INTERNET-ADDICTION understanding – counseling - coping

1. Dr. Samuel Pfeifer INTERNET-ADDICTIONunderstanding – counseling - coping

2. You can double-click as much as you like, but my hand is not a computer mouse! And I am not listening to the command open”!

3. LAN-Party – Lone Addiction

4. Computer Game Addiction in China has become a major health problem.

5. Internetpornography Chat Online-Games Internet-Gambling Four areas with addictive potential

6. No human longing is more powerful, more difficult to rein in. Sex has enough combustive force to incinerate conscience, vows, family commitments, religious devotion, and anything else in its path. Philip Yancey

7. Case vignette 1 • The 13-year old daughter wants to access the internet using her father‘s laptop computer. Suddenly, she is confronted with a hidden folder containing thousands of pornographic images. Within her, a world is breaking apart. Her father whom she has admired, the good teacher, the active Christian – how does it fit with such material? She suffers a nervous breakdown, cries all day long, stops eating, skips school. She smashes the laptop by throwing it out of the window. The whole family is in a dramatic crisis. It is in this situation that they come for family therapy.

8. Example 2 • Letter of an addicts‘ wife: • “I am desperate. Our marriage has been fine over the last ten years until we got an internet access. My husband spends hours in the internet – nothing but sex sites and chats with ladies offering their services. I have pleaded with him, but he only gave me hollow promises.Now he does it in secret, when I am out of the house.Our phone bill has reached utopian heights.He yells at the children, he lies to me. For four years I have tried to understand him, to talk it over with him in a calm way, but now I am at my wits’ end…”

9. Example 3 • A 32 year old woman seeks therapy for intense feelings of anxiety. Over the last few years she has had a positive experience with chatting, which has helped her in her loneliness. • A few months ago, she has made contact with a man in her chat room – at first only in the web – they chat, they flirt, they feel mutually attracted to each other. They make a date. The atmosphere is „loaded“, they finally have sex. Soon after, the man is not interested in her any more, they lose contact. • Only now, she starts to realize that she has been used. She is worrying about a possible HIV-infection. But she also wonders: Where has my internet addiction led me? What is happening with me?

10. Example: Self-Worth A boy writes about his girlfriend: • “She tells me that in the chatroom she can pose how she wants to be …She thinks nobody would like her because she is overweight … but that is hogwash. O.k., she is somewhat molly but nobody would take offence; I like her that way.In the Chat, she is desirable; everybody thinks she has a perfect body and is the most beautiful girl in the world… • But she thinks if they knew how she really looks they would not like her any more…”

11. Cybersex – „just a click away“ • easily accessible • affordable • anonymous • Cyber-Psychologist John Suler describes „Toxic Disinhibition“ • „You don‘t know me.“ • „You can‘t see me.“ Being invisible gives people the courage to write and think things they would never do in a real-life situation.

12. Some statistics • Sex Industry Statistics • $57.0 billion revenue world-wide - $12.0 billion of this is US revenue, more than all combined revenues of all professional football, baseball and basketball franchises or the combined revenues of ABC, CBS, and NBC (6.2 billion). • Porn on the Web • 25% of total search engine requests are porn-related. • 12% of total websites are pornographic • Affecting Children • 100,000 websites offer illegal child pornography. • 90% of 8-16 year olds have viewed porn online (most while doing homework). • Average age of first internet exposure to pornography is 11 years old.

13. Statistics II • Affecting Adults • 20% of men admit accessing pornography at work • 13% of women admit accessing pornography at work • 10% of adults admit having internet sexual addiction. • Business Productivity • 70 percent of all internet porn traffic occurs during the 9-to-5 workday. • Nearly one out of three companies has terminated an employee for inappropriate web use. SOURCE: http://healthymind.com/s-port-stats.html

14. Pornographic internet content • Everything is possible • „soft pornography“ • „hard pornography“ • „sexually explicit in the extreme, and devoid of any other apparent content or purpose“ – including violence, sado-maso, electroshocks, urine, feces, very fat women, pregnant women etc., „gang-bang“, animals; even „snuff-videos“ – killing victims in front of the camera. • pedophile content (often with sadistic torture) • Chat with explicit sex talk – often leading to real-life encounters. • Live-Video • Mobile telephones: growing industry of short films, pictures, explicit sounds.

