The Cyber Effect (32 page)

Rinko, Manaka, and Nene are adorable and devoted. And their personalities can be adjusted in settings. Best of all, unlike the cyber-melodrama
Her
, they are programmed never to dump you. It's just not in their code.

Players have declared that their love for these virtual girlfriends feels real—and is consoling, supportive, and nurturing. We know from studies that
people can form real and authentic emotional attachments to virtual characters. An avatar will always reflect an aspect of its creator and could be, in some ways, more revealing than a self-consciously manufactured and curated self-portrait.

Some have used the video game as a refuge when going through a bad breakup. “I would say that a relationship with a
LovePlus
character is a real relationship,” said anthropologist Patrick Galbraith, who specializes in Japanese popular culture. “People are really intimately involved.”

But can we really call it love when there's nothing to lose? Would anybody ever write a song to Rinko, Manaka, or Nene? If human beings
become used to unconditional machine love, what does it mean for their emotional resilience after a real breakup?

Let's take this a step further. If human beings begin to prefer demure and devoted Japanese anime characters over real women, what does this mean for the future of the human race? As Norman Holland writes, this parallels the sci-fi story
The Stepford Wives
, a male fantasy about women who are completely satisfying because they are docile and have no real needs of their own because they are machines.

In order for our species to survive and thrive, people need to mate with other people, not just fantasize about Rinko, Manaka, and Nene. In Japan, this concern is no longer mere speculation. A government survey released recently estimated that
nearly 40 percent of Japanese men and women in their twenties and thirties are single, not actively in a relationship, and not really interested in finding a romantic partner either. Relationships were frequently described as “bothersome.”

Another survey found that one in four unmarried Japanese men in their thirties were virgins. The number of virginal single women in their thirties was only slightly less. At the time, Shingo Sakatsume, who works as a “sex helper” and counsels middle-aged virgins, observed, “In Japanese society, we have so much entertainment beyond love and sex. We have animation, celebrities, comics, game, and sports….Why do you need to choose love or sex over the other fun things that don't have the potential for pain and suffering? The illusion of a perfect relationship, combined with the Japanese fear of failure, has created a serious social problem.”

By 2060, if current trends continue, Japan's population will have shrunk by more than 30 percent.

Don't assume the explosion in virgins is restricted to Japan. There are a number of factors online—invincibility for starters—that could create a heightened fear of failure in the real world and a wish to avoid pain by restricting human contact to virtual relationships. And the less practice the population gets with face-to-face interactions, presumably the worse they will become at them—only amplifying their vulnerability.
Cultural considerations aside, what is happening in Japan could come to pass everywhere.

Intimacy comes with a risk and can be difficult for some. For those who have had painful experiences in early relationships, or difficulty during a developmental stage, it can feel too dangerous, too risky. In her book
Alone Together
, Sherry Turkle provides some insight as to the appeal of tech and its ability to arrest or mitigate fears of intimacy. “
These days, insecure in our relationships and anxious about intimacy, we look to technology for ways to be in relationships and protect ourselves from them at the same time.”

I wonder, though, if technology itself could be keeping us from learning how to be intimate—and feel comfortable in a close, caring, face-to-face relationship. Some surveys suggest that face-to-face encounters between individuals—romantic or otherwise—are steadily on the decline. And there is evidence that dating apps and sexting, as well as other virtual encounters, actually may have a negative effect on people's sex lives—and, importantly, what we traditionally call human intimacy. Dr. Craig Malkin, clinical psychologist at Harvard Medical School, makes a case that technology itself can make us afraid of intimacy:

In other words, despite everything I said in
chapter 1
, and all the evidence that we might be in the midst of a sexual revolution, the current era of the easy hookup appears to have created more intimacy online, and perhaps even more sexual activity,
but less actual contact sex. As Turkle puts it, more people are “alone, together.” In an age of technology, this is the new definition of sexual intimacy.

Romantic love has never been easy. I guess you can't blame people for hunting down some simpler solutions, or for technology to keep designing them. The search for something that approximates real romantic love and companionship (but without the problems of dealing with actual people) leads technologists and the industry to create artificial-intelligence solutions—robots programmed for all kinds of purposes, to provide anything from comfort to therapy.

