Recently the an advisory panel for the Food and Drug Administration (FDA) recommended against approval for what has been nicknamed the “little pink pill” designed to address a lack of sexual desire for females (as opposed to Viagra, the “little blue pill” for men).  The FDA could approve it anyway, but it rarely if ever decides differently than the advisory panel.  Clinical trials sponsored by the drug’s maker, Boehringer Ingelheim, reported that pre-menopausal women on Flibanserin experienced a small increase in satisfying sexual activity, compared with women taking a placebo; however, the panel decided that the amount of increase did not outweigh the negative side effects.

Why the “little pink pill?”  In typical fashion, we have identified a problem (some number of women don’t feel like having sex) and attempted to address it expediently with medical intervention.  (There must be a pill for that!)  But it turns out that when trying to peer into the pool of sexuality we discover it’s actually a vast ocean that we have explored little of.

There has been a paucity of studies about women’s sexuality.  What few studies there are vary wildly in their results, estimating between approximately 10% and 50% of women experience problems related to sexual desire (a considerable difference) and provide no conclusive evidence about what the cause may be.  The debate over Flibanserin has highlighted how little we know about the mechanics of female sexual desire or lack thereof.  Experts have guessed that the causes range from hormones, to body image and self-esteem, to lack of a skilled sexual partner, but these are all guesses and so far no pill has been able to do what Viagra does: bypass further understanding about the psychological or emotional causes of dysfunction of male sexuality and simply increase blood flow to the necessary parts (in Viagra’s case, the penis).

In truth, there is much more we don’t understand about sexuality and the mechanics of desire than we do understand.  We have taken a preliminary stab at identifying what dysfunction looks like (lack of desire, desire for the wrong thing/person) but these definitions are for the most part subjective and based largely on the negative effect it has on others.  But what causes sexual dysfunction remains as elusive as what causes sexual function and sexual desire to begin with.

Clearly there is a hunger for sex – sexual connection, sexual desire, sexual energy.  Pfizer claims on its web site that nine Viagra pills are dispensed every second – nearly 300 million tablets per year.  There aren’t any good statistics about it, but it is questionable how many of those pills are related to biomechanical dysfunction on the part of the man who takes it versus any number of other reasons he might not be able to achieve or maintain an erection.  Additionally, there is an explosion in the media about the phenomenon of “sex addiction” – an experience of lack of control over compulsive sexual desire/behavior wreaking havoc in lives.

The study of sexuality and “sexual energy” has been around for a long time – Tantra emerged in India more than 6,000 years ago with an understanding of how sexual energy can be used to benefit health and reach enlightenment.  Chinese Taoist sexual practices have been around since the Han Dynasty (200 BCE).  But these practices take learning, patience, and time, just as talk therapy and reducing stress, anxiety, and fatigue through meditation do.  These techniques might all work to create a rich, satisfying sex life, but they would require us to slow down and investigate what is working and what isn’t; and to talk to people and evaluate their experiences in a quantitative way.  Perhaps the “failure” of drug companies to thus far find a “magic pill” that would increase sexual desire and functioning in women is not because women are sexually hopeless but more points a need for us to slow down and investigate the mechanics of sexual energy and desire; not just for women, but for us all.

Samantha Smithstein, Psy.D.

According to research, people consume approximately 12 hours of media a day on average while at home (with simultaneous use counting as double). Computer users visit an average of 40 Web sites per day and at work, computer users change windows or check email or other programs nearly 37 times per hour. In a recent poll, most Americans reported that generally devices such as smart phones, cell phones, and personal computers have made their lives better and their jobs easier.

But more and more attention is being paid to the possible downside of all of this media consumption as well. Some of it is simply a matter of time – when we consume 12 hours of media per day at home we don’t have time for other things. For example, one in seven married respondents said that use of devices was causing them to see less of their spouses, and 1 in 10 said they spent less time with their children under 18.

However, scientists who have been studying media consumption and media multitasking are finding that there may by other effects as well, which range from our ability to relate to others to actual changes in the structure of the brain. For example, we are designed as animals to respond to immediate opportunities and threats as a way to survive. Sudden stimulation (such as a phone call, incoming email, or text message) provokes excitement (a dopamine surge) which can become addictive. People can become bored in its absence.

