by Mary Aiken
Compulsive cybersex is a significant component in Internet addictive behavior for many men and women, according to The American Journal of Drug and Alcohol Abuse. Therapists report a growing number of patients addicted to sex online, with the standard problems associated with addictive behavior. In some cases the behavior was initiated by early exposure to pornography and conditioned by reinforcement. Other compulsive users have underlying trauma, depression, or addiction. But both men and women with cybersex compulsions show behavior that is described as “maladaptive.”
The subject of sex addiction has become as mainstream as it gets, represented by a growing number of celebrity poster boys like mouthy British comedian Russell Brand (who has also admitted to being addicted to heroin, cocaine, and booze) and Californication star David Duchovny, a brainy Princeton grad, no less. Not that long ago, there was no doubt of its being a diagnosable disorder. In 1987, DSM-3-R referred to sexual addiction as a sexual disorder “Not Otherwise Specified” (NOS). The term NOS is used to describe disorders of sexual functioning that are not classifiable in any of the specific DSM categories, and historically it was the description most commonly used for patients identified as “sexual addicts.” (One of the examples given for this disorder is “Distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.”)
Just as the topic of sex addiction was becoming more recognized and discussed, it became controversial within the APA. Why? How? In preparation for the fifth edition of DSM, Dr. Martin Kafka, a Harvard Medical School professor and psychiatrist, reviewed the entire body of scientific research and literature on the subject of hypersexual disorder, concluded that it very definitely existed, and prepared a proposed diagnosis for inclusion as an official disorder.
His findings in 2009:
Hypersexual Disorder is a sexual desire disorder characterized by an increased frequency and intensity of sexually motivated fantasies, arousal, urges, and enacted behavior in association with an impulsivity component—a maladaptive behavioral response with adverse consequences. Hypersexual Disorder can be associated with vulnerability to dysphoric affects and the use of sexual behavior in response to dysphoric affects and/or life stressors associated with such affects….Hypersexual Disorder is associated with increased time engaging in sexual fantasies and behaviors (sexual preoccupation/sexual obsession) and a significant degree of volitional impairment or “loss of control” characterized as disinhibition, impulsivity, compulsivity, or behavioral addiction….[Hypersexual Disorder] can be accompanied by both clinically significant personal distress and social and medical morbidity.
And yet the APA chose to disregard Kafka’s presentation of the facts and decided to exclude sex addiction from DSM-5. This decision is still shrouded in mystery. I can’t help but wonder what arguments experts made to one another to justify this omission. Perhaps the academy feels there is not enough scientific evidence proving that sex can become an addiction? Dr. Kafka clearly states that “the number of cases of Hypersexual Disorder reported in the peer reviewed journals greatly exceeds the number of cases of some of the codified paraphilic disorders such as Fetishism and Frotteurism.”
Given the effect technology has on sexual behavior, this omission feels both very odd and very much behind the times. Studies show that sexually compulsive individuals are more attracted to the Internet because their behavior, which often requires secrecy, is easier to satisfy there due to what Al Cooper, of the San Jose Marital and Sexuality Center, referred to as “the Triple A Engine.” The A’s stand for anonymity, accessibility, and affordability.
Anonymous, your secret is safe. With easy access, you can find an almost limitless supply of partners while you are at home, at work, at school, in a cyber café, or on your mobile phone. The affordability of just a few dollars per month means that almost anyone can access sexually based websites from a computer somewhere.
Excessive use of online pornography is regarded by some psychologists as a manifestation of both Internet addictive behavior and sex addiction. And of the reported sex addictions, pornography addiction is the most commonly reported, particularly among younger people. The definition of a “Phase One sex addict” is an individual who is addicted to sex that doesn’t involve others. This could describe untold numbers of adolescents today. The behavior is reinforced and ingrained in the same way other compulsive behaviors are—and develops very much like a drug addiction. After an initially rewarding experience with pornography, the urges become more frequent and more powerful. These connections can become so strong that simply sitting down at a computer elicits a sexual response.
Take the story of University of Pennsylvania psychologist Dr. Mary Anne Layden, whose patient, a young male who was so addicted to Internet pornography that he missed an appointment for a job interview. He literally couldn’t stop his behavior. Layden tells this story in a podcast about the growing problem of men—young and mature, students as well as fathers and husbands—who have lost all interest in their lives beyond their compulsive behavior. Brain imagery of online porn addicts shows a similar pattern as it does with other addictions. The craving is real—and destroys lives.
This reminds me of a study done in 1954 by researchers Peter Milner and James Olds in which the pleasure centers of rats’ brains were stimulated by electrodes that led the rats to forgo all efforts to live regular lives. The rats had to press a lever to be stimulated, then exhausted themselves pressing it over and over again. They stopped sleeping. They stopped eating or drinking water. They literally pleasured themselves to death.
