Introduction – Becoming Sexual in Digital Times: The Risks and Harms of Online Pornography (2020)

A benefit of getting older is that it affords the privilege of perspective. I note two striking changes as I reflect on my clinical practice with young people over a thirty-year span. First, the body has become increasingly a site of alienation and its more or less extensive modification is the apparent solution to a painful internal psychic state. Second, the process of becoming sexual (i.e. of establishing a stable sexual and gender identity irrespective of sexual orientation) has become more challenging than psychoanalysis has always recognized this process to be, even in the best of circumstances. Two external factors appear to have contributed to these changes: the domestication of a range of contemporary technologies and the greater accessibility of medical interventions that have normalized the modification of the given body – I will only address the former here.

The fast pace of technological developments far outstrips the mind’s capacity to manage the psychic implications of our interface with technology. As psychoanalysts from the pre-digital innovation era, we are trying to understand something that was not part of our own developmental experience. Our experience of pre-digital times may well provide a helpful perspective, but we cannot avoid the fact that we are the last generation(s) that will have experienced a non-digital world.

This generation is growing up neither online or offline but “onlife” (Floridi 2018, 1). A new and now permanent feature of network culture is that communication is mediated and digital connectivity, along with different strands of virtuality, are now an integral part of young people’s daily lives. The ubiquity of virtual spaces provides the current dominant context within which adolescents negotiate their sexual and gender identities, most notably through the domestic use of social media and of online pornography. Specifically, sexual development takes place nowadays in a social context in which what we once accepted as the “facts of life” (such as the given body and its limits), are now susceptible to ever increasing degrees of technological manipulation. Sexual development itself is technologically mediated. If we are to understand the sexual development of the digital generation, it is vital theoretically and clinically to recognize that these technological changes require new psychoanalytic conceptualizations of sexual development.

Like in every other aspect of the digital world, the new sexual climate brings both benefits and harms. At its best, the Internet provides an important medium for the exploration and elaboration of adolescents’ sexuality (Galatzer-Levy 2012; Shapiro 2008) and for many this has often included some exposure to pornography well before the advent of online pornography. However, the online medium for the consumption of pornography requires careful scrutiny and I will focus on this specifically. The technological developments that have made pornography available online are not intrinsically bad per se, but it does not follow that technologically mediated sexual experience is neutral in its effects on the development of sexuality in young people.

In this Introduction to this issue’s section on Internet pornography, I begin by concisely summarizing the research on the impact of online pornography on sexual health and relationships in young people. I suggest that the difference between pre-Internet and online pornography is not in any straightforward sense only one of degree. This is because the online medium changes, in prudentially significant ways, the young person’s relationship to the sexual materials by providing a virtual space within which sexual desire is gratified quickly and non-reflectively, undermining the capacity a) to mentalize one’s own sexual desire and that of the other and b) to evaluate the prudential risks associated with the consumption of online pornography. These risks are especially significant for the digital generation whose sexual development is now more likely to be shaped by online pornography. This might exert an impact through the direct consumption of online pornography or more indirectly through engagement with a partner for whom online pornography informs their sexual fantasies and expectations.

Online pornography: a public health issue?

For many, pornography use is a private activity, rarely openly discussed or examined. The domestication of the Internet and the introduction of the smartphone have invigorated the debates around pornography because technological developments have made it instantly accessible yet even more hidden. Never before so fast, so easy or so extensive, the range of content is a click away. And (mostly) free. In 2018 Pornhub received 33.5 billion visits – that is a total of 92 million daily average visits.¹ A UK study of children aged 11–16 years reports that 28% of 11–14-year olds and 65% of 15–16-year olds have viewed pornography online (Martellozzo et al. 2016). Regulation of access to online pornography for under eighteen-year olds has so far proven impossible.

