The Illusion of Explanatory Depth. Can you explain how your plumbing works?

My supervisor and mentor Sylvia always says that "clients come in with an idea about what the story is and our job is to confuse them."  I have seen this borne out.  Clients have a very firm idea about what the problem is and how they got there but no idea how they can solve it.  The therapist drills down and down and down, "slicing it thin" as Sue Johnson says.  "I don't think I understood that.  How does your mom being too lenient keep you from getting a job?"  "Sorry.  You said that when she gets angry, you shut down.  What does 'shut down' mean?"  "I missed that.  You were talking about how in 1985 you had a miscarriage and that was connected with not wanting to eat.  How does that work?" 

How does that work? 

I recently read about "The illusion of explanatory depth."  The illusion of explanatory depth is what research psychologists Frank Keil and Leon Rosenblitt call the human tendency to be confident that we understand something -- usually how a familiar but complicated piece of machinery works -- until we are asked to explain it.  Suddenly we recognize that a toilet or a sewing machine is way less familiar than we thought. The illusion falls apart and we become more humble.  We start to know that we do not know.  

I was amazed that nobody seems to have written about this in the context of psychotherapy.  It used to feel to me like this kind of questioning that psychotherapists were doing about a person's experience was disrespectful.  Aren't we supposed to see the client as the expert in his/her/their own story?  But there is a difference between being intimately familiar with something and being an expert in it.  Asking people to tell a coherent story about themselves and their difficulties can be painful but that doesn't make it disrespectful. 

One of the things that can happen in a family in difficulty -- particularly where there is a lot of secret-keeping -- is that the explanatory depth is very thin.  These families often have very limited, incoherent stories of themselves yet they are often very convinced that there narrative makes sense.  If a therapist asks clarifying questions it can feel very scary because the family may intuit that the illusion of explanatory depth is about to fall away.  Like all illusions, the IOED serves a very important function, it gives us a sense of coherence and comprehensibility in the face of things that feel chaotic and scary.  But more coherent narratives are therapeutic. 

John Byng-Hall citing the work of Mary Main among others wrote about attachment and coherent narratives in families.

“This would suggest that making sense of the events that traumatized the attachments is important. But the most effective way of creating a coherent story line is to help the family to manage their current attachments in a way that takes into account all its members’ attachment needs. This will require them to tune into each other’s pain. The children might then also be able to tell a coherent story to their children.”

One of the interesting elements of the IOED is that if we know that someone knows how something works, we take on that knowledge as if we knew it, too.  "Well somebody understands how a toilet works," our brains say, "So I must, too."  In a psycho-therapeutic context this can manifest as jargon not connected to real feeling or much detail; "I'm codependent."  "He's got a borderline personality disorder."  "It's because of early trauma."  "He's from Mars and I'm from Venus."   This is why a not-knowing approach by the therapist can be so important, even when it is frustrating for the client.  Families need to go from being familiar with their own family functioning and stories to being experts in them.  That doesn't mean they need to replace one prepackaged expert story with another, as easy as it is for our human brains to do that. 

When all goes well, the client or clients are able to construct a more coherent and flexible understanding of themselves, understandings that can better tolerate challenge and reorganization. 

Friendship, kids and mental health.

A researcher from Ste. Justine here in Montreal, Mara Brendgen did a really interesting piece of research about friendship as correlated with depression in children.  You can read the article (if you have academic access) or a nice summary of it at BPS Research Digest by Christian Jarrett.   By studying kids who have an identical twin with depression and kids with a fraternal twin with depression Brengdan and her colleagues were able to identify kids who were genetically pre-disposed to depression but not depressed themselves.  Then she looked at those kids and looked at the quality and quantity of their friendships.

“Genetic vulnerability to depression in girls was less likely to manifest if they had at least one close friend. Stated differently, the apparent protective effect of having at least one close friend was magnified in girls who were genetically vulnerable to the condition. This means that for girls there was an interplay between genetic risk and the protective effect of friendship. ”

— http://bps-research-digest.blogspot.co.uk/2013/05/stand-by-me-close-friendships.html

There was a beautiful piece on This American Life last week about a girl who had something like Asperger's.  Her stereotypical conversation and poor social reciprocity get in the way of friendships.  But she still wants friendships.  Eventually she becomes angry and aggressive because she is so lonely.  Her moms take her to all sorts of specialists (a humbling note for those who work with kids with learning and/or developmental disorders) and none of it really helps until... she makes a friend, a friend who is interested in the same things as her.   (It starts at about 41:00 minutes)

A question I have about Brengden's research (or Jarrett's summary, not sure which) is cause and effect.  While kids who are genetically pre-disposed towards depression may have fewer friends or friendships they value less, is that a cause or an effect or are they related through some other factor such as personality type or attachment style? 

