 I'm going to be the moderator today. So I want to welcome our audience. And for this session, three of our presenters have graciously accepted without too much arm twisting an invitation to be part of a panel to discuss life in a digital environment. And I hope they will forgive me for being, sometimes I'm a little forceful. We're going to be talking today about online presences and that can mean a lot of different things. It can mean social media, virtual worlds, video games. Really means any sort of virtual embodiment, I guess you could say. So our panelists include Tony Van Roogh who just finished the last session. He's from the Netherlands Institute of Mental Health and Addiction. Actually, I think the word gambling had to come out of the description of him that we put in the second life calendar because they wouldn't accept it. We have Dr. Michelle Kolder-Karris and she is a public mental health researcher and she's also an informaticist. That's a good question to have right now. And Dr. Nicholas Bowman, he's at the Interaction Lab of West Virginia University and he's just in a week going to be moving to Texas. All three of these panelists admit that they are active gamers. I think that's important to keep in mind. I'm going to ask our panelists to respond to some general questions before we open the discussion up to typed questions from the audience. And so the first question that I want the panelists to talk about is about themselves. I want them to tell the audience a little bit about their online presence because that's the context from which they're speaking today. For instance, I will admit that I do email. I very rarely do Skype. The only other thing I do online is second life and that's because I am a Luddite, I know that. Or maybe I'm just not social. So who would like to start on this question? Maybe I can start from the far left side of the screen and just go across. I think it's the left, maybe it's the right. So my name is Nick Bowman. Okay, we'll go from the right. That's about par for me. So my name is Nick Bowman and this is my probably third or fourth hour in second life, which is a bit embarrassing to admit because I've been using a computer to communicate or to get information or to talk with people ever since my parents installed ProdigyNet on our computer at the house in Missouri. So I'm an avid gamer. Currently I play a lot of Fallout 76. May not surprise you because it's based in West Virginia, although I think I'm the only person still playing in the game anymore. I'm active on Twitter and Facebook is Tony and Michelle can tell you we are professional colleagues from years back. There isn't a half hour that goes by that I haven't posted something online. So I take these interactions very seriously because in a way I really just don't distinguish between the interaction that we're having right now and the ones that I'm gonna have at an hour when I walk home to meet my wife for dinner. So it's pretty all-encompassing and I'm excited to talk about how we go about experiencing this extension of ourselves. Sure, shall I go next? So Tony, obviously, I'm pretty much active on everything I think, although I don't spend time on everything. I have Twitter, Facebook, Instagram, basically the whole range of things and I tend to play games and when I meet people in games, I guess I talk to them when it's necessary. I have grown a little bit wary with ultra-competitive games because 12-year-old children tend to shout at me and beat me and everything. So I'm a bit down-tuning on that. I guess otherwise, because I write papers, I'm now also, people find me through papers which they read and then reply to me but they also tend to send me a lot of spam and invitations for review. I'll open them up, thanks. I might send a couple of those. Yeah, I'm... I've lost audio. Can you all hear me? I can hear you. Okay, great, I'll just not worry about it then. So I'm a little older than Tony and Nick and I came late to the academic game. I'm 53 and my dad was an early adopter of computers, PCs in the 70s. So I've grown up with them. I played a lot of games in the 80s but then I had this long period where it wasn't really too involved with computers or gaming. I got back into it when I was seriously depressed in like the 2005, 2010 period. And there I learned the importance of a community that was based around games. From there I started playing World of Warcraft finally after my son's death. And the community that I found there and interactions that I found online communities and how they could be beneficial. But the interesting thing is that now I'm in a period of a real transition and I'm finding that the demands of these online media are, they really seem a little overwhelming right now. So I've really reduced my online presence in the last few months. And I'm not on Twitter right now. I'm hardly on Facebook. And I'm thinking about going back into World of Warcraft as a comforting place, a place that I've enjoyed spending time in the natural virtual environment. Thank you panelists. And we're gonna ask if you could speak just a tiny bit slower so that our transcribers can keep up. That's fine. We're doing fine. And each of you give us some examples of healthy uses of online presence. Some of you are gonna be talking about or Tony has talked about some of these. But could you give some examples of healthy uses of online presence that you know of? Yeah, I was gonna mention that I really do think that Tony and even Michelle just now covered some of the basics around the importance of social bonding. And it's something that I like to remind people when I'm teaching my courses, when I'm speaking with the media, maybe even when I'm doing my own research, that there seems to be a fundamental assumption that we're going to approach second life or the digital spaces in ways that are