Sex and the Single Psychologist

Should Dr. Al Cooper's fuzzy data and controversial subject stop him from becoming a media darling -- or getting a date?

In March 2000, Dr. Alvin Cooper, a clinical psychologist and an expert on the obviously marketable subject of sex and the Internet, made an appearance on The O'Reilly Factor. During the conversation, the host took an almost flippant tone with Cooper, who was on the show to talk about research he had conducted on the subject of cybersexuality.

O'Reilly told Cooper, who lives in Santa Clara and founded the San Jose Marital and Sexuality Centre, that he had never looked at Internet porn ("I don't know if I want to give my credit card to some guy named Monty with a -- you know, a raincoat on," O'Reilly said); the host also mentioned that it has "been documented many, many times" that organized crime is behind pornography on the Web.

While O'Reilly riffed aimlessly and carelessly on the subject, Cooper struggled to maintain his point. Finally, toward the end of the short segment, Cooper was able to elaborate on his findings, noting that some people can become cybersex "addicts."

Santa Clara's Dr. Alvin Cooper has been dubbed the 
"Masters and Johnson of cybersex."
Paolo Vescia
Santa Clara's Dr. Alvin Cooper has been dubbed the "Masters and Johnson of cybersex."
Sex therapist Dr. Marty Klein is a vocal critic of 
Cooper's "sexual addiction" model.
Paolo Vescia
Sex therapist Dr. Marty Klein is a vocal critic of Cooper's "sexual addiction" model.
The good doctor during a taping of Sex With Cindy 
Photo courtesy of Dr. Cooper
The good doctor during a taping of Sex With Cindy Crawford.
Cooper is an avid Internet dater.
Paolo Vescia
Cooper is an avid Internet dater.

"And people know [that they're addicted]," interjected O'Reilly, embodying, for a moment, all the ignorance that Cooper has struggled against in his career. "I mean, they know in their heart what's going on here."

"I don't think people do know," said Cooper, a compact man with dark eyes and hair and the nasally intonation of his native New York. "I think education about these issues is really important. People do all kinds of things that they don't realize might be illegal, might be dangerous, might make them lose their job."

"OK, doctor," O'Reilly interrupted. "We appreciate it. ... And coming up next, how Tom Cruise used the media to be a big superstar."

The exchange with O'Reilly, brief as it was, embodies Cooper's dilemma. The doctor clearly wants to help people recognize what appears to be a genuine problem -- being compelled to turn to the Internet for sex, over and over, without the power to stop -- but he has trouble getting past the snicker factor. It doesn't help that he's pursuing his education campaign via high-profile media soundbites like those he provided on The O'Reilly Factor. And Cooper rarely gets a chance to explain that his own data is based on an anecdotal, rather than a scientific, research method -- and that, though he's respected in his field, some fellow scientists aren't even sure there is such a thing as "cybersex addiction" in the first place. But it's all just publicity in the end -- for the issue, and for the avid Internet dater Dr. Cooper.

Cooper's office at the San Jose Marital and Sexuality Centre is spacious and sunny. A pastel floral couch rests at one end of the room, amid a semicircle of blue chairs. On his bookshelves, laden with texts on sex therapy and marriage counseling, Cooper has placed a number of "sex-themed" tchotchkes -- a penis gourd from Australia; a statuette of Priapus, the Greek god of fertility -- that he picked up during his travels around the world.

It's from this office that Cooper, a regular on the professional psychology lecture circuit, counsels patients or runs group therapy sessions. At the deep wooden desk pushed against one of the office walls, he often fields press calls from the major news outlets, which contact him for quotes on all things related to sex on the Internet.

In the resulting newspaper articles and television appearances, Cooper has publicly weighed in on topics ranging from Internet child pornography to women and online erotica. A local paper even dubbed Cooper the "Masters and Johnson of cybersex," a title he clearly relishes.