Whilst the Internet can facilitate access to important information about sex that supports well-being, research over the past fifteen years is showing how online pornography may also pose a sexual health risk to young people as well as undermining the pro-social nature of sex. Prior to the proliferation of online pornography sites,² the average rate of sexual dysfunctions, such as erectile dysfunction (ED) and low sexual desire, was low, estimated at around 2%-5%. In the 1940’s less that 1% of men under thirty experienced, or at least reported, erectile dysfunctions (Kinsey, Pomeroy, and Martin 1948). In 1972 this figure rose to 7% (Laumann, Paik, and Rosen 1999). Nowadays rates range between 30% and 40%. Recent research exposes a marked increase in reports of sexual dysfunction in men under 40, in the range of 30%-42% (Park et al. 2016). Studies on young men under 25 years of age and of adolescents under 18 years of age paint a consistent trend in the direction of an increase in these sexual problems (O’Sullivan 2014a, 2014b). This is corroborated by the evidenced rise in referrals for psychosexual therapy.³ In under 19-year olds alone, in the UK, the National Health Service recorded a threefold increase in referrals for psychosexual therapy between 2015–2018.⁴

Studies that have looked beyond the prevalence rates of these problems, have found a correlation between pornography use and erectile dysfunction, low libido, difficulty orgasming (Carvalheira, Træen, and Stulhofer 2015; Wéry and Billieux 2016), and a preference for pornography over actual sex with a partner (Pizzol, Bertoldo, and Foresta 2016; Sun et al. 2015). Relevant to the question of causation, even though this cannot be claimed to be decisive vis-à-vis etiology, we also have evidence that the cessation of the consumption of online pornography can restore healthy sexual functioning, providing further support for the contention that online pornography most likely plays an important part in sexual dysfunctions (Park et al. 2016).

Increased pornography viewing has been associated with sexual intercourse at a younger age, and higher numbers of partners and casual sex partners (Livingstone and Smith 2014). However, increasingly, there is a growing concern that the overall trend amongst millennials is toward having less sex (Twenge, Sherman, and Wells 2015), with one study of 18–20-year olds identifying a strong link between the consumption of online pornography and a withdrawal from actual sexual relationships (Pizzol, Bertoldo, and Foresta 2016). At this point in time we can only speculate about the meaning of such trends. We need more longitudinal empirical and specifically psychoanalytic research in order to understand what is happening in the internal world. It is probable, however, that such trends reflect the way in which the easily accessible option of technologically mediated sexuality all too readily leans into the narcissistic pull of a less relational and a more remote sexuality. Otherness is psychically demanding; if technology can circumvent the encounter with otherness, this provides shortcuts that can be seductive, especially for those young people who struggle with their bodies and sexuality.

Other research has noted the impact of online pornography on body image and self-esteem, with trends showing more young women opting for pubic hair removal so as to look pre-pubescent and labiaplasty. Both of these cosmetic requests have significantly increased, seemingly in tandem with the availability of online pornography (Gambotto-Burke 2019). For example, requests for labiaplasty specifically have increased by 80% over a two-year period in under 18-year old girls (Hamori 2016). Amongst boys too, negative preoccupation with the appearance of their body has been correlated with exposure to online pornography and the so-called “body ideals” implicitly promoted by the male pornography actors (Vandenbosch and Eggermont 2012, 2013).

The impact on sexual health also needs to be considered along with the growing evidence of addiction to online pornography that shares similar basic mechanisms with substance addiction (e.g. Love et al. 2015). The problem of addictive usage has been identified as a specific risk of online pornography versus its pre-Internet format. A number of studies have shown that there is a difference between frequent users of online pornography and healthy controls with respect to their proclivity to incrementally search for new sexual images. This is understood to result from more rapid habituation to images compared to healthy controls (Brand et al. 2016; Cordonnier 2006; Meerkerk, van den Eijnden, and Garretsen 2006). Although the risk of addiction to online pornography is most likely amplified by the particular contingencies of the online context (see Wood 2011; Wood 2013), in fact, as I will elaborate later, we do not need to invoke the potential risk of addiction in order to make a case for the problematic aspects of online pornography use by children and adolescents.

Research has also suggested a link between online pornography consumption and increased physical and/or verbal violence against women. There is evidence to indicate that the more one views pornography, and extreme pornography in particular, the more likely it is that the consumer holds more aggressive attitudes and is more likely to objectify women (Hald, Malamuth, and Yuen 2010). Longitudinal and cross-cultural findings also link sexual aggression and use of violent pornography (Ybarra, Mitchell, and Korchmaros 2011). Sexual coercion, abuse and negative gender attitudes on the part of adolescent boys are significantly associated with consumption of online pornography, as is an increased probability of sexting (Stanley et al. 2018a, 2018b; Ybarra, Mitchell, and Korchmaros 2011). The impact is not restricted to boys: young girls who use sexually coercive behavior also report watching violent pornography significantly more than a control group (Kjellgren et al. 2011).

