Is Internet Addiction Really an Addiction?
DeeAnna Merz Nagel
I recently read a blog post by John Grohol of psychcentral.com who often debates whether or not internet addiction is “real.” This is a debate that has existed for a years now and with the next DSM in development, questions arise as to whether internet addiction and cybersex addiction should be included, and if so, what might be the criteria?
What I have found is that it is often a debate of semantics. Is internet addiction real? I think it is real for the people who experience it. I think it is real for the people who describe their lives as out of control due to their compulsive behaviors involving the internet. I think when I client comes to me expressing a desire to change yet is so caught up in the net that they cannot find balance in their lives- well, for that client, I think this internet addiction thing is real. In fact, people actually use those words- “I think I am addicted to the internet.” So as a clinician, how should I respond?
To the client, naturally I validate his or her experience. To the counseling community, I debate what an internet addiction looks like, what the criteria would be for designating someone as abusive or dependent on technology. But really, what is it? Is it an addiction similar to alcohol or drugs? Is it like gambling? If not, what differentiates or sets apart problematic behaviors around the use of technology? For parents, the concerns involve gaming, texting, and sexting on the internet. For partners of loved ones whose behaviors are interfering with the relationship, the concerns are sleepless nights, surfing the web for hours on end, pornography and cyber-affairs.
I am interested in knowing what other counseling professionals think.
How do we help people who are struggling with an “addiction” that does not exist yet manage to validate their experience and support them on their path of healing? How does the client assimilate this ongoing debate that now appears on mainstream television as comedic story lines, documentaries and news?
What are your thoughts?
DeeAnna Merz-Nagel is a clinical counselor, teacher, workshop presenter, sat on the ACA Cyber Technology Taskforce, and is co-founder of the Online Therapy Institute
LOL! Funny you should talk about this! I just posted about this in my blog! Dr. Grohol is how I got my inspiration to write about it too years ago. Read here…
http://padschicago.wordpress.com/2009/09/23/bonus-post-internet-addiction-with-a-twist/
Thanks DeeAnna, this is an important discussion.
One of the problems here, as with discussions about other possible behavioral (non-drug) addictions, is that the DSM contains no definition of addiction, and indeed doesn’t make use of Addiction as a unifying concept. Instead, Substance Dependence, Pathological Gambling, and Bulimia are all to be found in different chapters (Substance-related Disorders, Impulse-control Disorders, and Eating Disorders). This is a serious flaw, not just at a theoretical level, but when it comes to discussing possible diagnoses (such as Internet Addiction) with clients.
I have worked out a thorough definition of addiction (given below for Internet Addiction – the online activities can be replaced by gambling, alcohol use, binge-eating etc depending on the addiction). While I don’t give all this detail to clients, I do explain that we will need to have an agreed view of what we mean by “addiction” in order to assess whether they might have an internet addiction. I then introduce concepts such as Initially Intense Mood-Alteration, Progressive Adaptation, Self-perpetuating Cycle, Unsuccessful Attempts to Control, etc (which can be easily understood by referring to other examples such as heroin addiction). Assessment is therefore a collaborative process, and sometimes an obvious pattern comes into focus, which cries out to be called “Internet Addiction” (what we might call a “text-book case”). Other times, the pattern is less clear; not all client problems fit into an easily definable category.
A Definition of Internet Addiction:
A progressively tolerated and progressively damaging
biopsychosocial adaptation to/dependency on
(and therefore preoccupation/obsession with)
the initially intensely mood-altering, but ultimately only superficially satisfying,
emotional rewards (pleasure, pain-relief or both) provided by
certain artificially-enhanced online activities (and their associated rituals),
which require minimal social investment
(e.g. gambling, gaming, pornography, chat-room cybersex etc),
leading to a self-perpetuating cycle of compulsive behaviors in some of the above areas,
which the addicted person sometimes tries to control, with limited success, when crisis points are reached
(including the crisis of withdrawal, but also in response to serious negative consequences in such areas as health, relationships, finances, employment, legal problems etc),
but which they otherwise resist acknowledging
by using various cognitive-emotional avoidance strategies (distortions/defenses).
Eoin Stephens
I have to agree with Eoin. There are many addictions that fall in the “addiction” category such as eating, gaming, and pornography (which can also be tied into the internet addiction.) However, these addictions do not have a place in the DSM. Just like many of the definitions in the DSM, I think a defining factor is if the problem affects more than one aspect of their daily life.
DeeAnna Merz Nagel’s first point sums it up really: “… it is often a debate of semantics.”; “I think it is real for the people who experience it. I think it is real for the people who describe their lives as out of control, due to their compulsive behaviors”.
I think we can get too caught up in the ‘theory’ sometimes. Theory can often get very complex and you then loose the simple perspective of the individual. You can even loose the simple perspective that sound ‘Theory’ can offer.
The common features of any addiction are simple enough. It usually involves a compulsion to do something which we feel have little control over; it eventually has more disadvantages in our lives than advantages; it affects our relationship with others; and we reach a stage where we need help to extricate ourselves from the compulsion.
Addiction of any kind, like any other problems, is ‘relative’. There are no absolutes. If a problem causes unbearable distress, conflict, breakdown in our social relationships and gets in the way of enjoying our lives, then it is a problem to be solved.
The only proviso I would make, applies equally to all ‘diagnoses’. I avoid the term myself, it is too medical / clinical and inflexible. ‘Features’ is a better concept. Most of people’s problems have a seriously powerful ‘social’ component, usually more challenging than any ‘organic’ condition.
Addiction of any kind does not exist in a psycho-social vacuum. If we focus on the features of the addiction, without considering all the other influencing ‘features’ in a person’s life, we can miss the main contributing factors to ‘dependency’.
Sometimes the great benefits of ‘internet’; enabling people to confront their demons in relative anonymity, becomes an alternative to meeting people. If that is a clear preferred choice, I can understand that. If it is not, it is a very sad experience.
Some many things contribute to social isolation, beside any ‘addiction’ to the medium. These would perhaps be better understood as ‘learned dependencies and resulting loss of social ‘skills’, ‘motivation’ and ‘confidence’:
Shyness, reaction to personal abuse, put downs, reduced confidence because of diminished self-image, getting older, physical disabilities, geographical isolation, unemployment and reduced social opportunities and for many other reasons.
The switch over from ‘dependency’ to ‘compulsion, or ‘addiction’, can be due to just about any feature, as we all know. In the end; it is the individual’s picture that is most important and the ‘Theory’ should give us a frame of reference for checking out our own perspectives, brainstorming and problem solving in our client’s interests.
I am glad it is on the agenda though. For all the benefits the internet provides, it is also an area of potential danger, with new kinds of abuses and subtle influences. This is going to become a sharp enough problem for us in the near future.
Agreed that (1) subjective experience is important, as is a common understanding of terms; (2) it’s not the “Internet” which is “addictive” as much as the various pleasure-giving, reinforcement-assured behaviors which can be accessed online – or on devices.
Add to the list: Farmville addiction (or “app addiction”), Facebook addiction, SMS/texting addiction, gaming, “being connected addiction” (purposely an absurdly impossible thing to quantify), twitter and micro-processing addiction, and top-of-my-list at present: “Device addiction”, and we’d have a fuller picture of today’s connected societies. Good and bad. It’s all possible, and there’s a candy store in every saloon… with slot machines and hugs.
Factor in what this all has done to our attention spans and our need to have a device in our hands at all times – which I observe in awe in the streets of the city – and I think: the times they are a changin’. For our notions of addiction, balance, and integrated lives.