Over the years, Cooper has earned the regard of many in his field, especially for his work as a clinician. "Dr. Cooper has done a lot of the seminal research in the area [of Internet sexuality]," attests Dr. Mark Schwartz, clinical co-director of a Masters and Johnson clinic in Missouri. "I would certainly say he's the leader in the field right now. Most of us use his clinical techniques and data to get sex addicts under control."

Numerous experts see Cooper's work as groundbreaking -- he was among the first to write, research, and lecture about cybersexuality. Cooper also edited Sex & the Internet: A Guidebook for Clinicians, the first professional book on the topic, published in 2000 (he's now working on an update). His research is being referenced by a group of prominent psychologists attempting to get an iteration of "sexual compulsion" included in a future edition of the Diagnostic and Statistical Manual(DSM), the psychiatrists' bible for mental health disorders. Indeed, Cooper, who has an impressive six-page-long CV, has made a name for himself by being a half-step ahead of the crowd when thinking about how the Internet might affect human sexuality.

But he's perhaps best known for being an expert on "cybersex compulsion," the so-called dark side of Internet sexuality. Many of his media appearances reference the subject, and he often cites research he has conducted through Internet-based surveys on the Web portal Through these studies, Cooper estimates that about 1 percent of American Internet users -- or more than 200,000 people -- are compulsives who have a serious problem with cybersex, and about 8 to 14 percent of Internet users are "at risk" for becoming compulsive users. He says his research shows that as much as 17 percent of the U.S. online population -- people who might not have had a problem with their sexual habits before the advent of the Internet -- is similarly at risk. He also estimates that about 25 to 30 percent of his center's patients arrive with computer-related sexuality problems.

While there are undoubtedly people who have lost control of their cybersex habits, Cooper has also managed to make PR hay out of his specialty.

In soundbites for the Chicago Tribune, the Philadelphia Inquirer, and other publications, he has made snappy comments about the problem; in one interview with the Charlotte Observer, he likened the Internet to "the crack cocaine of sexual addiction." And as he warned in the published results of his first Internet-based study in 1998, "This is a hidden public health hazard exploding in part because very few are recognizing it or taking it seriously."

When Cooper uses such language as "crack cocaine" and "exploding," he garners attention -- and opens himself up to criticism. Ask other scientists about Dr. Al Cooper, and it becomes apparent that he is the subject of both adoration and outrage. Though many admire his drive and innovation, critics say Cooper has drawn conclusions about Internet sexuality that remain largely theoretical and unproven. And in using Internet surveys to draw his points, they say, he has left his results open to question.

Even the terms "cybersex compulsion" and "cybersex addiction" are controversial. Since the phrase "sex addict" was coined about two decades ago by an Arizona-based addiction specialist, psychologists have argued about what to call the problem and how to treat it. The debate circles around whether people who have out-of-control sexual habits should be called "sex addicts" or "sexual compulsives," or some other name altogether. Though it may seem like a battle of semantics, experts explain that what the phenomenon is called can affect the type of treatment a patient receives. Cooper's research forms the cybersex branch of this debate.

Despite the questions surrounding the issue itself and the imprecise data Cooper uses, he continues to offer professional seminars and appear on various media outlets warning the public about the worrisome problem. He may be helping Americans confront a serious concern -- but he also appears to be flogging the issue to get the attention he seems to crave.

Even as a preteen, Alvin Cooper showed a propensity for giving advice. As his parents and siblings like to tell it, soon after moving from working-class Queens to the more affluent Long Island during middle school, Cooper, an eager listener, began to be approached by kids from the neighborhood for relationship advice. (Cooper, who says he was always interested in human behavior, remembers these encounters as long conversations with friends who were willing to open up to him about their problems.)

When Cooper was about 17, he insisted on weekly "family meetings," at which the entire Cooper clan would gather to talk candidly for an hour. But sex was not a subject readily broached within Cooper's Jewish family (he says he's "culturally Jewish" but not religious), even during these soul-baring sessions. "We were not that open," his mother says. "If, at 12 or 13, he said he was interested in sex, we would have washed his mouth out with soap. We modernized after a while, but when Al was growing up, it was not discussed that much. It was more something that he brought in. We learned a lot through him."