The field of cyber-love and robotics is growing, and the sexbot industry is now attracting big money, tech innovations, and high-level artistry—to make the bots as real as real can be. In fact, they are so real that one Japanese manufacturer of the humanoid robot, a cute puppy-eyed social companion called Pepper, had to take the
unusual step of creating an urgent “term of condition” for users: “The policy owner must not perform any sexual act or other indecent behavior” on the machine, which is designed to live with humans. One dissatisfied owner, after an alcohol-fueled rage, was arrested after assaulting Pepper.

As for love and companionship—a real relationship—someday, just like in the movies, there may be avatars and bots that mimic humanness so well that real human beings fall head over heels in love with them. For now, though, there's a well-known tech-design problem getting
in the way. In the film industry, this was first discovered and documented in 1988, when Pixar screened a computer-animated short film called
Tin Toy
and learned that the test audiences hated the sight of a realistic human baby who terrorized the toys. The reaction was so strong that Pixar decided that, going forward, it would create animations that weren't too closely human in appearance. Why would an animation that is “too close” to human repel audiences?

“We still don't understand why it occurs or whether you can get used to it, and people don't necessarily agree it exists,” said Ayse Saygin, a cognitive scientist at the University of California, San Diego, to
Scientific American
. “This is one of those cases where we're at the very beginning of understanding it.”

Some argue that a perfect replica might be acceptable, but an approximation is just too creepy. “
Pixar took a lesson from
Tin Toy
,” said Thalia Wheatley, a psychologist at Dartmouth College. “We have to nail the human form or not even go there.”

Filmmaking, especially animation, relies increasingly on the technology of computer-generated imagery, or CGI, which is capable of producing a close facsimile of a human being. But those avatars in the film
Avatar
were blue for a reason—and audiences found them beguilingly beautiful. And audiences and reviewers reacted negatively to the train conductor and other characters in the animated film
The Polar Express
. (Was that Tom Hanks or not?) Rather than replicating humanness, these facsimiles seem to leave people feeling queasy or sick, a reaction not unlike one that some people experience when they see bad plastic surgery.

Rather than admiration, many people respond to too-close human replicas with repulsion.

This phenomenon even has a name, the
Uncanny Valley
. The concept was first introduced in 1970 by Masahiro Mori, robotics professor at the Tokyo Institute of Technology.

Mori, now in his late eighties, became involved in robotics some fifty years ago, before the term
robot
or
robotics
was even applied to his field. He designed one of the first three-fingered artificial hands that was used as an industrial tool for handling radioactive materials and later was developed as a prosthetic aid for disabled people.

Working on the robotic hand,
he first experienced what he described as an “eerie sensation.” To scientifically illustrate the emotional effect of seeing the hand, he plotted a graph with “affinity” on one axis and “human likeness” on the other, to map how people reacted to various robotic prototypes. The chart showed a low human affinity score for crude industrial robots (which look nothing like humans) and a medium affinity score for toy robots (who can look quite cute in a mechanical way, like R2-D2 or C-3PO in
Star Wars
). But when robots become too humanlike, affinity crashed, causing a giant dip on Mori's graph. Hence the name, the Uncanny Valley.

In case you are wondering if this revulsion is culturally conditioned, the answer is no.
Even monkeys appear to have an Uncanny Valley reflex: An experiment found them looking longer at real monkey faces and unrealistic monkey faces than they looked at realistic synthetic faces. This means it is primal—and hardwired. But why?

Mori's observation has become widely known and discussed in tech circles only in the past few years, but his insight is timeless. “I think this descent explains the secret lying deep beneath the Uncanny Valley,” he wrote. “Why were we equipped with this eerie sensation? Is it essential for human beings? I have not yet considered these questions deeply, but I have no doubt it is an integral part of our instinct for self-preservation.”

And he speculates on the cause: “Proximal sources of danger are corpses, members of different species, and other entities we can closely approach.”

What Mori brings to science and research is unusual. He is listening to his own intuition and the mysterious but documented responses of many others. Without a doubt, he assumes there's a reason for this pervasive feeling. In the discipline of science, the opposite is expected. We aren't supposed to assume anything until there are studies and research evidence to back it up.

But Mori is saying something else. He is saying: Pay attention to the human feeling. It is there for a reason. And he recommends that we pursue nonhuman designs, and respect the intuitive yet mysterious human reaction to fakeness. Otherwise, why would we be equipped, as he puts it, with this uncanny sensation?

