Thursday, September 25, 2014

How to create motivation in the addicted gamer?

Motivational Interviewing (MI) offers a new perspective on what the role of the mental health professional is in the mysterious, perplexing, and often frustrating process of instilling motivation in video game addicts.  Failure to “inspire” gaming addicts to reach their goals, despite our best coaching and cheerleading efforts, has been a significant contributor to the conclusion that gaming addicts cannot be helped.  

Psychologists William Miller and Stephen Rollnick (1991) have conceptualized lack of motivation as the experience of being “stuck” in ambivalence. They developed a counseling style that elicits behavior change by helping clients to explore and resolve this ambivalence. This style is similar to the client-centered, humanistic approach developed by Carl Rogers and others; however, it is notably more directive, and can demonstrate results in a relatively short period of time.

The concept of MI originally evolved from William Miller’s experiences with the treatment of problem drinkers.  Since then, however, MI has been applied to much broader settings. It operates from the premise that ambivalence is a normal state that affects many areas of one’s life. MI uses a set of skills and principles that guide the client and counselor through the process of resolving ambivalence (Miller and Rollnick, 1991). 

In my next blog I will begin to explain how MI works as well as why MI is effective with gaming addicts.

Christopher Mulligan LCSW

Monday, July 14, 2014

Porn addiction similar to drug addiction?

LONDON (Reuters) - Pornography triggers brain activity in sex addicts similar to the effect drugs have on the brains of drug addicts, researchers said on Friday - but that doesn't necessarily mean porn is addictive.
Although there are no precise figures, experts in the field believe as many as one in 25 adults is affected by compulsive sexual behavior, more commonly known as sex addiction - an obsession with sexual thoughts, feelings or behavior they are unable to control.
Excessive use of pornography is one of the main features of the condition. That can affect personal lives and work, causing distress and feelings of shame, the researchers from Britain's Cambridge University said in a study published in the journal PLOS ONE.
The study looked at brain activity in 19 male patients affected by sex addiction and compared them with the same number of volunteers. The patients had started watching pornography at earlier ages and in higher proportions than the volunteers.
"The patients in our trial were all people who had substantial difficulties controlling their sexual behavior and this was having significant consequences for them, affecting their lives and relationships," said Dr Valerie Voon, who led the study at Cambridge's department of psychiatry.
"In many ways, they show similarities in their behavior to patients with drug addictions. We wanted to see if these similarities were reflected in brain activity, too."
The study participants were shown a series of short videos featuring either sexually explicit content or sports. Their brain activity was monitored using functional magnetic resonance imaging (fMRI), which uses a blood oxygen level dependent (BOLD) signal to measure brain activity.
The researchers found that three regions in particular were more active in the brains of the sex addiction patients compared with the healthy volunteers.
Significantly, these regions – the ventral striatum, dorsal anterior cingulate and amygdala – are also activated in drug addicts when they are shown drug stimuli, the researchers said.
The ventral striatum is involved in processing reward and motivation, while the dorsal anterior cingulate is involved in anticipating rewards and drug craving, they said. The amygdala helps process the significance of events and emotions.
The researchers also asked the participants to rate their levels of sexual desire while watching the videos and say how much they liked them. Drug addicts are thought to be driven to seek their drug because they want it, rather than enjoy it.
This process is known as incentive motivation, Voon said, and is a compelling theory in addiction disorders.
Patients with sex addiction showed higher levels of desire towards the sexually explicit videos, but did not necessarily like them more.
"Whilst these findings are interesting, it's important to note ... that they could not be used to diagnose the condition," Voon said. "Nor does our research necessarily provide evidence that these individuals are addicted to porn – or that porn is inherently addictive.
"Much more research is required to understand this relationship between compulsive sexual behavior and drug addiction."
(Editing by Larry King)