Even in the case of nonviolent pornography, there is concern (and some evidence) that young people who have limited sexual experience, are primed by online pornography to see the sex that it depicts as “real” rather than as fantasy, and this, in turn, negatively influences attitudes and real-life sexual behavior (Lim, Carrotte, and Hellard 2016a, 2016b; Martellozzo et al. 2016) and hence satisfaction in the actual relationship.

Alongside the findings that point in the direction of a link, it is nevertheless important to keep in mind those studies that are inconclusive or contradictory about the association between online pornography and sexually violent behavior (Horvath et al. 2013). Sexual aggression is multi-determined and is likely moderated by individual differences, urging caution against generalizations (Malamuth, Hald, and Koss 2012). Nevertheless, even though we should exercise caution in drawing a direct causal relationship between consumption of online pornography and sexual violence, this does not detract from online pornography’s contributions to harm in the domain of sexual health and on the quality of intimate relationships that young people establish.

The role of speed and its impact on the ‘work of desire’⁵

Pre-Internet we inhabited a world that I have characterized elsewhere as a 3D(esire) world where “Desire” was followed by “Delay” and finally “Delivery” of what we desired (Lemma 2017). The psychological “work of desire” (i.e. the conscious and unconscious psychic work consequent to the subjective experience of desire) rested on the development of a capacity to tolerate waiting and the state of frustration that this would give rise to. By contrast, the digital generation is growing up in a 2D(esire) world. “Desire” results in immediate “Delivery” and bypasses altogether the experience of “Delay”. A key feature of online pornography consumption is that it abolishes, or much reduces, the experience of resistance to the satisfaction of one’s desire. Internal impediments (e.g. shame) as well as external ones are removed or temporarily suspended. Speed (amplified by cost-free access to online pornography) now reduces the distance between desire and satisfaction: no effort and no waiting. Effectively, “the very experience of the cycle of desire has been disintermediated by the online medium” (Lemma 2017, 66).

The intermediary of “delay” – of time that we have to accept as given – is psychologically significant because it is the encounter with delay that makes possible the representation of desire in the mind. Without exposure to the experience of delay or frustration desire loses its 3D shape that would allow for the various dimensions of the experience of desire to be represented in the mind.

An important implication for the articulation of sexual identity in digital times, is that because online pornography can now be accessed easily and rapidly, there is immediacy without mediation. Or, to put it another way, if technology can be said to be a “mediator”, it operates by severing the essential connection between mind and body thus undermining the otherwise potentially helpful mediation of a reflective process. Online pornography fuses the body with a gratifying machine that delivers on tap what the mind would otherwise have to (more) slowly process and somehow integrate through the representation of desire.

The mental (secondary order) representation of experience affords important benefits: it allows us to reflect before we act such that action is informed by a cognitive and emotional process that supports (more) autonomous choice rather than being driven by unconscious factors. Too-muchness, an intoxication of sexual stimuli, is problematic because it leaves no room for the mind to represent what it needs or wants and then to evaluate if this desire is sustaining of well-being or, on the contrary, may be harmful.

Online, the young person is rapidly “presented” with numerous pornographic images. This encourages a rapid shift from the possibility of a second-order representation of desire to pure stimulation and sensation undercutting any reflection. This can conspire to quickly escalate potentially harmful (to the self and/or to the other) behavior online, something that was not possible on the same scale pre-Internet: for example, a pornography magazine or VHS video did not allow any immediate escalation in the material being searched.

