Essential Tools for Recovery from Pornography and Sex Addiction

CEUs are available for this presentation at AllCEUs.com/Porntrap-CEU Hey there everybody and welcome to this video on the porn trap based in part on the book by wendy and larry montz i'm your host dr donnelly snipes in this video we're going to explore the prevalence of pornography use reasons people watch porn and the hidden power of porn the consequences of porn 10 action steps that you might use if you are having a problem with porn then we're going to talk about handling relapses and identifying strategies for healing as a couple so let's start out with what

is porn pornography a lot of people automatically think of pornhub or video based porn but pornography is any sexually explicit or erotic video audio pictures or pros and when we talk about prose uh lady chatterley's lover comes to mind this is a book that was released decades ago but when it was released it was considered quite racy for the time the definition of what pornography is does not rely on how graphic it is but the person's relationship to it that is does it sexually arouse the individual and involve them in a fantasy or in a

relationship with it pornography use is actually relatively common and it's important to note here that in this video i'm not saying that all pornography use is bad that is a decision that an individual has to make what we're talking about in this video is how pornography use can become problematic and the effects of compulsive or problematic pornography use in any event a lot of people engage in the use of porn and most of the studies really look at video based porn they're not considering the text based they're not considering the images like playboy magazine or

penthouse or hustler if those even still exist and they're not considering pros so what we're really talking about is video 36 of men and 16 percent of women aged 18 to 39 years report having consumed pornography in the prior week now we know that 36 percent of men and 16 percent of women are not having problems with pornography are not quote addicted to pornography so it's important to recognize that like a lot of other things there is recreational use and then there is compulsive or problematic use another study found that 94.2 of college students had

viewed pornography before starting college now people start college 17 18 19 years old which means they were viewing it in high school in early adolescence and we're going to talk about how that can be problematic because the adolescent brain is so much more malleable and susceptible to neuronal changes and damage as the result of addictive behaviors so why do people watch porn well there's a lot of reasons and remember i said pornography use in and of itself is not necessarily bad and that is a personal moral judgment call that each individual has to make and

we're going to talk i'm going to try to present a fair and balanced view if you will of pornography in this video some people watch pornography to enhance their sexual arousal and or facilitate masturbation through fantasy sometimes couples watch together to enhance their sexual arousal and then they end up in having sexual relations sometimes people enhance their sexual arousal in order to facilitate masturbation because they cannot access their significant other for some reason or maybe they don't have a significant other at that point in time and they don't want to just hook up with anybody

some people watch porn to learn the mechanics of sex and increase their sense of sexual confidence there there is the talk that some parents have with their children not all parents have the talk with their kids but there is the talk that some have with their kids but a lot of times it does not get into the nitty-gritty of the mechanics of what's going on so some people explore for curiosity reasons to learn in order to enhance their sense of competence so they feel more confident going into sexual relationships some people watch it because they

enjoy it some watch it to improve their relationships maybe they want to add some spice to the bedroom and they don't know exactly where to find information about it or different techniques or maybe it's something that their partner wants to do with them there are a lot of reasons some people watch porn to relieve loneliness there are some studies out there that have looked at people who watch porn especially people who develop a problematic relationship with it and it can be uh used when somebody does not feel self-confident enough or their self-esteem is too low

to engage with another person whether it be whether it's because they have body image issues or because they have concerns about their prowess in the bedroom there are a lot of different reasons but there's a lot of pressure for people when you're in a real life sexual encounter and so some people that anxiety is too much so they engage in fantasy relationships with the pornography as i mentioned some people watch porn because their partner wants them to it's a mutually agreeable act and the only time they watch it is when they watch it together some

people watch porn to relieve boredom some watch it to decrease shame they look for pornography that highlights activities that they like to do that highlights things that are um well things that they like to do or that represent them more in order to decrease shame in order to feel like hey there's other people out there that do this to improve mood when people watch pornography it creates a tension within them it creates the release of a lot of different neural chemicals that we're going to talk about in a minute but that can improve mood it