There is a correlation between people with schizophrenia and social isolation which has lead to the recommendation (here, for example) that people at high risk of schizophrenia make a conscious effort not to self-isolate.  But we all know that correlation doesn't mean causation or else we would all demand more importation of Mexican lemons until highway deaths were eliminated (link to this and other bizarre correlations). 

Nurturing a kid's positive friendships and encouraging him/her to view friendships as worthy of investing some time and energy in seems to me like a good idea whether or not they are at elevated risk of mental illness.  Of course, for a kid who is less good at friendship or less interested in it placing a lot of emphasis on making friends can backfire by making him/her feel more incapable.  Socially awkward kids often view friendship as an ability akin to drawing or music that relies on a high degree of innate talent (it is interesting that many kids who feel bad about their ability to make friends do so around the age of nine or ten when they also start to notice that other kids are way better than them at some things without having to try hard).  It may be true that some combination of genes and very early wiring can make a person better at social situations than others, but I tell kids that friendship is more like riding a bike than playing music; it is something you can learn at just about any age, something you can always get better at by persevering and something you will never be able to learn do by watching others.  You need to try it, fall down and try again. 

4 ways therapy can do harm and why that is good news.

My former supervisor and teacher, Sylvia, used to tell me, "If you are stuck with a client, you need to put that on the table.  If you and the client can't get unstuck, stop the therapy."  I have been thinking about what great advice that is and how hard it can be to follow.  Clients will often say to me, "More therapy can't hurt, right?"  I even hear that from medical professionals and sometimes mental health professionals.  Generally, people know that insulin can hurt, and they don't take it just 'cause.  People don't undertake minor surgery for no reason.  Aspirin if taken improperly can put a person in grave danger.  If a therapy is capable of affecting someone's well-being for good, then it can also do harm if administered when it isn't indicated or in ways that aren't indicated.  Stated another way; If it can't do any harm then it is not worth doing.  I am not talking about an abusive or incompetent therapist or an unproven therapy.  I am talking about how psychotherapy can hurt when administered properly for the wrong situation or in the wrong dosage.

1. Psychotherapy directed towards a fundamentally well person in a bad situation can make the person feel responsible for his or her situation and aggravate worry.

This one happens with kids a lot.  The parents come into a therapist's office and say, "My kid is anxious/sad/angry all the time.  We don't want to discuss our fighting/grief/parenting.  Work with the kid."  The therapist can treat the kid using behavioral techniques for tackling whatever his/her symptoms might be.  I have heard therapists say, "At least I can offer the kid tools for dealing with X that may alleviate one difficulty in a difficult life."  I don't agree with this.  I think treating that kid in isolation gives the parents license to continue their behaviour and can put the spotlight on the child whose symptom is really the family's.  This may exacerbate feelings of responsibility for the family's difficulties.

2. Therapy that doesn't change the music.

This one happens with couples often.  Couples will come into therapy and insist on having the same arguments that they have at home.  I often say to them, "It's okay to fight in therapy, but I want you to at least have a different fight than you have at home."  Therapy is about making change in patterns and if you are doing the same thing in therapy that you are doing at home, you aren't changing a pattern, you are rehearsing it and you may be reinforcing it.   Some couples can't stop this, which is painful for therapists and the clients, but rather than have a bad experience of therapy and a lot of extra practice doing what hurts, it is better to stop therapy.  The couple may be able to come back when they are in a different place or work with a different therapist who can get them pointed in a different direction. 

