When I get a call from a Urologist to refer a patient suffering erectile dysfunction, my mind typically sees a 50 plus year old gentleman. Recently this image in my mind is being replaced with a 20 plus year old that is addicted to internet porn. Viewing porn has been around for some time, but it has never been as accessible 24 hours a day to the majority of men. Women also view internet porn, but not to the same extent. Women aren’t as visual as men when it comes to sex. A clean dishwasher, red pumps or an expensive handbag is more likely to turn women on.

Marnia Robinson, a former corporate lawyer, reported in “Porn-Induced Sexual Dysfunction” that low libido (which is now happening to men in their twenties) is caused by continuous over-stimulation of dopamine, the same neurotransmitter that activates the body’s reaction to sexual pleasure by repeatedly viewing pornography on the Internet. This causes men to become desensitized to normal stimuli, and they need increasingly extreme experiences to become sexually aroused.  Most of the young men I see never believed this could be a problem with Internet porn. In fact, the majority of them see me after seeing their Urologist only to hear that everything checks out normal. Although their testosterone and other health measures may be normal, the fact that they cannot achieve an erection is not normal. They suffer from an addiction and like all addictions, denial of the problem, and continuing to use the “vice” keeps it in place.

Internet porn addicts differ from porn addicts in that they don’t frequent strip clubs, and adult bookstores; rather, they isolate themselves while engaging in their addiction. They can spend hours or even lose days looking at Internet porn. Therefore, it is likely they are in a loveless marriage, or not dating. Their addiction takes over their life totally.

The most common signs and symptoms of an Internet porn addiction are listed below from a book titled, “The Porn Trap:”

• Using the Internet for hours with or without breaks
• Becoming more anxious or depressed
• They ignore friends, family, or personal responsibility
• They lie about spending time on the Internet and what they are doing while on the Internet
• They become irritable when Internet use is disrupted
• They anticipate when they may be able to use the Internet again

If you are in a relationship with someone addicted to Internet porn, you will notice they want less sex with you, seem to lack interest, and withdraw intimacy with you in many ways. They prefer spending time alone, and in the case of marriage, they withdraw from “family times” more and more.

There is a way out of addiction to Internet porn, but like any addiction, beginning is easier than quitting. These three suggestions are the best place to begin:

1. Cure depends mostly on the addict’s ability to see the problem. Knowing you have a problem is the first step to improving your life. If you are trying to help your partner give up Internet porn, try not to accuse harshly, but rather work with them at setting stronger boundaries. Just as with smokers or drinkers, the first time doesn’t always work with quitting.

2. Whenever you quit something that has been your main vice, you will have lots of extra time on your hands. During that time you are not calm, but incredibly anxious, depressed, feeling flu-like and impulsive. Trying to quit an Internet porn addiction without being enrolled in a support group will be less effective. When you are feeling at your weakest, being able to call a sponsor who has been there and done that is reassuring and helpful in making sure you stay away from Internet/phone porn.

3. Explore new healthy coping mechanisms to help you deal with stress, anger, boredom, depression, and life. This is done most effectively with the help of a counselor or treatment center. Counselors and treatment centers work as a team to help make you stronger, since being isolated with your addiction is the worst thing you can do. 

What may have begun innocently with a group of friends, can turn into a monster; isolating you from everyone, especially the one you love the most. At that point it is important that you shut off your phone, close your lap top, and take a good honest look at your life. The addicted mind will tell you all sorts of lies. When you believe your own lies, the addiction has conquered you. Having an erectile dysfunction at the age of twenty five or thirty because you cannot get turned on normally with your wife or girlfriend is not normal. For the health of it, get help. 

I run several support groups for the morbidly obese in the Houston area. Two of the groups specifically deal with food addictions. The members in this group participate in a 12 step program that helps them learn new coping mechanisms besides turning to food. It is very difficult. They have been using food as their lover for years. Their use of food is different from mine or others. They actually have a relationship with their food. Just as an alcoholic or a drug addict turns to their vice before they turn to their partner, food addicts turn to food. It would seem odd to the person who doesn't struggle with food to listen in on my groups. You would hear things such as, “If I can just have a bowl of Ben and Jerry's Cherry Fudge, I will make it through this,” or you may hear, “I was so upset. All I could do was run to Sonic and get my fix.” When I first began listening to this, I felt confused, or perplexed, thinking maybe they were kidding. Believe me, they were not. They cannot stop once they get started with their vice anymore than an alcoholic can stop after half a bottle of wine. Just as an alcoholic will go to the extent of drinking someone else's drink to get a fix, the food addict will eat off of other's plates, and several have admitted to going through the trash can for food previously thrown away.

