Computerworld magazine had a recent article comparing use of iPhones, and potentially iPads with addiction. “Something is going on here, and it’s not natural,” posits the author.  This weeks addiction podcast takes a closer look at I-addiction, and also s-addiction — sexual addiction — when taken to extremes they might all be compulsive-obsessive behaviors.  Dr Inaba shares some thoughts.

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Transcript (edited):

CNS:   Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions.

CNS:   Hi and welcome once again to the CNS Addiction Podcast.  I am Howard LaMere, here with Dr. Darryl Inaba.  Today we’re talking about sexual addiction and to what degree it is a legitimate addiction, and commenting on an article from Computer World (http://www.computerworld.com/s/article/9175200/Elgan_Uh_oh._Here_comes_iPad_addiction). drawing comparisons between the iPad and the Blackberry, which has been called the “Crack Berry” for its addictive qualities.  The iPad is kind of an overgrown iPhone.  In a recent study at Stanford University, 44% of the students interviewed who had iPhones claimed to have some level of addiction to them.  And only 6% said they had no addiction.  This article goes on to articulate 7 different aspects of addictive behavior – social gratification, instant gratification, social interaction, response to inputs, serendipity, windows on the world and identity and finally escapism.  What is your take on this list in terms of how they speak to addictive compulsive disorders in general and drug addiction?

DARRYL:      Both of these topics are timely and are of interest to me.  Sexual addiction and iPod or iPhone addiction (or whatever you want to call it) is generating a lot of concern in the news right now but the science is pretty soft in both those areas.  About 70% of American’s polled view sexual addiction as nonexistent; it is just an excuse….to mess around.  And so there isn’t a lot of real validation from the public’s perception about that and there aren’t any studies showing differences that occur in a person’s brain or in a person’s body that makes them respond to sex in a totally different way from another person who doesn’t cheat on their mate, or run around.  So, the science is not there yet and by the time the DSM 5 is ready for print in 2013, there may or may not be.  I don’t see a lot of research that actually validates any changes in the brain that occur with compulsive gambling for example, that will be included in the DSM 5.  Sexual addiction is connected to dopamine in the brain, which is a part of every addiction. The orgasmic feeling people experience from sex is due to the release of dopamine.  So it may come to light that there are inappropriate levels of dopamine in the brain of sexual addicts that isn’t present in somebody who has a usual sexual drive.  But right now we don’t have any science on that.  As far as the iPad and iPhone…a study like the one they did at Stanford – a sort of man on the street questionnaire….

CNS:   Yeah…anthropology….

DARRYL:      The question “do you have an iPhone addiction” reminds me of when I was in college – we’d all laugh and make fun of ourselves, saying oh yeah, man, I’m really into it and stuff.  So there isn’t much strong science in asking questions like these of students at Stanford. I think what is more to the point is really disruptive behavior like the Korean kid who was internet gaming and died from starvation.  There’s something definitely wrong with that. When those things occur on a regular basis, it is time to start looking to see if there are differences in the in the brain.  The iPhone has been around awhile and I do see some people using it as an extension of their body and their mind – not so much physiologically but in the realm of social networking and anthropology.  The jury is still out on this and I’m not sure it’s going to be in by 2013, but it is growing in attention and we do see a lot of compulsiveness in certain people who are involved with these activities.

The author says these are characteristics of drug addiction, but I don’t agree …I think they’ve morphed or modified into characteristic of iPhone or iPad or even technology addiction, but we can go through them.

CNS:   Some aspects …at least of compulsive obsessive disorder…and certainly instant gratification – fall into all categories, whether it is drug use or compulsive gambling or sex.

DARRYL:      That, I agree with. The brains of people who are actively involved in activities have been studied and show a temporal distortion or a cognitive distortion in their temporal sense.  Meaning that a person who develops drug addiction impairs their ability to have a sense of timing and part of that timing is delayed…what they call delayed discounting actually, which is the same thing as delayed gratification.  When an addict is asked whether they’d take 5 dollars for staying in treatment that day, or complete months of treatment and receive $500, many will take the 5 dollars because they can’t think that far down the road. It is not that they’re not smart, it’s because that part of the brain, due to the toxicity of drugs, is damaged. They cannot make the cognitive choice involving delayed gratification or delayed discounting. Whatever is instant… what’s more immediate to them is the instant gratification – give me the 5 bucks now.  That is how it is across the board with all addictions.

CNS:   Social interaction is also mentioned and it pointed out that it’s hardwired into human to have social interactivity.

DARRYL:      I just don’t buy that one with drug addiction or even with gambling addiction because although you don’t gamble by yourself, you’re certainly detaching yourself from social interaction.  You’re making yourself a competitor and trying to not give away any clues so you’re actually isolated from people.  The stronger a person becomes addicted to drugs, I see them getting more and more and more isolated.  As a matter of fact, one of the big treatment things and one of the most positive effects a 12-step has is to break that isolation and bring a person back to interacting with other people.  In residential treatment that is one of the first things we notice about new clients.  If they stay in their room, doing their work by themselves we force them to come out and do more with the group process and interact with others, because isolation is a big trigger.  When you isolate yourself your brain searches through your memories looking for times and places where you feel less lonely and the memory that surfaces the quickest is “hey go have another hit of drugs and you won’t care about being lonely”. So in treatment we have to break that isolation.