3. Psychotherapy in place of something else that would give more well-being.

People are busy.  Therapies can be expensive.  People may prioritize psychotherapy over other things, either other therapies or other activities that could improve their well-being.  People are often choosing between therapy and a gym membership or a babysitter or a speech therapist or a soccer practice.  Those can sometimes be false choices but I actually think that more often than not, they are real.  I am all in favour of people prioritizing their mental health and their close relationships but the best expression of wellness is living a full life, not being in therapy.  Sometimes people believe, mistakenly, that because they are in therapy, they are taking care of their well-being when, in fact, they are using therapy as a smoke screen.  A good question for clients and therapists is "If the client wasn't here, where would s/he/they be?  What does missing X mean?"

4. Ending too early.

The pioneer of systemic, family therapy, Salvador Minuchin pointed out that sometimes people try something new to make a change but stop early when they see no benefit.  Some changes yield benefit in a one-to-one ratio -- a straight ascending line -- but sometimes change comes more as an exponential curve or even a "hockey stick" curve in which a person sees little benefit at first but experiences big pay-offs when s/he persists.  The down-side of ending early is that it can feel disheartening to work at something and see no result.  Depressed people often cognitively distort failures so that is all they see and they see those failures magnified.  If a depressed person tries cognitive behavioural techniques in therapy, for example, and doesn't experience change fast enough s/he can view it as yet another failure and feel worse.  Going back to the surgery analogy, if we abandon surgery in the middle the results will be not only a return to pre-surgery function but worse functioning. 

Avoiding these pitfalls is part of providing good therapy just as providing good medical care involves more than just prescribing medication, but knowing when and where to prescribe and when not to.  All this isn't meant to scare people off therapy, but rather to point out that therapy has real effects.  If a therapy isn't working, feels like it is hurting more than it is helping or feels stuck, take the time to look at that, client and therapist together. 

What "The Americans" gets right and wrong about families, deceit and violence.

I have been making my way through FX's "The Americans."  (Spoilers ahead!)  It is about a seemingly normal couple, the Jennings, who are, in fact, Soviet agents living in a Washington suburb and raising two children.  The politics of the show are complicated; the Soviet agents at the centre of the show, Philip and Elizabeth, are very sympathetically portrayed but the very idea that Russian-born Soviet agents were able to successfully pose as native born Americans seems more like post-millennial sci-fi paranoia à la Battlestar Gallactica than cold-war Tinker, Tailor, Soldier, Spy realism.  That aside, the appeal of the show is the marriage at its heart.  How can two people who are expert deceivers and trained to see deceit everywhere, trust one another?  Because they absolutely need to trust one another.  They are alone in enemy territory.  They are one another's only source of safety.

This is the dilemma at the heart of every relationship; No one can betray me like my lover and my lover is the only one who can heal betrayal.  The show manages this with great psychological realism.  Its creator is a former CIA agent. 

I have a serious quibble with the Jennings children though, Paige and Henry.  I am about nine episodes in so this may change but the kids seem ridiculously well-balanced.  This isn't meant to be an action-comedy like "Spy Kids" where the parents bring the diaper bag instead of the bomb disposal bag but the show can't shake the very American convention that to be likable, the spies need to be good, loving parents, with essentially lovable, if slightly troubled kids.  Paige and Henry hitchhike when the parents don't come to get them (because they have been abducted) and Henry smashes a beer bottle over the creepy driver's head to get away and the sibs pledge to keep it a secret.  They get mad and sullen when the parents separate.  This is the early 80s and by the standards of the time all this is pretty small potatoes as troubled kids go. 

Meanwhile Elizabeth and Philip are patient and present for their kids when they hurt over the separation and sneak into their rooms and give them loving looks at night.  These are the same people who stab, blow-up and shoot enemies of the motherland while living a double life as tour agents, people who have given up their pasts and country for an ideology they can never publicly avow.

I haven't worked with someone who lived a double life (any more than we all do).  But I have worked with families that have kept big, dark secrets.  I have worked with families where one or both parents are violent.  There can be protective factors that mitigate the impact of these things but their children are always impacted.  Granted, the Jennings kids' don't see what their parents get up to at night.  But it is very hard to shut off violence and deceit, to keep it hived off, prevent it from leaking out.  And the show recognizes that, plays with it... except when it comes to the kids. 

When Elizabeth and Philip tell the kids that they are separating, one of the kids asks, "Will you stop loving us?"  It would have been far more interesting (and chilling) to show how profoundly Elizabeth has been marred by years of constant deceit if we were offered the possibility of doubting her sincerity rather than seeing a model of connected parenting.  It would be far more interesting if, instead of staring off into space in class, Henry reacted to his parents' separation (and years of hidden violence) by becoming violent himself.  How would Philip and Elizabeth see their son -- and each other -- if Henry was beating the crap out of other kids every week?