As the group progresses, what becomes clear is the majority of these patients have been brought up with another addiction. Maybe their parents were alcoholics, abusive, gamblers, smokers, or hoarders. The child learned it was safer to turn to food or some other substance for comfort because turning to a human for a hug or soothing words was impossible. Many food addicts lose weight to get married, only to find that they don't have the skills to communicate loneliness, boredom, or anxiety to their partner. They slowly begin to turn to what has helped soothe them in the past, which is food. Before long, communication is compromised in the relationship. There is severe weight gain, which begins a disastrous cycle of withdrawing from sex, and turning to food. Soon the partner isn't happy and the food addict feels shameful and guilty. These feelings of guilt and shame lock the cycle of turning to food even more securely. Members in the group tell me often that their eating has ruined their marriage, or the way they look disgusts their partner. For anyone in the health profession to tell these people to simply stop eating or to get the weight loss surgery without addressing the underlying feelings and emotions is malpractice. I say this, but understand it is done every day. After all, my food addiction group is filled with patients who failed with a weight loss surgery prior to joining. When I ask them if they had been counseled prior to surgery, the response is always, “No, I could not afford that.” In truth, they cannot afford not to get counseling prior to surgery.

How can you help if you are married or know a food addict? I am so glad you asked. Below are a few suggestions to help you get started.

1. Realize that your partner or friend has a bigger problem than just eating too much. They need professional help, and they need it now. Find out who is on your plan for insurance and what it allows for help with eating disorders.
2. Encourage your partner to begin turning to you for comfort. This can be done by paying attention to when they eat, and what they eat. Food addicts find the evening especially difficult to manage. They are tired, overwhelmed and depressed. Hold them, talk to them, and avoid food.
3. Help them join a food addiction group. There are several in Houston and “Over Eaters Anonymous” offers a 12 step program for food addicts.
4. Your partner suffers shame and guilt every day. Try to remember this, and be gentle. There is a lot of secrecy in this disorder. If they let you in, respect that.
5. If you are the over eater, I want you to know you are still loveable despite your weight. You many not love yourself right now, but that is possible to change. You need to make the first call, but there is help.

Food addicts are hurt, and we as a society can become part of the problem or part of the solution. Most addicts of food (and other addictions) have an enabler. The enabler complains about the behavior but also supplies the fix. They cover for the addict by making excuses for them. People who are co-dependent or have a low self-esteem may derive their security from enabling an addict. The perfect example is a man who is married to an obese woman. He keeps bringing home junk food to keep her happy and obese. He never worries about her being unfaithful to him because he knows her weight limits her confidence in finding someone else. Obesity has gotten so out of control that it is limiting the lives of our children, driving our medical costs sky high, and touching the majority of lives in the United States. Surgeries and medicines are helping us lose weight, but until we get at the issues underneath the weight we will never be able to cure this serious problem.

My dad was incredibly insightful. He wasn't well educated, but he knew so much from experience. When I was dating, his favorite saying was, “You drink the poison you select.” I was 16 years old, and I thought he was out of it. He wasn't. I am a psychotherapist now, and I can't find a better way to tell people to be aware when they are dating. Know what you want and what you don't. Men and women constantly tell me things they saw and noted with their dates, but married them anyway. They thought these things would change. These things don't change, they intensify after marriage. What you marry, you live with. You drink the poison you pick.

If you marry someone with an addiction, it is never going to go away. They can learn to manage it or recover from it, but it will always be there like a demon begging them to come back. It's tough to fight it, and they cannot fight it without your support. Telling your spouse to “get over it” is like telling you to keep a baby from coming out during labor; it is not going to happen. The baby is born, and your spouse, who is an addict, is addicted. It makes no difference in regards to the drug of choice-pot, food, sex, gambling, porn, the list goes on and on. It is a poison though, and if you marry into it, you are going to drink it.

If you marry for money, you have to drink that too. It may seem elaborate or seductive during dating, but you are marrying a very isolated, lonely lifestyle if you wanted a companion. Whoever has money is invested in keeping it. That investment takes a lot of time, and they may frequently choose work over you. That investment also makes the owner feel entitled to it. They begin to think they are better than others, more entitled to the good things in life, and more deserving. They may begin to believe you are the fortunate one; after all you did marry them and their money. Soon, you are invested in it also. You need a certain lifestyle, or you deserve a certain lifestyle-all because you are married to Mr. or Ms. Money. I also learned from my dad the bigger the rock, the bigger the problems. Once again…the guy was right.

