Can Using Porn Physically Change the Brain? Neurosurgeon Breaks It Down

This is an interview by our founder, Kristen Jenson, with Dr. Donald Hilton. Dr. Hilton is a world renown neurosurgeon and expert on the effects of pornography on the brain. He’s also a member of our Defend Young Minds Advisory Council (see end of article for full bio). This interview was recorded April 15, 2022. Transcript has been edited for clarity.

‍KRISTEN: Hey everyone! I’m Kristen Jenson and I’m the founder of Defend Young Minds, the author of the Good Pictures Bad Pictures series of read-aloud books, and the executive producer of the Brain Defense: Digital Safety curriculum.

Today I am so happy to welcome Dr. Donald Hilton to talk with us today. He is a noted neurosurgeon, he has done a lot of work with academics and teaching, he’s a published author and a noted scholar.

He’s going to talk to us a little bit about the brain and how it’s impacted by the things that we consume–the things that we watch, the things that we do.

Thank you so much, Dr. Hilton, for being with us today. I know our Defend Young Minds audience is excited to hear what you have to teach us.

‍DR. HILTON: It’s good to be with you, Kristen. Thanks for inviting me.

‍Can using porn physically change the brain?

‍KRISTEN: Let’s talk about how watching pornography actually physically changes parts of the brain. How does it physically impact the brain? How does it affect sexual function in someone that consumes a lot of pornography?

‍DR. HILTON: It’s important to understand that any form of learning changes the brain. It physically creates learning ruts–wagon wheel tracks for things that we learn. And that’s true with anything that we learn. 

The first studies came out back in the mid to early 90s on music. They found that with individuals playing violins, the younger they began to play and the more proficient they became, there were gray matter changes in the part of the brain that controls the violin string hand. I think that was the first study and that was published in Nature Neuroscience and other prominent journals. Other modalities have also shown similar gray matter change. The white matter tracks change as well.

So there’s no question that learning changes the brain. One of the authors of these early studies said “Learning sculpts the brain.” It changes brain structure–literally sculpts it. 

So how does that affect sexuality? Well, sexuality is a particularly potent form of learning. So with sexuality, as we talked about with cadaverine sex [in our last interview], the brain can learn to like things that it wouldn’t like otherwise, if it’s paired with sexual reward.

There have been several studies that have shown gray matter changes with pornography. There was a study several years ago that showed gray matter change in the reward system in people who were compulsively watching pornography. 

There have been other studies that have shown other areas of change. There have been metabolic studies showing that people who are compulsively watching pornography will look at pornography the way a cocaine addict looks at cocaine or an alcoholic looks at alcohol. It’s a heightened reward system, sharpened to that stimulus.

‍Related: How Porn Hijacks Young Brains and 3 Effective Ways to Defend Your Kids‍

‍How much does pornography change the brain?

‍KRISTEN: The brain is very sensitized to porn. So when you say there’s changes, what are we talking about? Bigger? Smaller?

‍DR. HILTON: There can actually be shrinkage in some of the gray areas. We don’t think this is neuronal drop out, but there are a lot of supporting cells that support the neurons--which are the thinking cells in the brain. How does each change directly relate to the actual action? We don't understand that. But what we know is this is a physical rut from learning. That is likely why it’s so hard for people to change.

One of the other things that was shown in a couple of studies of people who were compulsively watching pornography was that these wires between the frontal judgment areas and the reward system are attenuated–affected in a negative way–in those who are watching more pornography. That’s been shown in a couple of different studies. That frontal connection is not as prominent.

That’s been seen also with obesity. People who overeat can have a similar change, as can other people with drug addictions.

There are a lot of correlates to addictive behaviors and compulsive pornography use, which I firmly believe the evidence supports an addictive role for compulsive pornography use as well. 

‍KRISTEN: So to recap, as people get involved in consuming pornography, it physically changes the brain and it weakens parts of the brain. We call the frontal part the ‘thinking brain’, and it weakens that part in a couple of different ways. There’s some shrinkage that goes on. And also, as you said, the lines that go from the ‘thinking brain’ to the reward system and other parts of the brain are damaged or weakened.

