Organized Summary/Notes from the Best Porn Addiction Book

I've read and listened to Your Brain on Porn by Gary Wilson a few times.

However, it's a bit dense and it took me a few reads before I could consolidate the ideas that are spread throughout the book.

I've consolidated my notes below - feel free to suggest any additions. If you'd rather listen to this summary, I've published a summary video here.

Overview
Your Brain on Porn, written by the late Gary Wilson, is the most comprehensive book on Internet Porn addiction. If you're curious about the effects of internet porn (referred to as IP from now on), whether or not it is addictive, and how to stop watching it, this book will serve as the most useful resource to you.

Additionally, if you are experiencing issues, such as sexual dysfunction or undesired fetishes that you discovered through IP, this book can potentially help you reverse those issues.

Finally, if you find that you're not able to quit IP, this book can help you achieve that goal:

• Learn about the problems caused by IP, which is often compelling enough to help people quit.
• Understand IP addiction and why you're stuck in an endless cycle of trying and failing to quit.
• Get actionable advice for quitting IP, accumulated from research and thousands of success stories.
• Discover encouragement that might provide the push you need to finally kick the addiction.

Discovering a serious modern problem
In 2008, internet users discovered that IP was causing sexual dysfunction issues (erectile dysfunction, low libido) in their own lives. They noticed that erectile dysfunction only occurred in real-life encounters that were previously successful. Conversely, there were no erectile issues when viewing IP.

This motivated many online users to completely abstain from IP. Many reported a complete reversal of the issues they were having previously. At the same time, those who were able to quit noticed they no longer suffered from depression and social anxiety and they also noticed increased confidence and feelings of fulfillment.
These self-reports spawned numerous research studies and further anecdotal testing that continued to re-enforce these discoveries.

Despite the cause and effect that seemed pretty clear from self-reports, many also noted that they were unable to quit. As a result, they were never able to abstain long enough to notice any changes. This motivated researchers to look into whether or not IP could lead to addiction.

Early exposure
In 2008, 14.4% of boys were exposed to porn before the age of 13. By 2017, this number increased to 69% of males and 23% of females. 39% of males and 4% of females viewed porn daily - frequently via smartphone.
IP has become normalized and easily accessible to children during a critical stage in life.

Addiction vs. Compulsion
Does IP lead to addiction or is it just a compulsive behavior?
Addiction is about what happens in the person's brain, not the substance or behavior. - YBOP

Characteristics of addiction
Observations of IP users show characteristics of addiction:

• Inability to quit despite negative consequences - online communities like NoFap are massive due to the large amount of people who are unable to quit IP despite observing serious negative consequences from continued use.
• Tolerance - IP users become tolerant (numbed) to material they've been watching, so they escalate into more extreme genres.
• Withdrawal - Similarly to smoking, IP users experience withdrawal symptoms, which frequently keeps them coming back to their addictive behavior.
• Brain changes - IP users experience observable brain changes that are consistent with the addiction model. These are the observable brain changes:
  • Sensitization - unconscious memories of pleasure. Leads to powerful cravings when triggered.
  • Desensitization - numbed response to pleasure. Greater stimulation is required to achieve the same level of pleasure response, which is why IP leads subjects to seek out more extreme or novel IP. Also, everyday activities become less enjoyable because of desensitization caused by IP use, leading to mental health issues.
  • Dysfunctional prefrontal circuitry (hypofrontaility) - leads to weakened willpower for all activities that require willpower. This reduces ability to solve problems, make good decisions, and regulate goal-directed behavior. Basically this leads to poor self-control and prioritizing short-term pleasure over long-term reward.
  • Malfunctioning stress system - also leads to weakened willpower, amplifies cravings, and leads to withdrawal symptoms. Absence of the addiction triggers the malfunction stress system, which triggers anxiety, depression, irritability, and mood swings.

As of 2016, around 1 in 3 men self-reported that they thought they were addicted to IP (based on this assessment test).
Addiction assessment test (3 C's):

1. Craving and preoccupation
2. Loss of control in moderating the extent of the behavior
3. Negative consequences resulting from the behavior

The Perfect Storm for Addiction
IP leads to addiction because of how easy it is to access and the endless content provided by the internet. Addiction is not related to time spent watching, but variety and degree of arousal. High-speed IP makes it easy to switch between videos and find new and exciting content.

IP is addictive due to endless novelty, seeking behavior, and overconsumption.
The brain loses interest in familiar content (it's desensitized) and traditional methods (circa 2006) didn't provide easy alternatives to jump to. IP leads to addiction because the user can discover new and unique content with little effort.