automatically different than our corporal or physical spaces. And I think it ignores the fact that for many of us, you know, humans are human and we act sort of the same way. And I say that not to dodge the question but I think my immediate response is I see the same kind of behaviors online that I see offline. So in video games, we see kids goofing around and giggling, we see strangers coming together to beat monsters. We see a lot of social capital exchange and there's research to support these things. On social media, we see a lot of empathy, a lot of people discussing, you know, depressing moments in their lives and having individuals chime in and comment on those things. So I guess at the top level and to be, you know, sort of stereotypically a professor for a moment, I think I would say that I see the exact same behaviors online that are healthy that I do in my everyday life when I walk to work. I'll speak next if that's okay. I have to agree with Nick in that not just the healthy behaviors that we see offline, but the online environment is particularly beneficial for those of us who have some challenges. So we may not have access to the same kinds of healthy behaviors or healthy interactions in the real world that we do online. Tony, do you want to add anything? Tony, I'm not hearing you. We need more. We need more. I didn't change anything. There we go. And I'm just speaking really loud. Okay. Closer to the mic. It might help me slow down anyway. I wonder if there's some noise cancellation going on. I see the green lines and I don't hear you. Okay, Tony, going to type and he's talking about Pokemon Go. Cool. And playing with his brother. Those are positive aspects, healthy aspects of games. Hurrying to manage groups online. Thank you. Tony, turn off your mic and try rebooting your headset maybe. Okay. Okay. Earn healthy uses of online presence. Nick, you want to start? Yeah. I mean, so again, I sort of gave the same answer earlier that I would say that I get the top level just like when I'm walking home or walking around campus, I see lots of pro-social behavior. I see an incredible amount of anti-social behavior. And so, again, I'll remind folks that when I say humans are human, it doesn't mean that we're humane. There are some incredibly cruel people. When I see it online, what I see is some of the things Tony talked about with competitiveness and competitiveness sort of driving up to the level of cyberbullying. It's definitely easy to be angry at somebody who you've never actually formed a strong face-to-face interaction with. Griefing, someone just mentioned in the audience. And that's a situation that I'll talk about in my presentation later, where not everybody who goes online has the same extrinsic motivations to be involved. So they might hop in and see this entire auditorium is a giant sandbox to play with. And so, while we're trying to have an informed conversation about mental health, they might be in the back throwing eggs at everybody or calling people names, right? So you get these situations where folks do accept it as a fantasy and therefore they sort of suspend their own moral code in the environment. Bullying is a big one you see through social media and people far more experienced than I have been studying cyberbullying. So again, at the top level, it's, I think you see the same behaviors. What makes them potentially different is that the motivations for the individuals joining the digital world in the first place might be purely for their own fantasies. And you don't tend to see that as much when you're talking about going to the mall or going to the- Michelle? When I think about unhealthy uses, I think mostly about excessive use and how it can be very hard for people to self-regulate at times. We don't know a lot about how people self-regulate because that is something that is often left out of the health literature. There's some more research outside of public health, psychiatry medicine, but this isn't something that is even considered because it is outside of the biomedical sciences, which is ridiculous. So there is that question of, how do we self-regulate? How do we, what do we have to do to make sure that our use or the use of the people that we care about is not causing significant interference in other areas of their lives. Can you guys hear me now? I don't know what's going on. So negatives, I guess, like I said, league of legends. People, for some reason, wish for me to have cancer or to jump out of my own window when I mess up my lane in the league of legends. So like I said, the grieving, which Nick will discuss. And I guess unhealthy for the persons themselves is basically playing all night. Just playing too much to their own detriment, which basically my presentation was about. So those two things I would say. I guess maybe to add one other thing. We know fairly limited, we have fairly limited amount of information about the consequences of screen use and physical health. So I'm sitting a lot and that does something with my muscles. If you're growing up and you're looking at a screen, which is fairly close to your face and your indoors, that might do something with your eye development. So, but we really don't have the details on that. And recently, the World Health Organization, again, in another move, I guess, better research than gaming addiction, they released a report this week, which is about sleep and sedentary behavior and also screen time. And they really seem to be stressing to not overdo it when you're growing up. And for me, that makes a lot of sense, not because the screen time is bad for you, because, but because it does, if you're sitting in a chair, it does have impacts on your body, especially if you're developing. So it's really something that's objectively researchable and I guess balance in all things. And in this