Speed of access and the volume of sexual imagery available online bypass representation through an excess of “presentation”. In terms of sexual development, Freud’s (1930) latency stage has been superseded (Lemma 2017). We are now seeing children who are at the latency stage but seem to be very sexualized. Instead of latency there is what I have referred to as blatancy: the latency age child remains as excitable as the Oedipal child and, as Guignard put it;

Along with some analysts (e.g. Guignard 2014) I no longer think that it makes sense to conceptualize sexual development with respect to a latency stage. However, I consider that sexual development takes on a specific transformation at puberty and this represents a point of crisis for many adolescents. The psychic process of adolescence typically sets in motion a review of personal identity that is rooted in the body: the young person has to integrate their changing pubertal body into the image they have of themselves. This complicated and unsettling internal process nowadays unfolds in a distinctively different social context in which technology undercuts reflective processes that impact on the capacity to regulate emotions, to relate to others and on autonomous functioning. In the online pornography context, the so-called “choice” for a young person about whether to consume pornography and, if so, of what specific kind, is psychically significant: pursuing “vanilla” pornography is not at all the same for the young person as becoming aroused by watching torture chambers. The “choice” is meaningful and has psychological consequences for how the young person relates to her/himself (and their sexual desire) and how s/he relates to potential partners.

The Black Mirror: whose desire is it anyway?

It is developmentally appropriate for an adolescent to search for a mirror beyond the parental figures to elaborate and consolidate a sexual identity:

The Black Mirror differs in prudentially significant ways from previous media, not only in so far as it exposes the young person to an unprecedented range of the sexual content, but also because this mirror intrusively projects into the viewer rather than “reflecting back”. It “pushes” images and sensations into the body and mind, sometimes even when the young person has not actively searched for such images. When the search is more intentional, the online medium provides the young person with sexuality à la Carte: a wide range of sexual preferences that will not necessarily have been articulated as such until exposure to them online:

The Black Mirror is deeply seductive and hard to resist since it readily supplies concrete images and sexual scenarios that provide a close match to the central masturbation fantasy (Laufer 1976), now socially sanctioned through the medium of technology. Although we must recognize that this may provide some validation for something that feels disturbing within, and to this extent the young person finds something of value to them as they struggle to make sense of sexual feelings and fantasies, it is precisely because the Black Mirror supplies the ready-made sexual scenarios these need not be owned as belonging to the self thereby undermining the establishment of an integrated sexual identity. As Galatzer-Levy (2012) has proposed, the images/fantasies that are seized in this manner are ultimately not felt to be one’s own. I would add to this invaluable observation that the combination of this kind of alienation from any agency over one’s own sexual fantasies whilst being simultaneously compelled by them, is deeply destabilizing for the young person. The case of Janine illustrates this well.

Janine was 7 when she started to look at online pornography after being introduced to this by her elder sister’s friends. By the time I met her aged 16, she was using online pornography almost daily. She was excited, compelled and disturbed by her use in equal measure. She described significant difficulties with her appearance: she wanted labiaplasty so that she could look like the pornography actresses that she watched whom she both wanted to imitate and was also very aroused by. She was confused about her own sexuality: she was not sure if she was homosexual or bisexual and at other times feared that she simply hated sex.

As the work progressed it became clear that Janine had struggled to integrate her pubertal body into her self-representation. Aged 13, she recalled the sight of her felt-to-be large breasts as “repulsive” and she found herself drawn to images of flat-chested girls. She began to restrict her eating.

Janine had been sexually assaulted by one of the sister’s older male friends around the age of twelve. She thought that she had been “in love” with this man (many years older than her) despite the first sexual contact, which she had not liked because he was drunk, and it had been very painful for her. However, she had subsequently felt that despite this traumatic start, that they had created a special bond and that he made her feel less lonely. When she turned 13, he disappeared. She recalled that is when she started to retreat from others and spent increasingly longer periods of her time online.

Janine described a consistent escalation over the years in the nature of the pornography she searched online. She found that her sexual arousal took longer, and so she searched for new images that gave her a quicker “hit”. With considerable fear and shame, she eventually spoke with me about her sense that she was out of control. The more she felt out of control of her sexual fantasies and mind, the more she focussed on controlling what felt within easy reach, as it were: her weight. She became obsessed with counting calories and lost weight. It was the eating problem that led her parents to seek therapy for her but as the work unfolded it was evident that this was but the tip of an iceberg of a precipitous loss of control over her mind.

Like other young people I work with nowadays, Janine poignantly conveyed an experience of feeling at the mercy of a body that felt out of control and of sexual preferences that she was not entirely sure were her preferences. Technological mediation confounds the relationship the young person has with her own desire. Machine tethered sexual development undermines the essential developmental knitting together of personal history, unconscious conflicts and sexual desire: “The cost is that experience is flattened out and can become concrete” (Lemma 2017, 67).