Cooper's father owned a small glass and mirror business in Brooklyn where Cooper's mother also worked. Cooper's parents, second-generation immigrants who'd grown up during the Depression, labored exceedingly long hours; through their example, Cooper and his siblings adopted the workaholic lifestyle. After earning an A.A. in liberal arts from a local community college, Cooper graduated early from both UC Riverside (where he got a bachelor's degree in psychology) and Texas Tech, where he received a Ph.D. in clinical psychology. Before starting an internship at the VA Medical Center in Palo Alto, he joined a kibbutz halfway between Tel Aviv and Jerusalem for about two months, where he says he impressed (and, as a result, was able to date) some of the locals, particularly with his willingness to take on the hardest tasks, such as working on the chicken farms. Recently, he has taken up Buddhist meditation, tennis, and yoga in an attempt to curb his fixation on work -- but he has still suffered a few injuries from pushing himself too hard during these activities.

It's perhaps not surprising, then, that when he somewhat serendipitously unearthed the subject of cybersexuality, Cooper went full-bore in his research, writing, and media efforts. His days are usually packed from morning to night: professional seminars, back-to-back appointments with patients, exercise, and then more work from home. In 15-minute time blocks, he takes media calls.

In recent months, he has reduced his hours at the Stanford University student health clinic, where he is a popular staff psychologist, and dedicates the time to yet more media calls and research-related endeavors. In addition to promoting himself, his business, and his point of view, Cooper sees such appearances and interviews as opportunities to educate the public on sexuality.

"Supposedly, as a psychologist, you're a thought leader in your world and community and your family," he says. "I can talk to a group of 40 or 100, or I could have something in Cosmo or Men's Health or the Washington Post and have hundreds of thousands of people read it, and open their eyes a little bit."

But there may also be a more personal reason that media work appeals to Cooper. "We all want our family's attention and approval, right?" he confides. "My father ... is really a hands-on kinda guy: He could fix anything. He never really understood what I did. A lot of people don't.

"So for me, I got a kick calling up my father and saying, 'I'm going to be on 20/20 tonight,' so he can kinda see, have something to tell his friends: 'I guess he's doing something out there! He's on TV, he must be doing something!'"

On a Friday morning in early March, Cooper's cybersex addiction seminar has come to San Francisco. About 25 psychologists gather in a nondescript Holiday Inn conference room and munch on bagels and croissants while thumbing through the seminar manual, which cites an impressive number of statistics related to Internet sexuality -- many culled from Cooper's own research.

Cooper stands at the front of the conference room in a neutral-colored suit, fiddling with his PowerPoint presentation. One attendee approaches him excitedly, telling him he's "been seeing more of this kind of stuff." Another psychologist wanders up to say, "I'm referring one of my clients to you because I don't know what I'm doing."

Though Cooper is now an established expert in the field, his entree into researching Internet sexuality began almost accidentally, and was greatly aided by the media. "It was a combination of press and starting to see patients with these issues," he says. "I was starting to recognize that something was happening. At the start, [Internet sexuality] really wasn't taken seriously. It's hard to imagine now. I don't think people could really see how central the Internet was going to be to life and society and culture and business."

In the mid-'90s, Cooper -- who already had a fairly regular presence in the media -- began writing a sexuality column for a self-help and psychology Web site, spawning even more calls from the press. By 1997, he had been invited to pen a sex advice column for Men's Healthmagazine. Writing in a playboyish, jocular tone, he tackled sex-related issues ranging from Prozac as a remedy for premature ejaculation (yes, it is one) to the safety concerns behind penis enlargement (he doesn't recommend it). That same year, Cooper led the first-ever professional session on Internet sexuality at an annual gathering of the California Psychological Association and was asked to guest-edit the American Association of Sex Educators, Counselors, and Therapists' now-defunct Journal of Sex Education and Therapy.

