornography's immediate effect on relationship satisfaction. PSI CHI Journal of Undergraduate Research,16(3), Cohn, R. (2014). Calming the tempest, bridging the gorge: healing in couples ruptured by “sex addiction.” Sexual and Relationship Therapy, 29(1), 76–86, Corley, M.D., Pollard, S.E., Hook, J.N. & Schneider, J.P. (2013). Impact of disclosure of relapse for self-identified sexual addicts. Sexual Addiction & Compulsivity, 20, DOI: / Cravens, J.D. & Whiting, J.B. (2014). Clinical implications of internet infidelity: Where Facebook fits in. The American Journal of Family Therapy, 42, DOI: / Dedmon, J. (2002). Is the internet bad for your marriage? Online affairs, pornographic sites playing greater role in divorces. Press Release from The Dilenschneider Group, Inc., Nov. 14, Retrieved at: your-marriage-online-affairs-pornographic-sites- playing-greater-role-in-divorces html Delboy, S. (2015). Evidence-based practice for sex addiction: A clinical case illustration. Sexual Addiction & Compulsivity, 22, DOI: /

102. References (2):
Eldred, L. (2012). 5 Tips to Accountability on Smartphones. Retrieved at: Gilkerson, L. (2013) When Your Child is Looking at Porn. Owosso, MI: Covenant Eyes, Inc. Grubbs, J.B., Volk, F., Exline, J.J. & Pargament, K.I. (2015). Internet pornography use: Perceived addiction, psychological distress, and the validation of a brief measure. Journal of Sex & Marital Therapy, 41(1), DOI: / X Health and Medicine (2016). Findings from University of Nottingham in sexual and reproductive health reported (Pornography addiction in adults: A systematic review of definitions and reported impact). Health & Medicine Week, Retrieved from Hilton, D.L. & Watts, C. (2011). Pornography addiction: A neuroscience perspective. Surgical Neurology International, 2, 19. Karacic, S. & Oreskovic, S (2017). Internet addiction through the phase of adolescence: A questionnaire study. JMIR Mental Health , 4(2), e11. doi: /mental.5537 Kühn, S. & Gallinat, J. (2014). Brain structure and functional connectivity associated with pornography consumption: The brain on porn. JAMA Psychiatry, 71(7), doi: /jamapsychiatry

103. References (3):
Lambert, N.M., Negash, S., Stillman, T.F., Olmstead, S.B.& Fincham, F.D. (2012). A love that doesn’t last: Pornography consumption and weakened commitment to one’s romantic partner. Journal of Social and Clinical Psychology 31(4), Leahy, M. (2009). Porn university: What college students are really saying about sex on campus. Chicago: Northfield Publishing. Levert, N.P. (2007). A comparison of Christian and Non-Christian males, authoritarianism, and their relationship to internet pornography addiction/compulsion. Sexual Addiction & Compulsivity, 14, DOI: / Love, T., Laier, C., Brand, M., Hatch, L. & Hajela, R. (2015). Neuroscience of internet pornography addiction: A review and update. Behavioral Science, 5, doi: /bs Manning, J. (2005). Hearing on pornography’s impact on marriage & the family, U.S. Senate Hearing: Subcommittee on the Constitution, Civil Rights and Property Rights, Committee on Judiciary, Nov. 10, Retrieved at: f9e280e f735da10c87dc-1-3 Nielsen, E.J. & Kiss, M. (2015). Sexercising our opinion on porn: A virtual discussion. Psychology & Sexuality, 6(3), doi.org/ /

104. References (4):
Park, B.Y., Wilson, G., Berger, J., Christman, M., Reina, B., Bishop, F., Klam, W.P. & Doan, A. F. (2016). Is internet pornography causing sexual dysfunction? A review with clinical reports. Behavioral Sciences, 6. doi: /bs Poulsen, F.O., Busby, D.M. & Galovan, A.M. (2013). Pornography use: Who uses it and how it is associated with couple outcomes. Journal of Sex Research, 50(1), DOI: / Ribner, D.S. (2014). Editorial: The pornography question. Sexual and Relationship Therapy, 29(4), doi.org/ / Shim, J.W. & Paul, B.M. (2014). The role of anonymity in the effects of inadvertent exporsure to online pornography among young adult males. Social, Behavior and Personality, 42(5), doi.org/ /sbp Stefens, B.A. & Rennie, R.L. (2006). The Traumatic Nature of Disclosure for Wives of Sexual Addicts. Sexual Addiction & Compulsivity, 13, 247–267. DOI: / Stewart, D.N. & Szymanski, D.M. (2012). Young adult women’s reports of their male romantic partner’s pornography use as a correlate of their self-esteem, relationship quality and sexual satisfaction. Sex Roles, 67, DOI /s

105. References (5)
Szymanski, D.M. & Stewart-Richardson, D.N. (2014). Psychological, relational, and sexual correlates of pornography use on young adult heterosexual men in romantic relationships. The Journal of Men’s Studies, 22(1), DOI: /jms Szymanski, D.M., Feltman, C.E. & Dunn, T.L. (2015). Male partners’ perceived pornography use and women’s relational and psychological health: The roles of trust, attitudes and investment. Sex Roles, 73, DOI /s Štulhofera, A., Buškob, V. & Schmidtc, G. (2012). Adolescent exposure to pornography and relationship intimacy in young adulthood. Psychology & Sexuality, 3(2), 95–107 doi.org/ / Wilson, G. (2012). The great porn experiment. TEDxGlasgohttps:// Wright, P.J. (2010). Sexual compulsivity and 12-Step peer and sponsor supportive communication: A cross-legged panel analysis. Sexual Addiction & Compulsivity, 17, DOI: / Zillmann, D. (2000). Influence of unrestrained access to erotica on adolescents’ and young adults’ dispositions toward sexuality,” Journal of Adolescent Health 27, Zook, M. (2007). Report on the location of the Internet adult industry, in Jacobs, K., Janssen, M. & Pasquinelli, M., 2007) C’Lick me: A netporn studies reader. Amsterdam: Institute of Network Cultures, Retrieved at: