Understanding How Dopamine, Sexual Stimulation, and Modern Pornography Affect the Brain

Conversations about addiction—especially when pornography is involved—can easily become confusing.  

This guide will walk you through these misunderstandings in clear, practical language, helping you understand how the brain actually responds to sexual images, sexual stimulation, and addictive patterns of behaviour. 

 

Error #1: “Dopamine does not underlie addiction.” 

Dopamine is often misunderstood. It’s true that dopamine does many normal things in the body—helping with movement, motivation, and decision-making. But plenty of online commentary jumps from that fact to the claim that dopamine is irrelevant to addiction. According to every major expert in addiction neuroscience, this simply isn’t true. 

Addiction of any kind—whether to a substance or a behaviour—depends on repeated bursts of dopamine. When someone engages in an activity that the brain interprets as rewarding, dopamine is released. If those bursts are strong and repeated, the brain begins forming powerful learning loops. This process is not unique to addiction; it’s the same kind of learning that helps us form habits. But in addiction, the learning becomes deeply ingrained in ways that override healthy choice. 

For example, when someone regularly views pornography, the dopamine spikes associated with arousal pair the reward with whatever cues came right before it—being alone, opening a laptop, scrolling to a certain site, a feeling of stress, or even a specific name or fantasy. Over time, these cues begin to trigger dopamine by themselves. This is why cravings often feel like they come “out of nowhere.” 

Another common misunderstanding is that dopamine is the “pleasure molecule.” Dopamine isn’t about pleasure itself—it’s about wanting, looking, anticipating, and seeking. Pleasure chemicals are different. But when dopamine’s “wanting” system becomes overtrained, it can lead to compulsive behaviour—wanting long after the pleasurable effects have faded. This helps explain why someone might continue a behaviour even when they no longer enjoy it or when it begins to harm relationships, work, or mental health. 

This learning process is now understood as a major hallmark of addiction. Modern definitions of addiction—including those from the American Society of Addiction Medicine—consider addiction a disorder of reward learning. In other words, it’s not only about behaviour, and it’s not only about chemicals—it’s about how the brain has been trained over time. Once these pathways are reinforced, they become like deep grooves that are easy to fall back into unless someone makes active, sustained efforts to retrain the brain. 

 

Error #2: “Sexual activity is no different from playing with puppies.” 

It’s easy to think that if two activities both activate the reward system, they must affect the brain in similar ways. But not all natural rewards have equal neurological impact. 

Sexual arousal and orgasm produce some of the highest natural dopamine and opioid levels the brain can generate. In fact, animal studies show that the dopamine surge from sexual stimulation is comparable to the dopamine produced by certain drugs. Other natural rewards—like eating or petting a puppy—activate the reward system, but not nearly as powerfully. 

Sexual stimulation is also unique because it activates the exact same nerve cells that drugs like cocaine and opioids stimulate. Food and water do not have that level of overlap. Because of this, sexual arousal has the potential to create stronger learning pathways in the reward system than almost any other natural behaviour. 

This does not mean sex is “bad.” It means sex is powerful. It is meant to be reinforcing because it ensures the continuation of the species. But the same power that makes sexual reward natural and important also makes it vulnerable to hijacking. 

Addictive drugs exploit these same pathways. So can certain behaviours—especially when they combine high dopamine, novelty, repetition, and emotional triggers. Pornography, in particular, activates these reward circuits much more intensely and consistently than natural sexual experiences. 

The brain changes associated with sexual stimulation can be temporary and normal, but pornography’s endless novelty and rapid pace can amplify them. For example, research shows that orgasm leads to temporary reductions in dopamine cell size within a major reward system structure, similar to changes seen with drug use. Other hormonal and neurological shifts also occur exclusively during sexual climax. 

An important study in the year 2000 showed that when cocaine addicts viewed pornography, their brains responded almost identically to when they viewed cues related to cocaine use. In contrast, viewing neutral nature scenes created completely different activation patterns. In other words, sexual content lights up the brain in a very specific way—distinct from ordinary pleasure. 

No one builds the internet’s most profitable sites around watching puppies. They build them around sexual stimulation because of how strongly the brain responds to it. 

 

 

Error #3: “Modern porn affects the brain no differently than the static porn of the past.” 

