American Psychological Association
117th Annual Convention
Toronto, August 6-9 2009
Dr. Kimberly Young
First to present was Dr. Kimberly Young, who began by mentioning how Toronto was a special place for her, as it was here where she first presented her paper on "Internet Addiction" over a decade ago, instantly finding herself in the center of a media frenzy. She humbly recalled that "all I did was identify a disorder" which she framed similarly to the dynamics seen with compulsive behavior disorders such as gambling. Since that time, she and others (e.g, Dave Greenfield and Maressa Orzack) have understood that one can speak of "computer addiction" and "gaming addiction" and specific behaviors or activity which consume one's waking time (with or without Internet), often at great social or familial or vocational cost. Dr. Young reviewed how several large scale studies (e.g., Carnegie-Mellon) have focused on things such as social isolation, withdrawal from other activities, etc. She embraced the use of multiple criteria so that diagnosis would for example need to be based on demonstrating 5 or more symptoms for longer than 6 months. The new Diagnostic and Statistical Manual (DSM) - V appears to be set to embrace similar criteria. Some of the symptoms include things like:
- Preoccupation with the Internet (thinking abut previous online session, anticipating next session)
- Utilizing Internet with increasing amounts of time
- Unsuccesful efforts to control, cut back, or stop Internet time
In an overview of research trends, some of the highlights incuded:
- Consideration of "Pathological Computer UseL" as a diagnostic entity in DSM V
- Epidemic levels in China, Korea, Taiwan
- First Detox Center for Video Game Addiction developed in Amsterdam, NL (July 2006)
- First Military Boot Camp for Treating IA developed in Beijing (2006)
- New studies document IA in Pakistan, Portugal, Italy, Germany, India, Canada and the UK
In introducing her paper, Treatment Outcomes with Internet Addicts, Dr. Young again noted that social/societal context is important, as those who observe the ubiquitous use of cell phones, facebook, SMS, etc. can easily see. A decade ago, her early practice saw mostly chat room horror stories, and IM'ing preoccupation, "pre-Facebook". [Dave Greenfield focused mostly on the broken families following in the wake of online sexual activity.] Dr. Young noted increasing "facebook addiction" - something I've also observed and written about. [E.g., here.] Again, times change. For example, the dot-com bubble burst put an end to "addictive" day-trading, which was a trend for a while. At the same time, "63% of divorces were related to Internet infidelity". Fast forward, and at this time, there is still a lawsuit underway in response to an employee being terminated for "Internet addiction" rather than his having been given help and protected, under the ADA. It was in 2006 that the first "detox center" opened.
A number of approaches to treatment are emerging, most cognitive-behavioral in orientation. Some are convinced that "boot camp" type experiences are required; others try to isolate and relearn specific behaviors rather than totally "detox" from using computers at all, as they may well need to use email for work (but not to sit and read the news online if they can be retrained to spend time reading a newspaper for news, as an example).
In her 2007 study, Dr. Young described "Internet addiction as a new and often unrecognized clinical disorder that impact[s] a user's ability to control online use to the extent that it can cause relational, occupational, and social problems". The study investigated the efficacy of CBT with Internet addicts, and is based on an N of 114 clients presenting at the Center for Online Addiction. Using a survey design, outcome measures included "client motivation, online time management, improved social relationships, improved sexual functioning, engagement in off-line activities, and ability to abstain from problematic applications". Clients were evaluated after 3, 8, and 12 sessions, and at a 6-month follow-up. The cognitive-behavioral model was characterized as:
- Time efficient
- Structured, active
- Utilizing a collaborative, problem-solving approach
- Involving regular homework
"Results suggested that Caucasian, middle-aged males, with at least a four-year degree were most likely to suffer from some form of Internet addiction."... "Women were more relational..." "Certain applications are problematic." [Maybe apropos to time spent on social networks? The next speaker addresses this in part.] Preliminary analyses indicated that the majority of clients were able to manage their presenting complaints by the eighth session and symptom management was sustained upon a six-month follow-up. Clients reported that CBT counseling was effective at ameliorating the common symptoms. Upon six-month follow-up, most clients were able to maintain symptom management and continued recovery." Of course, Dr. Young repeated, it's not possible to avoid computers altogether any more than one can do entirely without food in working with food addiction. "You need to train yourself to do more things away from the computer" and make "positive lifestyle changes". In considering the alternative to vigilance, she noted the old "joke" that "You're only a mouse click away from relapse".
