Internet addiction – Epidemic or fad?

By Adi Jaffe, Ph.D., and Yalda Uhls, MA, MBA

1 in 3 people consider the Internet to be as important as air, water, food and shelter. Given how intensely people feel about this technology, is it any wonder that some psychologists are convinced that Internet addiction is a real pathology?  True, claiming that people are as dependent on the Internet as they are on air, food, or water is obviously a non-starter; it’s pretty clear that the actual role of technology is far less compulsory in terms of human survival.

But does this kind of dependence, compulsory or otherwise, qualify as an addiction?

While the DSM only currently recognizes specific dependence on substances as an addiction, it is apparent that a subset of people who overuse the Internet and digital media tools also display behaviors exhibited by substance abusers.  In the last decade, as the problem became more widely acknowledged, a few psychological measures have been developed to identify Internet addiction. While none of these are perfect, certain measures are becoming more accepted in the field (like Young’s Internet Addiction Test).  Using these scales, studies have identified correlates of Internet addiction and found that ADHD, depression, social phobia and hostility were all linked to excessive Internet use, a pattern reminiscent of correlates of alcohol and drug addictions as well.

The internet is just a tool, why should people who overuse it be considered addicts?

Some of the most compelling evidence comes from Asia.  In Korea, a country where technology is deeply enmeshed in the culture and Internet cafes abound, Internet addiction is considered one of the country’s most serious problems.  In the last decade, many people have died after marathon sessions of playing online video games, presumably from exhaustion and lack of nutrition, as they ignored their basic needs so they could continue to play a game. It’s a bit reminiscent of animal studies in which rats with electrodes implanted in their dopamine “pleasure centers” forgo food for lever presses to their own demise.  China has struggled with similar issues and in 2007 the country restricted game use to less than three hours a day (it’s important to note that there’s some loose consensus that more than 38 hours of recreational internet use a week is problematic).  In Korea, where they may be ahead of the curve in terms of dealing with the issue, more than 1,000 counselors have been trained in the treatment of Internet addiction and nearly 200 hospitals enlisted in the effort.  Moreover, preventive measures were recently introduced in schools and free Internet rescue camps are offered throughout the country.

In America, current estimates are that a child between the ages of 8-18 uses digital media nearly eight hours a day, while extreme users spend up to 12 hours a day with media, every day of the week.  Children are spending more time with screens than with their parents or at school; are we doing enough to protect vulnerable children from developing an addiction to the Internet?  No laws currently exist to protect children from excessive internet use. Doesn’t society have a responsibility to protect children, in the way we attempt to protect them from drugs and alcohol? If so, what would such protection look like and how would it be enforced?

You might be asking yourself whether people are actually addicted to the Internet itself or whether the Internet is simply a tool where other more basic pathologies, such as poor impulse control or social phobias, or fetishes are played out?

In the case of certain online behaviors, it may be simple to define the behavior as problematic because similar behavior offline has long been established as socially unacceptable when performed to excess.  For example, well established addictive behaviors such as gambling or sexual activity are easily played out online.   Even respected public leaders such as former congressman Anthony Weiner admit they have problems that are beyond their own control and that they need professional treatment.  In case you haven’t heard about Weiner, he was the Congressman who resigned after being exposed for texting sexually explicit photos of himself to constituents he had never met. Sounds like something an ignorant teenager might do right?  So when does this kind of behavior cross the threshold to compulsion or addiction when performed repeatedly?

Examples such as Weiners’ may be relatively easy to identify as a problematic compulsion but when online behavior is sanctioned by society as in the case of sending non-sexual texts, emails, or surfing the Internet for hours on end, it is more difficult to determine exactly when the line between normal and dysfunctional is crossed. Indeed, when one considers the “crackberry” nickname given to certain smart phones, a direct comparison to addiction seems relevant. Nevertheless, those who constantly check emails at the dinner table, on vacations, and while driving, are often extremely successful executives whose business culture demands this level of connectedness.  Indeed, some schools even promote the use of digital media as an exciting learning tool; for example, the curriculum for one elementary school in New York is designed entirely around video games. Given the potential for harmful behavior, how do we reconcile overuse of the Internet when our culture often validates and supports its use?

With all of these difficult issues still to be resolved, the answer to the question of whether or not Internet addiction is the same as substance abuse is obviously not yet, and may never be, crystal clear.  However, according to everything we know right now, there’s no question that for at least a subset of Internet users, online life can become disruptive to normal functioning. The question is how to minimize that sort of risk as our society becomes more and more globally dependent on technology.