In his advice columns, Cooper showed a natural flair for dispensing helpful and engaging pop psychology. Other press outlets noticed, and reporters began calling him for comments on such subjects as "orgasmofibbing" and Internet dating. Cooper says he enjoyed fielding the calls, and learned that if he wanted to be quoted, he had to come prepared with a whiz-bang soundbite.

By the time his sex and relationship column "Sexploration" debuted on in May 1998, Cooper had established himself as an Internet sexuality expert, and he began receiving more and more questions from reporters relating to the new medium. Typically, he says, he responded with industry-standard conjecture; he was always ready with an opinion. But the questions also made him realize that much of what he told the press was based on educated guesses; there'd been little research done on Internet sexuality.

"There was all kinds of guessing," he says. "In reality, no one knew anything."

Today, there's still a lot to learn. Cooper began his quest for more solid information on Internet sexuality in 1998, when he teamed up with MSNBC to produce a Web survey on cybersexuality. Web users were invited to participate in a 47-point questionnaire through a pop-up window that appeared on-screen. The survey sought to gauge the frequency and type of America's "online sexual activity." Cooper, who initially hoped to tally about 1,000 responses, received 13,505 replies.

Though the study attracted a large number of respondents (one of the widely acknowledged benefits of using the Internet for research), Cooper's critics say his method has a number of flaws. For one thing, the people who responded to the survey volunteered rather than being randomly selected -- a standard of good scientific research -- and thus, they weren't likely to accurately represent a large swath of the Internet-using population. And because Web-based research was so new, there was no way -- and there still isn't -- of ensuring that someone was being honest about his identity and answers.

Cooper, anticipating concerns about his methodology, tried to eliminate responses that would skew his data by dumping duplicate replies and throwing out surveys from people who didn't bother to fill out a significant portion of the questionnaire, among other strategies. He whittled down the responses he considered valid to about 9,000. After analyzing the data, he drew a number of conclusions, including:

More than 90 percent of the people who took the survey didn't have a problem with their Internet sex activities.

About 8.5 percent were at risk for developing cybersex compulsion.

People who spend 11 hours or more per week engaged in online sexual activities (which, according to Cooper's definition, included everything from viewing Internet porn to buying a vibrator online to researching STDs) are more likely to be cybersex compulsives.

Before the numbers were even analyzed, the flood of press calls started. When the research was released, reporters jumped all over the findings, zeroing in on the concept of cybersex addiction. Riding the wave of media and professional attention, Cooper went on to publish journal articles based on his findings.

But given the potential problems with his methodology, Cooper should have emphasized the importance of putting his findings in proper context. The numbers only revealed what was true for a select number of people: those who had Internet access in the United States, who visited MSNBC online, and who chose to participate in an Internet-based study. (MSNBC made a note on its site that the survey was "non-scientific.")

From the outset, Cooper's research results have been questioned. But though he admits that there are potential problems related to his methodology, he defends his work.

"I think there are questions," he says. "There are always benefits and limits to any methodology. In all of our research, we have taken a number of steps to increase our reliability and our confidence in our results."

Some sexuality experts still view Cooper's research with skepticism. "It is no different than when any [media] organization has a little poll on their Web site that says, 'Do you like John Kerry, yes or no?,' and then there's a footnote at the bottom that says the results are nonscientific," says Dr. Donna Hoffman, a professor of marketing at Vanderbilt University and the co-director of eLab, an e-commerce research center. "They're no different than what Cooper is doing."

"Al Cooper is relatively unusual in researching the use of the Internet for sexual purposes," adds Dr. John Bancroft, director of the Kinsey Institute. "This is an important area for study, and he has been a front-runner. [But his] large surveys of Internet users are of limited value because they are convenience samples. My impression is that he is viewed with some interest by the field, but with recognition of the methodological and conceptual limitations of his research so far."

Despite such concerns, Cooper's initial data was deemed significant by many sexuality researchers because it was an early attempt to get a handle on a mysterious, misunderstood world.