Isn't it possible that there are essentials for humans that we need to
pay attention to before we have conclusive studies? This is something I am passionate about, and a perspective I feel is needed at a time when technology will surely keep outpacing science. In the absence of studies, we need more common sense.

And respect for the human.

Some in the robotics and CGI industries view the Uncanny Valley as a design challenge, and are determined to solve it. What happens when they do? Imagine what the future could hold, when humans are emotionally targeted by the manufacturers of artificial-intelligence machines. Like the games and dating apps we've grown to use and love, and depend on for entertainment, pleasure, and intimacy, the robots will likely be seductive and irresistible. It could start almost benignly, with an adorable robot or avatar that you can't help but love. Artificial intelligence, whether it is embedded in a robot or in a Tinder algorithm, can impact human life on the most profound levels—from finding a mate to intimacy. We are moving from natural selection to cyber selection.

When it comes to technology, should we be trying to design beyond human instinct just because we can? I suspect that the Uncanny Valley is an evolutionary red flag—a warning call. Human beings have an innate intuitive fear of snakes and spiders, of heights and too-tight spaces (as well as corpses, as Mori points out). These aversions aren't pointless. They are primal fear—instinctive reactions for self-preservation and species propagation. These aversions evolved to protect us, and they have served us well, from contact with prehistoric Neanderthals to our complex relationships with fellow
Homo sapiens
. Perhaps we need to pay more attention to what Mori warns us about—the little things. And a much bigger thing too. Love.

T
he imagination is a beautiful thing. Scientists believe it has an evolutionary purpose, that we acquired imagination to help us anticipate danger. As our prehistoric ancestors struggled to survive in a threatening world, they learned to envision potentially dangerous situations—
If I walk past that clump of trees up ahead, I might be attacked by a beast hiding inside it
—and how best to avoid them. By imagining a worst-case scenario, we can control dread and anxiety and are able to make vital decisions with mental clarity and calm.

Something changes, though, when we go online to search for medical information. When we try to find out about a physical symptom we are experiencing—or worried about—what appears to be a useful exercise to help ease anxiety only escalates it. And as a growing body of evidence suggests, it may actually be making us sicker.

Today's medical doctors know this phenomenon well. More and more of the patients they see in their offices and clinics arrive consumed by fear that they are terribly ill.
Clutching their “Google stack,” as it's sometimes called, these individuals have been “researching” their symptoms and bring evidence to support an amateur medical opinion that's been formed by surfing the Internet. A small number of doctors actually welcome this collaborative approach. But by and large, this is
not the case—because it can interfere with the proper diagnostic process. This is particularly true if there is no physical evidence. A patient can go online and compare his or her own skin rash with images in a catalog of dermatitis and may be able to come up with some helpful matches. But in the absence of physical symptoms, it is speculative and unhelpful, and this is also true regarding mental health conditions. It may be fascinating for some people to complete online psychometric evaluations regarding anxiety or problem drinking, or even find themselves doing a “desktop” self-diagnosis of schizophrenia or borderline personality disorder, but only qualified professionals should be diagnosing such conditions.

Many medical colleagues have described to me the great frustration they feel when patients claim to know the diagnosis prior to their examination. Often the first part of the consultation is spent convincing these people that their hypothesis is flawed: “No, you do not have dengue fever” or “infectious river blindness” or some other disease found only in an Amazonian jungle.

What should be good news is often met with only mild relief, even tinges of disappointment. Patients don't like to be told their supersleuth medical detective skills haven't delivered. Meanwhile, out in the crowded waiting room, the clock is ticking and the truly sick are kept waiting for their consultation.

One reason that health coverage costs are so high: Reports state that up to $20 billion is spent annually in America on
unnecessary medical visits. How many of these wasted visits are driven by a cyber effect?

There are benefits to being vigilant about health. And the Internet offers so much good science and medical information that it should be helping us stay healthier and happier than ever. Sadly, it often doesn't work out that way. Consider the story of Lisa—a healthy, thoughtful, well-educated woman not given to impulsive behavior—and her virtual descent into the world of Lyme disease.

Lisa, a woman in her mid-forties, went to Cape Cod, Massachusetts, a few summers ago to see an old childhood friend, Michelle. The women
were on the planning committee of their thirtieth high school reunion and used their time together to begin their work. After a morning of brainstorming and too much coffee, they needed to clear their heads, so they took a walk in the woods along the bay. Lisa had heard there was a lot of Lyme disease on Cape Cod, and asked Michelle if it was safe. It was high tick season, in fact. The blood-drinking parasites in the wooded areas are most prevalent during the spring and late summer.

