American Psychological Association
Chicago, August 22-25, 2002
|Photo by Fenichel: Barry Gordon, David Greenfield
|Symposia #2193: Management of Cybersex and Cyber Affairs on the Internet|
By way of introduction: Dr. Barry Gordon worked on the MSNBC (Cooper) study in 1999 which resulted in 14,000 responses, which were eventually whittled down to 9300 sets of valid responses. Dr. David Greenfield did a 2nd study for ABC.com which brought twice as large a sample, and from which data is still being analyzed.
[Just to repeat something said earlier -- In the past 2 years of longitudinal study, Pew Internet has noted a "drop-off" in time spent online, due to what appears to be an increased comfort level and familiarity with online tasks. Still, it is precisely those who are comfortable finding things online who are the focus of this topic, those who engage in compulsive, or "addictive" online behaviors.]
David Greenfield, past-President of the Connecticut Psychological Association and founder of the Center for Internet Studies, has a background in "family systems and addictionology" which lends itself towards study of Internet use and it's impact on family and personal relationships. Personally he confesses to being "ambivalent about technology" itself, seeing the Internet (as many people do) as simply one of many tools or channels which can be used for information or communication. Like many "newbies", when he first got online he felt the excitement of "something going on here" and experienced what many know as an almost "psychoactive", mood-enhancing experience, replete with the promotion of disinhibition and the reinforcement that may provide. He noted the once-very-popular jokes about "Internet addiction", and added one I'd not heard before: "You know you have an Internet problem when.... you refer to going to the bathroom as downloading and eating as uploading".
[I remember being mildly confused to hear all the discussion years back about zipping and unzipping online! Btw... See my own 1997 article for one perspective on the dual nature of "addictiveness" to the object and reinforcement/need gratification, at http://www.fenichel.com/addiction.shtml ]
Dr. Greenfield outlined some ways in which the Internet is unique, notably how "the digital industrial revolution" provides both a way to communicate and a place to communicate to. He mentioned also the "paradox" which has been reported and studied whereby "the Internet offers social opportunity as well as social isolation". Noting his own bias that "we are genetically predisposed to socially connect and communicate", the interesting question is how the Internet is fostering social connections. "Is it a good thing", he asked, "that someone is having cybersex with someone in China but not able to have a conversation with their wife in the same room?" While this may be an obvious case of an exceptional example, it is clear that there is a huge potential for people to become engaged by online social/sexual relationships, with the Sex industry being huge (online just as offline). In adapting the DSM IV criteria for compulsive gambling to compulsive online behavior, Dr. Greenfield has come to think that there is a physiological correlate to the psychoactive experience online, which is the increase of dopamine level, which sexual stimulation can clearly elicit.
Now, what is happening online and when does it become a problem such as one might seek specialized treatment? "Is it a problem that a husband comes home from work and goes online for 9 hours?". Of course this may be the end-point of a process, as "for those who are compulsive, the hours tend to escalate and it does become a problem. Especially with primary relationships, but also financial, and legal."
Turning to statistics and demographics, Dr. Greenfield asked "how many people treat patients, especially couples, where time spent online is having a negative impact on their lives?". Some hands went up. "Americans are into ease and comfort", he noted, and "you can't get more convenient than having sex on a computer". [What does this mean? Sexual release, either simultaneously or taking turns, apparently a useful strategy when one needs to periodically type or use a mouse!]
Thirty percent of his respondents in the ABC.com study reported "mood alteration" from going online. The numbers are now roughly equal between men and women, with over 50% of women having Internet access and using it. In terms of sexual activities and interests, perhaps not surprisingly men predominently seek visual stimulation (pictures) while women seek relationships. (Some specific topics, including sex-related, may draw women into predominently male-populated chat rooms, however.) Dr. Greenfield noted that not only in terms of relationships at home, but also in terms of health, "all this convenience may not really be good for us... we don't leave our cars, people are not exercising and are eating too much", and now need not leave the easy chair to seek out sexual adventures. ("Can you even imagine getting up from the couch and turning the dial to change a channel?" he mused.) In terms of convenience, the Internet readily provides a "sexual smorgasbord" and so it is no wonder that it seems to many like a "petrie dish" which can breed all varieties and variations of online sexual behavior.
Several factors combine to contribute to reinforcing compulsive Internet behavior:
Other factors include the power of anonymity ("which it's really not" much of the time) which allows one to participate with abandon in "a virtual Mardi Gras" and the online disinhibition effect. Many people report a sense of "accelerated intimacy", with "love at light speed". Finally, in this age of instant gratification, "convenience is the mother of invention".
- Accessibility -- It's there 24/7
- Intensity -- "The power of connecting"
- Stimulation -- "an online high"(as the dopamines and reinforcers kick in)
- Time Distortion (lost in Cyberspace!)
Dr. Greenfield noted that there is also a "flip side", of positive social outcomes, such as reports of college students actually communicating more, and more openly, with parents, via e-mail. He noted also the neurological reality (which he and this writer had been discussing earlier in the day) which is that written language is processed differently than spoken language (and of course the former usually requires f2f presence as well). Similarly, reading a letter or anonymous chat is also much different than listening to someone's voice, replete with vocal inflection and often accompanied by visual cues.