Older generations may remember porn as magazines or VHS tapes—limited, slow, and repetitive. Today’s internet pornography is something entirely different. Modern porn delivers: 

  • Unlimited novelty 
  • Instant access 
  • High-definition video and motion 
  • Algorithm-driven suggestions 
  • A constant path to more extreme or diverse content 

This matters for the brain because novelty triggers dopamine. Research consistently shows that new sexual images produce stronger arousal than familiar ones. When a user can click endlessly to new scenes, they can maintain dopamine spikes far longer than would ever occur in a natural sexual environment. 

Scientists call this type of stimulus supranormal—an exaggerated version of something the brain is designed to find rewarding. The Nobel Prize–winning scientist Nikolaas Tinbergen showed that animals could be tricked into preferring artificial, exaggerated versions of natural stimuli, even to their detriment. Modern internet porn functions similarly: a hyper-stimulating version of sexual cues that can override the pull of real relationships and intimacy. 

Because today’s porn combines powerful sexual reward with unlimited novelty, it can foster stronger conditioning than older forms of porn. This does not mean everyone who uses porn becomes addicted. But it does mean today’s environment poses higher risks, especially for younger brains, which learn quickly and respond strongly to dopamine. 

 

Why these matters 

These three misunderstandings are often spread by people who want to reduce stigma or help others feel reassured. The intention may be good, but the science is clear: the brain plays a central role in shaping sexual behaviour, habits, and addiction. The genitals may be involved in sexual experience, but the brain is the true driver of desire, motivation, and behaviour. 

Understanding the brain’s role in pornography use doesn’t imply shame—it empowers people. It explains why certain patterns feel hard to change, why cravings can appear suddenly, and why willpower alone is often not enough. Most importantly, it shows that change is absolutely possible, because the same brain that learns unhealthy patterns can also unlearn them and build healthier ones. 

If you or someone you care about is struggling with compulsive pornography use, this knowledge is meant to help—not to blame. With the right support, the brain can adapt, heal, and build new pathways toward healthier, more fulfilling choices. 

Addiction and Compulsion or Something Else in Problematic Pornography Use (PPU)

Series 3 

The terms addiction and compulsion is often a subject for debate in PPU. Some say pornography is not addictive, some say it is. When people present with pornography use that feels “out of control,” and that involves harmful dependencies, they often ask a very understandable question: Is this an addiction, a compulsion, or something else entirely?  

In making an assessment about PPU, I use the definition from:-  

The World Health Organisation ‘s authors of the International Classification of Diseases, 11th Revision (ICD-11) announcing the classification of Compulsive Sexual Behaviour Disorder (CSBD) as a mental illness. The components of this are listed below. 

  1. Being pre-occupied and out of control with persistent repetitive sexual behaviour. 
  1. Continuing with the sexual behaviours despite harmful consequences, i.e., neglecting your health, personal care or other interests, activities and responsibilities and causes a significant impairment in personal, family, social, educational, occupational or other important areas of function. 
  1. Numerous attempts to reduce or stop the sexual behaviour despite adverse consequences or deriving little or no sexual satisfaction from it. 
  1. The pattern of behaviour to control intense, sexual impulses or urges resulting in repetitive sexual behaviour is manifested over a period of time – 6 months or more. 

 

Distress that is entirely related to moral judgements and disapproval about sexual impulses, urges, or behaviours is not sufficient to meet this requirement. 

 

Whilst this definition seems to suggest CSBD is an impulse control disorder rather than an addictionI offer services for people struggling with problematic pornography use, pornography addiction, sex addiction and compulsive sexual behaviours.  However, I do agree that these behaviours can be on a spectrum and follow the training and guidance of The Association for the Treatment of Sex Addiction and Compulsivity (ATSAC: www.atsac.co.uk). I offer a flexible approach viewing to make pornography addiction/compulsion approaches more integrative and avoid pathologizing or judging people with diverse sexualities.   

 

Ultimately my goal is not to label you; you may describe or find you own words for how you are. My aim is to understand your experience so you can regain a sense of control and peace. 

When Pornography Use Feels Like an Addiction 

Some people describe their pornography use as being driven by a powerful desire or craving. The behaviour feels exciting at first—something that brings pleasure, intensity, or escape. Over time, though, they need more time, more variety, or more extreme content to feel the same level of stimulation. This can create a cycle where the brain becomes wired to seek those intense experiences again and again. 