can improve energy in some people and the release of dopamine and other endogenous opioids and other things when a person masturbates also improves mood so people may be using porn as a tool or as a self-medication strategy as i mentioned some people watch porn to see people like themselves represented especially if they have are self-conscious about themselves for some reason then they may seek out porn that represents them some studies indicate that people watch porn to confirm their sexual orientation they watch porn to figure out what is it that excites me what types of people

excite me and some people just watch it out of habit that's what they've done and it's what they will continue to do unfortunately porn can have a hidden power and one of the powers is called the coolidge effect our brains are programmed our primitive brains are programmed to tire of one partner or stimulus but have a powerful automatic response to novelty so people for example that have been married for 50 years and have been in a monogamous relationship for 50 years may have difficulty getting as excited about each other but they have a powerful stimulatory

response to novelty to pornography the brain interestingly enough doesn't differentiate very much between 2d what a person sees on the screen and 3d partners so video based porn can be especially video based porn can be particularly stimulating for people and trigger that sexual arousal the desire and motivation to pursue sex arises largely from dopamine which motivates you to do things that further your survival and the survival of the species remember dopamine is not actually a pleasure chemical it's a motivation i want to do that again i want more of that chemical when you do that

again when you want more of that then there's a release of serotonin and norepinephrine and endogenous opioids and all kinds of other pleasure chemicals and the brain goes oh yeah let's get the dopamine out so to encourage us to do that again sexual stimulation offers the biggest natural blast of dopamine available to your reward circuitry now when we say natural blast that means things that you can do without ingesting chemicals or herbs or something something that is endogenous you're using your own internal chemicals porn can give people the illusion of power and control they can

envision themselves in this fantasy with another person they can visualize themselves being more competent or well competent in the bedroom and interestingly with porn there's something called a variable ratio schedule of reward and that is one of the hardest schedules to extinguish because if you get a reward every single time you do something then if that reward disappears you quickly kind of lose interest in it basically but variable ratio means that you don't exactly know when you're going to find that video that does it for you that stimulates your arousal so you may watch three

and then find a really good video and then five and find a good video and then one you know the very next one is another great video so it keeps people pressing the button pressing the lever so to speak in order to get that hit of dopamine in order to get that arousal video porn is far more arousing than static porn because it involves more senses and is more lifelike video porn you've got audio you've got visual that's going on as well as when people start to get excited they start to secrete pheromones so they're

smelling their own pheromones and so you start to get this trifecta to increase sexual arousal and raise declining dopamine people can instantly switch genres so like internet gaming that goes on and sometimes there's no actual end to a game and there's always constantly new novelty same thing with porn if one thing starts to get boring then you can switch to something else unfortunately with porn one of the things that they have found in the research is that people often go from more normative pornography to things that are less normative harder core and potentially more problematic

porn videos have been shown to replace people's imagination and may shape their sexual tastes behavior and trajectory especially in adolescence and it's important to recognize that watching porn you know it kind of hijacks your brain so you may remember what you saw in the video but it removes people's sense of imagination in real life where you're thinking about in this situation at this context and in at this time what could i do how could i improve this situation porn often just takes you to that place where you're like i want to recreate that vision so

it's much more disconnected much more role oriented as opposed to intimacy oriented it can also shape sexual tastes if you see if a person sees something a lot they may think it's far more common than it really is or if they see something that seems to produce a lot of pleasure or produces pleasure in themselves then that intense rush of neurochemicals they get may encode that as something that they want to do in real life pornography is stored in your brain once you've seen it you kind of can't unsee it which allows you to recall