case, in particular, can be important. Oh, it helps my, I'm sorry about that. We talked about the use of physical and online interactions. Does the healthy balance between the use of various online and offline presences differ for different people? You know, what's fascinating about that question and listening to Michelle's and Tony's responses to the other questions is that the scope of what we mean when we say unhealthy online activity somehow is very different, right? Because when we're talking about online, we have to start thinking about, you know, our literal physical engagement with the devices. Do they allow us to traverse the imagination of digital spaces, but at the same time, are we then confined to physical spaces and how those things work out? So I think the question of whether or not it differs for different people, the answer has to be yes, because we have so many different ways of engaging the world, whether it's our own motivations, whether it's our own lot in life or our own situations. You know, I study, you know, digital games. So I spend an incredible amount of time online. Is that healthy? Well, I mean, it does pay the bills. You know, I pay my mortgage by writing about the issues of online engagement. So there's a self-preservation there. Someone else mentioned just now that their watch has to remind them to get up and walk. In fact, I'm wearing my Fitbit. And for those of us who are mobile, I do try to make sure I go walk around. I bet Tony and Michelle can tell you and Michelle did mention it earlier. Sometimes we spend too much time in these spaces. So when we say different people, I think what we really have to think about is the context in which we're engaging these spaces. So it has to differ. And I think it's really a calculus between, you know, there's never going to be a formula that says if this, then that. But I think it's important for folks maybe to be informed about the potential detriments of any type of behavior. And that would include online behavior so that they can do the calculus, right? If they're making their living or if they're gaining a lot of socio-emotional support or if they've found that second place where they can be who they want, then that formula for that person isn't going to work for me if I have to, you know, go play with my dogs this evening. So I don't say it to be flipped, but I think it's important and I think Tony and Michelle would agree. And the point of all of our research is less about telling people what the boundaries are objectively. And I think it's more about letting people know what the potential outcomes are so that they can make the personal decision on how much they want. Yeah, I really agree with what Nick says about the concept of making a personal decision based on your own circumstances. From the perspective of a person with a disability who is parent to children with disabilities, I'm really conscious of the benefits of an online presence, but at the same time, the difficulty in establishing boundaries, whether you're an adult or a child, it can be very challenging. And my research supports this. People who get benefits from virtual worlds from their online presence also can report that it can tip over into problems. And so I would love to learn more about how we can help people develop, whether that's a systematic approach to really reflecting on the balance in their life or even just pro tips or hacks. For example, I'll talk about how one of the participants in a study I did during periods where he had to study for a test, he would briefly subscribe to the game he was playing so that he could not need to log in regularly to get resources. So subscribing gave him a tiny amount of resources, but with that, he felt like he didn't have to log in all the time. So he used what I think of as a hack to get past what he saw as deficient self-regulation. All right. So Tony here. So the question from C4 was, what defines unhealthy? So an isolated artist or an inventor might be working around the clock to really accomplish something. And then is that necessarily a bad thing? I think that really ties into the other question as well. The issue we have in this area is that it's really hard to say two hours is enough and above it's really bad and below it's good for you. It really differs per person. Somebody who's more introverted or might grow up to be an engineer later in life, it can be really detrimental if the parents say you're only allowed on the Xbox for 10 minutes. Basically, you put into the Xbox and then you have to go out, leave the house because it's healthy to play outside. It really takes some opportunities away from the child. On the other hand, if you might be blessed with a brain that's less cognitively able, then you might need your study time every minute of it. And in that case, it might be really helpful if you're only allowed to play for 10 minutes or not play at all. So it's really hard to give universal standards in this regard. And at some point it also becomes, I guess if you're an adult, it becomes a personal choice as well. Like you might decide to shift the balance in a certain way or not. But for children, it's a little bit different because in that case, I think we need more information on what a proper balance is between movement, screen time, learning things digitally or non-digitally, et cetera. And we really like the proper research on that. And I think fixating on one hour per day is a somewhat unhealthy approach to this. And I think some of the better examples I've seen personally are, for example, parents that say three days or the majority of days in the week, you're in time for dinner to sit down, but on one night a week you're allowed to play all night if you wanted your personal choice. So that might be another way to deal with this. There's another thing that I'd love to