On and Off The Spectrum
How do families react, respond and reorganize after receiving a potentially life altering physical or mental health diagnosis, either for themselves or for someone they love? Dr. Esther Hess and Dr. Ann Kirsch, two experienced and well-known psychotherapists offer strategies, guidance and realistic hope through some of the toughest times that families can face.
On and Off The Spectrum
Understanding and Treating Porn Addiction on the Internet - Part 2
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This episode is the second part of Drs. Hess and Kirsch discussion with expert Naomi Afriat, LCSW, on the timely and understandable disconcerting subject of internet porn addiction; it's origins, impact on individual and family life and course of treatment.
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So we want to welcome you to On and Off the Spectrum.
SPEAKER_00Yes.
SPEAKER_01And I am Dr. Estee Hess. And I am Dr. Ann Kirsch, and we welcome you again. So we have a very, very special guest this evening. It's Dr. Naomi Lewis. Remind me your last name again? Afriott. Afriat. Ephreat. Afriat. Thank you very much, Naomi. And we were so impressed because Naomi happens to be, I would say, a world authority on a very, very topical and challenging subject, which is internet pornography addiction. And so this evening we had so much to talk about the last time we got together that we decided that we needed more time to really explore some of the nuances of the questions that our readers and viewers have have uh brought to our attention. Um and one of the the uh the thoughts that kept coming up is because you know our our podcast is called On and Off the Spectrum. So we deal with a lot of both neurotypical and neurodivergent issues. But there is a difference when you're speaking about a neurodivergent individual who is addicted to the internet, and then particularly when there is a pornographic component to that addiction. And I think there's a different way that you need to approach that treatment plan, and I thought we would start with that part of the conversation.
SPEAKER_02Yeah. Yeah, that's great. That's great, Dr. Hess. Thank you both for having me here today. It's great to be here again. Um, we had some great conversations last time, and I look forward to some great conversations again today. Yeah, so talking about uh the neurodivergent client who is struggling with internet addiction that has a pornographic component. I think it's important for a therapist trying to do the assessment of a client like that with that presentation, uh, to really keep in mind what the neurodivergent um diagnosis means and how that's going to affect their functioning. Um, people you know on the spectrum might um struggle with socialization, they might struggle with um an intense focus on certain areas that they're very interested in, um, they might struggle with understanding how to um build a romantic relationship. There's they also might sometimes uh not understand some of the nuances and maybe the ethical pieces around why pornographic uh material might be inappropriate. Um so I think it's really important for a therapist to be understanding of that. And sometimes what what what to uh a therapist who works with neurotypical clients might look, might might seem like a like a straightforward pornography addiction, um, might to someone else who's familiar and is able to see that the person is on the spectrum, might not necessarily be that. Or it might be, you know, behaviors engaging in pornography. It might not necessarily be um the addiction. Remember that um people on the spectrum, I'm not I don't have to express that to you, doctors, um, is often um there's a certain amount of stimulation, right? They there's a certain amount, right? Um they seek they seek a certain amount of stimulation, and and um this can be one way of of doing that. Um so I think it's important to not just lump them all together and to be really mindful about where the client's at and what their diagnoses are, diagnoses are before you start looking at their sexual functioning and how they might be engaging in this way.
SPEAKER_01I think you you know you mentioned something about stimulation. I think that there is, for those of our of our viewerships who may not know necessarily the science behind this, there is a uh chemical in our brain, a neuro neurotransmitter called dopamine. And every time someone will go after like a hit on the internet in general, they're gonna get like a squirt of dopamine. And it is uh somewhat calculated by people who advertise on the internet because they want you to be, you know, stuck on that so you continue to purchase and and and whatnot. But there is um an incessant need to continue to get that kind of feedback to the brain, especially when for whatever reason your own chemistry doesn't naturally produce an adequate amount of this uh very needed neurotransmitter for appropriate regulation and concentration and focus.
SPEAKER_02Yeah, I think that's actually very relevant. I think look, all addiction or most addictions um engage with that feedback loop of dopamine and then the the need and then the dopamine levels dropping, and then this that will trigger the seeking of the dopamine rush or the dopamine hit, and then they'll engage in whatever their addiction is, whether it's gambling or shopping or eating or drugs or alcohol. Or in order to get that with games.