Just the word
tick
made Lisa feel itchy, as if the bugs were crawling all over her. Indeed, that evening before bed, she found a small deer tick, the size of a sesame seed, attached to the back of her neck. Unsure how to pull it out—pinch it with tweezers or between two fingernails?—Lisa went online, trying to remain calm as she clicked from one search result to another. With the tick happily feeding, Lisa's online investigations took her to a public information website created by the U.S. Centers for Disease Control and Prevention. Not wanting to wake Michelle, who was asleep in another part of the house, Lisa followed the step-by-step instructions provided by the CDC, and with clinical focus and the help of her surgical instrument (tweezers) and two mirrors, she extracted the hapless deer tick and flushed it down the toilet. For her “post-op,” she rubbed alcohol on the bite wound.

The tick was gone, but Lisa's anxiety was rising. Stressed-out and unable to sleep, she decided to read more about Lyme disease, a tick-borne illness that's been in the upper Midwest and Northeast regions of the United States since the late 1970s, when an improbably large group of Connecticut schoolchildren were diagnosed with juvenile arthritis, and it was traced to infected ticks found in the region.

One of the frustrating things about Lyme is the variety and murkiness of symptoms, and resulting diagnostic difficulties. Debates rage about the disease, in particular whether there is truly something called
chronic Lyme disease syndrome
and what the proper treatment should be. Lisa had heard somewhere—probably in one of the media stories about the disease she'd read—that if left untreated, Lyme could have dire consequences.

Click after click, as she tumbled deeper into the world of medical search, reading about the consequences of Lyme, from mood swings to meningitis, Lisa was doing what a lot of people around the world now
commonly do when they become sick, or believe they might be sick.
In a large international survey, a majority of people said they used the Internet to look for medicine, and almost half admitted to making self-diagnoses following a Web search. A follow-up survey the following year found that 83 percent of 13,373 respondents searched the Internet often for information and advice about health, medicine, or medical conditions. Individuals in “emerging economies” used online sources for this purpose the most frequently—China (94 percent), Thailand (93 percent), Saudi Arabia (91 percent), and India (90 percent) led the table of twelve countries.

Worrying about one's health—or that of a loved one—is perfectly normal. To some extent, it's a natural outgrowth of an awareness of one's own physical vulnerability and mortality. In cultures across the globe, when friends and family gather to lift glasses in a toast, what are they most likely to say? “To our health!” In Ethiopia, it's
Le'tenachin!
In Arabic,
Be sahtak!
In Bosnian,
Nazdravje!
, and in Czech,
Na zdravi!
In Ireland we say, “
Health and long life to you, land without rent to you, a child every year to you, and death in Old Ireland.” (That bit about “land without rent” is a throwback to our days as a colony. Just like the Internet, Ireland is a place that cannot forget—we've even found a way to politicize a popular toast to health.)

The essential question:
When does a normal desire for health, and the willingness to pursue it by combing all available information, turn dangerous? When do the “worried well” literally worry themselves sick?

Unfortunately, this happens very quickly these days, often aided and abetted by technology.

Twenty years ago, if you were experiencing the onset of any physical condition that persisted to the point of interfering with your activities and work, you would visit a doctor's office and consult a bona fide expert with years of rigorous medical training, a reassuring manner, and a selection of impressive diplomas hanging on the waiting-room wall. In the digital age, we do our own symptom search, as Lisa did. It's a layman's game, like “playing doctor” at home. When you're feeling crummy, the first step is often to seek an answer online by consulting one of many medical websites available, many bearing seals of excellence
and brand names that radiate credibility. It's a virtual magic box of medical marvels, ranging from the impressive online presentation of the Mayo Clinic to the opinionated offerings of personal blogs and chat forums. The choice is seemingly infinite.

Cyberpsychologists have learned that
people make judgments online in a number of ways. About half of the medical information offered on the Internet has been found by experts to be inaccurate or disputed, but
the criteria that online searchers use to determine their level of trust is pretty superficial: the overall design of the website, the brand recognition of the URL, and whether the advice appears to come from experts or those with shared experiences, rather than the integrity of the information itself. There are even design awards for “best health site” granted to the likes of WebMD.​com with its 40 million unique monthly visitors, NIH.​gov with 22 million unique monthly visitors, and MayoClinic.​org with 17 million. With their pristine, clinical look—and enormous popularity—
online medical websites seem like reliable sources of advice.

