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Digital worlds and new challenges

Adolescence is a crucial time for psychosexual development, for managing new bodily feelings, for shifts from familial to extra-familial relationships, and for sexual identities to take root. Such identities concern not only sexual orientation, but also dominant patterns of relating in intimate relationships, which are often linked to attachment styles. For example, one young person who has had the secure experience of lovingly attuned parenting might seek mutually caring intimate relationships, while another who has had the experience of frustration and being tantalised might seek to excite or arouse, and another who has been abused might seek to dominate or be dominated.

It could be suggested that the internet and digital technology, perhaps particularly pornography, have hijacked these long-evolved processes, confronting young people with challenges unknown to previous generations and impacting on their psychosexual development. From time immemorial, adolescence involved managing one’s own changing bodies, relating to others’ bodies, working out levels of tolerance of intimacy and the inevitable ambivalence that relationships throw up. Ways of relating sexually and otherwise are rooted in early family and attachment relationships. These days, it could be suggested that most young people learn about sex from the internet. It might be difficult to study the effects of pornography on teenagers, as a control group might be hard to find, due to its almost universal use. While the internet can be a valuable source of information, access to uncensored sexual imagery can trigger defensive processes such as manic excitement, omnipotence, narcissistic and part-object forms of relating and it can also encourage poor treatment of the online ‘other’. Via pornographic imagery, young people can create an imaginary world where they can ignore reality. Internet pornography frequently offers distorted images of the adult sexual body, idealised, dehumanised or sadistic versions of sexual engagement, including access to sexual imagery of mothers, fathers and children, that trample over normal sexual boundaries. Most adolescents seemingly think such images are realistic,¹ which is worrying, given images of male dominance, ‘perfect’ male and female body shapes and typical ‘tropes’ of pornography, such as large breasts on females, large penises on males and hairless bodies on everyone.

The body as powerful stranger

Often, clients referred to psychotherapy for compulsive pornography use are surprisingly out of touch with their bodies. A client I will call Abeyo, was a late adolescent who moved to the UK at eight years old. He was struggling in school, and masturbating up to 18 times a day while viewing pornography. The pornography that he watched was becoming increasingly violent, although still legal. Abeyo’s background was traumatic; his parents were refugees, his mother suffered childhood abuse, and his father was often violent. Abeyo had ADHD-like symptoms; he was fidgety and unable to concentrate. He was hypervigilant, had been bullied, and when he heard the slightest noise, his mind left the therapy room to attend to anticipated danger. He was vigilant to minute changes in the room, finding relaxation almost impossible. Abeyo had a typical proclivity for addictive behaviours. He often gorged on unhealthy food, and overindulged in gaming. Abeyo’s issues can be understood from many angles, perhaps most obviously his profound lack of ease, linked to a hypervigilant sense of danger. He had never been helped to bear difficult feelings and had always struggled with emotional and bodily regulation.

Young people like Abeyo can retreat from painful experiences into manic fantasies via online pornography, which offers myriad varieties of sexual encounters, while avoiding the need to face reality. Intolerable thoughts or feelings can be countered by speedily resorting to exciting sexualised imagery and masturbation. Only after months of therapy did Abeyo admit that his masturbatory retreats were linked to having difficult feelings.

Abeyo was likeable but not restful to be with. His legs would shake, his attention darted around, his mind was as jumpy as his legs. I often wished it was allowable to put a hand on his to calm him down. I did sometimes suggest he take a deep breath alongside me. What he needed, and had lacked, was a calming, caring parental presence, a symbolic safe lap to mould into, and a good object to internalise. His mother was highly anxious throughout his childhood, not psychologically minded, almost definitely unable to help him make sense of his experiences in a soothing way. When lacking the experience of another mind attuned to their psychological states, infants will cut off from physiological signals of distress, which otherwise feel overwhelming. Bodies express distress that minds cannot afford to know, and vulnerable young people can respond with their bodies, in sexual acting out or violence, while paradoxically remaining unaware of their body states, and meagre recognition of emotions. In such cases, the therapist needs to take a more body-aware and psychoeducational approach.

Abeyo benefitted from being helped to make links between his behaviours, impulses and their triggers. Initially, his emotional vocabulary and range of known feeling states were extremely minimal, with few nuances to build on. When I asked, ‘What has been happening?’ he replied, ‘Yesterday I wanked all afternoon. It’s been bad’. But I felt that he was pleased, even triumphant, although unable to describe any feeling that might have driven him to masturbatory acting-out. When he jolted at a noise in the clinic, seemingly expecting danger, I asked what was happening in his body, could he feel his heart beat, was it different to usual? He said, as he often did, ‘I don’t know’. I asked him to put his hand on his chest and feel his heart. He did, seemingly to placate me but became interested on discovering his heart beating fast. I suggested he keep his hand there and he was surprised that his heart rate and breath slowed as he calmed. As Damasio² helped us understand, emotions are body-states which can be ‘read’, if we develop the mental equipment to do so. When confronted by noises, Abeyo began noting his body tensing or his pulse quickening, the beginning of making links between external triggers and feeling states. I suggested, ‘when you reacted then, could it have been because you were anxious, or at least unsettled?’ Abeyo began to get interested, albeit reluctantly. Initially, I felt stumped by his insistence that he had no clue what drove him to masturbating, insisting he just ‘liked it’. Those moments of pleasure when he ejaculated, he claimed, made life worthwhile. He craved this sensation like a junkie craved their next hit.

