Pathways to Cybersex: Case-Report-Based Exploration

Case Report Pathways to Cybersex: Case-Report-Based Exploration Journal of Psychosexual Health 2(1) 96–99, 2020 © 2020 Karnataka Sexual Sciences Academy Reprints and permissions: in.sagepub.com/journals-permissions-india DOI: 10.1177/2631831819898567 journals.sagepub.com/home/ssh Manoj Kumar Sharma1 , Nitin Anand1, Ajith S. J.1, Pranjali Chakraborty Thakur1, Suma N.1 , Maya Sahu2, Nisha John1, Ashwini Tapatrikar1, Ankita Biswas1, Akash Vishwakarma1, Archana R.1, Priya Singh1, and Keshava D. Murthy3 Abstract The internet has become the preferred platform for use of webcam. The interactive online aspect of webcamming allows participants to have stimulating enjoyable experience for each act. There has been an increasing trend in users seeking help from the service for healthy use of technology (SHUT) specialty clinic for the management of pornography use. Clinical interviews were used to elicit details about their concern. The cases demonstrated the role of online behaviors especially cybersex in managing stress, free time, loneliness, boredom, as well as the need for novelty. It implies the need for screening the pathways to cybersex as well as to evolve intervention to manage these pathways in an Indian context. Keyword Internet, online sex, stress Introduction Technology advancements have had a direct impact on the lifestyle of mankind. Most of the activities of daily living have started seeking aid from the virtual world which also includes sexual activity. In the recent times, the sexual activity of many young adults occurs in the cyber world.1 Online sexual activities generally involve wide range of activities that include watching, downloading or online trading of pornography, or connecting to the chat rooms using the roleplay and fantasy.2 It generally facilitates the individuals to discover and examine their sexual urges and sexual fantasy through the digital platform.3 Females engaging in online sexual activities are more interested in interactive form of cybersex, whereas males are more interested in the visually oriented form of cybersex.4 Cybersex is one of the variant of the online sexual activity which can be defined as follows: “When two or more people are engaging in sexual talk while online for the purpose of sexual pleasure and may or may not include masturbation.” The study conducted in 4 countries showed that 76.5% sample utilized the internet for the purpose of online sexual activities and 30.8% of American students reported to be engaging in cybersex.5 Research in the area of online chatting found that 3 out of 10 adolescents had a conversation about sexual topics and also make request for the online sexual contacts in the form of sexually implicit and explicit messages.6 The adolescents who were socially anxious were less inclined to engage in visual cybersex. The adolescents with the high level of sensation seeking had high level of involvement in the text-based sexually arousing communication.7 The individuals who engage in cybersex tend to find each other over the internet and may or may not have met the individuals in the real life. The conversation ranges from flirting to having a dirty talk, such as providing the detailed description of having intercourse.4 Cybersex is also sometimes used as a compliment to an already existing sexual or romantic relationship. Cybersex sometimes by itself 1 SHUT Clinic (Service for Healthy Use of Technology), National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India 2 Department of Nursing, NIMHANS, Bengaluru, Karnataka, India 3 Department of Psychiatric Social Work, NIMHANS, Bengaluru, Karnataka, India Corresponding author: Manoj Kumar Sharma, Department of Clinical Psychology, SHUT Clinic (Service for Healthy Use of Technology), NIMHANS, Bengaluru, Karnataka 560076, India. E-mail: [email protected] Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Sharma et al. acts as a goal or serves as an initial step for sex in real life. Research also suggests that the individuals who are mostly engaged in cyber sexual activities were mostly young male heterosexual adults, who had a high level of education.8 Studies also suggested that significant number of women engaged in cybersex primarily with their romantic partners compared to men. High number of men are engaged in cybersex with strangers compared to the women.9 The general characteristics of the internet by itself facilitate the engagement of individual in the cybersex. The triple “A” model emphasizes the importance of 3 specific characteristics: accessibility (high number of sexual websites constantly providing accessibility), affordability (free or low prices on the accessible websites), and anonymity (the users who are accessing these websites are generally not physically seen and might consider themselves as undetectable to others). Some studies focusing on the motives to involve in the cybersex found that recreational cybersex users were involved in the activity for the purpose of sexual arousal, to relax, as a distraction, or for educational reasons. In the similar way, the problematic cybersex users were involved in the activity to decrease distress, to regulate emotions, and to compensate for the unfulfilled sexual fantasies in real life.10 The individual with the characteristics of having high level of interest in pornography that is primarily present only in the online modality searching for the relaxation and searching for the sexual satisfaction were also considered to be the significant motive that is found to be associated with the problematic cybersex.11 Research has also found that past traumatic or negative life events also tend to have a role to play on the problematic cybersex users. A study examining the cybersex users found that among the users 68% of individuals had experienced some form of past sexual abuse and 43% of individuals had posttraumatic stress disorder.12 The level of sexual arousal in the problematic cybersex users was significantly higher than the healthy cybersex users which directly reinforced the individuals leading to cue reactivity and craving. This was also acting as the mechanism for development, maintenance, and excessive use of cybersex.13,14 The following cases approached the tertiary specialty clinic for the management of pornography use. Case Report Mr A, a 40-year-old male, postgraduate, single, started accessing pornography from the age of 28 years. He developed the interest in accessing pornography due to free time, solitary life style, to overcome boredom, and it was only stimulating activity during day time. Initially, he was spending 60 to 90 minutes during late evening time in accessing pornography. Gradually, it increased from 4 to 5 hours a day. The particular day schedule used to include starting up the day with watching pornography or indulging in masturbation. At times, he missed office due to the inability to log out from pornography. He reported to have accessed pornography content during working 97 hours through personal mobile. Subsequently, he started watching pornography after reaching his residence. It was associated with the delay in having the food. He got introduced to webcam sites through a friend. He reported to have had good experience of chatting with