hear what Nick and Tony, how Nick and Tony feel about this and our audience. When we think about those questions of what's best, especially for kids, we still tend to think of children who have challenges. We think that it's worse for them to be in spending a lot of time in online environments or playing a lot of games. So the challenges are usually associated with negative outcomes. You don't read that a child with ADHD is motivated to play more games and maybe that's useful. You read, when you read that in a scientific study, it's always comes out as they're motivated to do it for this reason and therefore that's a problem. There's certainly a fundamental attribution error that sort of suggests that because what all of us are doing right now is seen as abnormal, right? I think from a normative perspective, we're on our individual devices in a digital space engaging each other in a way that's not treated as real by large swaths of the population. I think because of that, there's always a sort of an assumption that you're doing something different. You need to justify it or we're going to assume it's harmful. That doesn't mean it can't be harmful, right? But something that Tony made a point of that I think is really important to work into here and I see a lot of the comments are going in this direction is that for example, if we look at psychological wellbeing and I'm going to share a link right now because Tony brought up the notions of autonomy and competence and relatedness, those aren't objective things. Feeling good at something, feeling a freedom of choice and feeling as if I have authentic connections with others is a perception. And one way of thinking about why people balance out some of these digital engagements might be because those digital engagements are giving them the opportunity to satisfy those things. In physical life, I'm five foot eight and a half. I am very bad at basketball, but I love the sport. My first job was sports riding and in video games, I would play basketball. I think I won the NBA championship 17 times, right? Did it get me anything in life? Well, no, but after a long day of school and I didn't have a lot of friends, I would go home and play some basketball and maybe I felt really good at that for a couple of hours when I wasn't doing well on my math test. And so I think when we engage this notion of balance and we engage this notion of healthy and unhealthy, it seems really important to strip away what ought to be done, which often comes from maybe an ableist or a presumptive experience of what the world is. And I think what a lot of the panelists are saying today is that we can't assume that any of this is good or bad, but there is a lot of contextualization within the person that's gonna help us understand. First, are they getting any benefits out of these digital interactions? And then from there, are they losing benefits from other types of interactions and activities? And I think until we really balance those things out and encourage folks to do the same, it's just gonna be a tough one to figure out. I think we should talk about MOOC's observation. She thinks there's one key difference between doing something physically and doing it digitally. She thinks people find it easier to be both mean and nice online because it takes so little out of them. There's less involvement, less entanglement, less attachment. You're not there in someone's actual presence, so it's both less stressful to be kind and distant and anonymous enough to be nasty. She thinks this is one reason that digitalized reality has seemed to bring out both the best and the worst in humans because it's an easy dichotomy that's encouraged or fueled by the medium. Would you like to address that? You know, it's a really great point that one of the things we look at is the notion of social presence. It's just one idea. It's the extent to which we feel is if we are actually in a space with other social actors. When we don't feel that way, many of the things that MOOCs talked about tend to happen. When we do feel that way, things like social norms and things like some of our assumptions about the way that humans will interact carry over from space to space. And so I didn't mean to step on Tony's toes there, but I think there is some element to that and it goes into the extent to which the person is engaging the environments as a authentic environment versus maybe a game or a play space or maybe they're just not comfortable in the environment. I bet everybody in this room in the beginning maybe didn't quite know what to do. And then over time as you're in second life and in other spaces, you start to pick up on some of the behaviors for better or for worse, of course. They may not all be good behaviors. So I might add something to that. I think I have a smaller, narrow answer there. And that's, personally, I'm not very nice sometimes in games like World of Warcraft because if I don't know the persons at all, I tend to become more instrumental. I have a complete idiot in my group, I might just kick him out because it's ruining my play experience and I don't really know the person and I know that's not really friendly, but and I think that changes as soon as you start dealing with more persistent real identity or for example, social capital like guilds, right? You don't want a bad reputation in your guild. But for example, if you're playing League of Legends, I don't ever see those people again. That really contributes to a more toxic environment where people are more direct and nasty. Now, the more wider observation is that if we go into social media, there is a large trend recently to keep people on the platform is basically the ambition of these platforms because then they collect more information on you. And one of the most effective ways to keep people in a platform is extremely