Cyberpsychiatry
Cyberpsychiatry
Editors
Sudhir Bhave MD
Professor Department of Psychiatry NKP Salve Institute of Medical Sciences and Research Center
Nagpur, Maharashtra, India
Co-Editor
Sushil Gawande MD
Associate Professor Department of Psychiatry NKP Salve Institute of Medical Sciences and Research Center and Lata Mangeshkar Hospital
Nagpur, Maharashtra, India
Assistant Editors
Abhijeet Faye MD
Assistant Professor Department of Psychiatry NKP Salve Institute of Medical Sciences
Nagpur, Maharashtra, India
Anagha Sinha Saoji DPM
Psychiatrist District Mental Health Program Regional Mental Hospital
Nagpur, Maharashtra, India
Foreword
Salman Akhtar
Jaypee Brothers Medical Publishers (P) Ltd
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Cyberpsychiatry
First Edition: 2021
9789352702176
Printed at:
- Abhijeet Faye
- Assistant Professor
- Department of Psychiatry
- NKP Salve Institute of Medical Sciences
- Nagpur, Maharashtra, India
- Abhinav Tewari
- Senior Resident
- Department of Psychiatry
- King George's Medical University
- Lucknow, Uttar Pradesh, India
- Anagha Sinha Saoji
- Psychiatrist
- District Mental Health Program
- Regional Mental Hospital
- Nagpur, Maharashtra, India
- Avinash De Sousa
- Consultant Psychiatrist and Founder Trustee
- DeSousa Foundation
- Mumbai, Maharashtra
- Research Associate and Consultant Psychiatrist
- Department of Psychiatry
- Lokmanya Tilak Municipal Medical College
- Mumbai, Maharashtra, India
- Debanjan Banerjee
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Jayant Mahadevan
- Assistant Professor
- Center for Addiction Medicine
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences
- Bengaluru, Karnataka, India
- Karthick Subramanian
- Assistant Professor
- Department of Psychiatry
- Mahatma Gandhi Medical College and Research Institute
- Puducherry, India
- Koushik Sinha Deb
- Associate Professor
- Department of Psychiatry
- All India Institute of Medical Sciences
- New Delhi, India
- Mary Aiken
- Professor of Forensic Cyberpsychology
- Department of Law and Criminology
- University of East London
- University Square Stratford 1
- Salway Road, London, E15 1NF
- Mohan Sunil Kumar
- Psychiatrist and Director
- Augmenta Health (P) Ltd
- Bengaluru, Karnataka, India
- Neha Bhave Salankar
- Psychiatrist
- Bhave Clinic, Midas Heights, Ramdaspeth
- Nagpur, Maharashtra, India
- Nishtha Chawla
- Senior Resident
- Department of Psychiatry
- All India Institute of Medical Sciences
- New Delhi, India
- Nitya Dhruve
- Psychologist
- Augmenta Health (P) Ltd
- Bengaluru, Karnataka, India
- Prabhat Chand
- Professor of Psychiatry
- Center for Addiction Medicine
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences
- Bengaluru, Karnataka, India
- Prashant Choudhary
- Senior Resident
- Department of Psychiatry
- King George's Medical University
- Lucknow, Uttar Pradesh, India
- Pravin Dullur
- Consultant Child and Adolescent Psychiatrist
- Blacktown Early Access Team (BEAT)
- Mt Druitt, New South Wales, Australia
- Conjoint Senior Lecturer
- Western Sydney University
- Penrith, New South Wales, Australia
- Preethy Kathiresan
- Senior Resident
- Department of Psychiatry and
- National Drug Dependence Treatment Center
- All India Institute of Medical Sciences
- New Delhi, India
- Rachna Bhargava
- Additional Professor
- Department of Psychiatry and
- National Drug Dependence Treatment Center
- All India Institute of Medical Sciences
- New Delhi, India
- Ragul Ganesh
- Senior Resident
- Department of Psychiatry
- All India Institutes of Medical Sciences
- New Delhi, India
- Ruchita Shah
- Associate Professor
- Department of Psychiatry
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Savita Malhotra
- Former Dean
- Professor and Head
- Department of Psychiatry
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Shabina Sheth
- Senior Resident
- Center for Addiction Medicine
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences
- Bengaluru, Karnataka, India
- Sharmitha Krishnamurthy
- Head
- Public Health Division
- Augmenta Health (P) Ltd
- Bengaluru, Karnataka, India
- Shinjini Choudhury
- Resident (Addiction Psychiatry)
- Department of Psychiatry
- All India Institute of Medical Sciences
- Rishikesh, Uttarakhand, India
- Siddharth Sarkar
- Associate Professor
- Department of Psychiatry and
- National Drug Dependence Treatment Center
- All India Institutes of Medical Sciences
- New Delhi, India
- Sudhir Bhave
- Professor
- Department of Psychiatry
- NKP Salve Institute of Medical Sciences and Research Center
- Nagpur, Maharashtra, India
- Sujit Kumar Kar
- Associate Professor
- Department of Psychiatry
- King George's Medical University
- Lucknow, Uttar Pradesh, India
- Sushil Gawande
- Associate Professor
- Department of Psychiatry
- NKP Salve Institute of Medical Sciences and Research Center and Lata Mangeshkar Hospital
- Nagpur, Maharashtra, India
- TS Sathyanarayana Rao
- Department of Psychiatry
- JSS Medical College and Hospital
- JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
- Vijay Krishnan
- Assistant Professor
- Department of Psychiatry
- All India Institute of Medical Sciences
- Rishikesh, Uttarakhand, India
- Vikas Menon
- Additional Professor
- Department of Psychiatry
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)
- Puducherry, India
- Vivek Kirpekar
- Professor
- Department of Psychiatry
- NKP Salve Institute of Medical Sciences
- Nagpur, Maharashtra, India
- Vyjayanthi N Venkataramu
- Senior Resident
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- Yatanpal Singh Balhara
- Additional Professor
- Department of Psychiatry and National Drug Dependence Treatment Center
- All India Institute of Medical Sciences
- New Delhi, India
It's a great pleasure that the publication sub-committee of the Indian Psychiatric Society has come out with this book, Cyberpsychiatry. The Internet and cyberspace have exploded over the past two and a half decades, with millions of sites and platforms catering to all needs and tastes. Any new technology comes with its own pros and cons. And perhaps no technology developed so far matches the Internet in the breadth and intensity of the psychosocial effects it has on its users. Such effects are both desirable and undesirable. And it is largely with respect to the latter that psychiatry steps in.
Cyberspace is being used in myriad ways, which are potentially harmful for people of all ages, especially children and adolescents. The world over, psychiatrists are seeing patients who are showing psychopathology in the form of screen and Internet addictions of various types including Internet gaming disorder, cyberbullying, cyberstalking, cyberchondria, ADHD associated with excessive screen use, and the like. Having a comprehensive and authoritative text that gives adequate information on the various aspects of such problems is the need of the hour. And this book, we are sure, will fulfill exactly this need. We learn that this book, in its scope, is perhaps the first one to be published anywhere on the globe, and this gives us immense satisfaction.
We congratulate Dr Sudhir Bhave, editor, and his team, for having conceptualized and very painstakingly brought forth this multi-authored book. We are certain that the expertise and erudition of the authors will be a great help to any reader interested in this field.
We wish you all a very informative and enriching read.
PK Dalal President | Gautam Saha Vice-President | TSS Rao Hon. General Secretary |
Times change and with changing times new realities emerge. Cyberspace is a new reality, which veritably is man's own creation. This is a new virtual space, in addition and distinct from our very own mind which we are all endowed with through the process of evolution. Emergence of human mind is a quantum evolutionary jump which has enabled countless cognitive revolutions, including innovations, inventions and also creation of myriads of myths. Cyberspace and psychic space routinely interact to give us an enriching experience which is unique to modern millennium. The lure and attraction of cyberspace is embedded with possibilities of immense potentials as well as problems. In all system of orders, there inevitably is a residual trail of disorders. Cyberpsychiatry aims to tend to the disorders emerging at the interface of cyberspace and psychic space. Cyberpsychiatry is a new bloom of the academic disciplines, which deserves to be welcomed with a very warm and big applause. Indian Psychiatric Society has taken a lead in this direction.
In past few decades we have witnessed and have unwittingly become parts and participants of this magical phenomenon. Since this phenomenon has everything to do with human mind, it has both positive and negative impacts as well as possibilities of abuse in addition to innumerable uses. The happenings and findings of this interaction have compellingly inspired mental health professionals and researchers to study all the visible good and bad effects. The field is new and evidences are not enough but probably sufficient enough to give us clues to understand the psychiatric relevance of this omnipresent and seemingly omnipotent cyber phenomenon.
After a first ever comprehensive book on social psychiatry titled, Social Psychiatry: Principles and Clinical Perspectives, the Indian Psychiatric Society is now presenting another first book Cyberpsychiatry which embodies almost everything, from basics to updates on the psychiatric aspects of cyber-human relationships. This is outcome of formation of Cyberpsychiatry Specialty Section in 2018–19 to address the mental health issues in the light of ‘cyberization’ of human mind. Editors of the book Sudhir Bhave and Sushil Gawande deserve all praise and appreciation for their patience, insight, and commitment along with untiring hard work and devotion. Being part of IPS office and the Publication Subcommittee we have been involved as insiders and know what is required for such a pioneering work.