"We can't say that Cooper's data is representative of the general public, but [it] clearly shows that some people out there have Web-based sexual behavior problems," says Dr. Doug Epperson, a psychology professor at Iowa State University who is heading a large-scale study on sexual compulsivity. "His data is quite compelling in that it indicates people have problems; what is less compelling [from the data] is what percent of the population has that problem."

Even with their statistical fuzziness, articles based on that first Internet survey have been published in peer-reviewed journals. In that respect, Cooper is responsible for turning attention to an aspect of sexuality that had, until that point, been largely ignored by clinicians and psychology and sexuality academics.

"Before many of us did, he realized that the computer was going to have an extremely important impact on people's lives," says Dr. Howard Ruppel of the San Francisco-based Institute for Advanced Study of Human Sexuality. "His work shows -- and he was there before all of us -- about the downside: people who do become obsessively preoccupied with the Internet. [Cooper's ideas] were revelatory."

Cooper continued to work on the issue and produced a number of uncontroversial theoretical and clinical materials. He edited the first professional book on the subject, Sex & the Internet: A Guidebook for Clinicians, which therapists across the country say they have found useful.

Undeterred by the criticism elicited by his first foray into Internet surveys, Cooper has continued to conduct new ones with MSNBC and with a popular Swedish Web site. The later studies have produced more nuanced findings, he says. For example, they acknowledge that someone who engages in 11 or more hours of online sexual activity related to health education is not a cybersex compulsive. But overall, he says, the newer results have corroborated his first MSNBC study.

Though his cybersex-positive messages don't always make the airwaves, Cooper says he continues to work with reporters because he sees it as his responsibility as a mental health professional.

"Clearly, education is one reason [for the media work]," Cooper says. "As a psychologist, you're supposed to be helping people, and I can either help one person in my office or I can help a million people [through the press]. It's a different kind of help, but they're both helpful."

"He's tried to talk about [Internet sexuality] in a way that is ... catchy but not titillating," adds Cooper's ex-wife, Georgie Keyssner, who watched as his career blossomed in the late '90s after the MSNBC survey (they were amicably divorced in 2001). "If you don't get a soundbite out of it, then you're not heard. He's not promoting it; he wants to discuss it, to make people aware that there are issues around it."

At precisely 8:30 a.m., the always-punctual Cooper steps to the front of the San Francisco hotel conference room. He starts his presentation by acknowledging the white elephant in the room -- the long-standing professional disagreement over the problem he'll spend the day discussing.

"I'll be using the terms 'online sexual compulsivity' and 'sexual acting out,'" he tells the audience. "As this field develops, it's important to develop a consistent lexicon. ... There are debates about names and definitions in the field that are beyond the scope of what we're talking about today."

Then he plugs his book. "And if you buy it today, we'll throw in a blender," he jokes.

Throughout his speech, he avoids using the word "addiction," though he does reference the work and treatment philosophy of Dr. Patrick Carnes, the controversial figure who coined the term "sex addiction" in the 1980s. The seminar itself is titled "Cybersex Addictions: How to Identify and Treat the Affects of Aberrant Online Sexual Pursuits."

"I'm mixed about [the debate]," Cooper tells me later. "I think people kind of have an association with 'sex addiction,' but I don't think it's that accurate and I think it's a little simplistic. So, in professional meetings I usually say that. If I do an interview and they want to use the term 'sexual addiction,' I may make a comment about it, but I'm willing to do it because, I mean ... I know they're not going to take 300 words to explain the finer point."

Cooper, like many others in the field, prefers the term "sexual compulsivity." "A compulsion is more that you're driven by psychological needs, not a physiological dependence on it," Cooper says. "For me, I have a position, I believe in my position, it's the most informed position that I can have."

Certainly, the debate runs deep within the professional community, and Cooper is by no means considered an extremist on the subject. "[Professionals in the field] can't seem to arrive at a consensus as to what to call this clinical syndrome," says Dr. Eli Coleman, director of the human sexuality program at the University of Minnesota Medical School and a past president of the Society for the Scientific Study of Sexuality. "There is a problem with excessive and compulsive and impulsive sexual behavior. But 'sexual addiction' is a term that has caught on mostly in the media, and has not been greeted very well in the scientific community or the psychiatric community. The dangers are in oversimplifying a complex phenomenon. 'Sex addiction' is an unfortunate and imprecise term which can be very misleading to understanding the source of the problem, and can create a potential misdirection of treatment."

Still others warn that the concept of addictive sexual behavior -- regardless of whether it's called an "addiction" or a "compulsion" -- is a sex-negative perspective. The actual level of sexual danger has been inflated in the media, in response to the work of people like Carnes and Cooper.

"My issue with 'sex addiction' is that it pathologizes what, in many cases, are perfectly valid and helpful activities," says Dr. Marty Klein, an outspoken Palo Alto-based opponent of the sex addiction model who publishes frequently on sexuality. "And when it does address activities that are not healthy, it does it in a way that is based on certain assumptions about sexuality that I don't think are helpful.

"That people are more involved in the Internet and sexuality than they like to be is an important thing to talk about," he goes on. "But Dr. Cooper describes online sexual activity to include a lot of things that, if they were not done online, they would not be considered sexual. ... He has expanded the category so broadly that it inflates the number of people who are involved, sexually, on the Internet. It obscures the actual phenomenon of people who are involved in Internet sexuality in a problematic way."

Cooper, however, believes the issue is significant, and he says it merits the attention it's getting. "I think it's a big problem," he says. "We see it all over. It's a big problem for society and I don't think we're inflating it at all. ... We hear it from clinicians all over the country, we see it in the media, we see it in the Centre, we see it from our research."

There are many who agree with him. His data is now being referenced by about 20 psychologists and scientists who are conducting a large-scale study that may lead to the inclusion of "sexual compulsivity/addiction" in the next edition of the Diagnostic and Statistical Manual(DSM-V). (They are not an official working group for the publication.) The members of this group, which includes people with varying opinions on the terminology debate, have read Cooper's articles; their study will look at four different populations: a sample group representative of the American population as a whole; a group consisting of people receiving treatment for "out-of-control sexual behavior"; another group consisting of people receiving therapy for non-sex-related primary psychiatric problems; and a group made up of incarcerated sex offenders. These randomly selected individuals will respond to a test-piloted survey in order to help researchers better understand the issue and to clarify the phenomenon's defining clinical signs and symptoms.

"The main controversy around [trying to include 'sexual compulsivity/addiction' in the DSM] is that some people in the scientific community would probably argue that there isn't good empirical data to demonstrate that this is a disorder," says Iowa State's Epperson, who is heading the study. "The purpose of this large-scale study is to answer that question."

According to Cooper, Internet dating is among the strongest examples of positive Internet sexuality. This he knows from personal experience.

Since his divorce three years ago, Cooper -- who says he is ultimately a romantic at heart -- has focused much of his attention on finding "the one." Though he frequently goes on dates with women he's met over the Internet, Cooper continues to look for a mate on Web portals like (ladies, he wants you to know that his Internet handle is ADOCFORYOU). Unsurprisingly, he brings his unyielding intensity to this search.

"I'm determined," he says. "This is one of my major focuses in my life. It is. It's a major focus."

He has consulted with friends to craft his dating profile, which starts with an unattributed quote: "Love is like the tide; you need not fear for it will always come." Next, he tells prospective dates (the bad punctuation is his): "I am a PhD, not a RD :) A Psychologist to be exact. This next part is a bit awkward but if I dont tell you about me, who will :) My personality and profession combine to make me fairly atypical; particularly for a Silicon Valley guy. Y'see I am self aware, comfortable talking about my feelings and I want a partner also able to verbalize her needs and explore our relationship. ... I can be intense, and I have a hunger to fully experience, and be present in, my life."

In the past few years, he says, he has had great success with Internet dating, and he claims to have met about 100 women online. (He's not an expert in cybersexuality for nothing.)

"I'm interested in a family, settling down again," he tells me one evening over dinner. "I hope that will entail love. I'm definitely looking for a wife.

"Is this story going to help me?"

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