polarized perspectives because people like to click, they like to click on things that are extremely polarized. Well, we've all seen the, well, I can't come up with an example, but there's many, you know, things about Trump or things against Trump and people tend to end up in the same bubble. But the extremely polarized views tend to be clicked on and keep people on the platform. So in that sense, the platforms are really driving these polarizations inherently. Not exactly what's going on in games, but it's definitely a thing. Michelle? Sorry, we just had a windstorm and something slammed. So I completely lost my train of thought. How behavior is different? I remember what I was thinking that I think is good to touch on is that these online environments do make things different and potentially easier, but we can also kind of slip into a culture that may be good or bad. So I think our culture or our way of communicating is devolving on Twitter. Even in the scientific sphere, there's a lot of unprofessional discussion going on, even name-calling and such. In World of Warcraft, I have gotten into discussions about rape culture and how it is, or at least it was normative to make jokes about rape. But by the same token, these environments also allow us to get closer. So it is driven by the platform, I think, but there can be real benefits to the kinds of cultures that evolve there or they can be, I think, somewhat toxic. And perhaps one takeaway from this conversation is that we know this is how physical spaces work, right? The park in your hometown, certain bars and restaurants and other areas around us, the shape of the environment very much can dictate the culture that the environment takes on. And so it's not that I mean to deprivilege digital spaces, but it seems that it's not that the forces are unknowns, they're just new to us. Something that I have been grappling with in my research and my thinking lately is the extent to which are we really dealing with a new song or is it the same song, but a different verse? And I often wonder when I hear the conversations, I think Bukka's 100% right, we see this intensity going on, but it's likely similar to if anybody has gone to a sporting event lately and seen some of the vileness that can take place there and seen some of the absolute adulation people can show when things go their way. Yeah, just adding to that, I guess. One thing to keep in mind is that there are some differences in the implications and on the behavior of people in some examples. For example, an issue that schools have in the Netherlands and I guess worldwide is, for example, sexting. It used to be back in the day that if you wanted to spread a new picture of yourself, you needed to make a lot of copies. Wouldn't do that easily, but right now you can go viral in five minutes and basically ruin your entire reputation for 30 years so everybody can find you. So that's definitely a fundamental shift there that does make a difference. That's true. And if we look, for example, at one of my other research subjects and interest areas is gambling, I'm fairly sure that in gambling, especially if people can gamble at home, there's a big difference in the behavior than is compared to, for example, a physical casino because there's no people keeping an eye on you. You have easy access to alcohol, which limits your inhibition so you may end up losing more money. And in case your family is present, you could hide in the toilet and still be gambling and build up a massive problem that would be slightly more difficult if you needed to physically leave the house and go to the casino every time. So in that case, it's really disconcerting sometimes. Right, the scope of the behavior and the consequences in some ways are potentially so much more dramatic. And I think it's in part, I wonder if we're trying to chase down new explanations rather than maybe magnified explanations of things that we've studied before. I think it's a good point. Again, if we continue to approach these places as either false or less than the world around us, we at the same time don't take them seriously, but then also focus on the consequences maybe independent of the causes of those consequences. So it sounds like Nick, you're saying that for people who aren't deeply involved in this discussion, they almost have to strip away their, what do you call it, suspend their disbelief in virtual worlds as real worlds, essentially, in order to understand this better. I think so, or at the very least, we're not conflate the things that are new, the actual features of the environment that are new with the social and psychological forces that we already know are at play in these behaviors broadly. And I think sometimes we forget to do that or we get so honed in on pathologizing a behavior that we sort of skip over the thing that's causing the behavior. Because Tony makes a great point. I mean, he's absolutely right. And in fact, because we don't do a great job, I think of linking up digital and physical space. The problem is everybody around us does, right? So I send a sex message to somebody in second life and suddenly I've lost my job. Good point. Well, there's a lot going on there. So how could someone tell if their own online activity was unhealthy or if it was out of balance? I was hoping Tony could tell us the answer to that one. Well, that was my answer, too. All eyes on you, Tony. I'll keep it simple, I guess. So from a clinical perspective or my perspective as well, I guess, as soon as things start suffering in your life, in the short run or in the long run. So the most extreme example would be people losing their jobs or their business running into the ground or them losing significant educational opportunities. And a more soft answer would be, I know some people that played World of Rockward for years on end, and if