The act of discovering unique (novel) content fires a strong response from the brain. The "seeking and searching" behavior is part of what keeps users hooked.

Interactions in the brain
Various interactions in the brain are hijacked to drive the addiction cycle.

• Dopamine - motivates you to do things that further your survival so that you can pass on your genes. Dopamine ultimately drives motivation and the absence of dopamine results in apathy. In the context of sex, dopamine explains the craving you get. This craving goes away once you've satisfied the urge and dopamine levels decrease.
• CREB - dampens pleasure response by inhibiting dopamine. This numbed pleasure response is also known as desensitization, which leads to tolerance, meaning you need a higher dose to achieve the same effect. CREP is designed to prevent you from continuous binging.
• DeltaFosB rewires the brain to remember and repeat an activity. This is what causes cravings. It connects associations (triggers) with the addiction. This is similar to how Pavlovs dog was conditioned to salivate to the sound of a bell. IP users are "triggered" by non-sexual cues, such as seeing a smartphone or the name of a IP site.

Coolidge effect & novelty
IP overrides CREB, which is supposed to prevent binging behavior, by providing easy access to novelty and even more extreme material.

Researchers discovered that a male rat would lose interest in a female right after mating. This is due to the brain not producing the same dopamine response when exposed to the familiar female rat. However, when a new female was introduced in the cage the rat would have sex with the new female. The rat experienced a surge in dopamine due to novelty. This is known as the coolidge effect.

IP addiction started in 2006 with the launch of the first "tube" site. Tube sites were "Youtube for IP" and provided endless novelty and short clips of the best parts of videos - facilitating the coolidge effect. It's no coincidence that thousands of users started reporting IP-related issues less than 2 years later.

Related Issues
IP addiction can lead to a variety of issues.

Sexual Dysfunction
IP can cause sexual dysfunction as confirmed by urologists who have experienced a surge in young patients seeking help with dysfunction issues that usually effect older men.

A shockingly high rate of dysfunction was discovered in a 2 year observation of adolescent males (age 16-21). 78.6% reported a sexual problem during partnered sexual activity over the period.
Specifically:

• Erectile dysfunction (45%)
• Low desire (46%)
• difficulty orgasming (24%)

Research reinforces the correlation between IP use and sexual dysfunction.
Furthermore, thousands of anecdotal reports show that quitting IP reverses sexual dysfunction. As a result, urologists might prescribe complete IP abstinence as a treatment option for patients who do not have a problem "below the belt."

Examples of sexual dysfunction include:

• Difficulty achieving or maintaining an erection during sex
• Delayed ejaculation (and sometimes inability to orgasm during sex)
• Premature ejaculation
• Lack of libido for real life partners, but seemingly high libido for IP.

Warning signs of ED
Often porn users report that delayed ejaculation (DE) or inability to orgasm (anorgasmia) was a precursor to full blown erectile dysfunction.

Any of the following may precede or accompany delayed ejaculation and erectile dysfunction:

• Earlier genres of porn are no longer exciting.
• Uncharacteristic fetishes develop.
• Porn use is more sexually exciting than a partner.
• Sensitivity of penis decreases.
• Sexual arousal with sexual partners declines.

Mental health issues
IP users are frequently diagnosed with social anxiety, low self-esteem, concentration problems, lack of motivation, depression, and performance anxiety.
Causes of mental health issues:

• Accumulation of CREB in the brain reduces dopamine produced from every day activities. This can cause depression.
• Malfunctioning stress system in the brain leads to withdrawal symptoms when away from the addiction.
• Escalating into more extreme content can cause panic due to the belief that their sexual orientations have changed, or that they must be closet perverts.
• Fear that they will never be able to have intimacy due to sexual dysfunctions.

Content Escalation
Because continued IP leads to desensitization, IP users inevitably escalate into more extreme genres. The brain seeks more dopamine via novelty, shock, forbidden content, kink, etc.

Some men even escalate into content that doesn't align with their sexuality.
Society attempts to write this off as if these people are discovering their true sexuality, but really these preferences are IP-induced.

Sexual interests can be conditioned. IP users find that unwanted sexual tastes go away when they quit IP.

Just like Pavlov’s dog learned to salivate to the bell, today’s porn users can learn to wire unexpected stimuli to their erections.

Treatment
Quitting IP is the only way to reverse IP-induced dysfunctions.