it anytime you need a hit unlike food and drugs for which there is a limit to consumption you can eat only so much before your stomach bursts you can use drugs only so much before you overdose there are no physical limitations to internet porn consumption the brain's natural satiation mechanisms are not activated unless one climaxes so you can keep watching porn for you know hours or longer the satiation mechanism doesn't kick in until the person climaxes but even if they climax after a trajectory a refractory period then they're able to resume their resume the behavior

so it is important to recognize that porn is something that can end up taking up a whole lot of time so how does porn actually affect the brain let's just talk about some neurochemistry because you all know that that's one of my favorite topics your endogenous opioids are the main reward chemical your pleasure chemicals interestingly some studies have found that naltrexone has it is effective for blocking the endogenous opioids and reducing the reward and and may stimulate testosterone dopamine is the main motivation chemical so remember i said the ear endogenous opioids are the pleasure chemical

but dopamine says oh i want to go get more of that dopamine all about seeking and searching for rewards the anticipation and the wanting so dopamine goes up as tension builds when the person achieves the reward then they get that release feeling dopamine provides the motivation and drive to pursue potential rewards or long-term goals interestingly you know we think about dopamine as again something that says we want to continue to do that but dopamine is a perseverance chemical it's a motivation chemical that motivates us to survive it's not just for pleasure it's for survival so

dopamine is released to encourage us to seek novelty food sex and safety anything that violates expectations that produces shock surprise or more than we could have imagined will often trigger the release of dopamine if it's shock or surprise the dopamine may be released so we can seek and search for safety if it is novelty or more than we could imagine and it's just thrilling then dopamine is released because it says oh i want more of that strong emotions that can be elicited by porn which include desire guilt disgust embarrassment anxiety or fear all can elicit

dopamine for different reasons strong emotions elevate dopamine and boost norepinephrine and cortisol that increase excitement and amplify dopamine's effects so dopamine itself is pretty powerful but then when you add cortisol and other excitatory neuro neurochemicals then you've got motivation and energy and they amplify one another now obviously when we have positive emotions like desire then dopamine is going to say i want more of that when we have other strong emotions like guilt disgust embarrassment anxiety or fear dopamine may be released in order to encourage us to seek safety but if when those strong emotions are

released and that hpa access your stress response system is triggered cortisol norepinephrine excitatory neurochemicals are released your brain has difficulty differentiating is this good dopamine or is this bad dopamine it's dopamine it says i want more of that over time a porn user's brain can mistake feelings of anxiety or fear for feelings of sexual arousal so that feeling they get if they feel guilty about what they're doing but it's paired with a opioid rush it's paired with that release with that feeling of pleasure then that feeling of anxiety may start to be coupled or lead

the person to expect pleasure that feeling of anxiety may trigger reminders of porn which lead to viewing porn and masturbation and pleasure internet porn can alter brain circuitry for sexuality especially during adolescence when the brain is highly malleable and programmed to learn all about sex during adolescence there are a lot of physiological changes hormonal changes as well as neurological changes that are taking place that are designed to increase people's awareness of their sexuality you know a two three four year old often doesn't think about sex a 12 13 14 year old does and that's partly

because of just normal physiological changes where the brain saying okay puberty's hit you can reproduce now so let's get interested in perpetuating the species so i mentioned that porn used in and of itself is not necessarily problematic um and some people could argue that the way it shapes people's expectations about um about sex can be problematic we're not debating that here what we're talking about is when pornography becomes a compulsive behavior or an addiction the american society of addiction medicine defined addiction as addiction by saying 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 using a substance or other behavior so they change their definition of addiction to include behavioral or process addictions now the icd-11 which is the alternative to the dsm-5tr added compulsive sexual behavior disorder as code 66c72 but it goes on to really break down the criteria for diagnosing pornography addiction or compulsive sexual behavior disorder now compulsive sexual behavior disorder applies to sex as well as pornography in order

