The ongoing controversy over internet addiction disorder.
By Federica Valabrega–Culture11.com
It was a cold Thanksgiving afternoon when Liz Woolley walked up the stairs of her son’s apartment to find him slumped over the computer’s keyboard with the screen still on. But he wasn’t sleeping. He had shot himself in the head while playing an online game.
Shawn Woolley was 21years old when he committed suicide. An avid gamer all his life, he’d never experienced problems with his hobby. But in 1999, he picked up his first copy of Everquest, a massive, multiplayer game which puts players in the midst of a sprawling open-ended online world. What started as a way to pass the time quickly became a debilitating obsession. After just four months the game had become his “drug of choice.” He started having moods swings and difficulty with social interactions. During his older brother’s wedding, he left early to log on. Most nights, he went without sleep. Eventually, he quit his job and was evicted from his home.
His mother, Liz Woolley, tried to help, encouraging him to find roommates. But he couldn’t tear himself away. He found an apartment by himself and continued his marathon sessions. “He just could not stop playing the game,” Woolley says.
“And then, one day,” she says, “he informed me that he wanted me to support him for the rest of his life while he would continue playing games. He was serious.”
Clearly, something was wrong with Shawn. He had been diagnosed as a depressive with schizoid personality disorder, but his mother believes that an addiction to the online game-world played a part in his death.Shawn’s symptoms can be found in millions of Americans, says Dr. Jerald Block, an adult psychiatrist from Oregon. And, like other addictions, these symptoms may constitute a legitimate psychiatric disorder.
Just how many Americans might be affected is unknown, but Dr. Dave Greenfield, he author of Virtual Addiction and founder of the Center for Internet Behavior, a recovery facility for Internet addicts, estimates that as many as 20 million of the country’s online users can be considered “addicted to the Internet.” He says the addiction takes the form of excessive gaming, over-use of the computer to watch pornography, or compulsive Internet gambling.
Usually, it afflicts people who have had major stress in their lives and feel the need to fill the void left by a marriage gone sour, a difficult job or demanding life-style. They take to the net, where they can drown themselves the pleasure of a wonderland where everything happens just right. “The Internet itself is a giant slot machine when you search for something you don’t know when you gonna find it, how good it’s going to be,” he says. “It’s the same reason somebody will stand in front of the slot machine for 10 hours even if they know they might not win. It’s not a rational way of behaving, but they still do it because the brain loves unpredictable rewards.”
For the addicted, then, the formula is simple: plug in, turn on, get your fix. “It’s the overuse of the technology of the computer or the Internet or cell phones such that it interferes with the major spheres of the person’s life,” Greenfield says. And that, he believes, means the mental health profession must take notice. “It meets the criteria of a solid addiction, which elevates Dopamine levels in the brain like gambling, sex, food, and compulsive shopping.”
Internet addiction disorder (IAD) was first proposed in 1995 as a spoof of the ever-growing list of mental disorders. But despite its satirical origins, some came to view it as a real concern.
A controversy broke out immediately, with tech proponents leading the charge against the classification; as early as 1996, Wired could be found labelingInternet addiction media-hype driven “BS”. Dr. Ivan Goldberg, whose parody sparked the notion in the first place, insisted that the whole thing was a joke gone awry, and no one should pay any attention to it. Yet more than a decade later, the fight continues. And it’s of particular importance now, as the Diagnostic and Statistics Manual of Mental Disorders, the mental health profession’s official guide book to disorders, undergoes its fifth major revision.
In Shawn’s case, his mother believes he would still be alive had doctors been willing to diagnose him as suffering from Internet addiction. “He went to see a therapist, and the doctor told me I should be glad he was not addicted to drugs and alcohol,” They never once recommended that he spend less time online. “I did not know. I thought it was just a game,” says Woolley.
In memory of her son, Woolley founded Online Gamers Anonymous, a virtual support group for gamers in America and Canada. Brad Dorrance has now been game-free for more than 10 months, and he credits Woolley’s organization.
Dorrance started gaming in 1999, right after he got married. His job as a social worker became incredibly demanding, and he found himself looking for an escape, playing up to 80 hours a week. But soon, the game world consumed him. During that time, he says, “There was a lot of lying and deceiving going on. When my wife would go to work in the mornings I would go to a computer store and buy new internal components for the computer, like a new video adapter, a new processor or a new mother board to make it run faster so I could play brand new games.” It wasn’t long before his wife left him, he was on disability leave from his job, and $24,000 in debt.
But, in December of 2002, Dorrance hit the bottom and decided it was time to quit gaming or quit life. “Come December, I found out I was spiraling deeper and deeper into depression, I was having very strong suicidal thoughts. I actually took an overdose of prescription sedatives and for that went to the hospital,” he says. “It was around the third week of January, when I finally just sat staring the screen, I had been playing a bit, right after my visit to the hospital, and I just said I couldn’t do this anymore and logged off.”
Cases like Dorrance’s, however, are extreme and relatively rare. And they don’t resolve the basic question: Shouldspending too much time in front of the screen be categorized as an “addiction” on the same level as compulsive gambling?Clinical psychologist John Grohol argues that it shouldn’t. Writing at PsychCentral.com, he compares it to other hobbies: “Some people also spend too much time reading, watching television, and working, and ignore family, friendships and social activities. But do we have TV addiction disorder, book addiction, and work addiction being suggested as legitimate mental disorders in the same category as schizophrenia and depression? I think not.”
Without that classification, though, doctors lack any systemic approach to treatment. Since the APA still has not created a set of rules to diagnose and cure Internet addiction, Dr. Jerald Block has developed his own way to treat his patients successfully. His favorite idea for recovery is to send his patients to a camp where they would spend all of their time hiking, and doing other outdoors activities — no computer use allowed. “You don’t have to change them,” he says. “You change the system around them.”
But to change the system around the patients, you have to make sure that mental-health experts are all on the same page. That can be accomplished by including online addiction in the Mental Diseases Manual, said Block. That way, he says, psychiatrists “can stop trying to treat the major depression and see that patients have not responded to the treatment because instead it’s major depression complicated by computer use.”
There’s little doubt that the Internet can be abused, and that those with stressful lives and fraught emotional states have taken the tool and turned it against themselves. But the question remains: is such behavior a symptom of other, recognized disorders, or a disease unto itself? And if it isn’t a unique disorder, could labeling it as one lead to the pursuit of trendy therapies at the expense of treating the underlying causes? As the American Psychological Association prepares to release the next edition of its diagnostic manual, those are the questions it will have to decide. But John Grohol, who has maintained for more than a decade that it’s wrong to classify Internet addiction as a disorder, thinks the real issue is with the profession itself. “It’s the tendency of some mental health professionals and researchers to want to label everything they see as potentially harmful with a new diagnostic category. Unfortunately, this causes more harm than it helps people.”
Federica Valabrega is Culture11‘s Marketing Communications Manager.