15. Internet Addiction Disorder (IAD) - Diagnostic Criteria • A maladaptive pattern of internet use, leading to clinically significant impairment or distress as manifested by three (or more) of the following, occurring at any time in the same 12-month period: • (I) tolerance, as defined by either of the following: • (A) A need for markedly increased amounts of time on Internet to achieve satisfaction • (B) markedly diminished effect with continued use of the same amount of time on Internet. Author: Ivan Goldberg, M.D.

16. Criteria – IAD II • (II) Withdrawal, as manifested by either of the following: • (A) the characteristic withdrawal syndrome • (1) Cessation of (or reduction) in Internet use that has been heavy and prolonged. • (2) Two (or more) of the following, developing within several days to a month after Criterion 1: (a) psychomotor agitation - (b) anxiety - (c) obsessive thinking about what is happening on Internet - (d) fantasies or dreams about Internet - (e) voluntary or involuntary typing movements of the fingers. • (3) The symptoms in Criterion B cause distress or impairment in social, occupational or other important other area of functioning • (B) Use of Internet or a similar on-line service is engaged in to relieve or avoid withdrawal symptoms • (III) Internet is often accessed more often or for longer periods of time than was intended.

17. (IV) There is a persistent desire or unsuccessful efforts to cut down or control Internet use. • (V) A great deal of time is spent in activities related to Internet use • (e.g. organizing files of downloaded materials; researching Internet vendors, trying new browsers.) • (VI) Important social, occupational, or recreational activities are given up or reduced because of Internet use.

18. Destructive consequences • (VII) Internet use is continued despite knowledge of having a persistent or recurrent physical, social, occupational, or psychological problem that is likely to been caused or exacerbated by Internet use • sleep deprivation, marital difficulties, lateness for early morning appointments, neglect of occupational duties, or feelings of abandonment in significant others. • Isolation • Job loss

19. Value shift – destructive effect • Online addicts realize that they give up values which have been important to them: • Respect of the other person. • Repulsion of violence and coercion. • Christian values of integrity, purity and self discipline. • Pathological Cybersex destroys the life of a person • Internally (distorted fantasies, continuous craving) • in relationships (partner, family) • in the workplace (risk of job loss and poverty)

20. Complications - Comorbidity • Alcoholism: Alcohol is being used to get calmer but also to enhance the sexual excitement. • Substance abuse (from Cocain to Viagra) • Depressive Episodes: caused by negative psychosocial consequences of the cyber-addiction or the break-up of relationships. • Suicidal thoughts: out of despair and hopelessness. • Obsessive-Compulsive Behavior: Online addicts develop complex rituals to conceal their dependency and to make sure their family, colleagues or company cannot access their “hidden area”. • Paranoid Thinking: Fear of being discovered and being ashamed lets them associate even marginal observations with personal threats. (Examples: If a police car passes: “I hope they do not come to confiscate my computer!” – If the boss asks for a meeting: “Does he want to confront me with my Internet activities during last week?”)

21. Differences between men and women • MEN • „Kick“ through visual material • Sexual excitement with masturbation. • Collecting mania (thousands of pictures etc.) • Tendency towards violent and abasing content. • WOMEN: • „Kick“ through communication (Chat). • Romantic stories and images (80 %) • Sexual excitement is secondary.

22. Brain functions in sexual addiction 1 2 3 4 5 2 frontal brain LimbicSystem 1. Visual Stimulus 2. Sexual Excitement 3. Dopamin – „Happiness“ 4. Adaptation – Desire for more and stronger stimuli 5. Loss of control Genital Stimulation

24. Quelle: S. Grüsser, Charité Berlin, www.isfb.org

25. Quelle: S. Grüsser, Charité Berlin, www.isfb.org

26. Quelle: S. Grüsser, Charité Berlin, www.isfb.org

27. Addiction requires Detoxification • The biological component of sexual addiction is not to be underestimated. It can be compared to substance abuse. • „A Sex-Addict is like an alcoholic, but it is his own the brain which is his bar.“ • This makes decisive withdrawal necessary. • In contrast to substance abuse, here a return to „controlled sex“ would be the ideal.

28. Drive and conscience Conscience Drive

29. Risk factors for compulsive sexuality • Personality: impulse control, self esteem, introversion, patterns of tension reduction, • Disposition for addictive behavior upon stimuli (award dependence). • Inner emptiness, isolation, emotional burnout, neglect of rewarding interpersonal relationships. • Presence of harmful material (just a click away in the Internet)

30. Risk factors II • Dealing with hidden emotional pain. • History of childhood trauma / neglect • Pathological search for new stimulation. • Lack of inner discipline / behavioral control • Rationalising negative behavior: „This helps me to relax“ – „ I owe myself a treat“ – „It‘s only pictures“ etc. • Unrealistic expectations towards others, sexual partners, emotional immaturity.