you ask them now, they said they will say they had a great time, but they also say they have some regret, because they overextended themselves in the game. They, in hindsight, they would have liked to spend more time meeting girls or going to the disco or spreading themselves out over different activities. I think that's a pretty good indicator when things are going wrong, is if you're still in the game, but you have the time you're thinking about, what am I even doing here? It's just a habit and you don't have alternatives anymore. So that's an initial answer, I guess. And there's been some points. Jaden is making the point about a wearable health meter, and I am aware of a mental health support group in Second Life. The members of the group used to wear those kinds of health meters during their meetings, and then the meeting facilitator could keep track of the level of feelings of individuals and the group as a whole, and if there was a necessity, they could change topics. Katzai is saying she knows a couple of young kids that came in to grief and then got intrigued by building in Second Life. She got to know one of those kids and learned he was caretaking his grandmother and developing alcohol problems and building in Second Life helped him with both of those issues. He wasn't banned when he stopped drinking and he started building relationships. That what they're talking about relationships? Yeah, I mean, I think, and many of us have talked about this in different levels and it goes back to that relatedness concept. No person is an island, it's a really old saying, and there seems to be a lot of evidence for that, that even the most sort of misanthropic of us all still need some sort of authentic social connection and it's not the case that communication cues are required for communication. And so in spaces like this, we would have to go into much further detail with that individual user, but it's not remotely shocking that somebody could find a refuge in a space that allows them to encounter other people so long as they perceive them as human. In fact, even in my own research I'll talk about later, we see that folks form these relationships with an animate objects. They form them with their avatar even if the avatar isn't controlled by anybody. So it's both warming to know that we can find others in these spaces. As someone just mentioned, it all comes back to balance and I think Tony mentioned this, that there's a notion of displacement. There's a difference between I have some friends online and I have some friends offline and I spend time with both of them. Just like at the office right now, there are several people who will never come to my house but we're still very close friends on a different type of stage. It really comes down to the point at which area are you spending more time in and what are you getting out of the investments you're making in one space or the other and are those investments detrimental not because other people think they're detrimental but because you yourself are feeling those detriments. And I think this was Tony's point with a lot of the scales they're trying to refine and develop to get away from sort of a subjective assessment of person A's being unhealthy but rather the person feeling that they're losing out on something. The gamer who wakes up one day and says, I'm spending too much time at the expense of X and so perhaps then it has to shift to how do we educate people to know to self reflect enough to make an informed decision about are they making too much time in one space? So maybe adding to the question or answer even about the grief and the building in second life but we know from in public healthcare we know from the example of Iceland where they have the Icelandic model of addressing substance use among children is that the context in which you are really matters for what you do. It's a lot of self destructive activities that come forth out of boredom or lack of options. What they did in Iceland is they gave everybody free access to sports. They started programs to keep parents really well connected with children. So basically all the free time is filled up. There's a lot of options for children to develop outside of the house for basically free to go into sports or art or whatever and that really fills up their time and it ends up being really successful. So substance use and alcohol use numbers have gone down to historic low and that really addresses it. So, and then we see that in this case as well as soon as you have another passion that might be a little bit less self destructive and it fills up your time then the problems definitely start to evaporate. And in some sense this addresses to gaming as well because the figures from the study I showed we also see that people even if they're gaming in a risky manner in general if they're active in gaming they tend to drink less and they tend to be less involved with smoking because they're simply they're gamers and they're not hanging out drinking a lot. So gaming can even be very much a protective factor in that sense. It could also be dependent on what you're doing with your online time in your online setting. So you could see someone doing something that they feel is a time waster and not feeling great about that. But if a person say has a virtual business in second life then that's something that they find meaning from or if they're spending eight hours a day streaming on Twitch and trying to become a partner and build their career out of that when they feel like in the real world they don't have the opportunity to do that for whatever reason. In my research it's veterans maybe they're coming back from deployment or maybe they've suffered some kind of injury. So it could be a matter of is what you're doing in the virtual world or in your online environment something that is