Thursday, June 26, 2014

Watching Online Porn May Change The Structure of the Brain

Men who watch large amounts of sexually explicit material have brains with smaller reward systems, a study finds.
"That could mean that regular consumption of pornography more or less wears out your reward system," says Simone Kühn, psychologist at the Max Planck Institute for Human Development in Berlin and lead author of the study, published in the "JAMA Psychiatry" journal.
Your reward system is a collection of neural structures in the brain that regulate and control behavior by inducing pleasure.
The researchers scanned the brains of 64 men aged between 21 and 45 with a MRI machine.
Those probands - or study subjects - who watched porn often had a smaller striatum, which is an important part of the reward system and also involved in sexual arousal.
The study also found that the reward systems of porn-experienced men were less active when they watched sexually arousing pictures inside the MRI machine.
"We assume that probands with a high porn consumption need increasing stimulation to receive the same amount of reward," Simone Kühn says.
Consequence or precondition?
But were men with smaller striatum seeking more porn because they needed more external stimulation, or did the higher consumption of porn make this part of the brain smaller?
The researchers admit both could be true. But they say the latter is more likely.
Kühn says existing psychological, scientific literature suggests consumers of porn will seek material with novel and more extreme sex games.
"That would fit perfectly the hypothesis that their reward systems need growing stimulation."
MRI scan
Photo: Andreas Gebert, dpa
A brain scan can reveal a lot.
In future studies the researchers plan to observe brain changes in study subjects over a period of time to see whether the reward system really changes with increasing porn consumption.
Like cocaine and gaming
Kühn says the team had predicted it would observe changes in the reward system - but the opposite of what it ultimately found.
The striatum is also involved in drug addiction.
In 2001, researchers found that reward-system-related brain parts were up to ten percent larger in cocaine addicts than in non-dependent probands.
And as if that wasn't enough: "In a study with teenagers we found that frequent PC games playing leads to an increase in the size of the striatum," says Kühn. But she notes she was surprised to see that male porn-watchers had smaller - not larger - striatum than the other men in the study.
She says she had expected porn consumption to increase the size of the reward system - rather than make it shrink.
Is porn addiction real?
"Pornography is no longer an issue of minority populations but a mass phenomenon that influences our society," the researchers write in the journal, adding that an estimated 50 percent of all Internet traffic is related to sex.
Psychiatrists have been debating whether it is possible to develop an addiction to porn. But they have yet to even agree on a clinical definition of pornography addiction.
In February, psychiatrists wrote in "Current Sexual Health Reports" that there is no such thing as porn addiction. There was no sign, they wrote, that use of pornography causes any changes to the brain.
This latest research may change their minds.

Cris Rowan Offers 10 Reasons Why Handheld Devices Should Be Banned for Children Under 12