Dating a charmer that all of your friends love? They are so sweet, attentive, and sensitive. But just wait until you drink that poison; that is a bitter one. You find out your charmer wasn't only good at charming you, but that they also have an eye for people in need. They are great at focusing in and charming the person who needs them the most. All of that sensitivity and attentiveness that was once directed at you is easily aimed at another person. You are better off looking for someone who is honest and candid and maybe tells your friends the truth. Your friends may not like this person as much, but this person will be at your side long after your friends have forgotten your name.

Dating the best looking person? Do you feel special because this person is so good-looking and athletic? Do all the women or men want to date your boyfriend or girlfriend? That is my least favorite poison. Most people who are really beautiful know it and use it. Society treats good-looking people better than average. When someone only focuses on how they look, other areas are neglected. Areas of empathy, compassion, and humility are the first ones neglected. This may create an attitude of arrogance, judging, and sometimes aggression. When we first meet someone, their looks have a lot to say, but when we get to know them, their looks change. Plain people may become beautiful, and beautiful people may become ugly. Before you say, “Yes” to this person because you are so enamored with their looks, watch the way they treat someone not as beautiful. The way they treat others will sooner or later be projected on to you, and you will have to drink it.

When you get married, you do drink a certain amount of poison. No one is perfect, and a little poison won't hurt you from time to time. A wise rule of thumb is to be aware of whatever this person portrays. Anything you notice while you are dating will be multiplied by a thousand when you are married. Choose your “poison” with great care.

This past week I had a client who was relatively new to me. She is young, professional and seeking a relationship with a good guy. She wants a family and feels ready. She was all smiles this week, a change I noted immediately. When visiting with her more, I mentioned how happy she looked. She smiled coyly and told me she was in love. Being in love makes all of us happier. We feel cared for and euphoric with the idea that we matter to someone else. I asked her about the guy, and all of a sudden her expression, as well as mine, changed. This man who made my client so happy is married with three little kids at home. He told my client who “loves him” that he is married to a crazy woman. He said it has been bad for a long time, and he doesn't want to lose his children so he stays married. This is a typical story, and therefore I was not impressed. I was impressed by the lust, infatuation, and addiction my client held. So much so, that she said she loved him so deeply she could not let him go. I asked her how many people she had loved in her life. She responded that she had never loved any man this profoundly, and knew he was the right one.

After exploring further, I found out that my client had been treated poorly by men in the past. They had ignored her and made her feel inadequate. She went on to say this man made her feel smart, sexy, adored and that he was so thoughtful (I wondered if he was thoughtful in regards to the lie that he would no doubt tell his wife). Telling this client, at this time, what I was thinking would not work. She was in lust, infatuation, and addicted, but she was not in love. Love doesn't lie, cheat, and it isn't always charming. Instead, I advised this client to consider the following.

1. Believing you are in love with someone who is married is common. I hear and see it all of the time. The problem is that it is like seeing only the trunk of the elephant and blinded to the rest of the elephant's body. You cannot love what you cannot see. In other words, you love someone acknowledging their worse and best. If you don't know their best or worse, have a couple kids and you'll find out rather quickly.
2. Men (or women) who cheat have nothing to lose in the relationship. They have everything to lose if they leave their wives (or husbands) and families.
3. A cheating man (or woman) will tell their lover what they want to hear. It is very predictable for them to say that they will leave their spouse some day. They usually don't. The statistics for you and them if they do leave are poor. Many of the remarried couples struggle with jealousy. They know that each other can and did cheat.
4. Once you cheat with someone married, no matter how this term affects you, it is adultery.

What should this client do to let go of this married guy?

1. She must focus on herself and get so busy that she cannot attend to him anymore. To help her do this, I reminded her to get into the head of the other woman and her small children. How would she feel in this other woman's place?
2. Set up a support system of friends. Tell the friends what you have been doing. Ask them for their support in helping you let go. If you don't have many friends, this may be another reason why the married guy likes you (easier to keep it a secret). Confide in a clergy person. Telling someone is going to help you hold yourself accountable.
3. This guy said his wife is crazy. She may be, but how do you know? She may be feeling vulnerable, and this guy may be totally self-centered. Watch him. Charmers are good at charming because they understand what people's needs are, and they focus on fulfilling those needs. This guy cheated on his wife to be with you. What makes you so special that he won't cheat on you when he sees someone else who needs him?

Our hearts alone don't tell us who to love. It happens to all of us; we have a “crush” or feel an attraction to someone. This is the critical time to be honest, note it, and walk away. To become seduced by it when you have the potential of hurting a whole family and children is selfish and weak at best.

