'I sit in my room seven to eight hours a day – I can't seem to stop despite feeling lonely all the time."
This 18-year-old man is referring to his compulsive viewing of online pornography, which he feels is destroying his life. On the one hand he knows how to stop – turn off the computer. On the other, he can't seem to do it.
He explains that the last time he had a romantic relationship was a year ago and he ended that relationship because it was nothing like it was on his computer. He didn't understand that video pornography is not real and that relationships are far more complicated than just sex.
In my clinic, I often have very similar conversations with young men. In part, the topic comes up because I ask about it, but at the same time these young men are desperate and feel caught in a complex web. For some, the topic comes up as they ask me about the size of their anatomical parts. Others want to know if a drug they have seen advertised will enhance them.
Some of these young men use the word "addicted;" others merely feel the porn is getting in the way of their life and they feel trapped.
I also ask young women about online porn; interestingly very few admit to viewing it.
The attraction of male teens to pornography is not new – in the past it was reading racy books or acquiring magazines. But accessing porn has never been easier.
There is little scientific data on the harms of excessive pornography, but I believe the Internet's wide-open tap is not good for developing brains or developing self-images.
In my experience caring for teens, it seems that excessive pornography can lead to sexual callousness, body-image problems, loneliness, sexual harassment and sexual aggression.
Is addiction to pornography a mental health disorder? Well, the mental health community has recently suggested a new diagnosis called "Internet-use Disorder" that includes preoccupation with the Internet, withdrawal symptoms when it is taken away, a need to spend increasing amounts of time on the Internet, unsuccessful attempts to control Internet use, loss of interest in human-to-human social engagement, and deception of family and friends with regard to the amount of Internet use.
When studies have looked at what activities have negative effects on teens' academic performance, alcohol is not in the top 10, but excessive Internet use is on that list at No. 6. It is a worse problem for males than females.
The difficulty I have with identifying a health problem such as excessive online pornography viewing is the expectation that I can offer a solution.
In this case, I cannot. Parents should try their best to talk with their teens honestly about pornography. But that's not an easy task given teens' unwillingness to engage in such discussions, particularly with a parent.
The more we can encourage face-to-face contact for our teens to help balance the focus on cyber communication, the healthier they will be.