SPEAKER_00Right.
SPEAKER_02Oh the gaming, the gaming addiction is also very big right now. The gambling addiction is very big right now. I just spoke to somebody um who said it's really kind of getting up there. So any addiction will you know engages that feedback loop, right? That seeking of the dopamine, getting the dopamine hit, having a little bit of satisfaction, sometimes also raising tolerance and needing more of the dopamine, right? That tolerance level goes up and they need more and more dopamine. So I think it's important to all addictions will engage with that. I think people on the spectrum sometimes might be using pornography, not necessarily for the dopamine hit, but in order to kind of satisfy the need for in what in their mind might be a misguided search for a social connection, right? They might be thinking that this is, oh, they're chatting with somebody online, maybe she really wants to be my friend, right? Instead of kind of like, oh, she's you know, she's she's being sexual with me, maybe she's really interested in me. There might not be that the understanding always necessarily, right? Or they might not, you know, they're they're looking for the stimulation, uh, a sexual stimulation they might not get elsewhere because they might be limited in that way, or they might be not be able to find it because they don't have the social skills. Um, so it's it's it is important to understand that there is a difference to that, right? Now, when this when they're engaging, eventually very often that might be how it starts, and then they end up engaging in that feedback loop again and again, and then they might end up as a real addict that's possible.
SPEAKER_01Oops, Naomi, you're frozen in time here, just for a second. There we go. Okay, I came on back.
SPEAKER_02Yeah. Did I did I uh freeze? You froze for just a half a moment, but um no, what I was saying was that um one of the things that we do when we're working with any addict is trying to understand where this came from, right? How did this start, right? Usually there's some kind of trauma, traumatic underpinnings to most addictions. Um but I think that with people on the spectrum, there might be another another aspect, right? Something else that led them there. And that's also really important, right? Were they very lonely? Were they numbing the need of loneliness, which is very common in the neurotypical, in the neuro, right, in the neurotypical um population as well. But the need and the there, you know, maybe there was a lack or inability to gain that, you know what I mean? Like the the the way they got there might have been very different. And because of that, one of the ways that we help people who are addicted become unaddicted, um, is you know, if you understand why they got there, helping them develop healthy coping mechanisms so they don't have to go there again, right? So if somebody was numbing themselves because of some kind of trauma that they went through, processing that trauma and then finding them healthy coping coping skills, they don't have to go there, right? Somebody who got there because they were lonely or because they were seeking some kind of sexual contact because they couldn't get it elsewhere, because they didn't have the skills, they're not going to be able to stop so easily. And we have to teach them what it is they need to know in order to be able to function in the area so that they then don't need so that they could be comfortable weaning themselves off that. Does that does that make sense?
SPEAKER_01Yes, absolutely. It makes it makes a lot of sense and it's a challenge. It's a challenge because I'll tell you, a lot of the uh I'm gonna say more men than women, but it's it's actually in both in both uh male and female population. They're just very lonely, and it's tough to make any kind of friendships and it it occupies time. You know, there's like what how do I how do I go ahead and occupy time? Um I had a uh a client uh recently who was sharing that this individual feels very bad because they don't want to be on they don't want to be addicted to technology, they certainly don't want to be addicted in this, you know, in a in terms of pornographic material. Um they see an impact in their lives that they don't think as clearly, they aren't as creative as they used to be, and so forth. But the thought, the thought of so we began to experiment with like, all right, what if you like say from X to X amount of hours a day, could you just not be on the internet? And he just took a deep breath and said, I don't know. I d I really don't know. I mean it was an honest answer, which I appreciate it, but it it just it was like it's a very scary thought because it uh it's a huge void in people's minds.
SPEAKER_02And what do I do then? What is he gonna what is he supposed to do then? And if it fills the a very kind of maybe a more underdeveloped um void of what in their mind is socialization, um where are they gonna get the socialization otherwise if they don't get it there?
SPEAKER_00And it's an interesting thing to hear you say that because I've spoken with people of all age groups who who are neurodivergent or not, who have the same issue. It's the you know, it's the hidden magazines, it's not and we're talking about this time, not the 1930s or 40s. We're talking about um going out being online, hiding all of this. So the issue also of all this hidden life that's hidden from a spouse if there is one, friends, what does that do? What in your experience does all that hiding do? Because here we're talking about a young person who also feels guilty. Shame, yes, shame.