An important question is what distinguishes those young people who turn more predominantly to the online medium as a safe retreat from embodied relationships and even more specifically from embodied sexual relationships. Again, this requires more research. Based on my observations in the consulting room, I suggest that there is no single developmental pathway or specific psychopathology that can provide reliable answers to this question. However, for those young people who are at risk of struggling with the demands made on the mind by the physical changes of puberty (due to developmental deficits and/or conflicts), the retreat into virtual spaces proves especially compelling because it allows them to manage confusion and distress about the real body by interposing virtual distance between self and other and between their own body and mind.

The online medium per se does not cause psychological problems. Rather, I am suggesting that it can provide a culturally reinforced and readily accessible vehicle for the enactment of conflicts related to our embodied nature that some adolescents are especially primed for given their developmental histories. This medium is ideally suited to being “misused” in the service of managing a disturbing experience of otherness that is felt to be concretely located in the body. As I have outlined elsewhere (Lemma 2014), this may be understood as partly a function of some of cyberspace’s specific features such as how it can support a denial of corporeality, how it can be used to abolishes the reality of difference and separateness or to promote the illusion of interpersonal transparency. More fundamentally, it can be used to alter the relationship between internal and external reality:

Virtual space and the seductions of customization

A defining feature of the real world of sexual relationships is its unpredictability because of the actual presence of an ‘other’, which places a demand. By contrast, in virtual pornographic space, we witness the erosion of the principles of sexual reality, not least because there is no other “real” body to anchor the self in reality and limits. The virtual space provides a retreat away from reality into a fantasy in which there are no impediments to the satisfaction of desire.

Even if online pornography can only create the illusion of mastery over the other, this can nevertheless have psychological consequences that impact adversely on actual relationships if this alters how the young person then relates to her/himself and/or to the others in his/her life. For example, one nineteen-year-old male patient, had a particular sexual fetish that he was able to satisfy online. This brought him immediate pleasure that relieved him of other unpleasurable states of mind such as his depression and hatred of his body. Indeed, the avoidance of emotion has repeatedly been found to be strongly correlated with problematic online pornography use in both men and women (Baranowski, Vogl, and Stark 2019). Temporarily, when online, my patient felt in control of such aversive states of mind. However, the more time he spent online, the more alienated he felt from his girlfriend who was in the dark about his online activity and his fetish. Online sexual life traded short term “mastery” over aversive mental states for longer term helplessness as he incrementally distanced himself from the root problems.

The state of mind that the young person enters when using online pornography is one in which the unbiddable otherness of the other is reduced to a customized version of an “other” felt to be entirely controlled by the self. The customization is much enhanced online as the sheer number of images and videos allows the viewer to be highly selective and thus amplifies the underlying omnipotent state of mind. By contrast, in actual embodied relationships, the otherness of the “other”, we might say, imposes a (frustrating) delay of sorts because it requires a measure of psychic work. For example, we have to consider their sexual desire, and that takes time, can be frustrating and stands in the way of the immediate satisfaction of our desire. By contrast, online pornography allows the young person to insulate her/himself from the disturbing immediacy of the world of interpersonal contact.

The “work of desire” and the anxieties this mobilizes (e.g. of dependency), is short-circuited by easy and rapid access to online pornography images. Waiting for an actual other who might or might not want us is replaced by the “pornographic other” who becomes an object that can be manipulated and where sexual arousal is unimpeded by the complexities of different desires and arousal patterns, or the consideration of another person’s needs that, in turn, would require us to imaginatively identify with the other. Speed thus amplifies the likelihood that the underlying psychological process necessary to sustain positive relationships, is undermined. I call this underlying psychological process the “mentalization of desire” and I will elaborate this next.

Mentalizing sexual desire

Speed and ease of access to online pornography, coupled with the altered mental state resulting from the specific contingencies of the online environment outlined so far, erode a vital psychological process – mentalization – that is key to healthy sexual development and to well-functioning sexual relationships. I suggest that habitual use of online pornography un-trains, or impedes, the development and exercise of the capacity to mentalize the self’s sexual desire and the desire of the other. This represents the greatest threat to sexual development for the digital generation (Lemma 2020).