models. Initially, he started accessing the freely available sites. He appreciated the process of chatting or intimate conversation with available models. He reported to have better erotic experience while interacting with these models. In order to further enhance the erotic experience, he started accessing the paid sites. He started spending 5 to 6 hours per day on these sites. He also experienced financial issues due to money spent on talking/interacting with these models. The user reported high craving for talking to these models whenever he had cash with him or had available credit card limit. It contributed to the experience of psychological distress, absenteeism from work, decreased involvement in social activity, as well as involvement in high-risk relationship. His score was 84 on internet addiction test which was in the severe range. During the course of session, the user revealed the details about interaction with the web model. The user was demonstrated the relaxation exercise, as well as insight facilitation was carried out for the underlying reasons for the use of pornography as well as webcam sites. The contract was made for abstinence from these sites as well as for developing alternative pleasurable activities. Individual work was carried out for the management of psychological factors as well as for curtailing the expenses on webcam sites. Motivation enhancement sessions were conducted to facilitate the insight about the consequences of continuation of these behaviors. It took almost 5 months to enable him to work on increasing his productivity at work and to reduce interaction with the webcam model. On subsequent follow-ups, the user did engage in accessing the webcam sites but he accessed the freely available sites. The user’s reason for use was explored. The user attributed the interaction with webcam models to feeling of loneliness as well as boredom. The user was motivated to plan activities for free time as well as engagement in hobbies. Mr X, a 27-year-old male, from an upper middle-class family, presently living in a live-in relationship presented with complaints of spending excessive time on adult websites. He started accessing pornography out of curiosity from the age of 16 years. It used to be 15 to 30 minutes per day. Gradually, it increased from 3 to 4 hours every day when he was staying in the hostel. For the last 2 years, he developed the interest in interacting with webcam models. Initially, he used to interact on freely available online platforms, but gradually he started accessing the paid sites to seek more novelty, thrill, and starting appreciating the lack of inhibitory behaviors during the interactions. It also led to increased indulgence in masturbation. He attributed it more to the availability of free time and loneliness. He started using credit card to access the sites after exhausting his savings. Six months back, he decided to have a live-in relation with his girlfriend to manage this habit. The girl knew about his habit of accessing pornography. The female partner reported that things were 98 better in the first 3 months. Although, she reported an initial increase in libido in the client. However, the user was secretive about his access to online websites and the electronic devices used for the same. The female partner somehow got access to his devices and came to know about his habit of interacting with webcam models as well as frequent transaction of money. It led to relationship difficulties between them. The user experienced craving, loss of control, compulsion to engage in cybersex, and need to continue the behavior despite knowing the harmful consequences. He did not have the history of any other psychiatric morbidity. Systemic couple therapy was carried out to address the interpersonal and communication difficulties in the relationship context. There was improvement seen in terms of communication between the partners, he started working on relaxation, and involved in offline activities with his partner. Discussion and Conclusions The case demonstrated the use of online modalities in the form of pornography as well as webcam interaction for seeking novelty as well as for the management of free time, loneliness, and boredom. It was also associated with the need for enjoying thrill and disinhibition. These factors may also promote the excessive indulgence in cybersex. The involvement in cybersex impacts the interpersonal and intrapersonal lives of individuals. It also affects the social relationship of individuals as they are more likely to lose their self-control and expose themselves to dangerous sexual communications, promiscuity, and guilty conscience.15 The excess involvement in the cybersex activities leads to symptoms such as loss of control, preoccupation, urges to use, withdrawal, and continuous desire to engage in cyber sexual activities.16 Many people who engage in excess online sex activity hold an irrational belief that cyber sexual experiences are not real and thereby it does not lead to any actual consequence, which in turn maintains the cyber sexual activity of the people.17 The individuals engaging in cybersex show apparent changes in the lifestyle, personality, and loss of interest in physical intimacy and sex with partner.18 Particularly the spouse of the individual involving in online sex experiences intense reactions such as betrayal, hurt, rejection, devastation, and loneliness. Apart from spouses, children, siblings, and the other significant relationships of those involving in the online sex are also at the risk of ending up as unwitting victims due to the behavioral changes that occur for the users of cybersex.19 The tendency toward antisocial behavior was being associated with higher score on cybersex addiction scale.20 Some individuals with online sex activities are not problematic and do not have any significant negative consequences. However in significant group of individuals, it can become excessive in nature and may affect the different aspects of their lives.21 Journal of Psychosexual Health 2(1) The cases demonstrated the presence of varied types of cybersex and the psychological factors associated with excessive to addictive indulgence in cybersex activities. There is a need for longitudinal study to understand the pathways to cybersex, expectancies from cybersex and long-term psychosocial effects of indulgence in cybersex. These research findings will further help to evolve criteria for assessing the addictive use of cybersex as well as to develop intervention strategies to address the initiation and maintenance factors for cybersex. Acknowledgement DHR ICMR Delhi, India grant awarded to Dr Manoj Kumar Sharma. Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors received no financial support for the research, authorship, and/or publication of this article. ORCID iDs Manoj Kumar Sharma https://orcid.org/0000-0002-1129-1814 Suma N. https://orcid.org/0000-0002-1106-1488 References 1. Klein JL, Cooper DT. Deviant cyber-sexual activities in young adults: exploring prevalence and predictions using in-person sexual activities and social learning theory. Arch Sex Behav. 2018;48(2):619-630. 2. Cooper A. Sexuality and the internet: surfing into the new millennium. 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