Early exposure to pornography: a form of sexual trauma
- Posted by Caroline Giroux
- Posted in Editorials & Commentary, Trauma
Vol 10 #15 December 7, 2021
Caroline Giroux
Author information:
Associate Clinical Professor, Psychiatrist, University of California, Davis Medical Center, Department of Psychiatry and Behavioral Sciences, Sacramento, California, USA. [email protected]
Many years ago, a young father in his twenties was getting in trouble with the law because of repeated inappropriate exposure of his genitals in public. He also had explosive outbursts with destruction of property. During the first sessions with him, I was struck by his juvenile, almost child-like expression, with incongruent affect regarding his behavior, probably stemming from a lack of insight. His poor ability to deal with frustration, to regulate anger and impulses indicated some form of developmental arrest. Months (and another child) later, after gradually investigating his past and trying to understand what had led to his dysregulated sexuality, he eventually disclosed that when he was a child, his dad made him watch pornography. It was disturbing to try to imagine the effect of potentially overwhelming, arousing but also degrading images on a forming, innocent brain. Unlike erotic scenes in a movie or nude sculptures in a museum, pornography generally involves power dynamic, humiliation and a distortion of the reality around body and sexuality. In my opinion, it is a form of sexual trauma, just like witnessing a car accident or parental domestic abuse can be traumatic for the observer.
Another case example was a 16-yo who was admitted to the hospital after ingesting acetaminophen and NyQuil. He said he wanted to die because his masturbation caused him too much distress. He admitted doing it too much, and that it interfered with his studies. He had poor grades, failed his driving test many times, and had difficulty concentrating due to this. He also said that he had abstained from masturbating during three months and was doing great. I asked him if there was a clash of beliefs around sexuality in his family (I had seen another patient, a female, who had been raised Mormon and was apparently not taught about various aspects of sexuality, which might have led her to later become addicted to pornography. I had also heard of a young man who was raised Pentecostal and whose mother had avoided providing basic sexual education to him and who later on watched pornography). He said no. Then I asked if he had ever been touched inappropriately. He also denied. Then, remembering my patient from years ago, I asked him about pornographic material. He acquiesced, and talked about a “virus on the phone” that projected some images when he was 6. When I explored how he felt seeing this (I gave him a choice of answers including pleasure, disgust etc.), he said “pleasure”. This seemed to have induced a form of conditioning. He also disclosed having intrusive images of that material.
The following day, we were called to assess an 18-yo who had been admitted due to severe burns on both hands after he had put them under boiling water. He apparently had a diagnosis of schizophrenia. He explained having done that due to feeling “unclean”, and referred to the Bible. He also mentioned praying and fasting to cleanse himself. He was staring a lot, seemed guarded and avoidant of certain questions. One question led to another, which culminated in his disclosure of watching pornography on YouTube. I asked if he had a counselor and he said yes. I recommended processing this in that space if he felt safe. He terminated the interview so no more info could be gathered, but having the 16-yo boy’s story fresh in my mind, I tried to convey compassion by telling him that there were other people experiencing similar concerns, and that help was available to him. Schizophrenia was not as high on my differential as trauma-related disorder. I also immediately wondered if this was yet another devastating effect of the months-long pandemic-related isolation. How many other teenagers or young adults were suffering in silence, craving for social contact, crippled by shame?
For the majority of young people, the psychosexual stage of development can be a bumpy road full of complex, contradictory, overwhelming sensations and emotions. Looking back, one might realize it was not optimally harmonious (adolescence can be so confusing, tumultuous, and messy). Puberty, auto-erotic activities, physical attraction towards a person, peer influence, navigation of distance towards parental figures, regulation of sexual impulses, curiosity around body and intimacy, conflict with religious conceptualizations of sexual organs and sexuality, and erotic fantasies are all areas that most people had to face and integrate or resolve at some point in their development. With healthy modeling from adults and influential figures, coping strategies, scripts and narratives from the media, cinema, and society, many can eventually find fulfillment in this meaningful dimension of their being.