If your experience aligns with this, you might notice: 

  • A strong rush or anticipation before using 
  • Spending more time than intended 
  • Failed attempts to cut back 
  • Using porn to feel better when stressed or lonely 
  • Continuing use even when it has negative consequences 

In this model, the behaviour is being reinforced by pleasure—your brain learns, “This feels good; let’s do it again.” If this fits your pattern, we may focus in therapy on strategies used for addiction-like behaviours: managing triggers, interrupting automatic patterns, building healthier habits, and strengthening motivation for change. 

When Pornography Use Feels Like a Compulsion 

Other people describe something very different. They don’t feel particularly excited by pornography. Instead, they feel pushed toward it by stress, anxiety, shame, boredom, or emotional discomfort. The use is less about seeking pleasure and more about trying to quiet an uncomfortable feeling. 

Signs your pattern might be more compulsive include: 

  • Feeling driven to use porn even when you don’t want to 
  • Using it primarily to numb or escape difficult emotions 
  • Minimal enjoyment during or after use 
  • Immediate guilt or regret 
  • Feeling like the behaviour happens almost automatically 

In this model, pornography works like a temporary relief valve—you feel a little better for a short time, but it doesn’t improve the underlying issue. In therapy, we may focus on emotional regulation, stress coping skills, mindfulness, and breaking the cycle of using porn as a way to soothe discomfort. 

When It’s Both: The Most Common Scenario 

Most people don’t fall neatly into one category. Many start with pleasure-driven use (addiction-like) and then move into emotionally driven use (compulsive). Others begin using porn to cope with stress and gradually get caught up in chasing more intense stimulation. 

What matters is not the label, but understanding the underlying patterns: 

  • Do you use porn to feel good? 
  • Do you use porn to stop feeling bad? 
  • Do you use porn out of habit without thinking? 
  • Do you feel stuck in a cycle of shame that actually fuels more use? 

Therapy often works best when it addresses several parts at once—your emotional world, your habits, your thought patterns, your relationship dynamics, and your coping strategies. 

Moving Toward Change 

No matter which pattern fits you best, there are effective tools you can learn: 

  • Identify triggers and emotional patterns 
  • Build healthier habits and coping strategies 
  • Develop awareness of urges without acting on them 
  • Strengthen intimate or relational connections 
  • Create a lifestyle that supports your values and goals 

Recovery is not about perfection. It’s about gradually building a healthier relationship with your sexuality, your emotions, and yourself. 

Final Thoughts 

Whether your pornography use feels like an addiction, a compulsion, or a combination, the important thing is this: change is possible. You’re not alone, you’re not “broken,” and your experience makes sense given your history, stressors, and emotional needs. In therapy, we’ll work together to understand your unique patterns and build a path toward greater control, confidence, and well-being. 

How Can Problematic Pornography Use (PPU) Present in Therapy?

Series 2 

Problematic Pornography Use (PPU) can present itself in infinite ways. It doesn’t always involve uncontrolled or extreme usage, nor can it be particularly shocking or have an array of deviant themes. What it can do is distract from your sexual wellbeing by skewing your beliefs about how ‘good sex’ should look. PPU can significantly alter your view of your body image, distort your assumption of the intensity of pleasure – that is if there is not constant ecstasy then you are a below-par lover unable to satisfy and, what is seen on screens is what everybody wants.  

Often people present in counselling feeling shame about their PPU because it conflicts with their values and beliefs. It has become such a burden to ‘remember the lies’ to not get caught out and continue to live a secret life of a ‘public self’ and a ‘private self’. For some carrying the shame and the weight of these burdens of who you really are means that watching pornography becomes the go-to inflexible self-soothing strategy. People are caught in a cycle of desperately wanting to stop and desperately can’t stop.   

Typically, PPU presents in therapy due to the partner discovering the pornography and or objecting to it. Often partners are alerted to a change of behaviour, something that ‘feels off’, behaviours ‘don’t quite make sense’. Whenever they ask about those behaviours there are always excuses or responses that are often very damaging to the relationship such as ‘gaslighting’. It becomes a crisis issue in the relationship not only about PPU but moreover the lies and deceit of trying to persuade the partner it’s their imagination.  