The ABCnews.com study of 18,000 people found, not surprisingly, that people are going online increasingly in work situations, not only from home, and clearly time is spent on social/sexual pursuits during some people's work days. [As reported in yesterday's report on Cyber-Infidelity, increasingly employees are being monitored and found out, and may be humiliated -- or worse -- if found violating work rules, or the law.] Similarly, as a question from the audience elicited, not only bosses but spouses at home may have extreme reactions about "time spent with the computer" rather than significant others.
Results from the ABCnews.com study included the findings that:
- 17% of respondents reported feeling "preoccupied with the Internet"
[which the Pew studies suggest may have reflected the novelty for many, a phenomenon now tapering off, so it seems]
- Nearly 6% met the criteria for pathologically compulsive Internet use
- Over 11% reported feeling restless or irritable when attempting to decrease or stop Net use
Dr. Greenfield noted that cybersex may be viewed as "virtual gratification -- a new type of intimacy". He estimates that maybe 40% of those who engage in these behaviors online (e.g., surfing for pornography) would never go into a sex store. There seems to be a "threshold reduction", whereby "people are readily willing to do things online they wouldn't offline." And then, when a person then spends time surfing for sexual stimulation via one's own home computer, the partner "may feel betrayal", and/or hurt and rage: "How can you use the same computer little Johnny uses to do his homework, to have sex with that slut?" Or... "How can you possibly prefer sex with the computer rather than with me?"
So what exactly is "cybersex"? Dr. Greenfield's definition is "using the computer for any form of sexual expression or gratification". Under this rubric are a number of modalities ranging from viewing pornography to engaging in private chat. At the same time perhaps 30% experience "flirting" online, while at the other extreme some have reported (as with an example in his book) acquiring AIDS from sexual encounters with people met online.
What should therapists do to get a sense of dysfunction when treating couples or individuals who may be affected by "cybersex"? Dr. Greenfield counsels that it is very important to take a thorough sexual history and marital history, to better understand the dynamics in context. He also thinks it's important to note if there is a history of treatment with SSRI's, which may be effective at treating compusion but also tend to have an inhibitory effect on sexual function.
In summarizing what constitute online sexual problems, Dr. Greenfield noted that one sees both primary and secondary "Internet-enabled sexual behavior" and these may be multi-dimensional: "There appears to be a synergistic process" which may serve to maintain the behaviors in question. In terms of treatment, aside from good history-taking and clarification of "the problem", one also needs to consider, in addiction terms, whether or not abstinence is a treatment of choice for a given individual. Research suggest "it may not be necessary" about 50% of the time, "but for some people, they cannot go online because it's a trigger." [I can imagine the theories and research which might stem from looking at what happens to displaced sexual energies if the Internet is witheld!]
In practice, after a complete assessment of a relationship and sexual history, the clinician might seek to stabilize the identified problem behavior, employ a combination of individual and couples therapy, and may end up dealing more in depth with individual dynamics. Generally much of the work "begins with the couple, moves to the individual compulsion, and shifts back to the couple."
[No doubt such work may be very challenging, and as Beck said earlier, there needs to be ongoing research on specific treatment approaches for specific types of personalities and behaviors.]
Next, Dr. Barry Gordon offered his perspective on this phenomenon of online life, and its impact on social pursuits. He began by observing that "the time to become interested in someone is far less online... people don't talk dirty after 10 minutes offline". [Has he listened to Ellis?] :-) Point taken of course, that the anonymity and/or disinhibition afforded by the Internet has had a profound impact on many people who take advantage of the new opportunities. "What's changing", he noted, is not human nature necessarily, but "the technology".
Dr. Gordon went on to identify some of the most potent "Factors underying Cybersex and Cyber Affairs" beginning with the phenomenon of time spent online, reiterating the trend noted by Dr. Greenfield.
Using the data from the "Internet Addiction Scale", Dr. Gordon was able to describe the Internet "addict" both quantitatively and qualitatively. He added to Dr. Greenfield's list of problem behaviors reported (e.g., staying online despite vows, jeopardizing job, legal problems, and the symptoms of withdrawal when offline). Then he noted a "huge demarcation" in the data which suggests a basis for describing the true addict: 11 hours a week or more of online activity. "Ninety-two percent of people who access the Internet utilize it less than 11 hours per week". So there is a good starting point for discussing what falls within the range of "normal" Internet use. Aside from time spent online, "the whole idea of the IAS is to use it as a predictor". Another instrument which was used, the Sexual Compulsivity Scale (SCS) yielded results suggesting that those who become enmeshed in cybersex activity "need more sex stimulation to achieve satisfaction".
Dr. Gordon turned to a look at behavior in various online venues, beginning with one of the most popular spots, the chat room. Chat rooms are described as "the most common and intense way of relating". Among 17,000 subjects, those utilizing chat were 3 times more likely to be engaging in sexual behavior than non-users. Instant Messaging is also quite popular, though its use was reported as 74% among teens contrasted with only 44% of adults. Perhaps not so surprising, 64% of teens know more about the Internet than their parents. Sixty-nine percent of teens use IM several times per week [I'd say: per day!] and 60% of teens report getting mail from strangers. They reply 50% of the time. Fully 20% of children 10-17 report having received some sort of sexual solicitation, according to the study. How much was "spam" as opposed to individual contact was not stated.
The old adage was repeated, that "men engage in intimacy to get sex, while women engage in sex to get intimacy", and it is said that this aspect of human nature is alive and well online. Someone in the audience asked if there was any data specifically on "gay cybersex" activities online, but as of yet apparently not.