Dopamine Substitution Therapy and Sex Addiction.

Best read while playing "I Love My Computer" from Bad Religion.

Excessive consumption of Internet porn, just like extreme masturbation techniques, can lead to physical problems, particularly a decrease in sexual appetite or libido that in turn leads to erectile dysfunction, according to Researchers such as Marnia Robinson, or Carlo Foresta, who calls it "sexual anorexia." The suggested mechanism involves physical changes to the brain. The arousal we experience from watching porn or masturbating comes from a release in the brain of the chemical dopamine. It lets us feel pleasure, and thus motivates us to perform actions that give us pleasure. Studies suggest that dopamine also activates sexual desire in the primitive parts of the brain, and in men activates the erection centers in the spinal cord. Messing up the dopamine system thus messes up sex really badly.

Superstimulation from the never-ending stream of porn available on the Internet leads to a sustained high level of dopamine in the brain. The inordinate amounts of dopamine trick its primitive parts into believing the activity is good for us, even if it is not. Thus we crave more porn or masturbation. Ultimately, though, the body cannot handle the constant dopamine flood, and compensates by reducing its physical response to the chemical. The brain desensitizes to dopamine, thus also reducing the pleasure that comes from watching porn, like a message that it had enough stimuli from overuse. Receptors disappear and production of the chemical may decrease, too. When dopamine drops, so does motivation. Since dopamine also helps a man get an erection, the numbed pleasure response to it can cause erectile dysfunction. Watching more porn or employing extreme masturbation techniques to force an erection makes the problem worse. Escalation leads to more desensitization. The addict cannot get it up and has lost potency. Gary Wilson shows the process in great detail at the Web site YourBrainOnPorn.com.

Our hunter-gatherer brains simply did not evolve to handle porn. Dopamine surges on novelty, so we are curious, explore new territories, or search for new mates. The dopamine producing machines Internet porn or extreme masturbation overburden our pleasure system to the point that it physically changes to protect itself. The number of dopamine receptors in the brain declines, so fewer neurons can fire on dopamine release. Nerve cells that fire together wire together to form memories, however. The more we use them the stronger they get. Our reward circuitry thus rewires to a strong porn pathway, so the traditional pathways get ignored more and more. Not only does the pleasure we experience overall decrease, but what little we feel gets channeled along the strongest circuits that are now wired to porn and masturbation. It becomes difficult to get an erection without very strong stimuli.

Of course, responses vary from person to person. Researches distinguish among different forms of this dysfunction, such as it only happening with a partner, or complete impotence even when watching porn. There are other causes, too, such as performance anxiety, or medical conditions like diabetes. To understand the differences read "Is my erectile dysfunction (ED) related to my porn use?"

The research does not condemn porn or masturbation per se, or even occasional superstimulation, but excesses. Basically it is about addictive use of porn or particular sexual practices. Women, too, can become desensitized from overuse of masturbation.  Overeating triggers a body response just the same. Like sex, food is not bad, but if you overdo it, your body will react. Substitute the word "junk food" for "porn" and everything said here would apply. Any superstimulation has the potential to become addictive. As "Romy by any Other Name" deals with addiction to alcohol and drug, the similarities with porn were particularly interesting for me.

1. The research further supports the thesis that addiction has a physiological component. It is not all "in the head," as many people like to tell addicts. Porn addicts can abstain. Judging from the testimonies the reasonable time period of a few months and the high success rate helped motivate the men. Many of those who succeeded admitted, however, that breaking the habit was very hard to do. In the case of severe substance addiction free will alone may not suffice to break the habit. Detoxification from alcohol already takes month, and recovery can take years. The addict may then need medical treatment and additional motivation to stay with the program. Professional counseling and therapy certainly helps people cope with any addictive behavior.
2. At least in the case of Internet porn addiction, the changes are reversible in a few months by "rebooting the brain," i.e. returning the sensitivity to dopamine to normal by giving the brain time without stimulation. With abstinence from porn the brain also rewires as the porn pathways weaken. Men who stop viewing porn initially suffer from withdrawal symptoms that lessen their sexual desires even further, but over time recover their libido.
3. The loss in sexual appetite due to desensitization to dopamine agrees with similar claims from alcoholics and drug addicts. Not only do many of them need progressively larger doses of their "drug of choice" to feel good, they have less pleasure in other areas, too, particularly sex. Any addiction that overloads the dopamine receptors and leads to tolerance can cause erection problems. Ironically, addicts pay a tremendous price in less pleasure later for the initial highs they get.
4. A key to recovery is finding pleasurable alternatives to porn. Going back to it just reactivates the porn pathways. Substance addictions involving dopamine works the same way. That does suggest that the "dopamine substitution therapy" I utilize in "Romy by any Other Name" is possible, that is one can try to break an addiction to a substance by substituting an addiction to, for lack of better word, love. Theoretically, that is. The book delves into the practical problems of providing stimulation over a prolonged period, as drugs can, through touching and kissing.