Author: Cris Rowan
The American Academy of Pediatrics and the Canadian Society of Pediatrics state infants aged 0-2 years should not have any exposure to technology, 3-5 years be restricted to one hour per day, and 6-18 years restricted to 2 hours per day (AAP 2001/13, CPS 2010). Children and youth use 4-5 times the recommended amount of technology, with serious and often life threatening consequences (Kaiser Foundation 2010, Active Healthy Kids Canada 2012). Handheld devices (cell phones, tablets, electronic games) have dramatically increased the accessibility and usage of technology, causing escalating usage, especially by very young children (Common Sense Media, 2013). Cris Rowan, pediatric occupational therapist is calling on parents, teachers, and government to ban the use of all handheld devices for children under the age of 12 years. Following are ten research evidenced reasons for this ban. Please visit to view the Zone’in Fact Sheet for referenced research.
  1. Rapid brain growth
    Between 0 and 2 years, infant’s brains triple in size, and continue in a state of rapid development to 21 years of age (Christakis 2011). Early brain development is determined by environmental stimuli, or lack thereof. Stimulation to a developing brain caused by over exposure to technologies (cell phones, internet, iPads, TV), has been shown to negatively affect executive functioning, and cause attention deficit, cognitive delays, impaired learning, increased impulsivity, and decreased ability to self-regulation e.g. tantrums (Small 2008, Pagini 2010).
  2. Delayed Development
    Technology use restricts movement, resulting in delayed development. One in three children now enter school developmentally delayed, negatively impacting on literacy and academic achievement (HELP EDI Maps 2013). Movement enhances attention and learning ability (Ratey 2008). Use of technology under the age of 12 years, is detrimental to child development and learning (Rowan 2010).
  3. Epidemic Obesity
    TV and video game use correlates with increased obesity (Tremblay 2005). Children who are allowed a device in their bedrooms have 30% increased incidence of obesity (Feng 2011). One in four Canadian, and one in three U.S. children are obese (Tremblay 2011). 30% of children with obesity, will develop diabetes, and be at risk for early stroke and heart attack, gravely shortening life expectancy (Centre for Disease Control and Prevention 2010). Due to obesity, 21st century children may be the first generation many of whom will not outlive their parents(Professor Andrew Prentice, BBC News 2002).
  4. Sleep Deprivation
    60% of parents do not supervise their child’s technology usage, and 75% of children are allowed technology in their bedrooms (Kaiser Foundation 2010). 75% of children aged 9 and 10 years are sleep deprived to the extent that their grades are detrimentally impacted (Boston College 2012).
  5. Mental Illness
    Technology overuse is implicated as a causal factor in rising rates of child depression, anxiety, attachment disorder, attention deficit, autism, bipolar disorder, psychosis, and problematic child behavior (Bristol University 2010, Mentzoni 2011, Shin 2011, Liberatore 2011, Robinson 2008). One in six Canadian children have a diagnosed mental illness, many of whom are on dangerous psychotropic medication (Waddell 2007).
  6. Aggression
    Violent media content causes child aggression (Anderson 2007). Young children are increasingly exposed to rising incidence of physical and sexual violence in today’s media. Grand Theft Auto V portrays explicit sex, murder, rape, torture, and mutilation, as do many movies and TV shows. The U.S. has categorized media violence as a Public Health Risk due to causal impact on child aggression (Huesmann 2007). Media reports increased use of restraints and seclusion rooms with children who exhibit uncontrolled aggression (Vancouver Sun 2013).
  7. Digital dementia
    High speed media content causes attention deficit, as well as decreased concentration and memory, due to the brain pruning neuronal tracks to the frontal cortex (Christakis 2004, Small 2008). Children who can’t pay attention, can’t learn.
  8. Addictions
    As parents attach more and more to technology, they are detaching from their children. In the absence of parental attachment, detached children attach to devices, resulting in addiction(Rowan 2010). One in 11 children aged 8-18 years are addicted to technology (Gentlie 2009). Never in the history of humankind have there been child addictions.
  9. Radiation emission
    In May of 2011, the World Health Organization classified cellphones (and other wireless devices) as a category 2B risk (possible carcinogen) due to radiation emission (WHO 2011). James McNamee with Health Canada in October of 2011 issued a cautionary warning stating “Children are more sensitive to a variety of agents than adults as their brains and immune systems are still developing, so you can’t say the risk would be equal for a small adult as for a child” (Globe and Mail 2011). In December, 2013 Dr. Anthony Miller from the University of Toronto’s School of Public Health recommend that based on new research, radio frequency exposure should be reclassified as a 2A (probable carcinogen), not a 2B (possible carcinogen). American Academy of Pediatrics requested review of EMF radiation emissions from technology devices, citing 3 reasons regarding impact on children (AAP 2013).
  10. Unsustainable
    The ways in which children are raised and educated with technology are no longer sustainable(Rowan 2010). Children are our future, but there is no future for children who overuse technology.  A team based approach is necessary and urgent in order to reduce the use of technology by children. Please reference below slides shows on under videos to share with others who are concerned about technology overuse by children.
Problems – Suffer the Children – 4 minutes
Solutions – Balanced Technology Management – 7 minutes
The following guidelines for technology use by children and youth were developed by Cris Rowan pediatric occupational therapist and author of Virtual Child, Dr. Andrew Doan neuroscientist and author of Hooked on Games and Dr, Hilarie Cash, Director of reSTART Internet Addiction Recovery Program and author of Video Games and Your Kids, with contribution from the American Academy of Pediatrics and the Canadian Pediatric Society in an effort to ensure sustainable futures for all children.

Technology Use Guidelines for Children and Youth

Technology Use Guidelines for Children and Youth6

Sunday, June 22, 2014

Wilderness Day Group for Video Game Addicted Kids

                                  CYBER ADDICTION RECOVERY CENTER 
                                       CHRISTOPHER MULLIGAN LCSW
                                                       "Get Unplugged!
                Wilderness Adventures for “Tech” Dependent/Addicted Kids

Christopher Mulligan LCSW is offering therapeutic activities in our local-natural surroundings (Los Angeles) designed to help children and teens break the destructive cycle of compulsive internet and gaming behavior. Children/teens will be presented with the opportunity to participate in outdoor adventures that unfold in a therapeutic sequence that will develop self-awareness, physical skills, communication skills, trust in self and others, respect, psychological and physical courage, and empathy.

In order to create new and adaptive behaviors tech dependent/addicted children/teens must get “unplugged” from their home environment. Participating in outdoor activities is one of the most effective ways to help tech dependent/addicted children/teens create an accurate awareness of how technology is damaging the quality of their lives and develop new social skills and recreational interests that will help them “plug” in to a non technological dependent life style.