 Another common way PPU presents particularly for young men is the inability to form, maintain and sustain a relationship.  Their loneliness is profound. Whether its discovery by a partner or lack of relationships, often there is pornography induced erectile dysfunction (PIED). This term originated within online forums and self-help communities. It is not formally recognised medical condition.   

PIED hold the idea that (over) consumption of pornography can condition some men’s sexual arousal to respond only to the potent on demand stream of constant novelty. That escalation of ‘novelty’ means a searching for more hardcore footage found on more extreme sites (1). Suffers report that the threshold for arousal becomes so warped that sex with a real live person is no longer sufficiently exciting, or the reality of that person- their smell, their sounds and their agency is too far removed from what is being watched on pornographic screens to induce an erection.  Whilst there may be other factors for PIED some studies do suggest a link between ED and PPU (2) 

The PPU partner may not be the only one affected: their partner may feel rejected, lonely, unattractive and angry. Partners can feel betrayed on feeling cheated on. Their home can no-longer feel safe. Their sexual wellbeing is impacted upon on the comparison (wrongly) to the pornography. Pornography videos can be free and paid for such as Only Fans where there are personalised video recordings. Using the joint account to pay a sex worker while distressed over PIED can wreck a relationship. 

Presenting issues of PPU can vary, for example those who have experienced trauma or sexual abuse. Trauma can take the form of complex PTSD where early attachment issues such as domestic abuse, parental rows and separation or abandonment, a parent hospitalised or very ill and bullying by siblings or in school. Pornography can take the form of a violence or degradation allowing the person to re-experience aspects of the trauma in a more controlled way. Past trauma may have left the felling person powerless or helpless, reprocessing their experienced via pornography gives themselves the power to press play -and stop- choose a script without emotional connection. This can be an attempt ‘to fix’, however, using pornography to move from powerlessness to feeling powerful and in control can be highly addictive 

References 

  1. Wilson, G, (2014) Your Brain in Porn. Internet Pornography and the Emerging Science of Addiction. Commonwealth Publishing UK 
  1. Jacobs T et al., Associations between online pornography consumption and sexual dysfunction in young men: multivariate analysis based on an international web-based survey. JMIR Public Health and Surveillance 2021: 7(10): e32542.pmc.ncbi.nim.nih.gov/articles/PMC8569536 

Please see Addiction or Compulsion or Something Else in Problematic Pornography Use (PPU) 

Series 3 

Let’s Talk About Problematic Pornography Use: Series 1-3

Series 1 

Joe’s first experience of pornography was being shown it by his friend on his phone when aged ten. He remembers both the shock and excitement of watching what his family would have viewed as ‘taboo’. He quickly moved from watching standard mainstream pornography to brutal videos of violence and submission screwing his view of people, relationships, sex and life. This distortion encapsulated the duality of his experience of the horror and feeling revolted as well as being secretly fascinated by these acts and wanting to see more. The sad thing is, that little did he know (and how could he), that developmentally his brain and body was experiencing material long before he was ready to understand it and make any sense of it.  

This was to have a catastrophic impact on his life leaving him confused, anxious, isolated, and without relationships as he had lost his erection. He became caught up in a self-perpetuating cycle of performance anxiety and porn-induced erectile dysfunction (PIED). He came to dread being invited to have sex which felt like a humiliation ritual. He became ever more reliant and caught up in a vicious cycle of pornography as his ‘only relationship’ in it being safe and fun – no one was ‘watching me’ and I didn’t l have to see the ‘hurt of rejection in my partner’s eyes’.  Masturbating alone was seemingly his only option, and pornography went from Joe’s refuge to facilitating reclusion to making him feel repulsed with himself.   

Pornography is currently the subject of new legislation as politicians grapple with trying to troubleshoot these sites deemed to be having the most insidious impacts on young people and young adults. The New Online Safety Act (July 2025) states that all sites and apps operating in the UK that allow pornography must verify viewers as aged 18 plus, following research that 8% of children aged 8 to 14 years had visited a digital service in a month (1).  