meaningful and contributes to your mental wellbeing instead of feeling like it's a time waster or displacing or valuable. There's even research on the notion of the guilty couch potato. And it's the suggestion that when you're doing something and for whatever reason you're made to feel that what you're doing is not healthy it can actually diminish the healthy benefits of that interaction. So we've seen some people talk about watching television with friends and maybe engaging in a binge watching where they watch eight episodes of The Office in a Row and where that may have been a stress relieving activity because that individual has been told or believes that what they're doing is wrong who can sometimes see the benefits disappear. And so it's why I'm always careful to both recognize the incredible importance of anti-social and disruptive outcomes but also to make sure folks aren't made to feel that what they're doing is inherently wrong on its face. ASC4 is speaking to what I was just talking about. You're choosing a meaningful activity. One of the organizations that I work with is called STACA. It's an organization that was developed by a veteran who when he returned from Iraq he felt like he was not able to leave his house for about a month. So he spent his time in World of Warcraft and that passion led him to develop an organization devoted to using video games for mental health. There's really a lot to think about here. Do you think that the balance between healthy and unhealthy digital tech usage has changed recently? And do we have any evidence of this? It has to. I mean, in a sense, technologies evolve so quickly. There's a great article and I'll put the link in the chat by a scholar named Frank Bioka on the cyborg's dilemma. And I think it's a fairly accessible article. And he talks about how what's interesting about our technologies now and heck, we could argue all the way back to the domestication of fire is that technologies are inherently unnatural. So they're disruptive. And when we first pick them up they're weird and they're strange and they change our relationships with other objects in our environment. But as we use these artificial disruptive things they become more natural. And another great example is a guy named Clark who writes about the wristwatch. For many people, if you were to ask them what time is it or do you know the time? They would say yes. But they're technically lying to you. They don't know the time. They just know that they have a device on their hand that can give them the time very quickly. And I think it relates to the idea of the balance becoming healthy or unhealthy because that is the way this technology works as we continue to integrate it. We use it a lot more and the balance point at any one's pace and time is gonna look weird, but looking back it's always gonna seem like it was a natural progression. And I think that we are in a period of time and I think Tony hit this pretty well that what's happening right now is we are able to exist in lots of different spaces and we're still learning sort of how to do that. But I suspect as we always look back on these behaviors they're gonna seem like they were remarkably linear progressions towards wherever people are at 100 years from now. Think about in the 1990s this thing called or I guess early 2000s, this thing called MySpace was completely revolutionary. And now the idea that somebody could have a personal webpage that's networked to other personal webpages is commonplace. I like the idea of this is something that I saw actually I was lucky enough to visit Tony recently in the Netherlands and this makes me think about how we have gone from not having mobile phones to being constantly connected, responding to notifications, looking up everything we're unsure of and Tony had a black box sitting on his dining table that were to put our phones in during a meal because how quickly has it evolved that if you don't put your phone away specifically it's so tempting to take yourself away from the people that you're sitting with and physically interacting with to pop into that technological environment. So I think that's one of the changes that's come about kind of gradually. And I see in my children that it's very difficult to try to get them to set aside the phone and focus on the face-to-face interactions even for just a brief period of time. I think adding to that, I think it's important to realize that ambitions of these companies are not necessarily the best ambitions for you to have. So a lot of these products are developed to keep you in the product, so maximize your time in the product. And only recently we've started seeing a little bit of a backlash even from within the industry against that idea. And they're now looking at time well spent or a more optimal time in a product. But as soon as there's a profit motive that goes against this, I think it would be hard-pressed to find absolute or real hard reductions of this. So I'm a bit skeptical and I think we really need to coach and train ourselves to deal with this. So for example, that might be a black box. There are plenty of other ways to address this. And then secondly, I wanted to address the question that was asked in the chat about reading being addictive. Actually got that question from a journalist a while ago and unfortunately I didn't come up with the best answer a professor in substance use did. He said, well, better Harry Potter than heroin. I think he's right to some extent. But from my perspective, I do think technology has changed. There's a certain endlessness in gaming, specifically competitive gaming, but also the bigger games that's not present in books. You finish the book and then you're done. It's inherently a somewhat limited activity. Gaming really allows for people to spend basically unlimited amounts of time in it. I