Thus, a targeting of specific behaviors and use of CBT appears to be a promising direction, and further research was suggested, utilizing evidence-based protocols unique to this population. On a societal level, it might be desirable to follow what other countries have done and be "more proactive" in teaching sensible and safe practices online.
The next presenter was Katherine Somerville (aka Loufus), who picked up on the social implications and trends seen in particular across social networking participants. As a cautionary note, she reminded the audience of the 2006 suicide by a young girl due to what was presented as a complete put-down by a highly desired boy - "More shocking: the boy did not exist" but was the invention of a playmate's mother. As a footnote, no consequences ultimately befell the one who caused the death/suicide, except for a small penalty for violating the MySpace terms of use.
There are additional "frightening aspects of social networking" as well, an activity very common and frequent among "the Net Generation", and worrisome in that "relationships are seen as real even if they may be based in fantasy". [At the end someone in the audience asked about "imaginary playmates" perhaps being similar, but the point was made that it's somewhat different as it is public and in real-time. However...] Children and teens may tend to carry the fantasy play into daily life, blurring the line between fantasy names and identities with real characters.
Contextually/historically, it is perhaps relevant to note that "in the past children interacted on the playground. Now they log on." Citing Rifkin (2000), Ms. Somerville made the further point that for the first time in history, children are more adept with the technology than their parents. They easily tune in to online activities, assume fictional characters easily, and may then "integrate fictional characters into everyday, face-to-face life". The ambience of their online meeting places is often "eclectic and highly irreverent", and one may lose distance from the fact that things are "electronic rather than real". Without labeling it as such, the presenter also noted what is often called the "online disinhibition" effect, fostered by anonymity, especially. And "to hide a person's body is to hide their bodily issues". [There are of course arguments for positive uses of this "empowerment" as well as enticements to act out.] "No corporal body, no visual cues. You may not see as readily when you are being misled". In addition, another aspect is that of asserting control, over others or self or technology (e.g., having multiple conversations simultaneously). Research [and my own observation] suggests that often with multi-tasking teens, "the phone is reserved for when there's lots to talk about". Meanwhile, in the imagination-rich land of Cyberspace, according to Kendrick, "the relationship people have with the Internet is imaginary... it appeals to our needs and desires, to fall in love with fantasies." In conclusion she described how the Internet is changing, but remains too a "powerful tool for self expression". [I concur and have often said this myself: it is a tool, not de facto a way of life. It's just wires, the Internet. It's the people using it who invent a shared world of "Cyberspace".]
The third presenter is Dr. Dana Klisanin, whose interest area is Altruism and the Internet.
This aspect of the Internet - its power for positive change based on users' inherent altruism - was explored using web metrics to illustrate trends in web-based altruism, or "doing good" in small ways, like clicking to support a cause. One notion of this is Klisanin's (2003) description of "media designed both in content and context for the purpose of facilitating the societal emergence of planetary consciousness."
While Dr. Klisanin, as others, noted that the widespread use of the powerful Internet tool has some down sides such as lack of privacy, ease of plagiarism, and prevalence of pornography [which historically was once the ONLY profitable endeavor on the Internet], there has also been demonstrable growth in altruistic behavior - programmers donating time, web site owners putting up links to good causes, etc. There are a growing number of widely used web-based tools to promote positive causes. Among them are:
- User-generated content/sharing of expertise (e.g., Wikipedia)
- Care2.com and other sites where altruism is the essential component
- Microsoft's I'm Initiative
- Meta-cooperative endeavors, such as the World Community Grid
A few of the sites were presented as illustrations, such as care2.com and the Rainforest site, where one can click to protect endangered species.