to be diagnosed the person only has to have a persistent failure to control intense repetitive sexual impulses or urges that includes watching porn masturbation sex for at least six months as evidenced by one or more of the following so the threshold is pretty low here significant health and personal care or other interest activities or responsibilities are given up so the person can engage in sex porn masturbation unsuccessful efforts to control or significantly reduce the repetitive sexual behavior the person continues to engage in repetitive sexual behavior despite adverse consequences so a person who is able to

stop when they start experiencing adverse consequences would probably not qualify for this particular diagnosis continues to engage in repetitive sexual behavior even when they derive little or no satisfaction from it so that's a really broad definition and since the person only needs to meet one or more criteria for at least six months it means that it's really pretty easily applied to people who are presenting for treatment so from a reimbursement standpoint that can be a good thing additionally compulsive sexual behavior disorder must not be explained by another mental disorder for example mania or hypomania when

people are in a manic or hypomanic episode they may display hypersexuality there are other mental health issues that may also be displayed as hypersexuality we also want to examine whether it's due to another medical condition traumatic brain injury in the right places can potentially trigger hypersexuality or due to the effects of a substance or medication that triggers hypersexual desire or in the case of addiction to another substance some people may engage in sexual behavior in order to get their substance of choice they're engaging in even though they derive very little pleasure from it but it

is the means to an end the behavior results in marked distress or significant impairment in one or more areas of functioning the icd-11 does indicate that individuals who make or are concerned about religious or moral judgments about their own sexual behavior may describe themselves as sex addicts or describe their behavior as compulsive the clinician is advised to consider whether such perceptions are due to internal or external judgments or whether there's evidence that impaired control over sexual impulses urges or behaviors exist now that's a nice little note but if you go back to the diagnostic criteria

um the person may meet criteria based on cultural prohibitions against sex but remember the first criteria the main criteria is a persistent failure to control intense repetitive sexual impulses or urges for at least six months so let's talk about the relationship with porn what is what do we mean relationship well people are likely to become emotionally and physically attached to something that they regularly turn to for emotional comfort so if somebody is using this in order to alleviate feelings of depression anxiety boredom what have you then when they can't access it those feelings may become

completely overwhelming so they turn to that and they are emotionally attached to it we already talked about physical attachment we're going to talk about a little bit more in a minute because there are brain changes that result when the brain is regularly flooded with dopamine there are hormonal changes that take place when the brain is regularly flooded with dopamine and when that hpa axis or that stress response system is regularly activated so what is this physiological conditioning excess masturbation can be the signal to your primitive brain that you have hit the evolutionary jackpot it's like

hey there's a lot to go around and i'm spreading the i'm perpetuating the species in a big way with regular over consumption high levels of dopamine trigger the production of delta phosb which initiates several brain changes including sensitization so you may be thinking well i was thinking about tolerance well we'll get to tolerance in a minute sensitization is when the brain wires together sensory stimuli so the computer the room you're in the um whatever a sensory stimuli what you see what you smell what you hear emotions how you're feeling when you're doing it and memories

associated with a big reward so if there's a big reward your brain says oh i want to remember how that happened so i'm going to take in all of these stimuli and all of these associated triggers and i'm going to lump them all together so next time i encounter that trigger or any of those triggers i remember how to get that reward again so they create a pathway to the reward center that can be activated by cues or triggers which create cravings which is why we see in people who start to develop compulsive sexual behavior

disorder that things as benign as computers or internet access or a particular time of day can trigger these urges and cravings that feel extremely powerful desensitization or decoupling of those triggers with that stimuli occurs when stimuli become old and the person needs novel stimuli so remember we talked about the coolidge effect if they keep watching the same thing then it's not going to produce as big of a reward and when that reward gets bland enough then the person may start see seeking out something else now i did mention the adolescent brain and you know i'm

passionate about the adolescent brain because it is and i've used the analogy before a clay pot think about making a clay pot before it has been fired before it has gone into the kiln how malleable it is and that is the adolescent brain it's really easy to break it to modify it to morph it once it goes into the kiln then you know it's it's either solid or it's broken the adolescent brain is malleable like that they have an immature prefrontal cortex which is where we have impulse control executive functioning over responsive limbic or emotional