SPEAKER_02A lot of shame, a lot of guilt, yeah, yeah. And I so I think your question kind of really is, you know, goes for um, as you said, the neurotypical community and the neurodivergent community. And I think it's one of the big components of this issue is the betrayal and the secrecy around it, which have very much have a lot to do with the shame. And I think, you know, what shame is one of the things that inhibits healthy sexuality, right? People are not able to be their own healthy sexual cells when there's shame involved, right? So let's say there's a young man or a young woman and they're finally in a physical, healthy relationship, because they often feel so much shame because of their past activities potentially, they're not going to be able to explore in a healthy way because there's so there's often like a split or complimentalization with sexuality and and healthy relationships and intimacy. It's all kind of like the wiring is kind of off. Um, so first I just think that that's one piece that I think is important to acknowledge that that it becomes much more difficult for them to be comfortable in the sexuality because in their mind, you know, what what what fires together wires together, right? Are you familiar with that, right? So when they in their mind, the sexuality has always been associated with shame and with bad and with guilt and negative feelings. So now and now you're expecting them to be sexual with somebody in a positive, beautiful, hopeful, positive way, right? And that's very difficult for them. Um, so that's something that that we often then see that becomes very that's that's hard. It's difficult. Um but I also just think that you know, secrecy and shame obviously also erodes the trust in a marriage when it comes out or in a relationship, right? The the damage of betrayal, that's one of my my biggest areas um that I focus on in my work that I in the work that I do is mostly on betrayal, mostly usually women, but not always, or men that have been betrayed by their spouses, either by them watching excessive pornography online and having that affect their lives, or by going outside the marriage and doing all sorts of other things. Um but the the damage of the secrecy and the shame. Um not I'd say there's a few different victims in that. First of all, the person themselves, they're walking around with this big heavy load. It damages their sense of identity, a sense of self. Who am I? What am I doing? Right. A lot of times, if they're religious, they might have a religious crisis. You know, I can't stand before God and whatever religion they they practice, right? I can't stand before God because He can see what I'm doing. I'm not the person that I'm pretending to be, right? I'm I'm too dirty, I'm too damaged, I can't do that, right? Um, there's a split, like I have my private life that I do all these other things in, and then there's my public life where I'm, you know, this perfect person, right? So that's so that so just for the for the person that sells, it's it does carrying secrets and shame like that carries a lot is very damaging.
SPEAKER_01You remind me, I think there was a scene in The Godfather where I remember, I I remember one of the the the mob bosses had a mistress and a wife, right? And so the wife was he could kiss the wife on the mouth.
SPEAKER_02Yes, I remember that.
SPEAKER_01Right?
SPEAKER_02But not but not the mistress.
SPEAKER_01But not the mistress because because then you know he had to delineate in terms of what was allowed my my wife, I can do that because she kisses our children, right? And you know, and this this absolute split of division and you know comic relief or or whatever in the context of of a of a theatrical production, but I am struck also by the damage, the damage that pornographic sex, the message that, for example, there is no human that can manifest the speed of satisfaction that a machine can they can do.
SPEAKER_00Or a hand can do. Right, right.
SPEAKER_01And you know, so and and so there is an expectation, and there is also overuse and then damage to the you know to the actual uh mecha, you know, the physiological mechanisms uh of intimacy. And I and then I'm gonna overlay one more component, particularly in the neurodiverse community, where a lot of the individuals who I see have a despondency that they never imagine that they're going to ever have the capacity for an intimate relationship. And so they want a sexual release. Forget the dopamine for a second, they just want to feel good for a moment, and this becomes the avenue of a connection, or they decide.
SPEAKER_00I worked with someone quite a while ago who um decided that they were um asexual because they were too afraid of one, not afraid of the other, and so the middle was I'm asexual, and then spoke with me about it because they wanted to make sure that they knew what asexual was, even though they'd already decided that they were. And so there was a little bit off and a and we had a we had some amazing conversations. Um you are what you tell yourself a lot of the time, and so it is it goes it like this conversation for our listeners, all different directions.