Dr. Klisanin finds "digital altruism" a useful term to differentiate from everyday use of the word altruism. And then there is "everyday digital altruism" such as creating a site with links to altruistic causes, and higher-level, creative digital altruism. She is heartened by the fact that some sites (e.g., Rainforest) have seen their click-throughs to altruistic causes double between 2007 and 2008.
A few maxims, finally:
- All of the preceding examples of altruism rely on the Internet for transmission and/or actualization; thus they are 'digital' in nature.
- The ultimate goal of the altruistic act is to benefit sentient beings in the manifest world.
- The digital nature of the act is significant for the following reasons: ease of action, speed of transmission, potential impact.
Last to present on this panel was Brittany Landrum, who summarized her paper on "The Other's Face on Facebook: A Levinasian Focus Group Approach."
Briefly, this was a report on work with a focus group with a theoretical framework stemming from (what seemed to me) both a phenomenological approach as well as an almost Lacanian/Kohutian (i.e., linguistic, object relations components in addition to Levinasian) focus on self versus other, and who is observing, observed, &/or responding to whom. The basic tenet is that "the world is presented in the language of the other". Here I must confess, I'm not familiar with Levinas though I have a fair background (as a philosophy minor and psych graduate years devoted to existential/phenomenological and linguistic concepts). A few things ring true to me, though, which I'll try to spotlight.
One aspect of the discussion is how at times "the other has disturbed one's solitary [control]" of their world. So, a basic question is "what's in it for me?" to reach out in ways like Facebook, and surrender to being in a virtual fishbowl with constant invitations to see or be seen - or in this vernacular, to be, see, or become the "other". On Facebook, in her words, "the peripheral presence of others is manifest". [ I would say, based on my own current, ongoing research/observation of Facebook, that this is quite true - it's like being plugged into a network 24/7, and whether or not you actively participate, everyone is always there, and you can voyeuristically follow the exhibitionistically inclined in their every movement or application "addiction", or one can send hugs to 1/2 the known world - or an old shoe, or now, a Rorschach test which tells what items you got right and rates your "sanity" level. But I digress. ] Facebook is a parallel world in some ways, or it can be seen as fulfilling various discrete needs.
This presenter identified five "theme clusters" from the focus groups. One is what I just mentioned, I believe, and she called the "Voyeur/Spectacle" theme. There is also a community-belonging theme, "degrees of intimacy" theme, "other for me" theme, and "other constitutes me" theme, all hubs in a spoke with the central component being "peripheral presence". I am sure these all take some time (which wasn't there in this brief presentation) to explain, and how they were operationalized intrigues me.
The research questions were interesting, to be sure, including "How does the other appear on FB?", "What does it mean to feel 'connected' to someone via FB?", and "Are there ways in which one feels especially connected to particular others or communities via FB?" "Are there ways in which one feels especially estranged from particular others or communities via FB?" Respondents were surveyed with questions which directly asked if there are ever times FB feels inadequate to meeting needs of feeling connected, etc.
The results were definitely "phenomenologically" phrased, though I'd need to learn more to fully appreciate the implications and results, generally. Among the results presented: "The Other on FB appears as..."
- Opaque to me, opaque to them. The other as familiar and strange
- On a scale of comparison
- As in command (FB puts me at their beck and call)
- As my project (ie targeted searches, FB, stalking, etc.)
That does it for this short but pithy paper presentation.
Now I'm off to the opening ceremony. Tomorrow and Saturday are full days of events with many legends and a few novel topics as well. Will get the reports out as fast as I can type!
Regards from Toronto,
"Dr. Mike"
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Disclaimer: I try to ensure accurate reports of study results, names, dates, etc., and use a combination of verbatim notes, presenter materials, Power Point data summaries, and direct follow-ups with presenters. If I have inadvertently misstated or mis-typed any information I would be grateful for any corrections and will promptly update/correct any errors.
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