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‍What happens when the ‘thinking brain’ is weakened?

KRISTEN: If the ‘thinking brain’ and its ability to communicate or affect the other parts of the brain is weakened, what happens?

‍DR. HILTON: It’s kind of like wearing out the brake pads. You can think of one of the functions of the frontal control areas as a braking system. We’re going downhill and we enjoy the exhilaration of the speed, but we don’t want to crash into the river at the bottom of the hill, so we tap our brakes. 

With pleasure, [the frontal areas of the brain] kind of tap our brakes and at least contextualize the pleasure. So a simple way to think about it is the brake pads wear out. The person isn’t able to brake as well. 

Also, there’s a loss of contextualization of pleasure. In the limbic system of the brain–which is mediated through frontal and temporal regions–and the hypothalamic regions. They contextualize sexuality. 

In other words, there’s an emotional component of sexuality. There’s the whole oxytocin, vasopressin neuro connective type systems of the brain where we bond to the object of our sexuality. So then there’s this bonding to a pornography experience–it becomes a ‘friend’. Then there’s an impairment of bonding to real relationships as well.

‍KRISTEN: So not only does it physically affect the brain, it affects our ability to ‘put the brakes on’--which we know kids are impulsive and they need those brakes. We don’t want them hampered by addictive experiences like pornography. It only makes it worse. 

‍DR. HILTON: With kids, of course, those frontal control areas aren’t fully developed until the late twenties, anyway. So you have an immature braking system as well, versus an adult where their systems may be more developed. With kids, it’s not even a completed braking system that’s being attenuated further by pornography.

‍KRISTEN: Yes. That’s just one more reason we want to warn kids about what they are doing with their brains when they get into pornography, so they’ll have more of a choice to avoid it and reject it.

‍Can a brain that is damaged by pornography use recover?

‍KRISTEN: People often ask me, “If your brain is hurt by pornography use and damaged, can it recover?”

‍DR. HILTON: That goes with any other compulsive or addictive behavior. Consider all of the people who have recovered from significant drug addictions, be it heroin or alcohol. And they have years of sobriety and they end up helping other people. That’s certainly true with compulsive sexual behaviors, with sexual addiction as well. 

But it’s a learning process. As addiction is a form of learning, compulsive behavior is a form of learning, so is recovery. That neuroplasticity that changes the brain to be in these wagon wheel ruts that continue to help people relapse, can also–with time–be changed to where recovery becomes a different road that they learn to teach their brain to travel.

So it’s a process, just as becoming addicted to something is a process. Recovery is also a process. It takes time, work, support–as for any addiction. And that’s whether it’s a substance or a behavior.

‍Kids and addiction

‍KRISTEN: As we’ve talked about addiction and kids–because of teenagers’ more immature prefrontal cortex or immature thinking brain–are they more vulnerable to creating addictions of all kinds?

‍DR. HILTON: Absolutely. They're just more susceptible, they're more vulnerable. That’s the whole reason that one of the biggest components of the lawsuits against the tobacco industry was that they were found to be trying to market to children. 

There were internal memos in the tobacco companies where they found that people would choose a brand early–even before 18 years old–they would choose a brand for life. So if you want them to be a Marlboro person, you want to get them early so that they’ll be a Marlboro person for life. 

So having cigarettes dispensed from vending machines was prohibited for the same reason–because children weren’t able to adequately judge whether or not tobacco would harm them–which of course it did.

It’s similar with pornography. They just don’t have the judgment system to be able to understand that developing those kind of compulsive sexual scripts early will negatively affect them in 20 or 30 years? With their ability to develop relationships.

‍KRISTEN: Yes, and it will. And they don’t know it. And it’s unfair that they’re not being taught the harms of pornography and how it can affect their futures.

So that’s what we’re trying to do–get that information out to parents and kids so that they know all the good reasons to avoid pornography. It’s not enough to just say it’s bad. It’s bad for you. We need to explain how it can impact their one precious brain and how they can use their thinking brain to protect their entire brain.