SPEAKER_01I'm gonna I'm gonna jump on that for a second, Anne, because hot off the presses becoming enamored with an AI fantasy or partner. And I have a recent couple where it ha it this happened between the the man and the AI figure. And the wife is so but feels so betrayed. Yeah, and she's and I can't he says, I don't know what to do with this because it's not like a woman, but he he wants to have us both. He wants to have his technological mistress and me. And I I don't know what to do with it.
SPEAKER_02How would you know?
SPEAKER_00No one knows what to do with it because this is so brand.
SPEAKER_02So new. Yeah. If somebody had told us we're gonna be doing this ten years ago, we'd be having this conversation.
SPEAKER_01It's like it's really, I think there's a movie called She or Her that's out recently. That's very but but so Naomi, what do you do with a couple comes to you and says that my we've discovered it was a discovery, it was uh and it's it's caused damage in our marriage. My husband is in love with his AI mistress, and I know it's not real, but it is real, it's impacting our marriage. He doesn't want to give her up, but he wants me there, and I don't want to share this part of his experience.
SPEAKER_00Do you want her there in the room with the mistress, the AI mistress, or separate?
SPEAKER_01Well, that's a good question. I I think I think I think he is still experimenting with all different kinds of ideas. And the idea appalls her. She doesn't want to lose the marriage. You know, it's a family with children, and all and what what how do you address it?
SPEAKER_02What do you do with that? Yeah, yeah. So I'm gonna start to answer that, but I just want by um by going back a little bit. You right at the beginning of our segment, you asked me about um the difference on the narrative edge and the neurotypical community, and then um and you said um you just touched on something. I think it's important to remember that a lot of the people in the narrative agent community might not be able to, because they can't pick up the nuances of the interactions and the social socialization pieces, they might learn about sexuality from pornography. So they think that whatever they see there is that is pornography. By the way, that goes for the neurotypical community as well a lot, because they don't really give some very often as communities or groups that don't receive proper sex education or understanding or guidance around that. Um, so then you'll get a situation, and and you know, SDL, I'll I'll get to your answer in a minute. I'm sorry, I'm just backtracking. Um and uh they'll get they'll they'll be a situation where they're finding themselves with you know in a physical, real life situation with a partner and then either treating her like a sex doll or like a pornography um actress because they're thinking, well, the person on the screen wanted that and or I or did that for the guy, so I want her to do that for me, or I want to be able to do that for her. And the woman's just kind of like, whoa, whoa, whoa, what what what's happening here? This is not at all you know what I signed up for. Um so often there's just a lot of misinformation, which is really, really troubling. Um and in the neurotyp in the neurodiversity community, I think people might not know necessarily to be able to differentiate what's what. In the neurotypical community, by the way, you get this a lot of the same issue as well. Um they really should be able to see it apart a lot better, at least you know they do have that ability. Um, coming back to your question, Dr. Hess, is um so my my specialty, my area really is um betrayal the betrayal piece of it. And I think it's really important to stop and think about it. And what something that I hear over and over and over again, ad nauseum is oh, well, it's just pornography, it wasn't a real person, or somebody will say to one of the women, one of the betrayed wives that I'm working with, oh, you know, but but at least he didn't go outside the marriage with someone, you know, at least he didn't go out there. Um so I just wanted to kind of put out there that the research shows the research the ITAP, the Institute for Um institution that does all the research and promotes and all the um creates all the curricula and the and the treatment models and all that for all the for these particular addictions. Some of the research they've done shows that the damage that's done on a wife by a husband who has betrayed her, who has engaged in pornography, the damage that's done to her is the same as whether he'd gone outside the house and slept with 10 prostitutes. So to the wife, it doesn't actually matter that much what it is. Well, of course it matters. I'm not going to say it doesn't matter because in one situation she might have to go and do an STD test, which I've had to tell partners to do at times, and in one she might not. Outside of that, um, and that's not that's not that's nothing to be sneezed at. It is a big deal, and it's very upsetting to have to do that. But um aside from that, the pornography, the damage from pornography is is not that much different. It's almost the same. Uh the difference is negligible for a wife. So coming back to your question, Dr. Hess, about a wife where, you know, whose husband and and the the object of his betrayal that he's betrayed her for is an AI, you know, literally a fiction of his imagination, right? Um from her perspective, it's still