Addictive traits

People reach more for their object of addiction, whether sugar, gambling, shopping, alcohol or masturbating to pornography, when confronted with overwhelming feelings. Then the dopaminergic system is triggered, and key brain circuitry, such as the ventral striatum, is activated, at the sight of a cue, such as a laptop for a porn user,³ or bottle for the alcoholic. With pornography use, we see evidence of habituation, images becoming less stimulating, driving users to more exciting content, sometimes violent or illegal. High pornography use in young men can also lead to problems such as erectile dysfunction.^4,5 Paradoxically, porn and addictions can tune down brain areas used in empathy, executive functions or delaying gratification, needed to combat such addictions.⁶ Our dopaminergic system evolved to drive us towards what we to need to reproduce, such as sex and food. Yet this system can be hijacked by modern technology in a way that evolution has not prepared us for. Most feelings experienced by modern humans are as ancient as our species, including negative emotions such as sadness, anxiety or grief. Technology offers the false hope of taking such feelings away, a classic manic defence. Viewing alluring sexual images can mean we bypass awareness of feelings being triggered. For Abeyo, change required helping him to slow down reactivity, to try to bear the experiences that he was fleeing. He eventually started to notice what might have triggered a feeling, such as being upset. He could then be helped to recognise, stay with and bear such difficult feelings.

Interestingly, with no conscious prodding, Abeyo began to do yoga and mindfulness. This helped him to manage his feelings better but would have been insufficient without an experience of another, me, staying with his experiences, showing interest and empathy for his emotional states. Abeyo’s pornography use almost dissipated as he entered an intimate and fulfilling sexual relationship. In this period, he developed other capacities too. He started to read novels voraciously and began forming real friendships with young people who were emotionally literate. In effect, he was developing capacities we often see in secure attachment such as self-reflection and self/other compassion. At the time of leaving therapy, he was in a stable relationship, had lost at least 30 pounds in weight, and had only masturbated occasionally for several months.

Pornography as a ‘solution’ to the terrors of intimacy

A 17-year-old man I will call Paul was raised by parents who were unemotional and inexpressive. In therapy, he realised how lonely his childhood was. He was brought up to disdain feelings, his own and others, and became an unhappy adolescent, fearful of closeness. He started masturbating while looking at clothing catalogues at 11 years old, soon gravitating to pornography and hyper-sexualised images of women with so-called ‘perfect’, if surgically enhanced, bodies. Unsurprisingly, Paul was deeply afraid of commitment, but also yearned for it, and pornography often plays a role in such issues. Former Portman clinic director, Glasser’s, concept of the Core Complex⁷ usefully describes a longing to merge lovingly with another, while also fearing a loss of self, which triggers a distancing, a claustro-agoraphobic dilemma, where closeness brings claustrophobia, but aloneness feels unbearable.

Paul often turned to pornography after an enjoyable evening with friends. The unbearable transition from connection to solitude being bridged by pornography protected him from knowing his fundamental aloneness. These issues were slowly addressed in therapy, where he spoke of how masturbating with pornography created a fantasy of closeness, which he recognised was a poor substitute for the challenges of relating intimately with a real person emotionally and bodily.

Electronic transitional object or fetish

For some individuals like Paul, screens can function as a transitional object, providing comfort, conjuring the illusion of another, whose existence, shape, size, age and behaviour are totally under their control. Such mental mechanisms both fuel the illusion of a false reality, and maintain omnipotent states of mind. Some sexually exciting images are infused with aggression and autoerotic excitement that signal a further retreat from relatedness, and pornography becomes more an addictive fetish than a transitional object. Through the use of internet pornography, internally driven desires can be accessed, allowing for the expression of sexual impulses, while bypassing self-consciousness and shame about such impulses. Paul and Abeyo both used the world of illusion provided by internet pornography to defend against painful emotional realities.

Sexting and sexualisation as a response to deprivation and dissociation

Most compulsive sexual internet users are male, but females also get embroiled in worrying activity. Typical was a client I’ll call Bekka, ¹³, who became involved in a sexting scenario which threatened her reputation.

An only child, adopted from Russia at seven, she had been seriously neglected and exposed to sexualised behaviour. She struggled in friendships, and felt lonely, emotionally flat and deadened. She managed cravings for an intimacy she also feared, by engaging in inappropriate online encounters, which were her major source of excitement. Like many male pornography users, Bekka presented as emotionally dulled and lifeless. Her potential life-force, the Freudian ‘libido’, sexual or otherwise, seemed only to come alive via exciting online encounters.

