Regan McMahon, Special to The Chronicle
Monday, February 22, 2010

A 50-year-old married physician views Internet pornography for hours at home, masturbating five to seven times a day, then begins surfing porn sites at the office and risks destroying his career.

A woman spends four to six hours a day in Internet chat rooms and having cybersex, and eventually starts arranging to meet online strangers for casual sex in the real world.

A man spends many hours a day downloading porn, filling multiple hard drives, and devotes a separate computer just to pornography.

A married couple view pornographic movies together as part of their loving relationship, but the husband starts spending more time watching and less time with his wife, who feels left behind and rejected.

These scenarios are real-life examples of pornography addiction, a compulsive behavior that falls within the category of sex addiction - which has been in the spotlight since the explosive revelations of golf champion Tiger Woods' numerous sexual infidelities.

Millions of Americans struggle with porn addiction for years in secret, without getting caught, and continue their behavior even after it begins to have negative consequences in their life. For some individuals, images are enough, and they remain locked in the fantasy world of pornography. For others, Internet porn is a gateway to compulsive and risky sexual behavior with others.

Up to 8% addicted

The National Council on Sexual Addiction and Compulsivity estimates that 6 to 8 percent of Americans - or 18 million to 24 million people - are sex addicts. And 70 percent of sex addicts report having a problem with online sexual behavior.

"Sex addiction is an acting-out symptom," explains marriage and family therapist Jason Saffer, co-director of the Center for Creative Growth in Berkeley and a specialist in treating sex addiction. "It allows a person to mood-alter away from emotional pain that resides deep inside. In treating addiction, we have to stop the unhealthy behavior, but then do the work to find out what the underlying emotional pain is."

If people want to escape feelings of low self-esteem, shame, isolation or the pressures of life, work or relationships, pornography is a place to get lost and feel wanted, imagining the perfect partners who always desires them - and whom they can always satisfy.

"Like with any addiction, it's a predictable way to soothe," says San Francisco psychotherapist Gregory Rowe. "I've talked to soldiers back from Iraq who say the Internet centers there are jammed with soldiers masturbating to porn. It's a way to manage their anxiety.

"For 90 percent of men, images are a big source of stimulation," he says, whereas women - an estimated 25 to 30 percent of online porn users - tend to prefer interactive chat rooms. ComScore Media Metrix, a company that measures Internet usage, reports that more than 70 percent of men age 18 to 34 visit a pornographic site in a typical month.

"Porn addiction is a huge problem because people lose jobs over it," Rowe says.

In 2008, Nielsen Online reported that one-fourth of employees use the Internet to visit porn sites during their workday. Online porn sites report that highest usage is between the hours of 9 a.m. and 5 p.m.

According to the Web site Divorcewizards.com, huge numbers of divorce lawyers report that pornography is a big issue in divorce these days, which it never was before the advent of the Internet.

The anonymity of the Internet, says Drew Tillotson, a San Francisco psychologist who specializes in porn addiction, allows one to connect with others in chat rooms or online reality games such as Second Life without fear or insecurity, crafting an image of oneself or an avatar that bears little resemblance to who the person is in real life.

Dana Iscoff, a San Francisco psychotherapist who has treated sex addicts, says it is particularly difficult for patients to stay away from Internet porn because "we are always on our computers, and it's always available."

Goal: healthy sexuality

The big difference between substance addiction and sex addiction, says psychologist Brigitte Lank, founder of the Lank Institute for Sexual Addiction and Recovery in San Rafael, is that "the treatment goal is not abstinence; the goal is healthy sexuality. This is an intimacy disorder as well as an addiction."

Lank says addictive masturbation often goes in tandem with porn addiction, but for many users the goal is not to climax but rather to maintain arousal and be on that brink of orgasm for four, six, even eight hours. "It really starts to become a fetish."

The addicts who spend hours downloading, categorizing and storing porn display behavior similar to that of hoarders, she says. "The same kind of obsessive-compulsive aspect is part of the anxiety. You get comfort and satisfaction just knowing it's there, like having a lot of toys in the toy closet. It gives you a sense of mastery and control."

San Francisco marriage and family therapist Julian Redwood, who specializes in treating patients with pornography addiction, says the biggest problem is that there is a physiologically addictive nature to porn and all sexually addictive behavior. People build up a tolerance and need more and more stimulation to achieve the same high. "So someone might start by looking at images of a normal heterosexual couple having sex and then move on to watching bestiality or sex with children. People push their edge."

Sexualized culture

Twenty percent off all Internet porn involves children, according to a 2003 study.

"Online porn is so much about the hunt," Redwood adds, which is part of why people spend so many hours at it, at the expense of their jobs, family, social life and sleep. They keep searching for the image or video that is going to turn them on. It's similar to the drug addict going out to score the drug, or someone into prostitutes cruising the red-light district. "But there are lots of people who would never go to a prostitute who engage in Internet porn."

Saffer says the availability of Internet porn has increased the prevalence of sex addiction behaviors, especially in young people, who live in a more highly sexualized culture than existed 15 or 20 years ago.

Previously, a young boy might be thrilled to get his hands on a copy of Playboy to glimpse photos of naked women. But nowadays, boys and girls can watch Internet videos of people actually having sex, some of it violent.

"I'm amazed that more parents don't use parental controls on their computers," Redwood said. "It's like letting your kids play with crystal meth."

"The danger," Saffer says, "is it creates such a distorted view of what sex is and its place in a relationship."

Resources

Here are some resources for dealing with pornography addiction, including therapists and free, 12-step-type support groups:

Drew Tillotson: http://www.sexaddicthelp.com

Brigitte Lank: http://www.drlank.com

Julian Redwood: http://www.julianredwood.com

Jason Saffer: jasonsaffer@creativegrowth.com

Dana Iscoff: (415) 474-4567

Gregory Rowe: http://www.gregoryjrowe.com

Porn Addicts Anonymous: http://www.pornaddictsanonymous.org

Sex Addicts Anonymous: http://www.saa-recovery.org

Sexaholics Anonymous: http://www.sa.org

Society for the Advancement of Sexual Health: http://www.sash.net

E-mail Regan McMahon at datebookletters@sfchronicle.com.