It gets more complicated when we consider the issue of interpersonal relationships and what would often be termed "personal growth." Therapists tend to have a bias toward building positive and supportive intimate relationships in real life. In order to develop and maintain such relationships, quality time needs to be spent interacting in positive ways with loved ones and peers. Any activity that prevents or significantly interferes with that kind of quality time should be evaluated if one deems real life relationships to be important. People differ in potential and desire for intimate real life relationships however, and for some online friends may meet their needs. In many situations individuals may experience more intimacy with online friends than they do with those they know in real life.

Unfortunately many people, particularly those prone to compulsive behaviors, are not highly self-aware and have a hard time reflecting upon and regulating their own behavior. Children are not able to do this, which is why they have parents who regulate them. Adolescents do it sketchily. Adults vary according to many complex factors. Family and loved ones of an individual are apt to be the first to notice problems in functioning. But rather than filling out a questionnaire that asks things like "how many hours a week do you play online games?" in order to assess if someone has a problem, it might be more helpful to discuss the issues of "how well are you functioning in life overall?" and "are you living the kind of life you really want to be living?"

Any behavior that interferes with life functioning should be an area for further examination be it computer gaming or anything else. If you stop and think about it, these are questions we all should reflect upon frequently and with honesty. I must pause and ask myself "when I'm at the end of my life will I look back and feel good about the way I chose to spend my time?"