As a psychiatrist, I see various manifestations of the other reality, when this stage has not been properly protected, respected and nurtured. Experiencing sexual abuse in childhood, adolescence or emerging adulthood is an obvious mechanism that may affect in a major way how the survivor perceives and deals with sexuality or intimacy throughout the lifespan. It can be hard to make sense of a human dimension that can be perceived as both blissful and horrific, and to resolve the dichotomy between pleasure and trauma depending on the context (consensual sex versus rape). Avoidance of this sphere altogether (discussion, relationships) is then understandable but doesn’t solve the problem.
Exposing children to pornography should be forbidden and better regulated, as it is violating their spiritual boundaries and evolving beliefs around body, sexual development and intimate relationships, in a similar way that direct sexual abuse on their body does. If this trauma is not identified and processed promptly, the survivor runs the risk of reenacting as an attempt to resolve what once left him or her powerless, or of even engaging in similar criminal behaviors. Or one may trivialize what is considered sacred by many, hence squandering delicate, soulful facets of one’s self, engaging in promiscuous, high-risk sexual activities.
This sub-optimal integration of sexual themes and behaviors that we might tend to label as “sex addiction” can even reach the degree of violating others’ sexual boundaries. In addition to evaluating a few sex offenders at the beginning of my career, years later I have also met some patients who had committed various degrees of inappropriate or excessive sexual behaviors.
Etiological research has suggested that it is the interaction of biological and social learning factors that influence the development of sexual offending behaviors [1]. Genetic factors may predispose an individual to pursue a specific human need (e.g., sex or intimacy), but it is the environmental experiences (e.g., child maltreatment) that provide the methods for which these needs are met either appropriately through the development of relationships or inappropriately through the use of sexual violence [2]. This means we have no excuse as a society to not invest resources in prevention of sexual trauma of any kind.
In a study by Lin et al [3], sexually explicit media exposure in early adolescence was strongly related to three risky sexual behaviors—early sexual debut, unsafe sex, and sexual partners—in late adolescence, and this relationship was very close to causal. The association was dose-response, such that using more modalities of sexually explicit media led to a higher probability of being involved in risky sexual behavior later in life [3].
In summary, exposure to pornography is not trivial. It can have traumatic effects leading to significant distress, disruptive behaviors, compulsive sexuality and even suicidal attempts. Until our society becomes more aware to the point of preventing this by regulating access to such materials more effectively, psychotherapy should be the main intervention to address the unresolved trauma, help the person deal with shame, anger, remorse, and to decondition in order to facilitate the integration of healthier scripts and perceptions of sexuality. It will also contribute to break the cycle of trauma. A medication reducing impulsivity might be indicated in some cases, or even an SSRI if we want to use the sexual side effects to the patient’s advantage.
Once again, this phenomenon illustrates the more prominent influence of life experiences and exposure in the “nature versus nurture” paradigm. When we screen for ACEs (adverse childhood experiences), we should inquire about such exposure, at what age, the degree or dose, and its impact on the person’s views and behaviors around sexuality. Our youth has been especially affected by the brutal decrease in social connections at the beginning of the COVID-19 pandemic. Overwhelmed tele-working and homeschooling parents might not have been able to monitor the kids’ access to the internet as effectively. I think we need to keep our eyes wide open and remain attentive to our children and patients and decode the suffering, while doing inquiry like a detective. In our highly digitalized world, access to a plethora of sexually explicit media needs to be more regulated and monitored. It is important to educate and raise awareness about this preventable trauma, and also strive to protect the human body for the temple that it is, as well as its precious functions, including sexuality, a dimension that can be beautiful, spiritual and fulfilling by adding a thread to the bond between two people.
References:
- Ward T, Beech AR. An integrated theory of sexual offending. Aggression and Violent Behavior, 11 (2006), pp. 44-63
- Simons DA, Wurtele SK, Durham RL. Developmental experiences of child sexual abusers and rapists. Child Abuse & Neglect. 2008 May 1;32(5):549-60.
- Lin WH, Liu CH, Yi CC. Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood. PloS one. 2020 Apr 10;15(4):e0230242.