It is interesting: The show's creator, Joe Weisberg, said in an interview that spy-parents usually have "the talk" with their kids at some point and let them know that they have been living a lie.  I suspect that if their parents are doing anything one-tenth as convoluted and violent as what the Jennings get up to, the kids already know.  "The talk" probably doesn't involve much listening by the parents or they would have learned that.  Like so much that has to do with children, we don't like to face the reality of the impact of lies and violence on them, so much so that a gritty show, all about the subtle, polyvalent impact of deceit and violence on human relationships, can't dare to get it right. 

When knowing isn't enough

I have been reading John Gottman's latest book "The Science of Trust."  It is an interesting read on the subject with some great little tangents into history of science which I really appreciate.  Gottman became famous after he was featured in "Blink" by Malcolm Gladwell because Gottman is able to predict with great accuracy if a couple will divorce based on very short interactions. 

I love Gottman's approach to relationship questions.  He is a social scientist perhaps first and foremost.  He has spent years having couples come into his lab and seeing what they do that works and what doesn't.  He has discovered that much of what therapists thought was true about relationships wasn't.  In some ways, thanks to Gottman, now is the best time in recent history to seek help for your relationship.  Gottman has identified what he calls "the four horseman of the apocalypse" for relationships; contempt, criticism, stonewalling and defensiveness.  Couples where these are regular features of conflict are likely to set off a cascade of negative feelings that can be very hard to recuperate from.

My biggest dissatisfaction with the book -- and with other things that he has written -- is that it seems to say that people should "Just stop it."

Sometimes I feel like Gottman's prescription is; Read the book, understand the pain you are causing yourself and your partner and don't do it anymore.  (John Gottman is a couple and family therapist as well as a researcher and I would love to know what his therapy is like and in what ways, if any, he goes beyond a psycho-educational model).

This approach is useful for couples who are feeling some rockiness and want some tips to help them address it.  But I find it limited for the couples who go into a therapist's office or the therapist who treats them.  These couples usually say something like 'I know I probably shouldn't ____________ (fill in the blank: criticize, stonewall, put my partner down, insult my partner) but when s/he does ______________ (fill in the blank) I can't help it.'

There is a limit to the power of our intellects to think our way out of emotional entanglements.  There are a few times in my career where I have instructed people to stop some really destructive behaviour and they have listened to what I said and then complied.  I can count those moments on one hand.  Usually, by the time I see people, they know that what they are doing is hurting them and/or the people around them and they continue to do it.   So far as I have gotten in the book, Gottman describes these "absorbing" states in which the interactions are "nasty-nasty" very well and documents the destructive consequences of them for a relationship.  He says that they are not subject to the same game-theory model he proposes for the other elements of relationships in which people in a couple act rationally by maximizing their payoffs.  He determined 'payoff' by having people rate the payoff for the interaction after the fact while watching video of themselves interacting.  They rate these very miserable moments as very low on payoff.  Why then do they get into these states?  Why not "Just stop it?"  Gottman's answer, as far as I understand it, seems to be a sort of black box; it is an absorbing state, not subject to rationality.  Deal with other states, foster more neutral or positive states when couples are in them and try to keep the couple away from the powerful gravitational pull of these interactions. 

Assessing payoff for these highly negative states in the way Gottman describes might be subject to an important methodological flaw that has implications for therapy; the payoff is clear at the time but hard to access afterwards.  My experience both personally and professionally is that when someone is very angry and in conflict with another person, especially a loved one, the assessment of 'payoff' changes dramatically.  After people really stop being angry, they will often say that they don't understand what happened when they were angry, why they acted the way they did.  They may even have trouble recalling the details of what happened.  There is a sense of dissonance or discontinuity with the angry state.  While a person who is very angry may make decisions that are incomprehensible to him/her later, those decisions make good sense to the angry person who is feeling extremely negatively stimulated; s/he wants to eliminate the negative stimulation.  This poses a problem for a person who is angry about the relationship because his or her partner is both the cause and the cure for the negative stimulation.  That's why we do things that both hurt our partners and simultaneously try to keep them under our control by either keeping them near or at a safe distance. 