that. Imaging. Remember that we define betrayal as anything that takes away any emotional or sexual energy from the primary relationship. So and the trust. Right. So anything will be the trust, the emotional time, the sexual energy, right? Any of those things that take away from the primary relationship, which is the husband and the wife, right, is a betrayal, right? So that could be finances too, right? Gamblers and even sex addicts. Also some of the that's that could be financially betrayed. I've had women like that as well, right? But I think in this particular scenario, she wouldn't even she's been traumatized by a betrayal. There's a very real betrayal. Her husband is spending energy on something that's not her. Now it might not be a doll and it might be an AI, you know, pixel on a screen. But in his mind, he's expending energy on that. He's thinking about it. He might be masturbating to that. He might be engaging with it, thinking about it, talking to it, right? First of all, there's going to be time involved. There's emotional energy involved. There's probably sexual energy involved. And once we start siphoning off all those little pieces piece by piece from the main relationship, there's not much better for them for the primary relationship anymore. Right. So his sexual energy has now gone elsewhere. So he might be rejecting her or not be interested in her because he's got more excitement down there. I've been willing to bet you, by the way, that this AI um persona is always willing to go to bed with him, doesn't have any emotional needs, is always excited and willing to try all sorts of different um creative things in the bedroom. So of course he likes her. I mean everyone would, right? So I think for treatment, I would generally my my treatment plan for a couple like that would be I would separate the treatment of both of them because they both have very different types of work that needs to be done. She needs to go and sit with someone who's going to validate her, who's going to tell her she's not crazy for thinking that. Go through walk through the process of betrayal, the gaslighting that probably happened, the minimizing that probably happened, um, all the hurt and pain and whatever the trauma this trauma brings up in her because we all carry stuff around and all we need is a trauma, one trauma away from right. So go processing all of that and kind of helping her figure out what she needs in order to feel safe and secure again. Because remember, the trust is eroded now, right? There's no trust left in that relationship. So her trust is eroded. And remember, women get married for security. In this day and age, women don't get married for financial security. Well, we could all support ourselves more or less, right? Women can have from don't have a baby on their own. They can do all that, but emotional security, that's what we want. We want that safety with another person, with a guy, right? So if he erodes that, then what is she there for still? So we want to recreate the safety for her and that help her nervous system to calm back down again. So she's not you know hyper-vigilant and constantly on alert and bring her back down to safety for herself, and then create boundaries between her husbands that can maintain the safety, and then not somebody needs to sit down with him and talk about what brought you here. How did you end up here? What is it you were looking for? And help him understand that this is not real, and the fact that he's in love or really likes the AI, help him see that that's fiction, it's not real, and help him, and then at some point when he's able to start learning to express some empathy and remorse, or at the very least, empathy to his wife and to help him understand how this has affected her and help her see that, and then kind of move on from there. Yeah. And there are also just steps, other steps.
SPEAKER_00Very important what you what you just said, I think will will resonate with a lot of people listening.
SPEAKER_01Yeah, I mean it's I think it's to acknowledge you we're whatever the in this in the context of the portrayal, to acknowledge eventually the impact that one has on the other. Yeah. I think that's you know what what did your action create and and to and to try to understand why. And yeah, and I I like the I like the the the approach of separation where both partners get a chance to express themselves because it's a different kind of therapy and a different kind of support between between the two of them. Nah, yeah, this continues to be such a an important uh an important intimate conversation.
SPEAKER_00And it's so alive right now, you know, it it made me think that back in the 30s, 40s, 50s, and maybe into the 60s also, um women gave men a pass because they were looking at Playboy or Penthouse.
SPEAKER_02Oh, all men do that. Oh, it's no big deal.
SPEAKER_00Exactly. Right, right. And that women would all talk to their friends, girlfriends about that, and oh, my husband does it too, and as long as he doesn't put it on the coffee table where my kid can see it, then I'm fine with it. Because they had a whole cohort who that was dealing with it. Now this has changed dramatically because now it's available online, on a screen, coming to your home at any time. Children, teens, adults, grandparents' age, everybody is online and not doing what we think they're doing. And this is just gonna blow up uh in everybody's line. I I hear young teenagers.
