you know that woman sitting next to you in the bar has a boyfriend you know because he just left for the bathroom and still the minute he leaves you approached her and asked if she wants to come home with you for a night of fun she refuses you insist then the boyfriend comes back slaps you a couple of times until you back off after a while you catch sight of a good-looking guy sitting in the corner of the bar even though you're not bisexual you go over to him and offer him a drink and the same suggestion now this is quite an extreme example of what can actually happen when the addiction to pornography spins out of control but I heard this specific story from a guy in Cambridge we can call em who suffered from compulsive sexual behavior disorder before 2018 em would have never been diagnosed with this as it was only last year that addiction involving pornography was put on the World Health Organization's lists of diseases coined as compulsive sexual behavior disorder or cSPD two years before that I published one of the first narrow scientific studies on the brain changes associated with cSPD which helped pave the way towards its inclusion and acceptance as a diagnosis by the World Health Organization so what is cSPD compulsive this means something that you cannot stop doing and I know that none of you check your phones every five minutes for no reasonable intention to see if you've had any new notifications but if you did that would in some mild sense be compulsive sexual behavior this means that the compulsivity centers on sexual behavior and in most cases pornography and disorder this implies both personal social and occupational dysfunctioning for the individual to an extent where it becomes very difficult to lead a normal life basically it ruins people's lives that's why it's called compulsive sexual behavior disorder and not compulsive sexual behavior inconvenience and this is the exact behavioral pattern that we see an M twenty years ago if you wanted to get access to pornographic material you had to physically go into a store and rent a video or buy a magazine 20 years later in 2009 T Denmark's 10th and 13th most visited websites are both pornographic now think about that just for one second that's including Google YouTube Facebook Amazon etc and according to such a statistic pornography is one of the most sought-after digital services in Denmark and abroad as well according to a brand new Danish survey between 15 and 89 year-olds almost one out of five men and one twentieth of every woman actually watch more pornography than they want to and a British survey has demonstrated that 12% of children below 12 years old regularly watch pornography this is quite frightening statistics and the adult population it is estimated in the West that 3 to 6 percent suffer from cSPD so that means arguably that out of the 500 people here today you guys in the front row watch way too much porn and I'm sorry to call you out like this but actually you guys in the front row are addicted to pornography ok anyway that is if we follow statistics but quite a lot of people are able to watch pornography without necessarily become an addicted so where does this go wrong for some people and why do they lose control I'm a neuroscientist and basically what that means is that I stick people inside MRI scanners and see what happens inside their brains and we did this with people suffering from cSPD and what we found was that as a function here of a region in the brain called the amygdala was actually enlarged and the amygdala is a tiny structure that sits almost at the very center of the brain and which is very much too involved with emotional processing and emotional salience in the brain and not only was the amygdala enlarged the connections it had with the prefrontal cortex were reduced now the prefrontal cortex can be said to be the boss of the brain this is where we as humans consciously exert control over our actions and behavior so what this means is that when you have cSPD your brain is actually geared towards more instinctive behavior and so what's taking less control over that behavior and this actually corresponds very well with what many cSPD subjects report also cSPD has been associated with hypersensitivity to sexual rewards just like this is shown in gambling disorder that they are hyper sensitive towards monetary rewards so there's actually overlap across these disorders as well so why is it a good thing that this has become a diagnosis well the inclusion of cSPD into the diagnostic manuals means that now general practitioners throughout the world will be able to diagnose this which can lead to better treatment and better and less stigmatization as of now people who suffer from cSPD cannot really receive the same generalized help on par with other addictive disorders such as gambling or alcohol use disorder and that's the simple answer to this to give you guys a bit more of a nuanced impression of what this political decision means we can draw an example from gambling as an addictive disorder since the yes where gambling has been included into the diagnostic manuals 85% of gamblers are still in remission one year after treatment here in Denmark that's quite remarkable in this sense it's a genuinely good thing for these individuals that cSPD has become a diagnosis as these money as money are prioritized to these research areas so actually there may be hope for you guys in the front row but aside from all these political classifications in the scientific conceptualizations that may seem a bit fancy what it really boils down to it's the people suffering from their addictions based on the reports of M people and without those reports clinicians and neuroscientists alike wouldn't really know that that this phenomenon existed in the first place but we do thanks to the systematized and multiple reports of others like him and the reason that M came into treatment in the first place came down to the fact that he himself sought treatment and when clinicians and scientists begin to hear about this and talk about this research can be initiated to examine its scientific processes behind such phenomena or behaviors and from that research better treatment efforts can be applied to those suffering in this sense it really is the people's suffering that should inform the research in order to create value for these very people a century ago and may have been considered a freak by society and perhaps even admitted to the psychiatric hospital by a medical professional today M receives the best help he can possibly get at this moment in time through the combined efforts of the research conducted within this area and the International classifications based on that research help is on the way now therapists and clinicians around the world will be better able assess diagnose and treat compulsive sexual behavior disorder thanks for your attention [Music]