guess another example right now would be Netflix which has a slightly different modality but also there's more video than you can ever watch. So that's interesting as well. So yeah, it is different. I think we need to be careful with our personal preferences. And just to give it a more concrete example, Netflix has an autoplay feature. So you automatically go into the next episode and you really have to consider is that something you want to teach your children that if you don't stop, you're automatically gonna watch forever. And this is happening in games as well. It used to be in League of Legends, you finished your match and you had a bit of a hassle to set up your next match. Right now you're going automatically into the next patch. So these natural breaks, moments where you would leave the product or take a break or go outside for a walk are slowly being removed from products and that might be unhealthy in a sense or it might make it harder to be healthy. That's right. And that's considered an ethical game design to allow these natural breaks and to remove them, that's a way you keep people engaged. We've got some good audience questions and comments that I think would be useful to discuss. I wanna give a little context. Brenna's physical world employer provides addiction recovery support through virtual worlds. And so she says in her experience in her field, technology can reduce barriers to access and provide people with resources that they would not otherwise have access to. So providing an access, it's helped reduce transportation barriers for their clients and overall access to treatment. It helps people with disabilities, et cetera. You wanna talk about the use of technology in terms of just access? Absolutely, I would love to start with that. I have to tell you that a few years ago, Medicare decided to start reimbursing telehealth visits for just this reason because there's not enough access, particularly to mental health. And when Medicare decided to get on board, that kind of paved the way for it to be supported by health insurance companies and other payers in the United States. So we're really lucky that that is becoming a recognized thing. And ironically enough, my daughter was about to go to her therapy appointment at the beginning of this panel and she had a panic attack. So I encouraged her to text her provider who said, let's get on this secure video conferencing system and she was able to have her therapy session. And no, she does not mind me talking about this. She talks about it herself publicly. This is a great example of what's been talked about on the panel today about the motivations and intentions and the design of the platforms, right? This is an example of a technology being used for a very intended purpose to reduce the very barriers that we know prevent therapy and a recognition that therapy doesn't necessarily require a face-to-face interaction. And I think this is something that continues to remind us about and thinking about the conversations about game designers, at least in this one example, we can recognize a difference between the motivations for compelling individuals to use telemedicine versus compelling individuals that continue to slay dragons so that their eyeballs will be focused on advertising. And I think it's something about the technologies and the people promoting them that we kind of have to keep in mind. Because at the same time, I could see insurers engaging in a profit motive and suddenly shoving people into therapy programs online not because they work, but because they're cheaper. And so I think it's a nice reminder that no matter how much we study this as a social or psychological phenomenon, there's also gonna be an economic and a management phenomenon. That's a really good point because you can balance the ability to deliver interventions like therapy at the scale of the internet versus the different sorts of financing and business models that are associated with that. One of my favorite comments about gaming in particular comes from a designer named Ian Bogus and he makes this claim that he sort of wishes gaming was just mundane. And I think the point he's making is that at the point at which it reaches mundanity, we stop treating it as a new phenomenon and start treating it as a sort of natural part of our world. And I'm curious to know how our questions and interactions and research would change. We just saw this as a thing that's in our reality. I'm not sure, I'm ready to go that far yet because again, some of the things Tony and Michelle and others have mentioned consequences are different, mechanisms do seem different but it's a curious question to ask ourselves. Like how do we re-approach these things if we just leave them as option B and not sort of like a shiny new option that's definitely good or definitely bad? Wow, I hate to interrupt at this point but I wanna thank all three panelists for a very engaging, a very informative session. I wanna remind our audience that Dr. Bowman will have a presentation at noon which is in about 15 minutes. He needs to have time to get his HUDs set up and we need time to clear the stage and Dr. Koldakaris is gonna present at 1 p.m. SLT in about an hour and 15 minutes and you may wanna stay and listen to those sessions. They're gonna be really good to follow this. And remember that our last session of the day is a social event where we will continue to be able to have these discussions at that point and it'll help us, we can add in what we learned from the afternoon's presenters. So please everyone in the audience show your appreciation for our panelists. They've given us a lot of great information. Thank you all so much. Thanks. Thank you all for your great comments. And remember this is all gonna be archived in text and video so you'll be able to look over the comments later.