Lisa lost track of time—a few minutes became an hour, then another. In a state of heightened anxiety, her imagination ran wild and she ignored information that might have been comforting, like the fact that most ticks are not dangerous. Only small deer ticks carrying the bacterium
Borrelia burgdorferi
can transmit the disease to a human being, and only after being attached for thirty-six to forty-eight hours. Even though her walk in the woods had been only twelve hours earlier, and the tick likely had been attached for less than eight hours, Lisa continued to worry—and search for more information. Better safe than sorry!

She learned that the first sign of disease is commonly a red bull's-eye or target, called
erythema migrans
, located where the tick's mouth was attached to the skin. As Lyme progresses, the stricken individual can present a number of common symptoms within a week to a month—sore throat, stiff neck, fever, chills, rash, and severe body aches. It can feel like you're getting the flu. Just thinking about it, Lisa felt hot and flushed.

She put down her laptop, returned to her mirrors, and, by adopting a pose worthy of a contortionist, glimpsed some redness in the area of her tick bite. This only made her worry more. After all, if left untreated,
Lyme disease can lead to debilitating arthritic conditions, clinical depression, encephalitis, facial paralysis, acute inflammation of the tissue surrounding the heart, and other complications that, in some cases, although rare, can lead to death. In one five-year period, there were 114 reported fatalities resulting from complications of Lyme in the United States. This is fewer than half the number of
people killed by lightning strikes over the same period, but Lisa didn't know that.

Which was worse: facial paralysis or death?

Lisa wasn't sure.

Without a doubt, having a parasitic insect attach to your flesh, burrow in, and drink your blood is unsettling in itself. But reading the medical websites and forums frequented by Lyme disease sufferers took Lisa to an even more frantic and disturbed place. Forum participants used a clubby insider-speak to tell their personal stories, talking offhandedly and even competitively about their advanced cases of Lyme and how many treatments they had tried in vain.

I'm sure all of us, at some unfortunate time in our lives, have sat in a doctor's waiting room in the presence of a person I call Catastrophia, the Mother of All Patients, who chats you up with a catalog of unrelenting horror that is her medical history: “And just when I thought it couldn't get any worse…”

Silently you scream
Enough!
but you are a captive audience, and social convention dictates that you sit there politely and muster a nod.

The point is, most people who've been ill do make a good recovery and get on with their lives. Yet there is a minority who like to linger there and dwell on illness—enjoying the attention they get from regaling others with their medical nightmare stories. They seek an environment where they can broadcast their pain and suffering. Technology now offers them a doctor's waiting room in the cloud. The online health forum, where an audience of thousands awaits, is tailor-made for the chronic complainer and, worse, the truly mentally ill.

The treatment of Lyme is actually quite easy and effective, if caught early enough—three to four weeks of the antibiotic doxycycline usually takes care of it. Only a small percentage of unlucky patients experience continuing problems. But it is precisely this minority that tends to dominate the forums.

Attention is what they seek, and technology is there to facilitate.

Take the website MDJunction.​com—“Online Support Groups for Your Health Challenges”—which describes itself as “
an active center for Online Support Groups, a place where thousands meet every day to discuss their feelings, questions, and hopes with like minded friends.”

Participation in a community has been shown to encourage health and longevity and altruism is a known upside of online social interaction. So it's fitting that support and encouragement are the mandates and stated purposes of MDJunction, which claims on its homepage to have had more than 16 million visitors in its first eight years of operation. The site offers eight hundred different support groups where the ailing find their homologous counterparts—sufferers of lupus, rheumatoid arthritis, fibromyalgia, cirrhosis, Crohn's disease, various mood disorders, and many other maladies.

Not long ago, it would have been inconceivable—not to mention logistically impossible—to gather so many sufferers of elusive and complex illnesses in one place, particularly given the statistical rarity of some disorders, or connect them in real time. MDJunction does just that, offering a place for individuals to meet, gather tips on nutrition and diet, as well as share treatment advice. In an “off-topic” lounge, participants can tell jokes and let off steam.