Wednesday, February 29, 2012

What Makes Video Games Addictive?

Games are designed to be difficult enough to be challenging, while allowing players to achieve small accomplishments that motivate them to keep playing. In this respect, the design of video games is similar to the design of slot machines, which will allow players to have small "wins" that keep them playing.

There are several "hooks" built into games that increase the odds of making play an addictive experience:

1. The High Score

Whether you have tried the latest edition of Halo or Call of Duty or you haven't played a video game since PacMan, the high score is one of the most easily recognizable hooks. Trying to beat the high score (even if the player is trying to beat his own score) can keep a player focused for hours.

2. Beating the Game

The desire to beat the game is fed as a player "levels up" or finds the next "hidden clue."

3. Role-Playing

Role-playing games allow players to do more than just play to beat a level or a score -- they get to create the characters in the game and then take off on an adventure unique to their character. As a result of creating an "avatar," a strong emotional attachment to the character is often developed which drives ongoing play.

4. Discovery

The exploration or "discovery hook" is most often used in role-playing games. One of the most popular online games EVER is World of Warcraft. During the game the player spends time exploring imaginary worlds. The thrill of discovering fantasy civilizations/cultures can be extremely compelling -- especially for teens and adults who are dissatisfied with their offline lives.

5. Relationships

Online role-playing games allow teens to build relationships with other players who are also online. For some teens, this online community becomes the place where they are most accepted, admired and desired -- which draws the teen back again and again.

Massive Multiplayer Ongline Role-Playing Games (MMORPGs) are especially addictive because there is no ending to the game. Unlike standard games like Super Mario Brothers (where you win when you save the princess), the MMORPG goes on and on -- with new adventures and challenges unfolding.

In addition to the psychological addiction, it is now believed there is a strong physiological element to addictive game-playing. Researchers at Hammersmith Hospital in London conducted a study in 2005 which found that dopamine levels in players' brains doubled while they were playing. Dopamine is a mood-regulating hormone associated with feelings of pleasure. The findings of this study (and many others conducted in China, Korea, and the U.S.) show that gaming is chemically addictive and can permanently rewire the brain.

Although there is ongoing debate about whether gaming addiction is a diagnosable disorder, compulsive gaming behavior undeniably exists. The combination of intentional programming by designers and the predisposition many teens have to addictive behavior means this is a real issue that parents, teachers and friends should be aware of and take action to prevent.

Monday, February 27, 2012

Teens: Why Logging On is a Turn-On Parents Need to Turn Off

Social biologist Dalton Conley states that youth who multi-task in multiple media (gaming, texting, Facebooking) derive high degrees of pleasure because the brain releases dopamine -- a neurotransmitter that produces pleasure -- which then creates a "forward-feeding cycle" in which youth pay more and more attention to texts, instant messaging, posts on social media sites, etc. The intense focus spent on media erodes teens' ability to focus on schoolwork that requires sustained attention: writing, reading, problem-solving.

Children and teens who have pre-existing social-emotional problems are far more likely to become compulsively involved in media. Young people who lack appropriate social skills, who feel disconnected and alienated from their peer group, who are unable to initiate and sustain relationships, receive little if any meaningful benefit from their relationship to technology.

For many families with children/teens with special needs, computers, video games, and other technology are perceived as an essential part of their involvement or connection to the world. Although youth with special needs are certainly drawn to technology, the involvement is not essential. The problem for many parents is when they consider limiting their child's access to media and technology and are confronted with a daunting problem:

What will they do with their kids instead?

Unplugging children/teens from electronic entertainment and social media will bring on protests, complaints and tantrums. Parents will need to structure and plan leisure and recreation activities for their children, a necessity that is sure to feel challenging when faced with an angry kid.

However, the rough terrain that lies ahead for parents who choose to limit or eliminate access to electronic entertainment and social media is worth the effort. It requires young people with social-emotional deficits to live in reality and to become competent in reality, instead of living in perpetual fantasy.

Saturday, February 25, 2012

Your Cyber Addicted Child's Digital Diet

If your child is showing signs of compulsive behavior related to the internet or gaming, you will need to seek assistance through a trained mental health professional. The following are tips developed by The Cyber Addition Recovery Center to help parents lessen their children's overuse of technology.

1) Limit technology to one hour a day (non-school-related use).
2) Spend one hour a day, one day per week, and four days per month completely "unplugged" from all forms of technology.
3) Institute a "tech curfew": no recreational use of tech after 9:00 p.m.
4) Keep all forms of technology out of bedrooms at all times.
5) Turn off smart phones at 9:00 p.m. (no texting, surfing, etc.)
6) Collect all tech gadgets after curfew and have them "sleep" in the kitchen or family room.
7) Take family "field trips" at least once per week (parks, restaurants, beach, museums, hiking, movies).
8) Exercise as a family: biking, hiking, swimming, sports, boogie boarding, roller-skating, bowling.
9) Do not have conversations or meals with any tech device in hand (eyes "up" and focussed on your conversation partner).
10. Structure your "tech" day: set specific times for e-mailing, Facebook, chat rooms, eBay, research, etc.

