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.

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.

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