circuits an overactive dopamine system the adolescent instead of going yeah that sounds like something i might want to do is it's either i'm not interested or i'm all in there isn't the there aren't the degrees that we see in people who have a fully developed brain they have a more pronounced hpa axis or stress response because of their over responsive limbic circuits they when their hpa axis kicks off it kicks off more intensely they have a greater flood of excitatory neurochemicals so you see what sometimes we call more emotional dysregulation in the adolescent which can

be for positive things like in response to sex and masturbation as well as uh dysphoric things like anger anxiety depression which sometimes are self-medicated with porn and masturbation and there are also in male biologically male adolescents augmented levels of testosterone what are the negative consequences of compulsive compulsive sexual behavior disorder when the person cannot access their drug of choice when their dopamine levels start to drop they may become easily irritated depressed they may isolate or objectify people when they start using pornography regularly because they are regularly in this world where these things are normal and

typical and then when they are in in real life the expected behaviors may be somewhat different so we may start to see a change in how people perceive their partners and perceive other people even without compulsive sexual uh behavior they may neglect important life areas there may be sexual dysfunction people who regularly engage with pornography because vanilla sex or mainstream sex may be old hat that coolidge effect is kicking in so it may be harder to get aroused by what is more mainstream in real life likewise they may since they've been exposed to so many

different quote partners through pornography they may have difficulty getting aroused by their real life partner they may experience relationship issues because they start objectifying their significant other because of sexual dysfunction because of loss of interest in real life sex because of disagreements about whether porn is appropriate or not there are a lot of reasons and i have another video um called love you hate the porn that is based on a book called love you hate the porn that talks about some of the psychological effects of pornography use on the non-porn using partner but that's a

whole different presentation pornography use can cause shame and guilt in some people some people have no problems with it other people do it may include escalation into risky areas and that can mean online risky areas or it can mean trying to um experiment with some of the things that they see in porn in real life which may be pushing some boundaries and it can lead to physiological and psychological craving or need for pornography risk factors for the development of compulsive sexual behavior disorder or porn addiction include associating porn with pleasure or release relief of dysphoria

if this is one of the only ways somebody can feel relief or experience pleasure then that's a risk factor if they are dealing with untenable stress anxiety or depression they may be self-medicating in order to increase their dopamine serotonin and opioid levels if they have a lack of social supports then that can contribute to feeling untenable stress anxiety depression or loneliness which again can make them more at risk unrestricted access to porn now again a lot of people are on the internet a lot of people theoretically could have unrestricted access to porn however especially for

adolescents that have more difficulty with that impulse control and for people who started to develop problems with it then unrestricted access can be more problematic or for example when there were all of the quarantines a lot of people were locked in their house by themselves and they weren't able to go to work they weren't able to interact in real life with other people so we did see more engagement with online pornography people who had early access to porn in childhood and early adolescence experience brain changes that make them more sus can make them more susceptible

to problematic pornography use the frequent use of porn with masturbation makes them more at risk if porn is used by itself and then they engage in sexual activity with a partner that's less of a risk but if the porn use is associated with masturbation then it can become more problematic because it doesn't rely on that other person being there so we start having more unrestricted access to release people who have difficulty with intimacy including trust abandonment and communication are also at greater risk as i mentioned some people will engage in fantasy relationships with the people

that they're watching in porn because it is too stressful to engage with people in real life and then people who have non-traditional sexual interests may seek out um validation may seek out stimulation through pornography because that is not something that they are able to find in real life protective factors include disliking porn having limited contact with porn especially before age 25 which is when that prefrontal cortex solidifies matures feeling sexually secure and satisfied in real life wanting to experience emotional intimacy high self-esteem confidence and a sense of personal efficacy or competence in life as well