‍Related: How Porn Use Becomes an Addiction (Simplified!)

‍Advice to parents

KRISTEN: Thank you so much for your time today. I’m just going to end with one final question.

What kind of advice do you have for parents, and even grandparents out there, who are scared about the access that their kids have via smartphones to pornography and other sexually exploitative material?

‍DR. HILTON: It’s a different world. They will find pornography on the internet. It’s not filtered. I know in England they’re working on their age-verification bill. They haven’t been able to actually effect it yet, but they’re trying. We’re behind them in this country.

Be careful with people trying to say there’s ‘ethical’ porn. In fact, if you look at Netflix–some of the bigger shows on Netflix like Bridgerton, Game of Thrones–these shows now are inundated with pornography. 

In fact, one of the largest pornography sites–PornHub–took a collage of sex scenes from Bridgerton. The Bridgerton actresses acted horrified. “We’re not pornography performers!” But the people that watch porn on PornHub thought they were great porn scenes. They coat it with other scripts, but it’s really pornography. 

On these shows like Bridgerton, they have to have ‘intimacy coordinators.’ Because the actors/actresses are going to be abused by public exhibitionism, they have coordinators trying to help them feel good about exhibiting themselves to the world for the rest of their lives and to their grandchildren, because they will see these scenes. 

So ethical porn, in my opinion, doesn’t exist. Think about that. People who portray themselves on the street the way they portray themselves in front of a camera are arrested immediately–if you go out and take your clothes off and start having sex on the street. Yet if you do it in front of a camera in front of millions of people, then it’s considered ok. 

‍Related: Female Friendly Porn–What It Is and Why It’s Still Harmful

And so I think to just to understand it’s a pornography culture we live in now. We can’t trust our devices now. We have to do what I think you’ve done so well, Kristen, and that is to get the word out that there are good pictures and there are bad pictures.

And we want our youth to be discriminating from an early age, until they can protect their own sexuality and their own intimacy. So they can write their own intimacy and sexual scripts in the way they would like to write them as they grow. And not have the pornography industry write those scripts and imprint them with cadaverine sex from an early age.

‍KRISTEN: That’s a good way to put it. I’ve been asked about ‘ethical’ porn and I’m so glad that you mentioned it. Because people start and they think as long as it’s just showing a man and a woman having sex and it’s consensual, it’s ok. 

But it’s still sex as a performance. And because of dopamine that performance then needs to be anted up and anted up. It needs to be more and more extreme to get the same arousal and people may start with ‘ethical’ porn, but they’re going to head off to more extreme versions to keep that arousal up because of the nature of the brain. 

And the other thing is that I never wanted my kids or myself to think about my sexual intimacy with my husband as a performance. Then I’m thinking about myself. I think this whole idea of sex as a performance is very dangerous, very objectifying. It doesn’t lead to a really wonderful sexual intimacy between a couple. It erodes it.

‍Related: Healthy Sex vs. Porn Sex: 7 Crucial Comparisons to Teach Your Kid (Before XXX Hijacks Their Future)

‍DR. HILTON: Sex has become a screen. And that’s what’s happening with kids now, and that’s why sexting is such a problem. Because they don’t know how to become sexual. Many of them won’t have physical sex, but they’ll sext pictures of their genitals to each other. And now it’s sexual if it’s on a screen. And it’s because of porn. Porn has scripted this generation to look at sex as a screen now.

‍KRISTEN: Sex is not a screen! There’s our new battle cry.

‍DR. HILTON: It’s not.

‍KRISTEN: No. Thank you so much, Dr. Hilton, for being with us today. It’s so good to know there’s the power of neuroscience behind all of what we’re teaching about the brain, all that we’re teaching about pornography and how it hurts and harms the brain and harms a child’s future. Thank you so much! We appreciate it. Hopefully we can talk again!

‍DR. HILTON: Absolutely, my pleasure. Good to be with you Kristen.