We express our warmest regards to Professor Salman Akhtar for writing a ‘must read foreword’ from the connecting bridge of art and science of psychiatry. We express our sincere gratitude to all the authors for their immensely valuable intellectual inputs and also their time and toil.
PK Singh Chairperson Publication Committee | Vinay Kumar Immediate Past General Secretary Coordinator, Publication Committee |
Times change. Societies undergo transformation. Old laws are discarded. Rituals evolve and dissipate. Utensils of daily living acquire new shapes. Science advances, fresh discoveries are made, and practice of medicine begins to reflect such changes. Countries alter their territorial maps and cities acquire new names. Languages die. New forms of poetry and music emerge. Attires and recipes become obsolete. In essence, nothing remains the same forever. The great Urdu poet, Mirza Ghalib (1780–1869) was correct when he declared that Sabaat ek taghayyur ko hai zamaane mein (translation: “the only thing stable is change”). But the resignation implicit in such astuteness overlooks that man's need for connectedness, for attachment, for discourse with others, and for love survives all changes. It is unsurmountable. Being inherently a physically vulnerable and weak, if cognitively advanced, species, human beings need group affiliation, clamor for attention, and lose sanity if exposed to long-term social isolation.
Such human longing has gained strength due to fragmentation of close bonds consequent upon the current splintering of families as well as widespread migration of the world's people. To fill this void, a burgeoning sophistication of Internet technology has created an intricate web of ‘cyber- relatedness’ across cities, countries, and continents. Someone sitting in a small cafe in Cairo can now readily chat with his or her cousin in Toronto. A student in Patna can attend classes in New York or Los Angeles. Men and women can fall in love across continents, with little doubt about the veracity of their amorous heartbeat. To wit, I myself often chat with my cousins in New Delhi and friends in London while driving to work in downtown Philadelphia.
It is this world of communication and relationship that forms the focus of the book in your hands. Edited by two eminent psychiatrists of India, Drs Sudhir Bhave and Sushil Gawande, the book is a shining example of rigorous scholarship in the setting of scientific curiosity. It deals with both the normative and mind-expanding as well as regressive and mind-narrowing aspects of the freshly established kingdom of the cyber world. And, it does so with great integrity of thought and by deploying both clinical observations and empirical research methods. A minor quibble I have with the contributors to this volume is the restriction of their oeuvre and their overlooking the considerable psychoanalytic literature that has accrued in this realm of study. But then this reflects a more general and unfortunate tendency by which psychiatrists and psychoanalysts do not read each other. The weakness I note is thus not specific to this volume and hardly detracts from its enormous value. The essays contained in it cover a wide terrain of mental health and psychopathology. To borrow from the title of one particular contribution, the book tackles the ‘good’ (e.g., information seeking), the ‘bad’ (e.g., cyber stalking), and the ‘ugly’ (e.g., pornography) in this realm. It is a veritable smorgasbord of theoretical and clinical observations indeed.
In the opening paragraph of this brief Foreword, I had mentioned the Doyen of Urdu poetry, Mirza Ghalib, but now I want to go further back in the illustrious history of our nation and bring up the great Sanskrit poet Kalidas (circa 4–5 Century BC). His epic poem, Meghdoot, is an illustration extraordinaire of the ancient India's Sandesh kavya (message poems); it narrates how a man, separated from his beloved wife, mastered the pain by sending her lyrical messages via traveling clouds. Remembering this, an apt subtitle of Drs Sudhir Bhave's and Sushil Gawande's book might have been ‘From Kalidas's Meghdoot to Steve Job's i-cloud’. Mind you, this is a high compliment and, to my mind, the work they have offered us amply deserves such adoration.