31. H = Hungry A = Angry L = Lonely T = Tired Risk factors HALT

33. Integration Acknowledge your addiction 1. Acknowledge that your „habit“ is an addiction, which requires consequent action. 2. Realize the fact that you support sexual abuse and slavery of women and children with your behavior.

34. Integration Limit access 3. Filtersoftware – blockade of access (www.max.com). - Limitations 4. Be accountable to a person you trust.Work at immature expectations and solution strategies. Perhaps using special software.

35. Integration Transparency 5. Share your addiction with your wife, a friend or a counselor. • Keep your computer in a public room of the house. Keep certain times to access the computer to ensure control. Personal discipline and responsibility.

36. Integration Live without the internet! • Choose to live without a computer or internet access for some time („plucking out your eye!“) • Attend a self-help group to learn with other addicts about strategies how to deal with your addiction. (www.sexhelp.com)

37. What about medication? • Serotonin: produced as a side effect of addiction process. Antidepressants are also elevating serotonin levels. • Could Serotonin reduce Craving? – possibly reduce feelings of emptiness and underlying depression. • Dopamin (increases desire in addiction) • No proven strategies in this area without severe side effects (neuroleptics). • Opiates: central in addiction, creating the feeling of being „high“. • Although there are opioid blockers there is no indication that they reduce non-substance addiction. • Conclusion: • Medication (unfortunately) is not a solution; perhaps partially a support for behavior therapy, where a person is additionally suffering from depression. No proven effect!

38. Goal of therapy: relationship orientation • Not secular vs. Christian • BUT: individually centered vs. stabilizing relationships. • Short term satisfaction vs. long-term integrity. • Individual lust vs. an ecology of relations. • Double moral standards vs. dignity, respect and empathy. • Lack of boundaries is destructive – conscious renouncement increases the ability to enjoy.

39. Strategies to keep from Falling • Watch your spiritual health • Lapses in the spiritual disciplines of meditation, worship, prayer and healthy self-examination are certain to spell trouble. • Guard your marriage • Regularly evaluate your relationship with your spouse, keeping him or her involved in what happens in your ministry world. • Take adequate precautions • If you find yourself thinking more about ways to be with a co-worker than with your spouse, set strict parameters about that working relationship. Avoid meeting alone with him or her. • Understand subtle signs of sexual attraction • Exchanging notes and gifts, holding hands tightly in prayer, allowing the arm to linger just a bit longer on the shoulder, offering embraces more often—these may denote a relationship veering into dangerous territory. Compiled by Randy Alcorn

40. Marriage, Sex, and Sacrificial Love • Marriage strips away the illusions about sex pounded into us daily by the entertainment media. Few of us live with oversexed supermodels. We live instead with ordinary people, men and women who get bad breath, body odors, and unruly hair; who menstruate and experience occasional impotence; who have bad moods and embarrass us in public; who pay more attention to our children's needs than our own. • We live with people who require compassion, tolerance, understanding, and an endless supply of forgiveness. So do our partners. Such is the ironical power of sex: It lures us into a relationship that offers to teach us what we need far more—sacrificial love. (Philip Yancey)

41. Strategies to keep from Falling • Back off early • When you realize a counselee has become interested in you personally, it is time to refer that person to someone else. • Maintain clarity in your thinking • Never justify flirting, and never disclose to another person that you have lustful thoughts about them. • Make yourself accountable • Don't try to be a lone ranger leader. • Guard your thought life • "Our thoughts are the fabric with which we weave our character and destiny." With good reason Paul encourages believers to keep their minds focused on things that are noble, right, pure, lovely, admirable, excellent and praiseworthy (Philippians 4:8). Compiled by Randy Alcorn

42. Download Interesting texts, ressources, links can be found on this homepage: www.sexhelp.com

43. Group activity • How has the Internet changed your life? • Do you remember incidents that brought home the dangers of the internet? • Apart from overt pitfalls, where do you encounter problems (yourself, your children, loss of time, excessive surfing etc.) • What are you doing to prevent the dark sides of the internet invade your life? Group Activity / Questions