Wednesday, February 22, 2012

A Guide to Healthy Sex for Teen Cyber Porn Addicts

Here is a review from

Guide to Getting It On!

The Guide To Getting It On! has won five awards and has
 been translated into 12 foreign languages. It has sold
 hundreds of thousands of copies from the dorms of 
UC San Diego to thebedrooms of Tripoli. 

Some people say The Guide is the best
how-to book on sex ever written--we say it's the most fun to
 read. It is smart enough to be used in sex education courses, 
but is also a favorite at stores that sell the kind of sex toys 
that will land you in the slammer in Mississippi, 
Alabama and Texas. 

Schools even use it to train doctors. 
The Guide covers a full range of topics from romance, 
necking and losing your virginity, to things we can't even
mention here.(less)

Sunday, February 19, 2012

reSTART Visit

I flew up to Seattle Wednesday and visited reSTART - the nations first retreat center for technology addiction. I was able to spend time with Cosette Rae the clinical director and Hilarie Cash the executive director - both are incredibly professional, knowledgeable, and compassionate. They have created a perfect environment for young adults to get unplugged and restart their lives. Their program combines state of the art treatment methods with a nurturing and warm home like environment. They really know what they are doing with a population that is very hard to understand and help. They also have a great website that is updated regularly with information on all matters related to technology addiction. Great place!

Thursday, February 9, 2012

Interview with Wendy Maltz LCSW: The Impact of Cyber Porn on Teens

I recently had the opportunity to interview Wendy Maltz LCSW, co-author  (with her husband Larry Maltz) of The Porn Trap: The Essential Guide to Overcoming Problems Caused by Pornography, one of the most informative and thought-provoking books I have read on the topic of pornography. Over the past six months, I have given considerable thought to creating a curriculum for teens that would provide an open and honest appraisal of the risks and rewards or cost and benefits of exposure to online or cyber pornography (for more about Wendy go to: ).

Since 2005 I have worked with adult sex addicts and through this work it is clear to me cyber pornography creates more problems than any other behavior, including sex with prostitutes, exhibitionism, voyeurism, and sex with multiple/anonymous partners. Cyber pornography is accessible 24 hours a day, seven days a week (home, work, or any place with Wi-Fi connection) and can be accessed without any financial cost. When combined with compulsive masturbation, cyber pornography can produce serious and long term problems in psychological, physical, and spiritual well-being. As would follow, the relapse rate with cyber porn addicts far exceeds the relapse rate related to any other sexually compulsive behavior.

In my clinical work with adult cyber porn addicts a consistent story emerged: exposure to pornography began as early as childhood and certainly by adolescence. The vast majority of my clients said they believe their addiction began with their first exposure to pornography, particularly if that first exposure was online. The intensity and variety of online pornography provides a degree of sexual stimulation that is simply impossible to match in any other sexual context.

As a result of my work with adult sex addicts, it became clear to me that there should be cyber porn education, prevention, and treatment for teens. With this topic in mind, I asked Wendy Maltz how she would construct a sex education curriculum for teens that specifically addressed cyber pornography. I began the interview by asking Wendy what parents should do to help protect children from the potential lifelong damage produced by cyber pornography.

Wendy first explained it is vitally important for parents to engage in an open and honest conversation with children about the way sex is presented in the media. She believes parents need to think about what type of sexual messages are being endorsed within the media, which includes television, music, film, and online pornography. Parents then need to talk to their children about what they are seeing in order to create critical thinking skills. For Wendy the central challenge for parents is to empower their children to take a critical stance towards sexual content in media rather than become passive consumers.

Wendy encourages parents to examine what type of sexual content (and stimulation) is being introduced into their child's psychological and biological “systems,” in the same way they discuss eating habits, the use of drugs and alcohol, and smoking. By beginning a process of sexual media education within the family at an early age, children can develop a comfort level and sense of trust in talking about sexual behavior with their parents, which is crucial for providing parental guidance. If both child and parent feel unsure, anxious, and fearful about the discussion of healthy sexual behavior, more than likely they will have great difficulty addressing the complicated issues presented by cyber pornography.

When I asked Wendy what she would recommend parents regarding cyber porn specifically, she said the message that needs to be related is that porn, although exciting and entertaining, poses significant health risks. This conversation needs to happen in a way where the parent is not shaming their teen for looking at porn or attempting to provoke a guilt response. Parents need to explain, in a way that avoids lecturing and moralizing, that porn presents a limited, often unhealthy, view of sex. The sex portrayed in pornography is distorted as it presents “good” sex as impersonal, irresponsible, and cut off from values and feelings, and fails consider relationship dynamics and consequences as important. 

Rather than helping, habitual porn use often winds up harming a person’s self-esteem, social relationships, and ability to form a satisfying long-term intimate sexual relationship.  Again, the purpose of this conversation is inform and empower so that teens will be make positive choices with respect to their “consumption” of sexual content in the media and cyber pornography in particular, and the kind of sexual person they want to be throughout their life.