Salman Akhtar
Professor of Psychiatry
Jefferson Medical College
Training and Supervising Analyst
Psychoanalytic Center of Philadelphia
Philadelphia, Pennsylvania, USA
Preface
In the past millennium, if we think of the epochs which have been characterized by huge changes in knowledge, technology and society, the first that comes to the mind was the era of enlightenment (CE 1650–1800), dotted by luminaries in the field of science and humanities. The “Internet era”, beginning in the 1990s, is the second one. Tim Berners Lee, the eminent British computer scientist, with his invention of the Internet in 1991, led to a global explosion of activity in the cyberspace. And the world has changed forever! Over the past three decades, our lives are increasingly dominated by the cyberspace, and the varied possibilities, both good and bad, if offers. Activities in cyberspace have become a preoccupation of at least half of the world's population of seven billion—helping us in numerous ways, but unfortunately being a cause for much worry too. A premature exposure of very young children and infants to screen, a wide variety of screen addictions across all age groups, and misuse of the screen for maladaptive activities like cyberbullying, cyberstalking, webcam sex tourism, use of the dark web, etc., have become an order of the day for many. The uses (read misuses) that the screen lures people into, have become a major cause for concern for sociologists, mental health professionals and society at large. Cyberpsychiatry, as the term suggests, is the study of our relationship to technology and the way it affects our mental health in a myriad ways. (The term is often used as a synonym for online therapy or telepsychiatry, but that is a very restricted use of the term.)
Over the past three decades, much research has been done and much has been written on cyberpsychology, the study of interaction of humans with the cyberspace. Significant strides have also been made into the psychopathology associated with the Internet. But, a comprehensive text with an exposition of the various facets of internet-related psychopathology is scarcely available, if not nonexistent. This book aims at filling this hiatus.
Cyberpsychiatry, which you are holding in your hands, offers a comprehensive, multiauthored coverage of the various aspects of internet-related psychopathology. The book includes, amongst other areas, an overview of what cyberspace is, its impact on the intrapsychic and interpersonal dynamics, the various psychiatric conditions arising out of the misuse of the cyberspace, the assessment, management and prevention of such problems, research in the virtual world, telepsychiatry and the future of the cyberspace in the context of mental health. The coverage of these topics is in fair detail, if not exhaustive. The book purports to help students of mental health, all classes of mental health professionals, the various stakeholders and anyone interested in understanding the impact of Internet on the mind. We are pleased to state that the authors have been selected from the crème-de-la-crème of the academia in this field, and are experts in the respective areas they have expounded.
Here's wishing you an informative reading, which, we hope, will contribute to a society relatively free from the psychological ill-effects of the cyberspace.
Sudhir Bhave
Sushil Gawande
Acknowledgments
The book in your hands today would not have seen the light of the day, had not the immediate Past President of the Indian Psychiatric Society (IPS), Dr Mrugesh Vaishnav, and the then Honorary Secretary of the IPS, Dr Vinay Kumar, agreed to my proposal to bring forth such a volume.
Dr Pramod Kumar Singh, the Chairman of the Publication Committee of the IPS was a wonderful guide in every aspect of the book, including suggesting unique and apt names for each of the chapters, and helping me conceptualize their potential content. His experience in the field and his visionary abilities were a great help. Special thanks to the multi-faceted Dr Vinay Kumar, himself an acknowledged poet and author, and an old hand at matters concerning publication, for going much beyond his official duty, and helping me at every stage of this book, right from planning the chapters, helping finalize the authors, and liaising with the publishers. His contribution is immense.
I got a great and very time-bound help from Dr Sushil Gawande, the co-editor of this book. Along with me, he painstakingly went through all the submitted manuscripts for his considered opinion on every line between the covers. Both the Assistant Editors, Dr Abhijeet Faye and Dr Anagha Sinha Saoji rendered much help in various departments during the editing, as and when the need arose. My sincere thanks to them.
This book may not have been planned, had not Dr Mohan Sunil Kumar, one of the authors, planted the seed of thought in my brain that such a book should be brought forth. I don't think I can thank him enough.
All the 14 authors deserve salutations for writing wonderfully researched chapters, each of which can serve as a point of reference for anyone interested in any aspect of cyberpsychiatry. Special thanks to Professor Mary Aiken from Ireland, an internationally acclaimed authority in the field of cyberpsychology, who has co-authored the first chapter on the nature of the cyberspace. For the past many years, she has been criss-crossing the globe, being invited to share her vast knowledge in the field all over. I imagine it must not have been easy for her, in her extremely busy schedule, to take time out to author the chapter.
I am really fortunate to get a wonderful foreword from Dr Salman Akhtar, the internationally acclaimed Psychoanalyst and Professor of Psychiatry at Philadelphia, USA. The write-up truly shows what makes him the highly respected expert that he is—scholarly, erudite and a great thinker!
Drs PK Dalal, TSS Rao and Gautam Saha, the incumbent President, Honorary General Secretary and the Vice-President of the IPS respectively, deserve my sense of gratitude for the encouragement I received from them throughout the year in this book's publication.
And finally, I will be failing in my duty if I don't express my heartfelt thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director– Content Strategy), Ms Pooja Bhandari (Head-Production), and the entire team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for having agreed to bring forth this book and giving a tangible form to our year-long hard work.
Sudhir Bhave