1. Reboot - Completely eliminate IP, IP substitutes, and recalling the IP you used to watch. This means no surfing for "soft-core" content or even mentally fantasizing. Note: Avoid any kind of artificial sexual stimulation: browsing Facebook, dating apps or erotic services sites for images will trigger similar addiction pathways in the brain and slow your reboot progress.

Most people aim for 3 months for a "complete reboot."
Timeline:

• 2-3 weeks for some
• 2-6 months (or longer) for most

1. Rewire - re-sensitize yourself to physical connection (if you have the opportunity). Prioritize interactions with real people in real life.

How to quit porn
Most IP users don't know that they are addicted until they try to quit. Many discover that they are unable to completely quit IP.

Understand Withdrawal
For some people, quitting IP triggers withdrawal symptoms, which causes them to run back to IP. It's important to anticipate and plan for these symptoms.
Common self-reports include:

• Irritability
• Depression
• Fatigue and insomnia
• Inability to focus
• Complete loss of libido (the flatline)

These withdrawal symptoms have been confirmed because returning to IP eliminated the symptoms. This is consistent with addiction.

One of the most dreaded aspects of quitting IP is the "flatline" - a **temporary** period of complete loss of libido and lifeless genitals. This is one of the most shocking side effects that is widely reported and it causes many men to return to IP in an effort to "salvage" their libido.

The Flatline
The flatline is a temporary period of low-libido that occurs in response to IP-abstinence. It’s a standard withdrawal symptom in guys with porn-induced erectile dysfunction, but it also happens to some who don’t have ED at the time they quit.

Push through Withdrawals
Initially the rebooting process can be challenging. Withdrawals can be painful physically, mentally, and emotionally. It's your brain’s way of motivating you to return to the addiction.

Recovery tips
Another frustrating thing about withdrawal symptoms is that recovery isn’t linear; it’s up and down. Some people only experience acute withdrawal symptoms during the first two or three weeks. Others still have sporadic withdrawal symptoms for months, informally dubbed ‘Post-Acute Withdrawal Syndrome’, or PAWS.

Clean house

• Completely eliminate all pornography from all of your devices. In addition to deleting any downloading IP, you should also set up a Porn Blocking System.
• Move your furniture around and potentially replace your "masturbation chair". Environmental cues associated with use can be powerful triggers.

Lifestyle changes
You can’t expect to live the exact same lifestyle you’ve been living and expect anything to change.

• Consider using your online devices only in less private locations. For example, build a habit of going to a coffee shop when you want to browse specific content. If you work from home, consider renting a dedicated office space.

Focus on building other sources of dopamine:

• Friendly interaction. "The opposite of addiction is connection". You can start simply: hang out and read in a library or bookstore, or take a magazine to a coffee shop or park bench. Attend group events with a set structure (meetups, church, toastmasters)
• Time in nature
• Exercise
• Accomplishment
• Creativity

Habits to break

• Limit activities that cause ‘empty’ dopamine highs, such as frequent, intense videogaming, junk food, gambling, trolling Facebook, Instagram, Tumblr, Twitter and Tinder, meaningless TV, and so forth.
• Avoid listening, watching, or reading negative, stressful, and anxiety-producing content (especially social media and the news).

Habits to build

• Track your progress using a day counter app and journal about your progress on a daily basis. This is helpful to keep you focused on your goal and to use reflection to determine what caused a "relapse."
• Build a habit of regularly exercising. This could be as simple as going for a walk, but this can be a powerful mood regulator.
• Change what you listen, watch, or read to focus on positive, uplifting, and motivating content.
• Regular cold showers can increase willpower and help regulate emotions

Alternative approaches

• Exposure Response Prevention Therapy (risky). Pavlov didn’t just teach his dog to salivate at the sound of a bell. He later taught it to stop salivating to the bell by ringing the bell and then withholding meat (repeatedly). This is risky, but some users reported success using exposure/willpower building techniques: Every time I was on my PC I would open a porn website. Once the site opened I would turn it off so I could test my willpower. Those first 2 weeks were the hardest by far and I still don’t know how I was able to do it.
• Acceptance and mindfulness therapy

Understand common triggers
The desire to watch IP is not always triggered by obvious sexual cues.

Common non-sexual triggers:

• smartphones (especially when used in bed at night)
• too much sugar or too many carbohydrates
• too much caffeine
• hot showers
• videogames
• endless content websites (YouTube, Imgur, Reddit)
• stalking old romantic interests on social media
• using the computer for a long time without hourly 15-minute breaks