as in the bedroom and secure attachment relationships in childhood that help the person develop emotional intelligence or the ability to identify and modulate their own emotions and form a solid sense of self and self-esteem they have started looking at pornography literacy programs recognizing that pornography is probably not going anywhere and pornography literacy programs attempt to mitigate the negative impact of porn by helping people think more critically about the pornography they viewed increasing their awareness that porn tends to be somewhat unrealistic in a number of ways including heteronormative themes sexual behaviors and even the kinds of

bodies that are depicted in the in the pornography so let's talk about recovery strategies first the person has to want to quit they've got to want to alter their behaviors and for people who've developed compulsive sexual behavior disorder a lot of times it's recommended that they abstain from pornography for a period of time at least and i make the analogy of somebody who it drinks somebody who's an alcoholic would likely not try to recover by using controlled drinking that is a very hot button topic pornography is not essential to life so developing a motivation to

be willing to give up pornography for a period of time is one of the first steps so have people create a vision board of their rich and meaningful life what people things activities and values are important to them and i do have a video on the youtube channel that talks about how to create a vision board for a rich and meaningful life if you want to go into details on that once the person has the vision board so they can see what's important in their rich and meaningful life they've actually gone to the trouble of

thinking about it and creating a visual representation then having them regularly ask themselves when they start having a craving does using porn help me get closer to those people things activities and values that are important to me or does it move me away does it use my energy in a way that doesn't nurture those things or worse yet harms those things you can also use a decisional balance exercise and this is a very common activity that's used in motivational interviewing you create a chart that looks like this you have benefits and drawbacks on the far

column and then across the top row stop using porn or keep using porn why do we have keep using porn because there are benefits people that were using it were using it for a reason they were getting a reward so it's important that we acknowledge those benefits and potentially figure out alternate ways to meet those needs other than porn so in the first quadrant the benefits to stopping using porn how is it going to make me feel better emotionally and that can be they may feel less guilty they may feel more relieved we don't know

and that's up to each individual person for emotional benefits of keeping continuing to use porn could be relief from depression boredom and anxiety so that's one of those functions that porn is serving that in therapy needs to be a treatment target how can we help people meet those emotional needs how can we help them feel happy even without using porn benefits to stop using porn how does it make logical sense how will it improve their um attitude and their ability to concentrate and focus well you know what if they're not obsessing about porn all the

time then they may have some more mental clarity mentally the cravings that happen when they're not using may be a benefit to continuing to use porn so we want to look at how can we help people deal with those obsessive thoughts ruminations cravings whatever you want to call them physically the benefits to stop using porn can include increased energy it may include increased sexual uh functioning benefits to continuing to use porn physically some people will say that using porn and masturbation helps them relax and go to sleep again that's a treatment target there's a lot

of ways to help people get better sleep besides pornography interpersonally what are the benefits to stopping using porn and what are the benefits to continuing to use porn and then financially and legally you'd look at both sides and then you go down to the drawbacks and some of these are going to be repetitive from what we just went through but it's still helpful to get very granular with people to help them identify their motivations to quit as well as their obstacles or apprehensions to quitting so what are the drawbacks emotional drawbacks to stopping porn well

anxiety and feeling overwhelmed maybe what are the mental drawbacks physical interpersonal financial and legal so you can go through all of those with the person write it down don't just sit there and talk about it like we did but actually have them write it down so they can go back and they can look at it when they start having cravings they can see the reasons that they want to use they can see the alternatives to achieve the benefits of pornography next steps tell somebody about the problem now this is easier said than done for a

lot of people it's like well who do i tell a lot of people start out by telling a doctor or a therapist maybe a sponsor a coach or a significant other and then establish 24-hour accountability now obviously with a doctor and a therapist they're not going to be there to hold you accountable 24 hours a day so somebody that is outside of that realm is going to be important but you need to reach out for support if you've already tried to quit that's part of the diagnosis and have been unsuccessful then you're going to need

