Denying Reality: Why “Internet Addiction” Is a Virtual Red Herring
Last month Dr. Jerald Block, a psychiatrist in private practice in Oregon, wrote an editorial in the American Journal of Psychiatry calling for a diagnosis of “Internet addiction” to be added to the DSM (which is the catalogue of mental disorders used by doctors and other mental health workers, as well as insurance companies, to classify individuals with diagnosable mental disorders). He argues that that “Internet addiction” is experienced primarily by people engaged in “excessive gaming, sexual preoccupations, and e-mail/text messaging” and that its definition should include:
1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, 3) tolerance, including the need for better computer equipment, more software, or more hours of use, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue.
He cites a few studies to support his theory but seems to believe that we’re already past the point of debating if such a thing as “Internet addiction” exists. Not to put too fine a point on it, we aren’t. Media responses to the editorial were predictable. Newspapers reported on it as if it were a new piece of empirical research, boldly claiming that spending too much time texting or being online was a mental disorder. Bloggers tried their best to mask their understandable anxiety behind defensive jokes about the possibility of being the first to get labeled.
Swallow This with a Grain of Salt
I was particularly surprised by what seemed like a significant omission in the commentary. Of the 103 articles in Nexis and 92 articles linked from Google News that refer to Dr. Block’s editorial not one of them reported the fact that Dr. Block is the co-founder and president of SMARTguard, a company which owns a patent on technology that can be used to restrict computer access. It’s funny that no one mentioned it, since its right there in the editorial footnote. It’s possible no one read the full editorial. It’s more frightening to think that everyone did, but were reassured by the footnote which reads :
Dr. Block owns a patent on technology that can be used to restrict computer access. Dr. Freedman has reviewed this editorial and found no evidence of influence from this relationship.
I’m sure that Dr. Block is ethical, and I’m sure the reviewer was thorough (although I wonder what sort of evidence would have indicated influence). But I can’t imagine anyone seriously suggesting that his business interests aren’t in some way related to his interest in making this particular argument. Whether or not his opinions are guided by his business interests, the undeniable connection between the two ought to make readers skeptical and perhaps even incredulous.
Denying Reality
I’d like to make an argument of my own about “Internet addiction”, more specifically about the labeling of it as a mental disorder. Calls for “Internet addiction” aren’t just attempts to define and treat a behavior; they aren’t even attacks on technology per se. Rather, this all has something to do with a need to keep technology at a distance from human experience, something which it hasn’t been for many years.
In this way it’s hard not to read Block’s argument as an attempt to build some kind of border fence around human experience as a means of fending off the dangerous technologies which threaten to destroy our supposedly idyllic lives. In an era of ubiquitous and intimate computing the lines between computer technology and human experience are increasingly blurring together. I’m not describing a future where robots take over the world, I’m describing the present where we often fail to acknowledge how much computing technology is embedded in our daily lives and our subjective experience of ourselves and the world around us.
This reality is one that still threatens many people and I see this particularly among mental health professionals. Almost without exception, research into online sexuality uses as its yardstick offline psychological markers. To prove that spending too much time online causes social and psychological problems we compare people on how they manage offline. It’s like comparing apples to avatars. There is a faint echo of legitimacy but once you listen closely there’s nothing to hear.
But if mental health and legal professionals succeed in defining the Internet as just another variable to study, just another addiction to manage, they also succeed in momentarily keeping out of their awareness a reality that we are all already living. This reality is hardly a new one; it’s just another iteration of the medium being the message and the message being us.
In this way it seems ironic that mental health professionals are leading the charge, since ultimately the charge is a denial of an integrated part of people’s experience of the world. .
The Real Problem with “Internet Addiction”
Dr. Block’s editorial is not without its merits. After all, regardless of conscious or unconscious motivation, the editorial is trying to speak about those of us who are having serious problems in the world. Whether Internet use is the cause or the effect, there’s no doubt that some of us are struggling with living, and being online makes things worse, not better.
We should be talking about these people, but more than talking about them, we should be talking with them. There is a time and place for the kind of quantitative social science research on which the DSM is built. But this is not the place or the time. What’s called for now is an effort to describe these experiences in ways that don’t neatly reduce complicated lives to coefficients and standard deviations. Now is the time for us to be collecting descriptive and narrative data. We need to understand the depth and richness of both the struggle and the drive to keep acting in ways that are self-harming. And we need to stop wasting our time pretending that the fault lies with technology and recognize that technology is no longer something we can separate out from our selves.
The American Journal of Psychiatry - Issues for DSM-V: Internet Addiction
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Comments
The blurring of previously “solid” boundaries and the speed of social change seem to be key to the rise of interesting in things like “internet addiction.” I think you are exactly right when you say “In an era of ubiquitous and intimate computing the lines between computer technology and human experience are increasingly blurring together.” In fact, I think there are two other boundary lines that are increasingly blurred and that are cause deep cultural uneasiness. One is the line between work and home and the other is the line between public and private. The Internet speeds the blurring of both of those lines. We increasingly work from home — after our regular shift at the office, not in place ofit — and we increasingly bring the outside world into our private spaces (and let our private lives become publicly accessible).