Bekka inevitably got caught, provoking her mother, who became despairing and angry. This pattern itself became a sadomasochistic enactment, allowing her to avoid real intimacy with her mother while keeping her closely ‘on her case’, a variant of the core complex discussed previously. After being caught posting naked selfies, Bekka’s technology was removed. Ostensibly, she was pleased to be protected. However, at stressful periods, less conscious forces took over. Then, she would addictively scour the house, ghostlike in the night, for discarded technology, communicating online with unknown men. Vulnerable girls like Bekka are easily groomed by men who make them feel special and unique. Bekka’s paucity of love and attention early in life and her preverbal exposure to exciting sexuality, made her ripe for exploitation. In therapy, Bekka learnt to bear the feelings stirred up in intimate human encounters. More genuine emotional relating became possible, enabling vulnerability and dependency, especially with her mother and therapist. She began to crave attention, and to believe in benign loving relationships, which felt like a huge risk. She would quickly retreat if she felt spurned, and would become manipulative to get attention. Therapy can be a kind of practice for life, a place to learn about emotions and one’s inner life, where intimacy and trust in genuine closeness can be played with.

The process of becoming emotionally healthier for young people like Bekka is slow, with many false dawns. Powerful feelings of need can get stirred up, such as during gaps between sessions. As Bekka learnt to bear such feelings and gain belief in being known emotionally, her symptoms began to abate, and she began to rely less on worrying patterns as belief in her lovability grew. Worrying tech use increases at times of vulnerability and emotional challenges. Without a good internal object to help bear difficulty, many young people resort to worrying solutions. Of course, as with any addiction, there needs to be a gradual weaning from technology. Worrying technology use is a turning away from challenging emotions, human relationships and intimacy and when these can be borne, addictive tendencies diminish.

Risks of enactment in the virtual world

A young man I will call Dillon, 16, was caught accessing indecent images of children. He had been sexually abused at nine years old, and his sexual fantasies were about children of that age. Initially, Dillon accessed legal images, but then discovered the ‘dark web’, finding pornography depicting sexual encounters between prepubescent girls and adult men. Discovering such pornography meant he felt less different and alone, lessening his fantasising about real-world children. Many, but not all, who have sexual fantasies about children were abused as children or inappropriately exposed to sexual stimulation at a young age. Accessing indecent images of children can represent a revisiting of a troubled history, sometimes projecting onto someone else, who becomes abused and helpless, as they once were. Dillon was initially unbearably gripped by the temptation to click on such images of children, but as his traumas were worked through in therapy, his reenactments lessened.

When he was first referred to therapy, Dillon barely left the house, to avoid being besieged by desires for prepubescent girls on the street. Family beach holidays were his biggest nightmare. He unsuccessfully expended huge energy trying to push away his desires, hating himself for having them. I encouraged him to stay with his feelings and fantasies, getting to know them compassionately, in all their granularity. Interspersing psychodynamic work and mindfulness, he could explore his feelings and fantasies in a titrated way, moving between explorations of his sexual thoughts and his immediate body sensations, especially those he experienced when aroused. Over time, this yielded remarkable results. He became able to bear feelings of sexual desire for girls while in public, without feeling at risk of acting on them or being overwhelmed. Finding that he could actively ground himself by focusing on his body-states was liberating and transformational. He could watch thoughts and feelings come, step back from triggering sexual fantasies, become aware of his body, such as fast heart rate or shallow breathing, and find a way back to calmer breath. This was not about avoiding his feelings, but rather bearing them, something that mindfulness and psychoanalysis share. Dillon eventually left therapy to go to university, confident that he could manage in the world, no longer plagued by self-hatred and shame.

Conclusions

The dangers posed by digital technology are much higher for vulnerable children and young people than those who have had a good-enough upbringing. Those with less favourable attachment relationships have generally been helped less to bear difficult experiences. Hence, they are more vulnerable to the lure of technology to defend against overwhelming emotions. Particularly for abused and neglected children, the internet can contribute to an increase in manic, narcissistic, omnipotent and sadistic ways of relating to imagined others. With the support of psychotherapy, the inner world changes, and virtual sex can lose its allure. Central to this are the challenges of managing real-world relationships, whether with the therapist or sexual partners, with all the terrors this throws up. This generally is slow and painstaking work, but sensitive psychotherapy can offer a genuine alternative to the immediate excitement and gratification of the virtual world.

Graham Music (PhD) is consultant child psychotherapist at the Tavistock Centre and adult psychotherapist in private practice. His publications include Nurturing Children: from trauma to growth using attachment theory, psychoanalysis and neurobiology (Routledge, 2019), Nurturing natures: attachment and children’s emotional, sociocultural and brain development (Routledge, 2016, Routledge, 2010), Affect and emotion (Icon Books 2001), and The good life (Routledge, 2014). He has a passion for exploring the interface between developmental findings and clinical work. A former associate clinical director at the Tavistock, Graham has managed and developed many services working with the aftermath of child maltreatment. He now works clinically with forensic cases at The Portman Clinic and teaches, lectures and supervises in the UK and abroad.

References

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