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FEATURE
EDITOR’S NOTE: Earlier this year Dr. Donald Hilton was invited by the Vatican to give an address at Grego-
rian Pontifical University in Rome, Italy on the deleterious effects of pornography on the developing minds
of children. Following is the full text of that speech.
Pornography and the Developing Brain:
Protecting the Children
Gregorian Pontifical University
Rome, Italy
October 4, 2017
Donald L. Hilton Jr. MD, FAANS
Adjunct Associate Professor of Neurosurgery
University of Texas Health Sciences Center, San Antonio
The brain’s reward system balances rational thinking and wanting, The nucleus accumbens, or reward center, is interposed physically
what Thomas Aquinas called the rational and the animal appetites. and functionally between these two areas. Our current understand-
Addictive behaviors can include substances like cocaine or behaviors ing of how the brain balances these forces was remarkably described
like viewing pornography, and youth are particularly vulnerable to almost a millennium ago by Thomas Aquinas in his writings about
the harms of pornography. Five considerations are discussed: the natural or animal appetite and rational appetite, or will. It is the
immaturity of the frontal judgment areas, the sensitivity of the de- balance of will and appetite that allows pleasure to become a re-
veloping reward center, cultural conditioning of youth, imprinting warding garnish which motivates, as opposed to addiction, where
of the mirror neuron system in forming sexual scripts and tem- pleasure becomes a master which overrides the will.
plates, and the exposure of vulnerable and impressionable minds
to the powerful supranormal stimulus of pornography. It is imper- In the last 20 years we have found that learning changes the brain
ative that we effect a cultural and legal change to protect children physically. Like a muscle enlarging with exercise, the brain enlarges
from pornography and secure their future. physically with learning. Music, sports, and studying have all been
shown to enlarge different parts of the brain; one scientist said,
I would like to thank all who have done so much to organize and “The brain is the source of behavior, but in turn it is modified by
administer this marvelous event, and I am grateful for the oppor- the behaviors it produces…learning sculpts brain structure.”
tunity to share a few thoughts with you. I have had the privilege of
performing and teaching neurosurgery for almost 3 decades, yet I The reward system of the brain can be highjacked and diverted
still feel a sense of wonder and awe each time I see and touch the from its purpose of helping us survive. If we take in powerful re-
human brain. wards indiscriminately, the reward center can reset the pleasure ther-
mostat of the brain, and a new normal occurs. This can become
We have, simplistically speaking, two brains. Our cortex, or addiction. Two scientists studying how brain cells change with ad-
‘thinking brain,’ allows us to think and to feel, to plan and to plot, diction said, “Addiction represents a pathological, yet powerful,
and most importantly, to love. Our brainstem, or ‘wanting brain’ form of learning and memory.” Indeed, addictive learning
simply wants, and powers the brain with dopaminergic desire. Both “sculpts” the brain in a very damaging way.
of these areas sent projections to the reward center of the brain.
The brainstem stays, “Just do it if it feels good,” while the cortex In addiction, whether to a substance like cocaine or a behavior
says, “Think about the consequences of just doing it, no matter like sex, physical changes happen at the macro and microscopic
how good it feels.” The cortex also colors and flavors our pleasure level, and we can see these on brain scans. These structural changes
with meaning and context. It knows the difference between fast are associated with the behavioral changes seen in addiction. The
food and a candlelight dinner. American Society of Addiction Medicine, comprised of medical
doctors, defined addiction in 2011 as including sex and food addic-
28 San Antonio Medicine • December 2017