SPEAKER_01Well, you know, I tell you now we would have you back for a a a third session because this can you know it it continues to expand and expand. You know, what comes to my mind is that, and I and I think I'm not I'm not gonna blame COVID, but COVID came at such an interesting opportune time, and the consequences where we all had to be on our computers as a way to be the only way to stay connected.
SPEAKER_00And school gave you permission, gave children permission, and parents gave children permission. Go to the colour.
SPEAKER_02All of our socialization yeah, all of our socialization tend online as well. So then that's not that that you know it becomes so close to the fire.
SPEAKER_01We are raising a generation behind a wall. And I think then when we actually have the opportunity for intimate up in experiences, we don't have practice or we have a preference. It's been it's more comfortable to do it in isolation. And we also don't check up on each other to you know to say, because if everybody's behind a screen, then you know, are you doing everybody, you know, nobody goes what are you looking at?
SPEAKER_00But there are so many parents that I've uh kids that I've talked to who have said to me, I want to tell you something, but I I don't want my mother to know. Okay, what do you want to tell me? Um, you know, this is a teenage age, um, young teenage, saying, I'm talking to a really nice guy online, and then and that girl does have doesn't have a clue what this nice guy could be, maybe anything, because they're not being taught that. Yeah. More so now in some schools, but they really aren't being taught that. Parents don't know it. And so this one girl told me a story that made my toes curl. And she must have known something was afoot because she got to me, I felt right in time. This was an ongoing client, right in time for me to save her. And and we did. Yeah, and and that's just one terrifying.
SPEAKER_02It's terrifying. And that touches on internet safety, which is a little bit of a different topic, but it they there's definitely overlap, but it's utterly terrifying.
SPEAKER_00There is well, look, I feel like we will probably have you back. I would like to hear, you know, we haven't talked about this, but I think, you know, we get a lot of feedback.
SPEAKER_01And so I want to see what kind of feedback, what kind of questions we are, but there's no doubt there's no doubt in in either one of our minds the importance. And I think it speaks to the fact that we as a as a large community are desperate for information. I think people want to reconnect and sustain communication and intimacy, and a lot of people just don't know how. And they see these problems and don't know what to do. So I am we both are so grateful, Naomi, that you've been back to join us.
SPEAKER_00The way you speak, I just have to say the calming way that you give the message is so uh important because this is a topic that scares everyone.
SPEAKER_01And not everybody knows how to speak about it, yeah, you know, and you and you normalize it, which which is.
SPEAKER_02Yeah, I think yeah, taking the shame out of it and being able to use words that are not slang and not you know negative, and I you know, I think it's very important to differentiate between shameful sexual things and private sexual things, right? Things are private and there's something dignified in the word privacy. Secrecy has a little can have a shameful connotation. I think it's really important to bring sexuality back to the privacy realm and not take it out of the shameful realm, if that makes sense. And I think it's so important.
SPEAKER_00This is what I rem it feels like I'm I'm listening to you and I'm remembering how I spoke with my children about exactly those issues.
SPEAKER_01It's important and how we have to and how we have to address this in a much larger audience.
SPEAKER_00Yeah.
SPEAKER_01I want to thank you, Naomi, Dr. Dr. Lewis Arif. Afriatic. Excuse me. I'm so sorry. And uh it's been again our mutual pleasure to have you. Yes. I'm Dr. S. D. Hess. And I'm Dr.
SPEAKER_00Ann Kirsch, and this has been on and off the podcast. On and off the spectrum. The spectrum podcast. Right. And it has been our delight to meet you in this way, but also to share such important information with everyone out there who may be listening and telling other people that this is something important to see.
SPEAKER_01So we want to encourage our listeners first off and and our viewers to please uh contact us uh and let us know your thoughts regarding both this podcast. If you yourselves think that you would be an important guest that adds to not only this conversation, but to our conversations in general that we've been uh expanding on uh on this podcast, please don't hesitate to reach out to us as well. But until that point, we want to wish you all a good and safe night. Naomi, again, thank you for being with us. Thank you so much.
SPEAKER_02It's my pleasure. Thank you both. That's been great. Thank you for having me.