If you think you might have a problem with the Internet, ask yourself the following questions – if you answer yes to more than 5 of these problems, you may need to seek treatment.

1. Do you often feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop your Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of your involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

As with other compulsive or addictive behavioral patterns, the key to combating internet-addiction-like symptoms is to intervene early. Since many addicts start out using their respective drug/behavior of choice as a coping mechanism, realizing early on that unhealthy patterns of behavior are developing is crucial. If a child draws his or her self-esteem from retreat into the online world, it would be extremely helpful to find additional activities that could similarly boost confidence. If compulsive use patterns do develop, it is likely going to take a concerted effort to break them without bringing up serious resistance. Techniques such as Motivational Interviewing (MI) will likely prove as useful in this domain as they have with substance abuse and addiction – gentle guidance is often more effective than cornering a troubled individual and forcing them to act.

The good news? Internet withdrawal is not likely to cause much in terms of physiological withdrawal symptoms, so if cutting off access does become necessary, at least there’s no risk of going into shock, cardiac arrest, or DT-like symptoms. Still, expect that psychological withdrawal-like symptoms will be similar to those experienced with many drugs: Depression, anhedonia, anxiety, irritableness, sleep disturbances, and more are all likely to be part of the picture. If we’re talking about cutting off a child, expect screaming… lot’s of screaming.

 

For more information about technology and its effects on human development, visit Yalda T. Uhls’ website:  Inthedigitalage.com

 

Citations:

Cisco Survey on Internet, 2011: http://www.cisco.com/en/US/netsol/ns1120/index.html

American Psychiatric Association. (2008). Issues for DSM-V: Internet addiction.

Byun, S., Ruffini, C. R., Mills, J. E., Douglas, A. C., Niang, M., Stephchenkova, S., Lee, S. K., et al. (2009). Internet addiction: Metasynthesis of 1996-2006 quantitative research. Cyberpsychology and Behavior, 12(2), 203-207.

Christakis, D. A. (2010). Internet addiction: A 21st century epidemic? BMC Medicine, 8.

Young, K.S. (1998). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior 1:237-244.

Pathological Gambling – Is it an addiction?

Michael Campos, Ph.D.

In the past few decades gambling has become an increasingly available and socially acceptable activity; however, some individuals who gamble do so in a way that results in severe and wide-ranging negative consequences. Although the majority of individuals who gamble do so without experiencing problems, many people have themselves suffered, or know friends and family members who have suffered dire personal, financial, and social consequences as a result of their gambling behavior. Continue reading “Pathological Gambling – Is it an addiction?”

Tips for consistent boundaries and better addiction outcomes

People close to addicts (mothers, wives, brothers, and such) often find themselves struggling when trying to decide how to treat the substance abuser. They feel betrayed when the addictive behavior is displayed, but are lost when it comes to what they can do. For example, a mother with an alcoholic husband may feel that it’s unfair to withhold a father’s love from her child, even if he did get drunk when he promised he would not. She doesn’t want to punish her boy for his father’s behavior.

Consistent boundaries are important for the substance abuser

When teaching people how to behave, one of the worse things to do is to provide inconsistent feedback. It’s true for babies, hell, it’s true for dogs, and it’s certainly true for addicts. The basic principles of learning research tell us that rewarding good behavior while not rewarding (or even punishing) bad behavior is the best method to affect change. Being inconsistent will make the substance abuser more likely to repeat their offensive behavior than rewarding them for it all the time! It’s called a random reinforcement schedule and is the best method to teach a simple behavior and the hardest one to unlearn. Even mice in an experiment are more likely to repeat an action if they know that they’ll get rewarded for it once in a while and can’t predict when that reward will come. Consistent boundaries let people know what to expect in return for their actions.

Tips for better addiction outcomes

So before you go any further, decide on what behaviors you want to reinforce and make them clear – Not going to happy hour with coworkers, not hanging out with that friend who always ends up mysteriously getting some coke, or any other such behavior that seems to keep creeping up in your particular situation. Then make sure that you have a little list of “rewards” – they can be as simple as quality time with the kid, a nice dinner, or spending money for your kid. By having the list ahead of time, it’ll be easier to stay consistent, knowing what to withhold and what to use as rewards (depending on the behavior).

Addicts should never be rewarded with things they want after failing to deliver on their promises of staying clean. No matter the manipulation, the rules must stand. I’m not necessarily a big supporter of punishment, since it can often put additional stress on a relationship, but rewarding bad behavior should not be an option. This way, the hope is that the substance abuser will change their behavior even if their own willingness to change isn’t quite there, out of their need for the rewards that are being withheld. Slowly, they should begin producing more of the desired sort of behaviors.

