WASHINGTON -- The ubiquity of online pornography and easy access make it problematic for people who otherwise might not be susceptible to the lure of pornography.
For mental health professionals, the challenge is to clarify which individuals are at risk for problems, said Dr. Thomas Kalman of the department of psychiatry at Cornell University in New York.
"The dramatic growth of Internet pornography and its insinuation into many aspects of culture lead logically to consequences of such availability and frequent viewing," Dr. Kalman told a packed room at the annual meeting of the American Psychiatric Association.
Dr. Kalman offered three clinical vignettes involving heterosexual males seen in private, outpatient psychotherapy to illustrate how the
use of online pornography can play a problematic role in an individual's life.
A 31-year-old man presented for analytic psychotherapy for mixed anxiety problems. He reported difficulty becoming sexually aroused by his current partner, eventually confiding that he was drawing on specific pornographic images to become aroused.
Over time, he elaborated on his use of Internet pornography-something in which he had engaged sporadically since his mid-20s.
He also noted that he now could be aroused by material that he once had no interest in viewing. Coercive, almost violent images now elicited a sexual response, though they had once been off-putting. "With some new pornography, he found himself simultaneously anxious, uncomfortable, and aroused," Dr. Kalman noted.
At a follow-up visit, a 65-year-old man described increasing Internet pornography viewing at his office. The patient could not curb his behavior, Dr. Kalman said.
This activity began shortly after the closing of a local video rental store, from which he had rented x-rated videotapes and DVDs for more than 2 decades. He had begun to arrive earlier and earlier at work so that he could privately access Internet porn sites, and he experienced "Friday letdown" when faced with being away from his new hobby over the weekend.
A single, 36-year-old man returned to psychotherapy, after a hiatus of several years, for help with an acute depressive episode …