to add some additional tools to your toolbox create a porn free environment you can use a family oriented internet service provider or cable change your email so you're not getting flooded with pornography or triggering emails likewise i know i get tons of spam that is completely inappropriate for what i want to see in my inbox but i have set my spam filters very very high and i have my spam folder automatically delete mine is every 30 days but my guess is you can set it to delete at the end of every day install what i

call net nanny programs these are programs that are on all of your digital devices that report to someone else when you're going to an unapproved website so that way you can't go to the library or to a coffee shop or somewhere and get on somebody else's wi-fi but with your mobile device call ahead to hotels and have porn movies not available on your particular television so none of those pay-per-view things don't drive by adult stores don't drive by places that are triggering for you and add competing stimuli if as most of us do you spend

a fair amount of time on the computer or on your mobile device because of work or because that's how you communicate with your friends there can be some very benign reasons for doing that if you pair it so it's an uncomfortable situation to watch porn or masturbate then that will help decouple that particular stimulus so on your mobile device you know obviously you have a net nanny program but then you can also have on your lock screen a picture of your kid or a picture of your mom have pictures on your desk and around your

computer that really kind of take the motivation for porn away whether whether it's religious icons or family or something else that can be helpful it's not going to do everything but it does tend to sort of dampen the mood get involved in treatment or self-help programs in these programs you you're going to need to identify and address your vulnerabilities and those are some things that you may have identified if you went through the decisional balance exercise with somebody but identify and address your vulnerabilities what physical or emotional states what times of day what environments what

relationships might make you more vulnerable to being triggered might make you more um there's just not another word i can find vulnerable to triggers in your environment sometimes for example you can be in front of a computer and not be triggered you're not vulnerable at that point maybe because you've got pictures of your family all around it or something but other times the environment you're more vulnerable in the environment because you're by yourself and there are not those competing stimuli around so identify and address your vulnerabilities and a lot of those are probably going to

be time of day mood and access and then triggers what things or emotional states or physical states trigger your desire to use trigger your cravings when you're already vulnerable and then all of a sudden you see a particular store or you're in a particular environment then you may be triggered or your compulsion compulsive thoughts may be triggered explore the function of pornography or compulsive sexual behavior in your life what purpose is it serving and what are alternative ways to meet those needs address underlying physical psychological and relationship issues physical issues we do need to look

at those make sure a person gets a physical to make to assess whether they're dope um testosterone levels are within range whether their other gonadal hormones are in range whether there is thyroid dysfunction whether there is you know anything else going on physiologically that might be contributing either to hypersexuality or to depression and anxiety if somebody is has hypothyroid they may feel they may label it as depression and they may be trying to self-medicate with pornography and masturbation so we want to address the underlying physiological issues that are contributing to not only directly to the

porn use but to the reasons people want to use porn address underlying psychological and relationship issues including communication and start healing your sexuality what what i mean by this and start healing your sexuality is start defining what a healthy sexual relationship looks like for you and what does it mean does it mean caring for somebody sharing a genuine connection with a partner healthy communication with that person now not all people are enthralled by what is sometimes termed vanilla sex it is more mainstream sex there are people that also embrace kink and embrace bdsm but all

of that involves communication healthy communication and in the kink community there's a saying safe sane and consensual so it's important that people no matter whether they're engaging in quote vanilla sex or very traditional sexual behaviors or things that are more non-traditional that they are communicating with one another and respecting each other's boundaries and that these sexual encounters enhance each person and their self-esteem we don't want people leaving sexual encounters feeling bad about themselves or ashamed about themselves in terms of relapse relapse prevention is a lot like what you addressed in treatment but it's just kind