Given all that blurring and all that change, I am not at all surprised that one popular response is to medicalize our relationship with it. Another response of course is to demonize it, hence all the mass media focus on online sexual predators.
In addition to the kind of research you propose, which I think is incredibly important, I think we need theory that puts those individual stories in this larger context of social change.
before the internet was readily available, i read 10-20 magazines a week. did i have a “magazine addiction”?
i think not. i just transferred my thirst for reading and new knowledge to a medium that provided the same thing for free and instantly.
one person’s addiction is another person’s thirst for information. do we need a “cure” for that?
This is a particularly interesting case, which seems related to other attempts by clinical psychology to medicalize aspects of everyday life, but which is also different in important respects, some of which you’ve pointed out.
One important similarity is the way that owners and producers of new means of treating a problem (usually, this refers to pharmaceuticals) end up selling a disorder rather than a product. So, generally speaking, it’s usually the development of some new technology that spurs the medicalization.
Conflicts of interest seem to arise when pharmaceutical companies fund research on certain conditions even when they do so for independent scientists who have no stock (literal or figurative) in the sponsors. (I say “seem” because it’s not clear that undue influence is being exercised in some of these cases.) Here, however, the conflict is much more pronounced.
In this specific case, though, there is an important distinguishing factor: you are right that there’s a cultural value, a kind of skepticism about “unnatural” technologies, that lurks beneath the surface. The function of the treatment, though itself a technology, is anti-technological in an important respect.
As it happens, I am actually in favor of the medicalization of everyday life, including cases like this one. Let them put “internet addiction” in the DSM V, I say, or whatever else they like!
Why do I say that? My reasoning is primarily strategic. As it so happens, many of the drugs that are developed to treat conditions like depression, anxiety, ADHD, OCD, etc. tend to be as effective for people irrespective of whether they fit the diagnosis (which is not to say they work for everyone, but that how well they work may have nothing to do with how disordered you are). So whether you call it “treating a condition”, or “enhancing a trait”, the effect is the same: an increase in some human capacity, a possible improvement of quality of life.
Unfortunately, instead of letting adults be personally responsible for what substances they put in their bodies, our society requires us to get a permission slip from a doctor (especially if the drugs in question are ones that a person might actually want to use!). We can’t let people have full control over their own bodies after all, can we?
The prescription system is unlikely to be lifted anytime soon, so medicalization offers us an easy way to game the system in our favor. It’s relatively easy to attain a diagnosis for many mental disorders (particularly those which are defined statistically; i.e., the ones for which the lowest, say, quintile of the population on a given measure automatically qualify as having it, such as ADHD, which more or less applies to people on the low end of the spectrum for human attention span, or social anxiety disorder, which consists of the shyest 10 or 20% of the population), so it’s not overly hard to get access to these drugs which can produce real benefits in people.
I’m in a tiny minority (people who see psychological disorders as, by and large, social constructs but who nonetheless support medicalizing everyday life) on this point, I know, but I do have my reasons. In fact, I’d say that the very same social fear of technology–and especially of its possibility for “human enhancement”–is at work in the widespread disapproval of psychopharmaceuticals.
Dom your comments are very interesting and honestly a perspective I haven’t heard before. I’m particularly interested in thinking more about the connections between pharmaceuticals, science, and technology in terms of social fear. I’m sure there’s a book out there somewhere for me to read. Anyway, thanks for the comments.
What we have is an addiction to expression! The internet is as revolutionary as the printing press. Its freedom and availability is something that threatens those that hold power over information and our media, the ultimate social conditioning. Look what’s going on in terms of censoring in China and the politics of Tibet. The term “cyber bully” also keeps popping up everywhere and it functions the same way as this “addiction” label; to point the finger at the medium not at the actual social problems. If they can start making people believe the medium is to blame and it’s not safe for us, then it’s easier for us to comply and loose this incredible freedom and human expression, the internet.
P.S. As to pharmaceuticals being a good thing, folks, look at it this way; everything you put in your body has an effect. So if you’re feeling a certain way then it’s because something you’ve put in even before you plunge thousands of dollars and high hopes into prescription drugs. There are side effects from epidemic sugar consumption, dehydration, fluoride, nicotine, heck even toxins from your shampoo fragrance, (www.cosmeticdatabase.com) and oh about 20 000 other chemicals invented in this century. Before filling up on pharmaceuticals that “cure” the side effects of this plague of diet pollution, (then taking more drugs that cure side effects, upon side effects, upon side effects…) try experimenting and eliminating even just refined sugar from your diet and you’ll feel different, clearer, happier, more relaxed, less social anxiety, (actually you’ll feel crazy for about a month, but that’s what happens when you go through the withdrawal of breaking any addiction… coffee, cigarettes etc. AND throw in some psychology too, a good shrink, a good book, self awareness). Want some reference to start? Sugar Blues by William Duffy.