“When I stand before thee at the day’s end thou shalt see my scars and know that I had my wounds and also my healing.” — Rabindranath Tagore1
Recovery from addiction requires that we understand the causes of addiction and develop healthier methods to address those needs. While substance abuse recovery treatment work has its own four pillars,2 recovery from pornography addiction and other compulsive sexual behaviors must get at the root causes unique to this form of addiction: attachment, emotional regulation, core beliefs about identity, and brain-based elements. Thus, treatment approaches to aid an addict’s recovery from sexual addiction must address these four areas.
In this article, we’ll take a look at the last of the four pillars of recovery from sexual addiction which focuses on Brain-based Elements. If you missed the first three articles about Attachment, Emotional Regulation, and Core Beliefs About Identity, be sure to check them out on the Lifestar blog.
Brain-based Elements
Most people are surprised to discover that process addictions such as compulsive gambling, compulsive porn use, compulsive exercise, and compulsive shopping have a physiological impact on the human brain, but the growing body of research shows that it does.3 As a result of neuroplasticity – the brain’s ability to change, “rewire,” or reorganize itself in response to stimuli and repeated behavioral responses – the human brain is constantly adapting and changing based on how we respond to experiences.
For example, we know little babies and children who are provided nurturing and stimulating experiences have their brains developed in healthier ways in comparison to the brain development of neglected children. Human brains develop “neural pathways” every time we repetitively engage in behaviors that are rewarding and stimulating. Our brain sends a biochemical called dopamine from one brain cell or neuron to the next as a reward. Dopamine causes a reward center in our brain to feel good and creates a sense of thrill, excitement, or anticipation of good things. There’s nothing wrong with dopamine in and of itself, but when a person uses porn as the most common (or exclusive way) of generating excitement and pleasure, they form a neural pathway that truncates out other forms of enjoyment. There’s an old saying that “neurons that fire together wire together.”4
When the neuron that is actively sending dopamine in response to porn use becomes the dominant way to get excitement and enjoyment in life, the other nearby neurons make that connection, and the neurons related to other fun things like playing catch with your child, going fishing, or playing a musical instrument get neglected.
There are, of course, other biochemicals involved in the process. Research5 has shown that in addition to dopamine, adrenaline, norepinephrine, serotonin, oxytocin, vasopressin, DeltaFosB, and endorphins also play a role in human sexuality and sexual addiction, but dopamine is the main biochemical underlying addictions. One researcher describes the role of dopamine in addiction in the following:
“Dopamine is the neurotransmitter involved in the mesolimbic system that coordinates all natural reinforcing behaviors (eating, drinking, sex). It is also the primary neurotransmitter that most addictive drugs are known to release. Dopamine plays an important role in reinforcement and is part of the reason why craving occurs. Sometimes referred to as a pleasure chemical, dopamine focuses our attention on things that have significance to us.”6
The significance of dopamine to sexual addiction cannot be understated. We can actually map the parts of the brain where the neural pathways are deficient during active porn addiction.
Porn and sex addiction affect many parts of the brain, but the prefrontal cortex seems most affected. What SPECT scans show is that the area in the prefrontal cortex (the front part of the brain) where all of a person’s executive functioning skills are located has less and less activity flow as a person becomes addicted to porn and sexually compulsive behaviors. As a result, a porn-addicted brain looks like this:7
Now, let me be clear that it is not the actual structure of the brain that is changed, but rather the “activity flow” of the neural pathways of the brain that is measured by the scans. What looks like two gaping holes at the top of the porn addict’s image is the area of the prefrontal cortex. This is the area of the brain where decision-making, impulse control, willpower, empathy for others, forward-thinking, and organization skills (among many others) are controlled. Thus, an addict’s brain is impairing the very things they need to overcome the addiction. Fortunately, research has shown that the brain can heal after abstaining from compulsive sexual behavior.8
Some research shows short-term healing in the first few months of recovery, with even more significant healing after about a year, and full restoration of the brain after about three to five years. Though sexual addiction can be a lifetime battle, the road generally gets easier after the first couple of years.
Dr. Patrick Carnes offers the following general timeline for recovery:
“Sex addiction expert Patrick Carnes conducted a study that covered five years of addiction recovery. Carnes suggests a timeline for six stages of recovery.3
1. The Development Stage: This is the stage prior to acknowledging there’s a problem. Some are here only briefly. For others, it takes years. Some people never recognize there’s a problem with porn. The timeline won’t start until someone is past this stage.
2. The Crisis/Decision Stage (0-3 months): This stage lasts anywhere from one day to three months. “At some point, the addict crosses a line where there is a fundamental commitment to change.” For many, it’s a life-shaking crisis, such as being caught looking at porn at work or a spouse threatening to leave. For others, it’s simply a decisive moment when they choose to no longer be controlled by porn.
3. The Shock Stage (1-8 months): This stage may be the most difficult for individuals in recovery. Carnes advises, “Disbelief and numbness alternate with anger and feelings of separation.