Regulating pornography has proved to be very challenging, Politicians have made recommendations that depictions of non-fatal strangulation (NFS) should be outlawed (2). In effect, what was barred in person was now disallowed on screens.  Whilst NFS was criminalised by the Domestic Abuse Act of 2021, ‘sexual choking’ was being ‘normalised’ by pornography to the extent that 38% of women aged 18-39 reported being strangled in bed (3).  

AI tools being used as image generators to create fake depictions of people mostly female and almost exclusively non-consensually may be next in line to be considered. Young people’s views of deepfakes of themselves were found to be a greater violation then sending their nude photos because of the total lack of control they had over fabricated images (4).  

Whilst Ofcom research found that approximately 13.8 million UK adults in May 2024; that is 29% viewed pornography in May 2024. Many people would have assessed their personal relationship with pornography to be primarily healthy and not a concern (5). However, for Joe (and people like him) they viewed themselves as having a problematic pornography use (PPU). It is hard to obtain precise figures, but studies estimate PPU affects up to 38% of men and up to 23% of women (6).  

Over the past number of years, I have had an increase in the number of referrals specifically around PPU, causing PIED and inability to form and sustain relationships. Joe and people like him; are often sad and lonely realising they need to begin a therapeutic journey if they are to recover and be able to connect with themselves again and so make lasting enjoyable relationships with others.   

References 

  1. Ofcom. Children’s Passive Online Measurement report 26 June 2025. Ofcom.org.uk/media-use-and-attitudes/media-habits-children/childrens-passive-online-measurement 
  1. Ministry of Justice. Strangulation in pornography is to be made illegal 19 June 2025. www.gov.uk/government/news/strangulation-in-pornography-to-be-made-illegal 
  1. Savanta ComRes. BBC 5 Live Women’s Poll 21 November 2019. Compesglobal.com/wp-content/uploads/2019/11/Final-BBC-5-Live-Tables_211119cdh.pdf 
  1. Internet Matters. The new face of digital abuse children’s experience of nude deepfakes. October 2024. iternetmatters.org/hub/research/children-experience-nude-deepfakes-research 
  1.  Ofcom. Online Nation 2024 Report 28 November 2024. Ofcom.org.uk/siteassets/resources/documents/research-and-data/online-research/online-nation-/2024/online-nation-2024-report.pdf?v=386238 
  1. Bothe B, et al, International Sex Survey Consortium, Kraus SW Problematic pornography use across countries, genders and sexual orientations: insights form the International Sex Survey and comparison of different assessment tools. Addiction 2024:119(5): add 16431(accessed 27 February 2024). 

Please see ‘How can Problems with Problematic Pornography Use Present’? Series 2. 

The Pinch-Crunch Model For Couples – How Small Problems Can Grow Into Big Ones

Within the context of relationships and communication, I have found one useful framework that I often discuss in counselling is the Pinch-Crunch Model. Developed by John J. Sherwood and John C. Glidewell in the 1970s. This model explains how interpersonal relationships evolve and how small, unresolved issues ‘Pinches’, can escalate into serious conflicts ‘Crunches’ if not addressed constructively.

Using this model, I have found it possible to help some couples develop new awareness about their interaction and gain skills in dealing with difficulties as they arise.

 

How Does A Pinch-Crunch Begin?

Every relationship, even casual ones begin by a gathering of data…Dating? You get to know each other, likes, dislikes, attitudes, opinions, behaviour.  If you are satisfied with the data that is gathered, you may continue the relationship.  You then share and exchange information and negotiate expectations:

‘I can expect her to be serious when we’re alone and kid around when we are with others’.
I can be myself with him, he isn’t demanding.
‘She likes to be looked after; I like to look after people …. It makes me feel good’.

You begin to lay down the ground rules of your relationship and building a relationship where you need to exchange enough information so that behaviour of you both is more or less predictable, and uncertainty is reduced to an acceptable level. This means clarifying roles.

Role Clarity

You become clear as to your roles with each other you may feel safe enough to eventually make a commitment and with the commitment comes stability.

Stability

This stability produces a period when shared expectations are met. This predictability frees you to be productive in other areas of their lives as the relationship no longer requires such sustained attention.  You then are free to concentrate on such things as home building, careers, study etc.

BUT

Soon or later one or other will feel PINCHED by the relationship.

