Brief report: private pleasures and the damage done: asking the unasked question about consumption of online pornography


In this Brief Report, Professor Alessandra Lemma argues that, based on the evidence of online pornography’s risks, health care givers should routinely ask patients about pornography use and explain why it matters. In Dr. Lemma’s view, today’s porn “poses a sexual health risk as well as undermining the pro-social nature of sex.” Pornography use is also a contributory factor in making such potentially lethal behavior such as strangulation seem normal and even attractive.

“Speed and ease of access, coupled with the altered mental state resulting from the specific contingencies of the online environment outlined so far, undermine the capacity to mentalise one’s own sexual desire and that of the other. … Mentalising underpins a person’s ability to imagine, for example, that no matter how strong one’s personal desire for sex, this does not imply that our partner feels the same.” This is harmful for relationships.

By Alessandra Lemma

Psychoanalytic Psychotherapy

2024 Vol. 00, No. 00, 1–11,


The domestication of the Internet has invigorated debate about the harms of pornography. The difference between pre-Internet and online pornography is not in any  straightforward sense only one of degree. Compared to pre- Internet pornography, speed,  and ease of access to an extensive range of pornographic content, along with the
consumption of pornography in a virtual context, have introduced new prudential risks.  In this Brief Report I restrict my focus to the impact on sexual health and on  personal relationships and summarise the relevant research. Drawing on a  psychoanalytically informed conceptual framework, I argue that the online medium changes, in prudentially significant ways, the consumer’s relation- ship to the sexual materials by providing a virtual space within which sexual desire is gratified quickly and non-reflectively, undermining the  consumer’s capacity a) to mentalise their sexual desire and that of the other and b) to evaluate the prudential risks associated with the consumption of online pornography. The risks are especially significant for the digital generation whose sexual development is now  more likely to be shaped by online pornography. I conclude by outlining one key practice implication arising from the research.