1. Sexual Addiction and Technology: The Influence Evolving and New Media on Assessment and Treatment Robert Weiss LCSW, CSAT-S Director of Intimacy & Sexual Disorder Programs Elements Behavioral Health Promises, The Ranch & The Sexual Recovery Institute

2. What does it mean to have No Diagnosis for what we treat? Moral Judgement Religious Judgement Misdiagnosis Misdirected Treatment- often with meds Clinicians accused of creating issues to make $$ Does some of this sound familiar? Moral Judgement Religious Judgement Misdiagnosis Misdirected Treatment- often with meds Clinicians accused of creating issues to make $$ Does some of this sound familiar?

3. Sex and Technology The Evolving Influence of Social Media and Technology on Hypersexuality

4. The NEW GENERATION GAP The NEW GENERATION GAP Sexual Mores Rock & Roll Television Recreational Drug Use Liberalism (Gender, Social & Racial equality) Children seen & not heard Personal Privacy “ We Won ’ t Listen to you! ” Sexual Mores Digital Immigrants vs. Digital Natives Rude Interpersonal Communication Fantasy = Real Life Social Networking = ongoing immediate interconnectivity Neural Development Personal Privacy “ We Can ’ t See or Hear You! ” Old GapNew Gap If you don’t know the lingo and or feel dismissive of his/her world- then it is hard to help your client...

5. Online sexual content, chats and interaction has forced us to reassess sexuality in our culture. For example, today what do you consider to be… Online sexual content, chats and interaction has forced us to reassess sexuality in our culture. For example, today what do you consider to be… Infidelity?

6. Infidelity can be defined as The Keeping of Secrets in an Intimate Relationship It’s not the sexual acting out itself, but rather the breaking of trust that hurts spouses the most deeply and encourages trauma responses.

7. What are the most profound changes in our experience of sexual content & sexual contact over the past 20 years? Access Affordability Anonymity * Cooper, Del Monico et al 1998 - 1999

8. How long did it take for mass access to the following technologies following public introduction? Radio - 38 years to 50 million people Television - 13 years to 50 million people Internet - 4 years to 50 million people Social Networking - 16 months to 50 million Smart Phone apps - 9 months to 50 million Whatever comes next will happen nearly instantaneously and in our lives before we know or even fully understand it. So get ready...

9. Sexual Access Timeline 1.0 Pre-history - 1860’s Recreational and Intimate Sexuality Cave drawings and painted pornography Affairs & Infidelity Public Baths and Steam Rooms Prostitutes & Harems Masturbation

10. Sexual Access Timeline 2.0 1860’s - 1970’s All of the above plus... Photographic Porn Porn Movies Porn theaters (XXX) Adult Bookstores Bath-houses & Strip clubs

11. Sexual Content Access 3.0 1977 - 1990 All of the above plus... Video = VCR and BETA Phone Sex Soft-core on cable TV- at home “Adult” and “Escort” Sections in Yellow Pages, magazines and newspapers

12. Sexual Content Access 4.0 1990 - 2004 All of the above plus... BBS - Online bulletin board systems (BBS) Websites for porn and prostitution Online Porn and file transfer sites Chat Rooms Online Hook-ups - i.e. craigslist Webcams and interactive live sex

13. Sexual Content Access 5.0 2004 - Present All of the above plus... 1. Sexting and live video streaming from your smart phone 2. Smart Phones with GPS & apps 3. Social Networks (facebook, twitter, mySpace) 4. Virtual World Sex (2nd-Life, virtual games etc) 5. Virtual Sex and Teledildonics 6. QR and AR codes 7. Chat Roulette 8. Eye Tracking Software

14. About Sexting Eewwwwwwwww! And some are using it to offend...

15. About Ashley Madison Started as a website - now also a mobile app - perfect example of content access progression AM Slogan: “Life is short, have an affair.” AM Mission Statement: “To provide an interactive way for like-minded users to explore whether they wish to meet each other, chat with each other and/or explore extra-marital relationships” Over 9-million members internationally In May 2011 1.2 million men and women used the service to contact a sexual partner in that single month 92% of males on the site sign in as married 60% of female members sign in as married

17. facehooked? “Before entering treatment I was spending up to 5 hours a night some nights cruising facebook for sex. Well, not for sex exactly, it was more cruising for faces and profiles I thought might respond to me. I was looking for friendly, engaging women, then leaving messages, poking them, trying to get a response from someone who cared. Then we would take it from there... ” - A 32 year old married SRI-IOP client

18. Smartphones They have GPS locators = immediate live access to sexual partners and sexual content anywhere, anytime Universal Internet access anywhere - to porn, to sexually oriented environments (strip clubs, adult bookstores, etc) Live video streaming to phones and pads They use Apps -Apps are applications loaded from the Internet onto your smart phone or ‘pad’ to perform specific functions. For example - if you load a dictionary app onto your phone- you can then use your phone to look up words and spelling from your phone Sex apps are the same - loaded from to your phone to help find sexual partners.

20. Now let’s take a closer look at these apps... Ashley Madison Grindr And something to make you feel better after...

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30. Teledildonics = Rudimentary Virtual Sex By hooking up the hardware components up to the two Wii-motes, wiggles and thrusts on the first Wii-mote are detected and sent via Bluetooth to a nearby computer. From there this information is sent over the Internet and reproduced by the other Wii-mote which acts as a Wii- brator on the other end, allowing remote partners to simultaneously enjoy each others stimulations.

31. The good news... Treatment and recovery are also entering the new media frontier. We all need to be aware of these options for our clients: Tele-meetings Online 12-step Chats Face to Face Skype Meetings Face to face video sponsorship Virtual Reality de-sensitization techniques...

32. Why Does Technological Advance Lead to Behavioral Escalation ? 1. Increasing access means decreasing inhibitors to impulsive problem behavior 2. It’s just so easy to find, get, have and use... and faster! 3. Increasing accessibility thru phones and pads means sexual acting out is easier to hide 4. Those with preexisting social/emotional deficits (read teenagers, among others) no longer need to evolve a social skill set in order to be sexual 5. Certain sexual behavior considered illegal/offending/consequential in the “real world” is not so online

33. QUESTIONS?

34. Sexual Addiction and Technology: The Influence Evolving and New Media on Assessment and Treatment Robert Weiss LCSW, CSAT-S Senior Vice President of Clinical Development Elements Behavioral Health Promises, The Ranch, The Right Step, The Recovery Place and The Sexual Recovery Institute