This isn’t exactly like tough love (which normally includes punishment), but it’s not far from it either. Obviously, this falls under the category of “easier said than done.” Still, as difficult as it may be, as in raising a child, changing the behavior of a substance abuser requires consistency and perseverance. If a good dose of basic training can help, I say why not give it a try, even if it feels a little bit like training your favorite pet.

Good luck!

The misunderstanding of addiction neuroscience

I just read a comment on another blogger’s post about the neuroscience of sex addiction. The commenter just couldn’t understand why an addict’s behavior could be rationalized by neuroscience when so many other people have little problem, even when exposed to sex, drugs, or whatnot.

It seems simple to me, but I’ve been doing research on this stuff for almost ten years (not including my own time out there using). I want to try this analogy on you and hear what you have to say:

We’re all used to people speaking different languages. We think nothing of the fact that another person can make sounds that mean nothing to us but yet seem to mean so much to others who understand. Our brains are quite the same. People look a lot alike, but small changes in brain structure -through genetics or exposure- can lead to some very significant changes in actual behavior.Our brains all speak slightly different languages.

To me, this makes complete sense, but I’d love to get an idea of what others out there think. For more reading on how our brains differ, check out other AllAboutAddiction posts.

Also, check out this video lecture (it’s long) on the neuroscience of emotions:

What does it mean to be love addicted? Sex addiction explained.

What do you think of when you hear the words “sex addict“? Do you imagine someone who has sex dozens of times a day? Someone who owns a lot of sex toys? Someone who spends all their time immersed in pornography?

While all of these scenarios, and others, can identify someone with a sexual addiction, the crucial part of identifying an addict has to do with the consequences of the behavior and the person’s inability to control them. That being said, sex addiction is a relatively recent idea. In fact, it’s sometimes called love addiction instead.

So what is sex addiction?

A sexual addict experiences the same type of uncontrollable compulsions that others feel in different forms of addiction (like substance, alcohol, gambling, shopping, etc). In his book (Out of the Shadow: Understanding Sexual Addiction) Carnes talks about the compulsive sexual behavior as guiding a misperception of the self.

In simple words: Sex addicts’ view of themselves depends on their relationship with sexual behavior. Since they often find themselves unable to control the behavior, they often have trouble with their self-image.

What is sex addiction NOT?

Let us look at some of the NOTS of sexual addiction. Sex addicts are not people who are just hypersexual and get satisfied with their sexual behaviors; rather, they are often not satisfied with the sexual activities that they engage in. Sex addicts are not necessarily Casanovas, but are often normal functioning people who find themselves having to hide their compulsive sexual urges.

While some sex addicts do pay for sex, others are compulsive about watching porn and others simply struggle with monogamy. The point is, the stigma of sex addicts as predatory child molesters needs to be put to rest.

How common is sex addiction?

Sex addiction is a major problem in our society. Some estimate that as many as 15 million people in the U.S. are sexual addicts (roughly 8% of all men and 3% of women). Easy access to porn offered by the internet has most likely increased the prevalence of sexual addiction in the past decade. In fact, for most people getting porn addiction help specifically is the problem.

The costs for those suffering from sex addiction are also numerous: Relationships and families are disrupted and destroyed, the addict’s self-esteem diminishes as they are unable to be productive in other areas of their life; illegal activity (like prostitution) ends up causing arrests, and health is often affected through the contraction of diseases.

Am I a sex addict?

Now, don’t immediately assume that you are a sex addict because you fantasize about sex a lot. But how does one know if they are addicted to sex?

The simple rule is: no impairment, no addiction.Sex addiction

On the other hand, if day to day functioning is affected by the behavior (in this case, something sexual), this may be an indication of a problem. So, whether it be having sex often, thinking of sex, or even just being extremely horny, if it’s making a person’s daily activities or relationships dysfunctional and if they are unable to control their behavior they may be defined as a sex addict.

In future posts we will look more into the symptoms, forms, theories, and treatments related to sex addiction. In the mean-time, keep reading, and if you feel brave enough, share your story; who knows, you may be able to help someone else who is love addicted!!!

Sex addiction help from All About Addiction

If you need help finding treatment for your own, or a loved one’s sex addiction, make sure to give our Rehab-Finder a try: It’s the only evidence-based, scientifically created, tool for finding rehab anywhere in the United States!