Sue Johnson, the founder of Emotionally Focused Therapy, has a different take on this from Gottman that I think makes a good counter-point here.  She sees couples in therapy as needing to work on what I think of as the operating system level rather than the software level.  Those absorbing negative states need to be addressed precisely because they are not subject to intellectual scrutiny in the cold, hard light of day.  When I am calm and able to reflect, I do not have access to my operating system, to all the things that are going on in a primal emotional state.  I have to go to that state.  My partner comes along with me and if I experience my partner as a supportive figure (a positive attachment figure; Johnson's EFT is very attachment-based), then when I re-enter that state I will turn towards my partner rather than seeking to hurt and control.  

Why the Therapist is not Sherlock Holmes and the Beautiful Soul of Carl Rogers

I found an old copy of On Becoming a Person at Encore Books a month or two ago.  It is by Carl Rogers, the founder of client-centered psychotherapy, and I have been reading it slowly ever since.  The first essay "This is Me" is a list of the very humane things Rogers learned over his years working as a therapist and researcher.  Perhaps the central piece, the motto of client-centered psychotherapy is "I have found it highly rewarding when I can accept another person."   Really accepting another person in his or her otherness is at the heart of Rogers' vision of psychotherapy (and humanness as far as he was concerned).  My supervisor and teacher, Sylvia, has been telling me for the last year and a half that the greatest resource a therapist has is the client; I might summarize her teaching to me as, "Be curious.  Ask, ask, ask."  That is very much in the spirit of Rogers.  You may, as a therapist, think you know, but rather than proceed with that assurance, ask.  He describes the experience of the research scientist afraid that the evidence might disprove one's hypothesis;

"... It seems to me that I regarded the facts as potential enemies, as possible bearers of disaster.  I have perhaps been slow to realize that the facts are always friendly... I still hate to readjust my thinking, still hate to give up on old ways of perceiving and and conceptualizing yet... these painful reorganizations are what is know as learning." 

I cannot tell you how many times I have thought that I understood something about a client, some clever idea I had, that when I checked it out in the form of a question turned out to be totally wrong.  Sylvia gave me a great example of this that she had from another therapist;  a client comes in for a first session and announces that her father has just died.  "Oh, how horrible, I am so sorry," says the therapist.  The client has the strength to say, "I hated my father.  He was cruel to me all my life."  I am guessing many clients would not have been so courageous and might have succumbed to the therapist's assumption, really an assertion about how the client ought to feel. 

I imagine it must have been very challenging for Rogers to take such a stance in the nineteen-fifties.  RD Laing of the famed Tavistock clinic critiqued the idea that he saw current at the time that the psychiatrist is the detective who enforces the law of illness.  Even today therapists whether psychiatrists, psychologists, social workers or other allied professions, are encouraged to think of therapeutic work as detection, seeking to unmask through superior knowledge and reasoning psychopathology whether within an individual or a system.  Psychiatry and detective novels grew up together.  Freud and Holmes both proceed -- by a bizarre logic apparent only to themselves -- to a conclusion that seems inevitable once announced. 

It is very hard to practice accepting the other when you approach the other as a suspect.  I would say that Rogers' and Sylvia's teachings about client centered-ness have been a great life lesson for me.

Rogers also valued pursuing what "feels right."  In this regard he is very much a part of the existentialism of the mid twentieth century.  He quotes Kiekegaard and Buber, the philosopher of the "I-thou" relationship.  This is one piece of Roger's thought that I don't buy. 

Therapists and therapy are often informed (misinformed, I believe) by the idea that there are deeper more authentic parts of the self which are obscured by less authentic elements of the self.  A good example of this is the idea of primary and secondary emotions (see Greenburg and Safran) which informs many therapies.  Primary emotions are viewed by Greenburg and Safran as more authentic and more somatic, secondary emotions are reactions to these first feelings.  This can be a useful distinction, it can be helpful for therapists and clients to focus on feelings that are outside of the client's usual repertoire.  But I don't know how one can say definitively that one feeling is more authentic than another or distinguish meaningfully between authentic and inauthentic elements of self.  