Again, gender plays a role. Psychologist Philip Zimbardo, of the legendary Stanford prison experiment, argues that young men are becoming hooked on arousal via online pornography and the results are catastrophic for both schoolwork and relationships with others. In Zimbardo’s notable TED Talk in 2011 (“Why Are Boys Struggling?”) and his recent book, Man (Dis)Connected: How Technology Has Sabotaged What It Means to Be Male, he describes the damage to boys from excessive Internet use, excessive gaming, and pornography consumption. Zimbardo categorizes these as arousal addictions, and says, with “drug addiction, you want more. Arousal addiction you want different—you need novelty.”
I cannot help but feel that this resonates strongly with seeking—specifically in an online context. The average boy watches fifty pornography videos a week, according to Zimbardo’s estimates, which partly explains why pornography is the fastest-growing industry in America, increasing $15 billion annually. By the time an average male is twenty-one years old, he has played ten thousand hours of video games (two-thirds of that in isolation). Both gaming and porn, Zimbardo argues, have effectively caused a digital rewiring of boys’ brains to need novelty, excitement, and constant arousal, which means they can be totally out of sync in traditional classrooms and romantic relationships.
It’s time to have a discussion about online pornography addictive behavior, or arousal addiction. When people talk about it, they discuss men, teenagers, and boys all in the same spectrum. But in reality, you are talking about very different things. A grown man who develops an interest in online pornography is one thing. But for a young boy who does the same, during critical developmental phases, the problem behavior can manifest in a different way and therefore become more complex and much harder to treat.
Oculus Rift—VR Headsets
Around the corner—and perhaps by the time this book is published—is mass distribution of Oculus Rift, a virtual-reality headset for 3-D gaming. With a helmet that will literally encase your head, eliminating the possibility that you can see the real world, or even a hint of real sunlight, the user will be psychologically and physically immersed in the cyber environment, which will only amplify and escalate the levels of engagement, investment, and addiction. The technology was purchased and is under development by Facebook, which will undoubtedly do a bang-up job of marketing it too. If you think the adolescent gamers are havin
g trouble giving up their remotes now, just wait until you try to get them to take off their helmets.
I feel certain that this amazing technology could be used for better purposes. Along those lines, I have recently published an extensive protocol to use virtual-reality head-mounted display units (VR HMDUs) for the treatment of post-traumatic stress disorder (PTSD), involving a full range of sensory stimulation. On a positive note, my research in this area also makes me wonder if this technology isn’t a potentially powerful way to relax and engage a child with behavioral difficulties. I am imagining a calming immersive VR experience of swimming with dolphins or floating down a river on a raft.
My underlying belief is that the problem is not technology—but what it is being used for. For the moment, it seems designed to always overstimulate, when just as easily it could be soothing.
Abstinence or Adaptation?
Technology offers enormous advantages in terms of accessibility and choice. We can shop online for food and have it delivered conveniently to our door. We can shop for presents and have them delivered to someone else’s door. We can purchase everything from clothing to electronics with ease. The problem occurs when this behavior escalates and spins out of control. As it stands now, technology offers the optimum environment for this to happen.
While academics argue whether there is sufficient evidence to describe any of these behaviors using standard addiction criteria, the problems continue to evolve. There is no denying them. Rather than debate their existence, it would be more productive if we could talk about treatment. Abstinence, one of the proven methods for recovery from addiction, is not possible. Giving up alcohol, cocaine, or cigarettes may be an option in the recovery process for those addictions, but giving up technology is not. Which is why I believe we need to rethink our approach to the concept of Internet addictive behaviors.
The Internet is not going away. We are moving to a place where we don’t have a choice but to engage—if you want to study, have a job, do research, be informed, access your healthcare benefits, or pay your bills. Technology has become as natural as the air we breathe, as necessary to twenty-first-century survival as the water that replenishes our bodies. It has become part of our environment. Therefore the challenge could be an evolutionary one. Rather than talking just about addiction, we could discuss adaptation.
The best way for an individual to adapt effectively to a new environment is to be informed—know the new environment well, study it, and be aware of the dangers and pitfalls. The Internet could be the most beguiling and enticing creation of humankind. Our evolutionary instincts, such as seeking, make it hard to resist. Not to mention the hooks, signals, alerts, prompts, fun failure, and heart-stoppers. To adapt intelligently, we need to know ourselves well and learn how all things cyber affect our behavior.
For an individual who has behavioral control issues or attention deficits, or who is predisposed toward compulsive behavior or is simply higher on the impulsivity scale, the cyber environment may be problematic. These people are more vulnerable online. It can cause trouble for them the way a racetrack or casino causes trouble for a compulsive gambler. Take caution if you are given to impulsivity.
To me, whether we are clinically “addicted” may have already become an arbitrary argument. Are we addicted to running water and hot showers? Are we addicted to the personal freedom granted by the automobile? A Darwinian approach may be better. Maladaptive behavior is a term used to describe attitudes, emotions, responses, and patterns of thought that result in negative outcomes (for example, biting your nails when you’re nervous). When presented with a situation, a maladaptive approach seems to render good results, but these are temporary and can lead to greater problems.