Some studies have suggested that excessive dependence on our devices is akin to an addiction, similar to issues people have related to food or sex. It may be an apt comparison, because while people can abstain from drugs, alcohol, or cigarettes, electronic media has become essential to modern life. In excess, though, the evidence is mounting that it is counterproductive at best and detrimental at worst.

Additionally, while multitaskers report feeling more productive, research indicates that heavy multitaskers actually have more trouble focusing and shutting out irrelevant information, and experience more stress. Even more concerning is that even after the devices are shut off, fractured thinking and lack of focus persists – our brains are actually being “rewired by technology,” says Nora Volkow, director of the National Institute of Drug Abuse. Dr. Elias Aboujaoude, director of the Impulse Control Disorders Clinic at Stanford, has stated that we are “paying a price in terms of our cognitive life because of this virtual lifestyle.” Some experts believe that our personalities are being reshaped due to exposure to technology, causing us to become more impatient, impulsive, forgetful, and even more narcissistic.

The nonstop interactivity people experience these days is one of the most significant shifts ever in the human environment, said Adam Gazzaley, a neuroscientist at the University of California, San Francisco. “We are exposing our brains to an environment and asking them to do things we weren’t necessarily evolved to do,” he says. Apparently that environment is here to stay. The question is how to we manage our relationship to it, and what the consequences are if we don’t.

As experts study the effects of “getting wired” and sound the alarm, no one has yet to spell out the solutions for us. Looking back in history, there have been periods of technological breakthroughs that have happened and we have plunged ahead, thrilled with the new convenience and speed in our lives, without thinking about future consequences. These days, new programs are springing up around the country to attempt to help people struggle with the technology that appears to be taking over our lives at a rapid pace, but it is a challenge for them to get the attention of the general public. If we could just, for a moment, sustain our attention in their direction, we might be able to hold on to that ability for just a little longer.

Samantha Smithstein, Psy.D.

Earlier this week, Sara Konrath, a researcher at the University of Michigan Institute for Social Research, released her results on a study analyzing and comparing empathy among college students over the last 30 years. The results? The “biggest drop in empathy” in recent history. She writes, “College kids today are about 40 percent lower in empathy than their counterparts of 20 or 30 years ago.”

In related survey research, psychologist Jean Twenge has labeled the current generation of young people the “iGeneration,” or “Generation Me”. In her books she describes how young people today “take it for granted that the self comes first,” and has labeled this time a “narcissism epidemic,” stating that we are “living in the age of entitlement.” Konrath and O’Brien link the self-absorption and lack of empathy together, calling the current generation “one of the most self-centered, narcissistic, competitive, confident and individualistic in recent history… It’s not surprising that this growing emphasis on the self is accompanied by a corresponding devaluing of others.”

There are some who argue that this description fits most teens and young adults and is appropriate to some degree for everyone in this developmental phase of life. However, both researchers compare similarly aged kids from other generations and the difference is striking.

This difference raises the question of why? Researchers Konrath and O’Brien hazard a few guesses, most related to the increase in exposure to and use of media. For example, many in this current generation have had repeated lifetime exposure to violent video games and films, and there is a growing body of research suggesting that violent video games (and perhaps films) are a cause of increased aggressive behavior, thoughts, and feelings, and a decrease in empathy and prosocial behavior across both gender and culture. Additionally, the researchers surmise that the ease of having (and ignoring or dumping) online “friends” may make it easy to tune out when they don’t feel like responding to the distress of others, and may carry over offline as well. They also add that the inflated expectations of success fueled by “reality shows” creates a social environment that encourages self-focus and works against slowing down and listening to someone who needs a bit of sympathy.

Obviously, any statements about an entire generation are not true of every person in that generation. Clearly there are young people today who are deeply empathic and caring. But the general trends and statistics are alarming, and it would behoove those of us in a position to influence today’s youth to pay attention and be proactive about it while we can. Paying attention to the forces that influence children and young people so that they can grow up to be empathic is not only better for them, but ultimately better for us all.

Samantha Smithstein, Psy.D.