The homunculus fallacy is the name given to the idea that there is the psychological or neurological equivalent of a little man inside each of our heads - a homunculus - who experiences our experiences and commands our responses, an authentic self buried within our bodies and minds.  The fallacy is that if there is indeed a self within the self, then why not say that within that there is  yet another self and so on.  Self becomes a Russian doll and the pursuit of the authentic self a recursive pursuit at great expense of time and money.  One of the extraordinary cultural shifts that one can see in Rogers book is in the expectation that therapy be a process that goes on for years.  He talks casually of seeing clients for a 48th or 60th session of therapy for what seems to be a therapy of self-knowledge rather than any more focused goal.  (I don't know if these were sessions for which clients paid or not).  This certainly was before the age of HMOs. 

A final piece from Rogers, perhaps his best known quote from the same essay "This is Me," and a truly beautiful bit is the paradox of acceptance and change.

“... [T]he paradoxical aspect of my experience is that the more I am simply willing to be myself, in all this complexity of life and the more I am willing to understand and accept the realities in myself and the other person, the more change seems to be stirred up. It is a very paradoxical thing — the degree to which each one of us is willing to be himself, then he finds not only himself changing; but he finds that other people to whom he relates are changing.”

Carl Rogers

What trauma leaves behind

Trauma impacts mental health especially trauma in childhood.  In a previous blog post I wrote about how kids who are poor are more likely to be exposed to trauma than wealthy kids.  Now there is research that indicates that the effects of trauma can be biologically transmitted across generations.  The researchers subjected mice to trauma in the laboratory in the form of electrical shocks.  When baby mice were conceived using the sperm of the traumatized mice, the babies had a stress reaction to stimuli that were associated with their parents trauma, in this case a particular smell, and the effects seem to stretch over several generations.  The theory put forth by the scientists to explain this is epigenetics, that certain genes are 'turned on' or 'off' by experiences creating heritable traits as a result of what happens in the environment. 

If this carries over to humans, it could mean that a kid whose grandmother or grandfather experienced trauma could still carry the impact of that trauma in his or her body.  My clinical experience is that trauma does seem to pile up in families.  Sometimes the people who come into my office will describe three generations of abuse.  It can be hard to get out from under that.  Now we have another indicator of why that might be the case.  Not only can there be a cultural inheritance of trauma in a family, the genetics of one's descendents can be marked by traumatic experiences. 

On a more hopeful note, epigenetics may work to undo some the hurt of previous generations.  Researchers here in Montreal, at the Douglas Hospital, have looked at the effect on an epigenetic level of nurturing by a parent on mediating stress (more traumatized rodents).

“Baby rats that are licked often by their mothers—with licking in rats fulfilling the same function as cuddling in humans—are calmer than rats that are not licked enough. Michael Meaney and his team delved further into this idea by tracking the imprint left by maternal care in the brain of young rats. They were able to do this because the action of licking influences the activity of a gene (called NRC31) that protects rats against stress; when activated, this gene produces a protein that helps decrease the concentration of stress hormones in the body. A specific part of this gene must also be activated via an epigenetic switch. ”

— http://www.douglas.qc.ca/info/epigenetics

According to this theory loving cuddling can help kids deal better with stress than they might even if they have an epigenetic inheritance of trauma.  So why are you still reading?  Go hug your kids. 

Teen use of internet porn. When is it time to panic?

The ubiquity of pornography has got to be one of the biggest changes in society in my lifetime.  An acquaintance asked me what I thought the long-term effects of total access to porn would be for shaping the sexuality of kids growing up today and I really had no idea how to answer.  There is much heat and little light on the subject because sexuality in general and kids' sexuality in particular is such a fraught topic.  

On the one hand, today's nearly unlimited access to pornography via the internet is part of the demystification of sexuality which has been building steam over the last one hundred years.  It is connected -- at least in a six-degrees-of-fornication kind of way -- to changes which I view as absolute social goods, like decriminalizing miscegenation and homosexuality, allowing women (and everybody) a greater degree of control over reproduction and generally removing some of the shame from sexuality for everyone, male, female, gay, straight etc.  It is worth remembering that lynchings of non-white men for sex with white women, death by back-alley abortion and 'curbing' of gay people are pieces of North American history that happened within living memory (and are practices some would like us to return to).  The impulse to curb sexual freedom, including the freedom to view porn, can be an instrument of sexual repression and shame.  A lot of the conversation about pornography and young people -- any sexual topic and young people for that matter -- seems to smack of a old-person's cocktail of wistfulness and resentment ie. "If I can't have lots of crazy sex, then nobody should."  