The importance of mentalization for healthy human relationships and for mental well-being is widely acknowledged in the psychological and psychoanalytic literature. Mentalizing involves the ability to reflect on one’s own behavior (self-mentalizing) and to predict someone else’s behavior (other-mentalizing) based on an appreciation that behavior is informed by intentional states (e.g. beliefs, feelings, wishes and desires). In a sexual context, mentalizing underpins a person’s ability to imagine, for example, that no matter how strong one’s personal desire for sex, this does not imply that our partner feels the same. In turn, this requires us to manage our thwarted desire when it is not reciprocated. Mentalizing is what helps to bring perspective to why a partner might not want sex because it allows us to relate to a partner as having a separate mind and volition: it may simply be that the partner is tired or feeling preoccupied with something at that moment. In this instance, mentalizing thus potentially helps not only with impulse control (i.e. it inhibits an aggressive response to the felt rejection) but it also minimizes the risk of a more “personal” and negative interpretation of the partner’s lack of desire.

Mentalizing is part and parcel of self-awareness and is thus essential to self-regulation, which is why dysfunctional mentalizing can lead a range of psychological problems that undermine mental well-being (Bateman and Fonagy 2019). If online pornography undermines the capacity to mentalize one’s own sexual desire and that of the other, for example by promoting sexual scripts that are taken as real sex by the young person, but often bear little or no relationship to what a sexual partner wants to do, then personal relationships are potentially undermined. This might operate, for example, through encouraging denigratory attitudes toward a partner because these are normalized by pornography. This is all too commonly observed when working with young male patients whose expectations of “exciting sex” are underpinned by degrading and sometimes violent sexual scenarios viewed online that are felt to be normalized by the online medium and then imposed on sexual partners who, in turn, feel under pressure to comply because that is what they think “boys want” – a recurrent complaint from my young female patients.

Mentalizing is a matter of degree and depends on context and relationships, but importantly non-mentalizing invariably leads to more non-mentalizing. The more we inhabit contexts where mentalizing is inhibited or not supported, the more likely we are to neglect aspects of our experience that undermine our mental well-being. This is why habitual use of online pornography can be problematic and why it poses particular risks for the digital generation.

Conclusion: protecting the development of sexuality

For the digital generation specifically, online pornography is the new context for sexual curiosity and experimentation and, as such, it seems reasonable to propose that it plays a role in the development of sexuality. This is not only of psychoanalytic interest. It also raises ethical concerns with respect to the impact of online pornography on children’s “well-becoming” with respect to sexual development (Graf and Schweiger 2017, 39).

Technological mediation has truly become a defining condition of contemporary culture. Psychoanalytic theory and practice need to be articulated within this new context. In digital times a child’s body is no longer primarily libidinised through his identifications with parents. The child’s interface with technology plays a very significant role in his embodied experience. Nowadays the body of childhood bears the imprint of the technology it is tethered to and the virtual worlds that extend physical and psychic geographies for better and for worse.

The case of online pornography starkly illustrates the pressing need for a considered psychological response to the risks it poses. Age verification systems are hard to implement and so far have failed and/or have been abandoned as strategies to tackle these risks. Moreover, just because the problem arises due to new technologies, the solution need not be a technological one. On the contrary, it is clear that because technology amplifies risk that cannot be reliably reduced due to the pervasiveness of technological mediation in our culture, we need to think of solutions that are not limited to technology. Psychoanalysts need to venture beyond the confines of the consulting room to engage with policy and large-scale health and education initiatives to inform interventions that strengthen young people’s mental fitness to manage what technology makes possible or easier, especially if this is not necessarily for the better in terms of mental well-being. We need to develop psycho-social interventions that “inoculate” all children and young people against the potential risks of online pornography (Lemma 2020). Just as the flu vaccine cannot guarantee that we will not get the flu, no intervention against the potential harms of online pornography will be full proof but it can still contribute to a reduction in the risks associated with its consumption.

The governance of the digital (Floridi 2018) is a pressing concern. As psychoanalysts we have a valuable model of the mind that can and ought to contribute to current debates around the impact of online pornography. As Floridi aptly puts it: