Trapped on the Web: Internet Addiction Disorder
For some, the Internet has become a full-blown addiction. Can it be treated?
It's an understatement to say that the Internet has changed the way we communicate. We turn to our computers in search of information, and e-mail friends rather than pick up the phone. Some of us shop over the Internet while others spend hours reading messages in a Usenet group, playing cards online, or even looking for romance. If you click around long enough, you might also stumble across the Internet Addiction Quiz or the web site of Internet Anonymous, sites that spoof the compelling desire that many of us feel for the new forms of communication available on the Internet.
A Result of Computerized Life
A 12-step program for Internet addiction may sound amusing, but a number of psychologists and other medical specialists have claimed that certain people really are at risk for computer overuse.
Dr. Ivan Goldberg, a New York City psychiatrist, has coined a term for this problem, calling it Internet addiction disorder. He claims that victims of this disorder are growing as our culture becomes more and more dependent on the computer, not only through work that is ever more computer focused, but also through socializing that is increasingly computer mediated.
Priscilla C., in fact, met her current boyfriend through an online card game in a chat room. "I'm not sure how you get attracted to someone over the computer, but that's how our relationship started," she said.
John D., a computer technician, also spends many hours online playing computer games at work and chatting with various people through a number of listservs. "In my role as tech support, there's a lot of downtime when we're just waiting for someone to call for help. Having the computer around really helps with those slow moments." While neither Priscilla nor John has a problem, both use the computer to supplement face-to-face relationships rather than replace them. There are others who use the computer to avoid real human contact or pressing responsibilities.
When the Computer Takes Control
Dr. Maressa Hecht Orzack, PhD, founded the Computer Addiction Services at McLean Hospital in Belmont, Massachusetts. She became concerned after discussing the issue with colleagues who were treating more and more patients with complaints that involved computers, mothers who played computer games rather than caring for their children, unproductive employees, or seriously depressed adolescents who used the computer to find friends rather than risk interactions with real peers.
Orzack uses the various terms computer addiction, internet addictive disorder, or cyberaddiction to label abuses that can range from overuse of computer games, excessive monitoring of pornography sites, or simply staying online with little regard for the time. In fact, the Internet and its ability to connect us with others in a simulated environment seem to have a mysterious hold on many of us.
Leaving Yourself Behind
"People like the instant connection the Internet can offer them," Orzack explains, "and people who are lonely and have low self-esteem may very well want to be hidden by the 'Net. During interviews people often tell me that they fantasize about the Internet as a place where they belong, where they can find romance, or have a new identity."
Defining Computer Addiction
Computer addiction covers a wide category of abuses and the symptoms can also vary, combining both psychological and physical dimensions or perhaps manifesting in only one area. The following are the characteristics that Orzack uses to help define computer addiction in her practice at McLean:
- A sense of well-being at the computer and/or a sense of depression or emptiness when not at the computer
- Craving more and more time at the computer and an inability to control computer time
- Problems with job or school because of the time spent at the computer
- A lack of honesty about how much time is spent on the computer
- Ignoring family and friends
A Compound Problem
Internet addiction disorder is often linked with depression or attention deficit disorder, and many individuals are seeking help for another condition when they are diagnosed. Dr. Kimberly Young, executive director at the Center for On-Line Addiction has been studying the phenomenon since 1994, and reports that a previous addiction or emotional problem is often evident with people that suffer from computer over-usage, with about 50% having a prior history of compulsive behavior. "The number of people I've talked with is easily in the thousands; the demographic mix includes men and women (slightly higher in women) in low-tech careers or non-careers, with those in middle age more at risk."
Treating the Addiction
As with any addictive pattern, Dr. Orzack stresses that patients have the ability to control their own behavior if they so desire. "If a patient wants to change," she says, "they will, and my job is to help them to see the parts of their behaviors that they are willing to change."
Moderation, Control and Time Management
Young uses a program that is similar to that used with food addiction, stressing moderation and controlled use as a form of primary treatment. She also suggests using time management strategies to help them discontinue their abuse, or software-based solutions to modify behavior. Says Young, "I've also recommended spiritual healing, such as the 12-step program used by Alcoholics Anonymous or pastoral counseling."
The evaluation methods at McLean include standard measures for stress, impulse control and anxiety, and depression, as well as parameters designed specially to measure computer addiction. Orzack's preferred treatment is cognitive behavior therapy, a therapeutic method that allows the patient himself to identify the problem, take an active role in determining the solutions, and relearn skills to prevent a return to bad habits.
In fact, Orzack had her own personal experience with a case of computer overuse when she noticed she was spending too much time on computer solitaire and as a result, neglecting meetings and staying up too late. "I treated myself by asking 'what is it that I really want to do here?' and then making some modifications to my behavior. To address my excessive card-playing, I decided to play to time rather than to play to win, a strategy I also offer to my patients as a way to regulate their own time online."
The Center for Online Addiction
Computer Addiction Services at McLean Hospital
Last reviewed November 2007 by Theodor B. Rais, MD
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