I then asked whether she would recommend parents take the position of banning pornography within the household. Wendy began by saying that although she appreciates there are many different views of cyber pornography (e.g., it’s harmless fun, teens are only curious, porn shows a variety of forms of sexuality, censorship is wrong) and recognizes some teens can manage to engage with cyber porn without significant negative consequences, she  would nonetheless recommend parents take the position that porn will not be part of the family’s media diet--  in the same way that a parent would set a limit with respect to drug use, alcohol, smoking, and consuming junk food.

I then turned our discussion to sex education for teens focusing on cyber pornography (middle and high school settings). I posed the question “If given the opportunity to speak to teens, what would you say about cyber pornography? Would you recommend moderation? Abstinence?” In response to this question, Wendy talked about her personal journey through pornography, which began with the perception of pornography as a risk-free source of pleasure and stimulation, to a positive influence on individuals and couples in the context of sex therapy, to a concern about how pornography was affecting individuals and couples, to the belief that pornography represents a true public health risk. Wendy’s journey is described in detail in an article on her website (Out of the Shadows/Is Porn Bad for You? Available at:

Wendy explained teens need to be made aware that cyber pornography can have a destructive effect on the way their brains function that is very similar to the negative impact of drugs such as crack cocaine. Consistent exposure to cyber pornography, particularly when this exposure is combined with masturbation, dramatically increases the production of the neurotransmitter dopamine, which produces intense and sustained states of pleasure. The pursuit of this pleasurable/euphoric state can shape a teen’s sexual preferences and choices in a way that can substantially reduce (even eliminate) their capacity to experience deeply satisfying, passionate sex with an intimate partner. In addition, cyber porn can easily shift sexual interests into extreme, risky and illegal sexual activity, putting the user’s public standing, health, career, and freedom in jeopardy.

Wendy made the important point that sex is a form of behavioral and emotional conditioning. Every time we have sex certain thoughts, feelings, and behaviors are reinforced by virtue of the pleasure or discomfort we experience during sex. Wendy explained that an orgasm is perhaps the most powerful physiological re-award/reinforcer that exists in all of human experience. Wendy said teens need to understand that the thoughts and feelings they have at the point of orgasm are reinforced and ultimately become hardwired into their perception of sex  -- which in turn shapes their sexual needs and preferences. Hence, when a teen masturbates to orgasm using porn, the teen’s understanding of what sex is and his or her future sexual desires become intensely fused with what was shown in the pornography.

Wendy believes that as a society we are going through a period of experimentation with cyber pornography and this experiment has the potential to change our sexual values and needs and behaviors in ways never imagined before. Without realizing it, we may be changing human sexuality in ways that move away from love, full-body sensual pleasures, and life-affirming/deeply rewarding sexual connections. As we were concluding our conversation, Wendy made the interesting and important observation that what is available to children and teens on the Internet has the potential to produce the type of trauma that we see in victims of sexual abuse. Wendy then wondered, given the present shame and silences surrounding porn use, whether our society will ever take active and decisive steps to protect youth from online pornography, as we have with smoking and alcohol.

After our interview I began to think about how to frame a sex education for teens that that would include the topic of cyber pornography when Wendy forwarded me an outline of the type of content she would include in a cyber porn sex education curriculum.

Wendy's outline included the following topics:

1)      Sex basics and realities (bodies, brains, desires, functioning)
2)      How sexual interest begins and is developed and shaped
3)      Defining healthy sex
4)      The role of sexual pleasure in mating, bonding, love, self-esteem, and healthy communities
5)      Sexual rights (in contrast to sexual exploitation)
6)      Gender similarities and differences (what does it mean to “be a man” or “be a woman”?)
7)      Sexual harm (what are harmful influences and behaviors and why?)
8)      Pornography (defining pornography; traits of today's product; the effect of regular/heavy use on the brain; how porn differs from other sexually explicit materials; how content is often sexist/racist and becomes more violent/extreme; what pornography does not show/teach; the benefits/rewards of looking at porn; risks related to looking at porn; common problems; the lack of warning on pornography; the absence of informed consent and regulation; similarities to sexual perpetration/abuse; trickery; peer attitudes and pressure).
9)      Making wise sexual choices
10   Understanding empathy and integrity (the impact of your sexuality on your self-esteem and on others)
11  How to create and maintain healthy sexual relationships
1     How to build a healthy sex life (with yourself)
13  How to develop skills for being a good lover
14  How to recognize sexual problems and get help when needed

It is difficult to understand, 12 years into the 21st century, why the topic of teen use of cyber pornography has not been incorporated into mainstream sex education at the middle and high school levels (Wendy has great free posters on her website that are intended to educate teens about porn:

The reasons for the absence of this discussion in school settings is obviously complex and would invite debate from many different groups, ranging from those who believe pornography is morally reprehensible, to those who see pornography as a First Amendment issue, to those who see pornography as a harmless form of sexual stimulation, to those who have worked with sex addicts and see the potential damage of a relationship with pornography.

Notwithstanding the need to address the various concerns of these groups, it seems more than reasonable for adults, particularly those who are in a position to educate teens, to begin to at least take on the process of developing a sex education curriculum that candidly addresses the types of choices and experiences that teens have via the Internet.

Christopher Mulligan LCSW