A Pinch is a small hurt, disappointment, or moment of tension in a relationship.
It might look like:

  • Feeling ignored or dismissed in a conversation
  • A promise that isn’t kept
  • A tone of voice that feels harsh
  • A small action (or lack of one) that stings emotionally

Pinches are a normal part of any relationship. The problem comes when they’re not talked about. Many people try to ignore pinches, thinking: –

‘It’s not worth it,
‘I don’t want to start an argument’

The irony is that this very avoidance of conflict often makes more serious but later conflict more likely. When pinches are left unspoken, they don’t go away — they build up.

A PINCH becomes a CHOICE POINT.

What Happens When Pinches Build Up?

When pinches build-up they may eventually lead to a point where the discomfort with the relationship leads to a disruption. The disruption is to do with dissatisfaction with the way the relationship is going, with a sense that previously held expectations of each other are not being met. Ground rules have been broken.

Disruption

Disruption occurs when one or another of the partnership violates expectations, breaks the rules particularly when there are relational transitions. A new baby is a good example of a change in the rules and re-negotiation being needed.

‘It’s your turn to get up’
‘It’s alright for you, you just go out and see your friends, I’m stuck in the house’

There is a BIG ROW.  It’s now a chance to make creative change.

You can respond to a disruption in three different ways: –

  • Re-negotiate, acknowledge the disruption, update their information about each other and change.
  • Choose not to change, attempt to return to ‘the way things were’ …. A premature reconciliation.
  • Terminate the relationship.

Re-Negotiate – You can exchange new information about each other, gain new perceptions, re-negotiate the ground rules

BUT

Disruption creates uncertainty, anxiety, anger, discomfort …. Strong forces which make for tension between the two individuals.  The quickest way to reduce this anxiety and the most tempting is to: –

  • Turn to the way things used to be. Kiss and make up, apologise, let bygones be bygones. This is often a mistake.

I can help you stay with the anxiety and tension during the re-negotiation which can take place within the counselling process. I can help you hold open the relationship, learn negotiating skills, where you may be able to allow change to enter your lives.  You need to see that disruption is inevitable and part of a living relationship.  No relationship is settled once and for all and a continuous process of updating and re-negotiation is a natural part of life.

If each disruption is not seen as an opportunity for change and re-negotiation does not take place there will eventually be a build-up of pinches/disruptions ….  To lead to a CRUNCH.

A CRUNCH is a CHOICE POINT.  The same three choices apply only now resentment, hostility, lack of trust enter the arena.

Termination

Termination can mean divorce or separation, but some relationships can be terminated in other ways by alcohol, drugs, affairs and workaholism. These relationships become a comfortable disaster.

Sadly, I sometimes witness terminations that are destructive and resentful, and which expose the rigidity and inflexibility within the relationship.  Change cannot be accommodated and splitting up seems to the only escape.

When You Have Already Hit A Crunch: Talk About Pinches Early

When a crunch has already occurred, don’t lose hope, counselling can facilitate repair and learning. Through guided reflection, I can help you explore what led to the breakdown, express unmet needs safely, and rebuild the emotional connection.

The best way to keep your relationship strong is to talk about pinches before they become crunches. I can enable you to identify and become competent in expressing this.

Repairing a crunch takes patience and honesty, but it can lead to improved communication and a stronger, more understanding relationship.

The Key Takeaway

Pinch-Crunch isn’t a sign of failure — it’s a sign that something in the relationship needs attention. By catching small pinches early and talking about them openly, you can prevent bigger problems, deepen your connection, and create a healthier, happier partnership.

In counselling, I can offer you support and containment during a period of planned re-negotiation.  I can help you see that you need to deal with the PINCHES to avoid getting to the CRUNCHES.  That re-negotiation is a vital part of a relationship and is healthy.

When one person feels a pinch, the other person may also feel it in some way. If you can share it, this new information may be all that it takes to adjust the relationship.  I can encourage you to share your difficulties in terms of problems to be solved rather than cases to prosecute or fights to be won.

Pinches are experienced by the individual, disruption and Crunches are experienced by the whole family, not just you, the couple, but any children as well.

I can help you see that re-negotiation is a necessary if at times uncomfortable process, but it is far better to do regular maintenance on the relationship than to wait until the relationship engine seizes up.  As a couple’s counsellor, I can help our you develop the communication skills that make this servicing a reality.

Please take a look at the handout below as it is a useful summary.