of making sure that you don't end up going back down that road there are five different types of relapse physical or behavioral relapse is occurs when you start engaging in the behavior again and triggering those tsunamis of neurochemicals affective or emotional relapse is when you start experiencing depression or anxiety or other emotions that may have triggered the or be associated with pornography use and that pornography use maybe to alleviate the feelings of boredom or depression or anxiety cognitive or mental relapse is when you start justifying well i can watch a little or i can watch

it with my partner or i can watch it in this particular situation when you start justifying minimizing and denying then that can be a road to relapse environmental relapse is when you start taking away any of those things in the environment that prevents you from accessing the porn or remind you not to access the porn so you get rid of the nanny apps you take away the firewalls you start going to sites online so you're bringing that porn into your environment and relational relapse can be for example starting to engage in more non-intimate sexual behaviors

engaging in more masturbation and fantasy relationships or engaging in more one-night stands one-offs and unemotional sexual encounters for relapse prevention you need to know your triggers and how to prevent them when possible or when you when the triggers exist how to mitigate them so if you go somewhere like maybe you're staying at your family's house or a friend's house and they have the internet and computers there and you know how to get on their internet or computer they may not have the firewalls so how do you mitigate that trigger so you're not obsessing about getting

on that computer and viewing porn one of those ways maybe to have them password protect their computer and not give you the password but it's important to know if i encounter this trigger this thing that makes me start thinking about and craving porn how can i mitigate it how can i keep it from hopefully triggering those cravings develop healthy alternatives to viewing porn or masturbation so when you do start having those cravings what else can you do that can help you feel pleasure that can distract you that can help you quote ride the wave learn

to stress tolerance skills i talk about this as the b theory when you have a b on your arm it's kind of like having a craving your urge is to swat that bee away you know you don't want that bee there well with cravings you don't want to um feel the way you're feeling you want to make that feeling go away well if you swat the bee it's likely going to sting you if you give in to your urges it's likely going to end up with negative consequences practice mindfulness if the more mindful you are

the earlier you're going to notice early warning signs of relapse prevent and mitigate your vulnerabilities physical vulnerabilities maybe you tend to be more vulnerable to being triggered when you're tired or environmental vulnerabilities maybe you tend to be more vulnerable to being triggered when you're at home alone so figure out how you can address those things add in pleasure to your life do other things to increase your dopamine whether that's exercise or playing with your dog or flying a kite or rock climbing or whatever it is develop a support system and an emergency plan when you

start feeling urges or cravings what are some steps that you can take in order to manage that situation in terms of healing as a couple an intimacy oriented approach to sex involves creating ground rules regarding emotional and physical safety you know how can we reconnect in a safe way engage in courtship with one another and i encourage you to watch the video on love languages and figure out how to communicate love for your significant other in a way that is using their love language and i also have another video on increasing intimacy in order to

help improve the relationship practice looking at each other with love just gaze into each other's eyes and see how that impacts you become more mindful when you're with your partner stay focused on the sensations the sights the smells the sounds the non-verbals of your partner when you are with your partner not just in sex but anytime in order to start becoming more aware of the moment and not have your thoughts out there talk with your partner about sexual likes dislikes needs etc and you can go online and search for something called a yes no maybe

list and there are a lot of them out there some more detailed than others but this can serve as a opening way to initiate this conversation where you can both fill it out and exchange it and then you can talk about it explore the realm of sensual pleasure with your significant other it doesn't necessarily need to lead to sex initially but start out by just getting back to basics holding hands foot back head massages sitting in a hot tub together experiencing aromatherapy or practicing different forms of touch like feathers or massage balls pornography is everywhere

unfortunately it can hijack people's primitive drives for survival and reproduction although it doesn't always do that pornography is not always bad to begin to change the process if pornography has started to become problematic for somebody it's important to describe how they envision a rich and meaningful life the effects pornography has had on them and how it keeps them from achieving their rich and meaningful life identifying triggers and vulnerabilities for use and preventing or mitigating them as much as possible identifying needs that porn fulfills and alternate methods for meeting those needs practicing mindfulness and getting support