If we consider our struggles with cyberspace, it may be shortsighted to get bogged down in the addiction debate. If technology is a substance that we need—and is central to our survival going forward—then we need to learn to live with it, but on our own terms. Once we realize the specific triggers that facilitate cyber-seeking frenzies, the ones that drive dopamine surges and fuel impulsive, compulsive, or addictive behavior—whether it is online shopping, gaming, or pornography—technology could be designed to be more compatible with its users. Or we could learn to adapt and become more resilient, more restrained and disciplined, more focused and less compulsive.
We are still at the beginning of an unimaginable shift in how we live. Let’s give ourselves a break. If you have a problem with technology, perhaps you’re not addicted, just cyber maladapted. And the good news: There are things you can do about that.
CHAPTER 3
Cyber Babies
Not long ago I was sitting on a train going from Dublin to Galway. A mother and a baby came to sit across the aisle. I had some work to do, some reading, but as we headed west toward the Atlantic Ocean, the countryside of Ireland was so beautiful, I took a break and just enjoyed the view out the windows. Looking at the ever-changing cloud formations passing over the dramatic Irish landscape always relaxes me.
The roads and fields of Galway are lined by spectacular stone walls. The land is stony, and over the centuries, each time a field was cleared, more stones were dug up and more walls and cottages were built. Looking through the window, I thought about all the labor that went into building these walls—the moving of each stone and the artistry of the masons, some of whom also worked on the ancient towers, churches, and cathedrals of Ireland.
Stonemasons loved to work on cathedrals because their stones held the spires aloft. They reached for the sky, for the heavens. And by building the cathedrals, the stonemasons believed they were reaching for something better. Each generation needs to reach for something better—to build things, to create a legacy. As the train jostled and chugged along, I began to ponder the works of civilization being created now. What fields are we clearing and what is being built? Where are our cathedral spires?
Across the aisle, the mother settled in and began feeding her baby. In a wonderful display of dexterity, she held the bottle in one hand and clutched a mobile phone in the other. Her head was bent to look at her screen. We’re all busy these days, and it’s hardly my business to judge how a young mum feeds her baby. Out of the corner of my eye, though, I observed her with a researcher’s curiosity. Ethnography is the immersive study of people and cultural phenomena, when the researcher is embedded in the social group being studied. As a cyberpsychologist, I am living in a continual ethnographic study. Hardly an hour goes by when I don’t notice how people are interacting with technology.
Ten or fifteen minutes passed. The mother looked exclusively at her phone while the baby fed. The baby was gazing foggily upward, as babies do, and looking adoringly at the mother’s jaw, as the mother continued to gaze adoringly at her device. For half an hour, as the feeding went on, the mother did not make eye contact with the infant or once pull her attention from the screen of her phone.
Forget the lovely view of the Irish countryside, by this time I was riveted to the human scene unfolding across the aisle from me. It was a good thing I was wearing sunglasses.
My mind filled with questions. I couldn’t help but wonder how many millions of moms and dads around the world were no longer looking directly into the eyes of their babies while they were feeding or talking to them. Obviously, they might look sometimes, but what if that direct contact was in fact one-half or one-quarter as much as the days when my generation was raised? How will this seemingly small behavioral shift play out over time?
Would a generation of babies be impacted?
Could it change the human race?
Parents usually ask me this question: What is a safe and healthy age for a baby to be introduced to screens? They mean anything from iPads, tablets, and mobile phones to televisions. Without a doubt, this is a very important question. But first, I ask parents to think about this question:
What is the right age to introduce your baby to your mobile phone use?
Face Time with Your Baby
Did
you know it’s really important to look at your baby’s face? Feeding and diapering alone aren’t enough. A hug and a quick kiss aren’t enough. Babies need to be talked to, tickled, massaged, and played with. And they need your eye contact. There is no study of early childhood development that doesn’t support this.
By experiencing your facial expressions—your calm acceptance of them, your love and attention, even your occasional groggy irritation—they thrive and develop. This is how emotional attachment style is learned. A baby’s emotional template, or attachment style, is created (or “neurologically coded”) by the baby’s earliest experiences with parents and caregivers. When a good secure attachment is formed by consistent interactions between baby and parents, the template for future emotional connections is more secure. And a secure attachment pattern will give a baby a much better chance at becoming a confident and self-possessed individual who is able to easily interact with others. An individual’s attachment style affects everything from how we form friendships to how we choose a life partner to how our relationships may end.
The science of love is fascinating. In the 1930s, Harry F. Harlow, an American psychologist, looked at infant-mother bonds and the impact of maternal separation by studying baby rhesus monkeys whose mothers had died. He noticed that infants raised in a nursery became very different adults from those raised with mothers. These orphaned monkeys were slightly strange, reclusive, and very attached to the soft blankets in their cages. When these blankets (they were actually cloth baby diapers) were taken away once a day and cleaned, the orphaned babies became super-agitated and upset, often curling into fetal balls and sucking their thumbs. This led Harlow to suspect that physical contact and the role of the primary caregiver were much more important than previously believed. At the time, institutional nurseries and hospitals did not provide physical contact for human babies; it was considered unnecessary, even unhealthy.