CNS:   That isolation is certainly what you see as a dominant factor in a technology obsession.

DARRYL:      Yes, it is anonymous really, you know.  It’s something where you’re right there talking and interacting..

CNS:   You’re interacting, but you’re…

DARRYL:      But you’re detached.

CNS:   You’re detached.  I was at a party recently and a whole bunch of people with iPhones were standing in a corner sharing iPhone apps. This was going on while the rest of the party continued with regular party stuff.  And I thought – boy this is strange.

DARRYL:      I just heard a story about the new iPad. A mother gave her son one and  accesses movies on it  – so rather than watch movies with his family, he sits in front of their large HD TV, watching a film on his iPad instead of watching a film on TV that you can see in much better definition while interacting with people.  I think addiction is isolating.

Another thing about drug addiction – addicts don’t want to share their dope as

their addiction becomes stronger. They don’t want to buy a gram of cocaine only to have their connection snort up half of it with you before he leaves the room. People tend to buy and separate themselves from everybody else. When you first start, its social interactive, but the more addictive you become, the more isolated.  The other thing about addiction is the guilt and shame people suffer because of their behavior and their compulsivity to it makes them want to avoid exhibiting that behavior to other people.  I’ve also noticed at family gatherings that those with serious alcohol problems don’t drink.  They sort of standoff at events but then we find them drunk and passed out at home on the couch all by themselves with wine bottles around them.  So they get more and more isolated, so I don’t buy this isolation thing.

CNS:   Okay…

DARRYL:      I don’t buy the social interaction thing.  I buy more the isolation thing.

CNS:   Well, we’re wandering between chemical dependency, drug use and the realm of gaming obsession/ compulsive obsessive behavior. A lot of these things are related, but in some cases we’re on thin ice. Response to input…this deals with buying into an alternate reality and the rushes of adrenaline and endorphins that happen when you are controlling a made-up as is the case with the popular games on Facebook that people are compulsive about.  And so…the gismo…the iPad just makes it easier to do that because it’s always accessible and you can “water your pets” or whatever you have to do.

DARRYL:      The people who make these things and the marketing arm that promotes them create updates now and then so in order to get the latest game or latest application; you have to buy some new feature. You get hooked into paying money every few months to keep going.  That’s how people get hooked on using technology. In my day, if you got some new piece of technology you got excited over it for about a month or so and then you got tired of it and then you never picked it up again.  I remember my first pocket TV-   I would go to the 49er games and watch the game on TV as I’m at the game,  …you know within half a year, I was saying what the heck is this all about?!  I’m at the game!  I can figure this out myself!  I don’t even know where that thing is now. Today’s’ gadgets are so well tuned…so well thought out it makes you more and more dependent.

Some say this behavior is escapism and relate it to drug addiction, but I’m not convinced of that either.  I’ve worked with heroin addicts and it’s not about escapism really, it’s about numbing their feelings and about controlling the thoughts about bad things that have happened to them but it’s never to escape. They are able to manage their thoughts better under the influence. People like my wife who like Farmville on Facebook, seem to connect with a lot more people through it in the social networking part because in order to get more privileges or more rewards or whatever you have to have more neighbors to give you more things and this creates more interactions.  So…I’m not sure escapism as the author characterizes it in regards to iPad addictions has the same application to other addictions.

CNS:   And…identity.  I don’t see how that really applies to drugs or other compulsive obsessive behaviors. The window to the world reference …. I guess I could lay claim to an internet obsession because as an information junkie I do use it to look for things that I’m interested in, and things that are new and really intriguing.  So I don’t know if that would be considered pathological or not, but that’s one of the uses that I’ll admit to.  That is a feature I’m looking forward to the I-Pad for. I use my I-phone as a mobile computer to access the web when I’m out and about and a question comes up.

DARRYL:      Mike Elgen, the author of the brief article on Computer Land that comments on iPad and iPhone addiction lists those seven characteristics, but I think he is characterizing how people get into it and not the addictive part of it.  The talk about “identity, windows to the world” could characterize the initial allure of drugs or other addictions, but that’s not the addiction.  Addiction goes far beyond that.  Certainly in terms of young people getting involved with drugs, the” identity” applies. They feel so uncomfortable at that time in their life because they’re trying to find out who they are.

CNS:   So uncomfortable with themselves…

DARRYL:      Yes, and acceptance is a big thing because there is always the feeling that “you’re not good enough” or people don’t like you and that identity thing… smoking pot with all the dopers, gives you an instant identity. Playing on a baseball team with all the other baseball players does too – so anything that can create an identity provides a new window through which to look at the world from a different way.  I ‘m sure that is an attractive lure into using drugs or gambling or anything else but once addiction occurs or if somebody is prone to an addiction, it’s a totally different thing than the comparisons Elgen talks about.

CNS:   Well, this has been an interesting discussion.  A little bit different than usual.

DARRYL:      I found this to be an interesting topic because it gives us the ability to start looking at drug addictions and the other more established addictions and looking at new behaviors and how we define them in terms of human activity,   I find that to be a fascinating way of looking at things.

CNS:   It’s always good to be able to look at things from a slightly different perspective.