On the other hand, pornography has to own some of the criticisms made of it; it is hugely male-oriented and at least some significant portion is downright anti-women.  It seems pretty intuitive that a barrage of woman-degrading porn would do anybody's developing sexuality harm.  More generally, porn is, by definition, commercial sexual objectification.  Young men and women who grow up viewing sexuality (and we are talking largely about women's sexuality) as an object for purchase or trade, rather than a subjective experience seem more likely to generalize some of those lessons to non-porn sex.  These are both arguments that can be made about any type of pornography.  There is also a particular techno-bent to some anti-porn writing that makes the argument that a quantitative difference of the internet makes for a qualitative difference. 

“What happens when you drop a male rat into a cage with a receptive female rat? First, you see a frenzy of copulation. Then, progressively, the male tires of that particular female. Even if she wants more, he has had enough. However, replace the original female with a fresh one, and the male immediately revives and gallantly struggles to fertilize her.
You can repeat this process with fresh females until he is completely wiped out.
This is called the Coolidge effect—the automatic response to novel mates. It’s what started you down the road to getting hooked on Internet porn.”

— http://yourbrainonporn.com/doing-what-you-evolved-to-do

Digression:  Perhaps 2014 should be the year that nobody says "The area of the brain that lights up when..."  Regular readers will know that I am sceptical of some of the claims of 'brain science'.  The next post on "Your brain on porn" has fMRI images showing how sections of the brain "light up" when exposed to porn which proves that the subjects of the brain scans are addicted much as people get addicted to heroin. ( A primer on fMRI goofiness. )  Here is a picture of a dead fish in a fMRI with its brain lighting up when asked to imagine humans in social situations.

End digression:  There is a growing set of men who say that they are addicted to internet porn and/or incapable of erections with actual humans as a result of using porn regularly.  This is a tough claim to verify since it is so subjective.  Men may experience less frequent erections and attribute that to the use of porn; that doesn't necessarily mean that was the primary cause.  That is what is known as the post hoc ergo propter hoc fallacy.  It does seem to make intuitive sense that if you don't masturbate for a long time you are more likely to experience an erection in a particular circumstance.  It also seems like it would be pretty hard to look at a lot of porn and avoid masturbating, so the two do go hand in glove (as it were). There is a whole online Nofap community where people, mostly men, pledge to stop masturbating and/or viewing porn.  They support one another to achieve goals in days.  When does this shade over into shaming a normal and healthy sexual behaviour that has already been the target of a lot of shame?  I wrote a blog post a while ago about Marty Klein's argument that the term "sex addiction" is a way for people living in a sex negative culture not to address their sexual desires about which they feel incredible shame. 

There are a couple of things I am pretty confident about in all of this. 

1.  The whole "erectile dysfunction" piece of the conversation about porn and masturbation needs to get scaled way back.  Men are easily goaded into thinking that a rock hard penis is the only legitimate route to sex.  That's false and it isn't good for men's sexuality (or for their partners).  Start having sex without an erection and you may get one.  Keep having sex after an erection goes away, and it may come back.  But if you make having and maintaining an erection a prerequisite, that can mean a lot of heart ache.  Paradoxically, lots of porn and lots of nofap both seem to perpetuate the myth of no sex without an erection. 

2.  Porn is not sex education.  Teens need to know that what they will see in porn is not what happens between most people's sheets. Talking to teens about what porn is and isn't is part of the job description of every parent, and that needs to go beyond telling them it's bad or women-hating.  Porn:Human Sex::2Fast2Furious:Driving.  A fantasy. 

3. Teens will try to make their own porn.  Not every teen but plenty of them.  Maybe not your kid but plenty of kids your kid knows.  As Dan Savage has pointed out, smart phones are -- among other things -- mobile porn production and distribution suites.  And parents hand them over to kids without thinking about or talking about that.  If you must give your teen a smart phone, disable the camera.  Tell your kids you will search through the contents of their phones and then follow through.  Millions of adult Americans use their phones this way, should we expect teens to act any more maturely?