Prior to the start of each wilderness experience there will be a group check-in where therapists will facilitate introductions, allow for the exploration of each person’s history including what brings them to our program, set the stage for the events of the day, and focus on helping the group members develop their observational skills and a greater awareness of their environment as well as the impact they have on their environment.

Therapists will review and emphasize the importance of the safety of group members and discuss how communication, trust, and accountability factor into the activities chosen for a given day. Throughout the day therapists supervise and process individual and group dynamics and connect these dynamics to tech dependence/addiction. After the completion of the group activities, therapists check-in with the group and review reflections and lessons from the day.

Adventure 1: Day Hike Adventure 2: 2-Day Hike (1 Overnight) Adventure 3: Climbing Adventure 4: Learning to Rappel Adventure 5: Hiking and Rappelling Adventure 6: Multi-day Outing

For more information, contact Christopher Mulligan LCSW at 855-735-HELP (4357) or email

Huffington Post Blog on Cyber Porn

Watching Porn Linked To Less Gray Matter In The Brain

Posted: Updated: 
Print Article

Right or wrong, porn has been blamed for all sorts of social ills, from perpetuating sexist attitudes to destroying relationships. But does porn affect the brains of men who watch it?
To answer that question, German researchers recruited 64 men between the ages of 21 and 45 who watched an average of four hours of pornography per week. The researchers did MRI scans of men’s brains while showing them a mixture of sexually explicit images and non-sexual imagery. Their research was published May 28 in the journal JAMA Psychiatry.
"Our findings indicated that gray matter volume of the right caudate of the striatum is smaller with higher pornography use," the researchers wrote in the journal article, referring to an area of the brain associated with reward processing and motivation. Men who watched more porn also showed less activity in another area of the striatum, called the left putamen, which usually lights up in response to sexual images.
Heavy porn consumers also had a weaker connection between the striatum and the prefrontal cortex, an area of the brain associated with decision-making.
"Dysfunction of this circuitry has been related to inappropriate behavioral choices, such as drug seeking, regardless of the potential negative outcome," the researchers wrote in the article.
Yikes. So does that mean porn can really shrink guys' brains? Not necessarily, the researchers say.
“It's not clear, for example, whether watching porn leads to brain changes or whether people born with certain brain types watch more porn,” study author Dr. Simone Kühn of the Max Planck Institute for Human Development in Berlin told Reuters in an email.
Kuhn and her colleagues said they hoped future studies would reveal how "excessive porn consumption" may affect the brain over time, and how it affects the brains of new viewers.
Until then, the jury's still out on porn's effect on the brain.
“Everything is going to be bad in excess and it’s probably not terrible in moderation,” Dr. Gregory Tau, a psychiatry professor at Columbia University who was not involved in the new research, told Reuters.


Thursday, June 5, 2014

The industry of human trafficking and sex slavery is utilizing 21st-century digital media to target children.

The industry of human trafficking and sex slavery is utilizing 21st-century digital media to target children. How does this work? First, technology abuse and exposure to pornography during childhood can produce promiscuous children and teens who then go on to post sexually suggestive photos on social media. The sex trafficking/slavery industry (pimps) can target these children, befriend them on social media, play online games with them, in an attempt to lure them away for abduction into sex slavery. Children and teens can be tricked into leaving their families to meet with a fantasy online “lover,” only to be abducted by organized criminals for the purpose of sex trafficking. As children and teens use social media excessively and play more games than spending with real people, they are vulnerable to falling prey to online predators on social media, Minecraft, PS3/4 network, Xbox live, and online games. Sex in human trafficking is now more lucrative than narcotics. It has been reported that one pimp with five girls can generate nearly $1 million in revenue annually.

What is the most effective way of safeguarding children and teens? Providing education to children and teens about the human trafficking/sex slavery industry combined with parents who can maintain an open and honest dialogue about online sexual behavior dramatically decrease risk. Children and teens that fear talking to their parents about their online activities are far more likely to be secretive about online risk-taking and mistakes. Hence, the best practice in terms of protecting children and teens is a relationship with parents/caregivers that encourages honest and candid discussions that occur on a regular basis. This solution often makes parents/caregivers uncomfortable because it requires a discussion about human sexuality and online sexual behavior. Many parents opt for parental controls to do the work of keeping their children safe from predatory behavior. Research supports the view, however, that it is parents who can engage in an open and clear discussion about healthy human sexuality as well as the risks of posed by predators that ultimately serve to keep children safe.