Addicts describe physical symptoms of withdrawal that are at times agonizing. They also report disorientation, confusion, numbness, and inability to focus or concentrate. Feelings of hopelessness and despair become more intense as their sense of reality grows.”
4. The Grief Stage (6 months): This is where someone begins to deal with the pain caused by porn. They also dig into the underlying causes of their porn use, which can result in a period of deep grieving and emotional turmoil as these issues are unearthed and dealt with.
5. The Repair Stage (18-36 months): Once the grief stage is complete, the person in recovery focuses on learning balance, self-care, and positive habits that can replace porn. This is an exciting and positive time for people in recovery. Based on Carnes’s timeline, this period can last up to three years.
6. The Growth Stage (2+ years): This is the final stage of recovery. It marks a mature outlook on life and one’s relationship with porn. They can look back on their addiction to porn with gratitude for what they’ve learned. Dr. Carnes says, ‘Relationships with partners, friends, children, and family go through a period of renewal. Here, too, is where life-satisfaction measures showed improvement in the study.’
“Dr. Carnes found that most slip-ups occur six to twelve months into recovery, but those who persisted experienced increasing success after this.”9
The LifeStar program of the Central Valley encourages healthy brain recovery from sexual addiction by encouraging activities that strengthen and heal the prefrontal cortex and re-introduce healthy forms of acquiring dopamine in a variety of ways. This vital aspect of brain-based elements of healing is one of the key differences that distinguish LifeStar from other treatment approaches.
Conclusion
In summary, LifeStar of the Central Valley is uniquely poised to offer treatment for pornography and sexual addiction and other sexually compulsive behavior disorder-related concerns because it is based on four pillars of recovery specific to sex addiction: attachment, emotional regulation, core beliefs about identity, and brain-based elements. Our ten “dailies” (ten activities each participant in the program does on a daily basis to support their recovery) are based on these four pillars of sexual addiction recovery.
They include making a connection to themselves and their emotions (attachment and emotional regulation), a connection to God or their Higher Power (attachment), a connection to their spouse, partner, or key people in their life (attachment), and a connection to their accountability partner and group members (attachment). Other dailies include healthy sleep (brain-based elements), healthy eating (brain-based elements), healthy exercise (brain-based elements), and having dopamine-producing “fun” in wholesome ways (brain-based elements). Finally, we encourage the participants to engage in Mindful Self-Compassion exercises/meditations (core beliefs about an identity of worth) and to use the tools we teach in the program to fight and abstain from lust.
As the addicts participate in LifeStar, engage in the workbook and other reading materials, and honestly work the “dailies,” they will likely see their whole lives transformed in healthy, happier ways. We’ve seen this work in the lives of so many we’ve already treated, and we hope to see this recovery program work in the lives of many more who struggle with this dreadful addiction. Be sure to check out the rest of the blogs about the other pillars and if you’ve read them all, we appreciate you sticking with us through the month.
References:
1 Tagore, Rabindranath. (2012, Kindle Open-Source Edition). Stray Birds, #290.
2 See https://kimberlycenter.com/recovery/the-four-pillars-of-recovery/
For substance addiction, the U.S. Federal agency SAMHSA (Substance Abuse and Mental Health Services Administration) lists Health, Home, Purpose, and Community as their four pillars. Extending from that, pornography and sexual addiction have four pillars to consider: Attachment, Emotional Regulation, Core Beliefs about an Identity of Worth (as opposed to an Identity of Shame), and Brain-based Healing.
3 See Hilton & Watts (2011) at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050060/
Also see: Doidge, Norman (2007). The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York, NY: Penguin Books.
Wilson, Gary (2015). Your Brain on Porn: Internet Pornography and the Emerging Science of Addiction. Kent, UK: Commonwealth Publishing.
And see: https://fightthenewdrug.org/how-porn-can-change-the-brain/
4 See Doidge, Norman (2007). The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York, NY: Penguin Books, pp. 63-66 for a good discussion of neural map-making.
5 See Struthers, William M. (2009) Wired for Intimacy: How Pornography Hijacks the Male Brain. Downers Grove, IL: InterVarsity Press.
6 Struthers, William M. (2009) Wired for Intimacy: How Pornography Hijacks the Male Brain. Downers Grove, IL: InterVarsity Press, pp. 100-101
7 See https://www.linkedin.com/pulse/pornography-brain-m-renee-kuhn-lpc
8 Doidge, Norman (2007). The Brain that Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. New York, NY: Penguin Books.
9 See https://www.covenanteyes.com/2021/11/03/how-long-does-it-take-to-recover-from-porn-addiction/
By: Kyle N. Weir, PhD, LMFT
LifeSTAR of the Central Valley helps individuals, partners, and families to heal from the effects of pornography and sexual addiction. Complete our Self-Evaluation today to discover if LifeSTAR is right for you.
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