A recent study reported that every 39 seconds a new pornographic video is being made. There are 1.5 billion pornographic Internet downloads a month. Between the years 2005 and 2006 the pornography business increased by almost one billion dollars. It is well into the billions now. Addiction to Internet pornography is a growing problem in the U.S and almost everywhere in the world due to the ever increasing ease of being on the Internet and the large amount of porn sights available. Each year the pornography industry grows by millions of dollars. If you are reading this thinking it affects others but not you, don't be so sure. Our husbands, wives and children may be watching pornography. Not only may your own family be watching it, but your parents, brothers, and sisters may be too. In fact, it is so insidious, available, and addictive that by the time you begin to wonder if your partner's interest in the computer late at night is becoming an addiction, it may be too late.

Trying to find out what causes a porn addiction is as puzzling as trying to find out who is susceptible. There are some basic questions you may want to ask yourself to assess if you or someone you love is addicted to porn:

1. Is sex or thoughts of watching sex interfering with your life, work, or your relationships? Do you find yourself withdrawing from your partner so you can be alone to watch porn?
2. Is it becoming more difficult to desire your partner due to watching porn?
3. Do you feel disconnected from your partner due to watching porn?

Porn affects all genders, income brackets and sexual orientations. Viewing pornography on the Internet can happen at home, work, in the car, at a hotel, on an airplane or anywhere. Many people who are addicted to pornography have had dysfunctional families and may have suffered abuse verbally, physically or sexually. Before you point the finger and think only men have this problem, let me reassure you that women have it too. In the last count, men outnumbered women but women were still a sizeable number. It parallels the number of women who struggle with alcohol/and or drug addictions.

Feelings of shame (staying up in the wee hours masturbating to pictures or going out to meet a stranger to have sex), secrecy (feeling you must keep this behavior secret to avoid trouble with your spouse or job), and sometimes abuse (in your efforts to deny the addiction you can get verbally and physically abusive with your spouse) are the emotions that eventually destroy your relationship. The addict cannot stop, and they risk everything they once loved or cared about. They run huge debt on their credit cards (although many of the web sites are free, meeting up with the stranger is not), they suffer from lack of sleep, and they become increasingly irritable and withdraw from their spouse and/or family.

How do we treat a porn addiction? Addiction to pornography is treated as a psychological addiction. There has to be an underlying reason for one's addiction. The 12 Step Recovery Institute adopts a 12 Step Program from the Drug/Alcohol Program to be used for addiction to pornography. Porn addiction programs are successful, but according to Sneider, who has worked extensively in this area, the most important predictor of relapse after treatment is the failure of the partner to be involved in the treatment program. We could prevent pornography addiction if we could educate couples in regards to the dangers of pornography-what to look for, how to prevent it, and how to begin the tough conversation when you are suspicious. Experts say 85% of women were correct when they had a “gut feeling” their lover was cheating (pornography is another form of cheating), 50% of men were correct when they had a “gut feeling” their lover was cheating. One thing is for certain, if we continue to say “it will never happen to me” we will ensure the growth of pornography. Currently approximately 12% of total websites available on the Internet are porn related. How many more families are we willing to sacrifice?

I watched Tiger Woods' apology about his treatment for sexual addiction on national television. Watched and listened along with millions of others to the words that are so frequently said when someone is in rehab. "I have ruined my life and it is my own fault. I need to ask your forgiveness, and I need to make amends for the pain I have caused you."

I run a food addiction group at Methodist Hospital in Houston, Texas, and work with sexual addictions in my private practice. One thing I know for sure, an addiction is an addiction and it makes little difference what the drug of choice is. Lives are ruined with all addictions and anyone who loves the addicted person is hurt over and over again. The addict is on a slow spiral downward and cannot get well until they decide they have had enough.

What makes addictions so difficult to treat, whether they are food, sex or drugs, is the denial that keeps them in place. The addict cannot see clearly and they are no longer the person you loved, were married to, or birthed. They are addicted, and the drug has full control over their personality. They will steal, lie, cheat, and care nothing about what you think. They are totally self-absorbed toward getting the next fix. Forget it if you think you are helping them by covering for them when they are too depressed or hung over to go to work. If and when that happens, you have become part of the problem. When an overeater wants to celebrate at their favorite restaurant and you take them and eat with them, you are part of the addiction. When a friend wants to meet up with a date in a new town and you keep it a secret from everyone, knowing this friend has had many other lovers you are part of the addiction. Tiger's handlers who didn't hold him accountable and didn't stand up to him became enablers of his addiction. He may need to reconsider who he hires, and tell them up front that they need to be firm in what is acceptable and what is not.

The three teachings that Tiger already learned, and that I teach in the food addiction group, as well as with my sex addicted patients, are: