Indeed, like alcoholics with favorite drinking buddies, Internet
addicts form close bonds that fuel their compulsions. Dan, a college
student, earned a 3.2 grade point average his freshman year. Then he
moved in with roommates who played an interactive Multi User Dungeon
computer game as a team from separate computers, and soon began logging
on 50 to 60 hours a week. Dan's grade point average nose-dived to 1.6.
His fiancee began to complain that he spent too much time with his
computer friends; they, in turn, griped when he signed off to spend time
with her. Faced with the reality that he might not graduate or get
married, Dan tried to cut back, a goal that grew easier after his
roommates graduated. A year later, his use was down to 1.0 hours per
week. "I still get high on the Internet," he admits, "but I'm in
control."
Get high? Internet addiction? Time was when the word "addiction"
referred to drug and alcohol problems -- period. Today, so-called
addictions are everywhere: sex, exercise, work, chocolate, TV, shopping,
and now the Internet. Have we been, well, abusing the word?
An Addiction? Really?
"Addiction," notes Young, "is a layman's term, not a clinical one."
In fact, the DSM-IV doesn't even mention the word. Young chose the label
"Internet addiction" because it's readily understandable by the public.
When writing for clinical journals, however, she refers to "pathological
Internet use," modeling the term after that for pathological gambling in
the DSM-IV.
Other experts shun the term addiction altogether because it means
too many things to too many people. "It's a sloppy word," says
pharmacologist Carlton Erickson, Ph.D., head of the Addiction Science
Research and Education Center at the University of Texas at Austin. In
the drug abuse field, he notes, "dependence" has replaced "addiction".
"In dependence, people can't stop because they have developed a brain
chemistry that does not allow them to stop," explains Erickson. Excessive
behavior that hasn't quite reached full-fledged dependency, meanwhile, is
called "abuse". If Internet abusers cannot stop for a month, suggests
Erickson, then "Internet dependence" would be the appropriate term.
Others believe that the problem is best described as a compulsion,
suggesting the phrase "compulsive Internet use". And many psychologists
question whether excessive Internet use should be pathologized at all:
John Grohol, Ph.D., who directs the Web site "Mental Health Net," says
that by the same logic, bookworms should be diagnosed with "book
addiction disorder".
Perhaps the controversy will be definitively resolved when
researchers determine whether behaviors like pathological gambling or
Internet addiction produce chemical changes in the brain similar to those
found in drug abusers. In the meantime, Young believes that the often
severe personal consequences of Internet addiction justify popular use of
the term. "Internet addiction does not cause the same physical problems
as other addictions," she says, "but the social problems parallel those
of established addictions."
Treatments for Internet addiction are beginning to emerge. Trouble
is, not all mental health specialists recognize the problem or know how
to treat it. Internet dependents have been told by uninformed therapists
to simply "turn off the computer." That's like telling a heroin addict to
just say no to drugs -- and just as unsuccessful. What's more, HMOs and
insurance companies do not pay for Internet addiction therapy because
it's not recognized by the DSM-IV.
Among those developing treatments for the problem is Maressa Hecht
Orzack, Ph.D., a psychologist at Harvard University's McLean Hospital in
Belmont, Massachusetts. Orzack founded Harvard's Computer Addiction
Services in Fall 1996, after seeing first hand the fallout from
Intemet-related problems: divorce, child neglect, job termination, debt,
flunking out of school, legal trouble. One client, she says, had
separated from his wife but couldn't afford to move out because he spent
so much money on computer services. He moved his bed into the computer
room and started an affair with an on-line sweetheart.
A cognitive therapist, Orzack likens Internet addiction to such
impulse control disorders as pathological gambling and kleptomania.
However, "gamblers have a choice to gamble or not," she notes. "People
addicted to the Internet often do not have that choice, since so many
activities require people to use a computer."
Like Binge-Eating
So the best approach for excessive Internet use, Orzack believes,
will be to treat it like binge eating, where the individual frequently
engages in the activity to be restricted. She treats both by teaching
clients how to set limits, balance activities, and schedule time, without
having to go cold turkey. "People often change in six or eight sessions,"
she says.
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