Testimony from some men does suggest that "dopamine substitution therapy" can help cure erectile dysfunction from desensitization. Research indicates that recovering from porn addiction is fastest with elimination of intense sexual stimulation, particularly masturbation and orgasm. Playful touching and kissing may actually help, however, as it produces oxytocin. This "cuddle hormone" is one of the chemicals needed for an erection in addition to dopamine. The benefits of "slow" sex have been known for a long time in practices such as coitus reservatus. By contrast, testosterone supplements don't work for this particular dysfunciton, because the pathway still involves dopamine. A brain desensitized to dopamine cannot be helped by chemicals, such as Viagra, Cialis, or testosterone, that deal with other medical conditions. There are no quick fixes to problems caused by addiction.

Finally, a few last words for those scientifically inclined. Yes, "dopamine substitution therapy" is a misnomer, since it actually substitutes the pathway to dopamine, not the chemical itself. The term sounds better than "alcohol/nicotine/drugs substitution therapy," though, doesn't it? An interesting scientific question remains. If too much porn can so screw up the brain's pleasure response, can too much sex with real people do the same? I think multi-year medical studies with volunteer test persons should be funded to answer this important question. Where do I sign up?

More Information

Erectile Dysfunction at YourBrainOnPorn.com: http://yourbrainonporn.com/erectile-dysfunction-question

Marnia Robinson: http://www.psychologytoday.com/blog/cupids-poisoned-arrow/201107/porn-induced-sexual-dysfunction-is-growing-problem

Carlo Foresta: http://www.ansa.it/web/notizie/rubriche/english/2011/02/24/visualizza_new.html_1583160579.html 

Overuse of vibrators: http://www.psychologytoday.com/blog/cupids-poisoned-arrow/201106/vibrators-and-other-pleasures-when-moderation-fails

Could Love Have Saved Amy Winehouse?: http://socyberty.com/sexuality/saving-amy-could-love-have-saved-amy-winehouse/

Coitus reservatus: http://en.wikipedia.org/wiki/Coitus_reservatus

"Amy Winehouse found dead in her London home." That's not the headline I wanted to read after writing a book where the male protagonist goes to great length to support a star in her journey to break her addiction to alcohol. Is my premise just plain wrong? Must the story of Marilyn Monroe or the "Forever 27" club, celebrity musicians like Janis Joplin and Kurt Cobain that died at age 27, repeat forever and ever?

I don't think so. In "Romy by any Other Name" Peter has a chance encounter with famous actress and singer Rose after her latest stint in rehab and jail. Determined not to let another girlfriend go down the deathly, destructive path of alcoholism, he showers her with love and affection, while firmly imposing rules to limit her consumption. Amy had no such person.

Winehouse died alone from as yet unknown causes. Rumor has it she had a fight with her supposed boyfriend over her relationship with her ex-husband. Had someone been with her that night, he could have called paramedics when there was still a chance to revive Amy. Only a boyfriend could realistically be with her in her bedroom all the time. The security man who checked on her was in the apartment, but in another room.

A boyfriend like Peter could have possibly prevented the chain of events leading up to her death to begin with. Winehouse's management tried to ban all alcohol from the hotel before her disastrous concert in Belgrade. Amy managed to get drunk or high for the concert anyway. A boyfriend that was with her most of the time would have made that much harder. As it says in the book, Peter is in Rose's room, between her and the mini-bar. Alone the embarrassment of Peter catching her with alcohol may moderate her behavior.

After all, others can push and prod, the addict herself has to decide to change her behavior. Someone she loves very much can provide the motivation to kick the habit that so many addicts cannot find on their own. Amy supposedly said so to a former British tabloid in 2009: "I'm in love again, and I don't need drugs." While her father pushed her in the right direction, a boyfriend may have had more and lasting success. Blood ties are one thing, but someone who loves her for herself out of his own volition can be a much more powerful motivator. Especially if she fears losing that love. Feeling loved by someone special also can help deal with many root causes of addiction such as depression and self-doubt. The behavior of Lindsay Lohan, who many people suspect will suffer a similar fate as Amy, also seemed to moderate when she was in a stable relationship.

Of course, this double-edged sword cuts both ways. Loved ones often allow the addictive behavior to continue by being enablers that engage in denial. Many claim that it was Amy's beloved husband that led her down the destructive path of drugs and alcohol. For love she jumped off the cliff with him. Then she could not find a lasting love to climb back up with.

Admittedly Peter's positive influence on Rose is the most unrealistic part of the book. Dealing with an addict is difficult. Although psychologists agree someone with long running addiction problems like Amy Winehouse or Lindsay Lohan requires intense one-on-one counseling, they are thinking of trained professionals. Most boyfriends lack the knowledge or experience to stand up to an addict. When the going gets tough they are more apt to leave. I acknowledge as much in the extremes I had to go through to guilt Peter into supporting Rose. It is an idealized view where the motivation for "counseling" is higher than going to an untrusted, unknown therapist. It also takes away the excuse of high costs that both Amy and Lindsay have cited as a reason against individual counseling sessions.

Could love have saved Amy Winehouse? We will never know. Her death should encourage us to learn how to better deal with addiction, for ourselves and our friends and family: get help, give support, and intervene firmly when needed. It's difficult to pull off, I'll admit. That's why my book is fiction where I can pick the ending. To paraphrase another quote from it: real life often does not have a Hollywood ending. Rest in peace, Amy.

\\/olf

Published at http://socyberty.com/sexuality/saving-amy-could-love-have-saved-amy-winehouse/

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