A New Disorder is Born

I want to start off by saying that it is clear that sometimes gamers play too much and their game playing impacts their work and relationships in negative ways. There are many many anecdotes by friends and family of gamers as well as gamers themselves who describe how extreme game-playing can become. On the other hand, making this observation in no way necessitates creating a new psychological disorder with which to stigmatize games and gamers. It is this distinction and the gap between those two notions that I want to explore in this article.

A New Disorder is Born

The American Psychiatry Association does not officially recognize Internet Addiction Disorder (even though that term has appeared in academic papers quite often recently). There are several reasons why. The foundational work behind the concept of Internet Addiction Disorder derives from survey studies using a set of criteria developed by Kimberley Young (1996).

1. Do you feel preoccupied with the Internet (think about previous on-line activity or anticipate next on-line 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 Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay on-line 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 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)?

A person who answers "yes" to five or more of the above questions is considered to have Internet Addiction Disorder (IAD). Thus, in the original survey work, it was found that some people fell into this criteria and thus a new disorder was born. The primary objection to this methodology of creating psychological disorders is that for any given media form, hobby, or activity, it is probably true that some percentage of people will fall into this criteria of "addiction". The only difference is that researchers choose only certain activities to investigate for addiction disorders. And thus, we have IAD and we are asked to believe that people never watch TV too much, never play golf too much, and never work too much. The Internet is dangerous whereas other activities are wholesome and good. But if any and every activity can have its very own addiction disorder, it's not clear that such a notion is meaningful. On the other hand, picking and choosing which activities we deem "addictive" seems more and more arbitrary.

Another problem is that it conflates all kinds of things that people do online. In this model, shopping online, chatting online, looking for information online, and playing games online are all the same thing. It were as if any normal activity suddenly becomes potentially deviant and dangerous when it happens online. And by fudging the important differences among those activities in terms of motivations and social interactions, these survey studies typically manage to sidestep the most important question of all - what causes people to become addicted to the Internet to begin with? What is it about the Internet that is so dangerous?

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Call It What It Is

Young has proposed a model for IAD known as the ACE model - Accessibility, Control, and Excitement. She argues that these three aspects of Internet use encourage addictions. One problem is that most forms of media have ACE components. For example, TVs are accessible, remotes give us a great deal of control, and there's plenty of sex, gore, and action on TV. The same is true of non-media activities such as rock climbing or golf. Now it is true that living close to a golf course increases accessibility and thus the likelihood of developing an intense interest in golf, but using that as an argument for creating an addiction disorder for golf seems strange. It is equally strange when it is done for the IAD.

More importantly, the ACE model leaves out one very important fact. Not everyone gets "addicted". In fact, I know many first-person shooter gamers who find MMORPGs to be the most boring games in the world (and vice versa). If IAD were solely caused by aspects of the technology, then either everyone or no one would get addicted. In other words, whatever is causing IAD has to involve something more than just pointing fingers at the technology itself. It's got to have something to do with the individual as well.

The emphasis on the media creates the illusion that the blame belongs to the media itself. It portrays the Internet as a predator that every person can fall prey to. But the more we look, the less this seems to be the case. Being addicted to one thing makes you more likely to be addicted to other things. People who are depressed are more likely to spend too much time online. People who are diagnosed as online gaming addicts typically have other problems - such as depression or low self-esteem. Recent studies show that one out of ten teenagers is depressed. The overall picture is quite clear, internet addiction may just be an expression of other well-understood problems such as depression. In other words, it may have more to do with the people than it does with the technology.

For a long time, we've known that people who are severely depressed may do harmful things to themselves, but whether we create a whole new set of "addictions" to explain it (and shift the blame from the person to the technology) or whether we call it as it is - depression, low self-esteem, etc. - is very much a social decision that is tied to the paranoia and mindset of the world we live in. If IAD were really about the person rather than the technology, then taking away the technology alone won't solve the problem. And if the technology isn't really the problem, then why create a disorder that stigmatizes a technology and its users?

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The 7 o'clock News

If someone dies while watching TV, that is not newsworthy. If someone dies on a golf course, you can bet that you won't see it on the 7 o'clock news. But every time someone dies when they're playing online games, it will be all over the news. We treat the Internet and online gaming as if no other media forms or leisure activities exist. On average, people watch 25-30 hours of TV a week, yet we seldom question whether people watch too much TV these days. But is that because TV has become a socially acceptable "addiction" that everyone is guilty of?

In a more recent paper, Young devotes several pages to the online affair as a common dangerous consequence of internet "addiction" (2004 - need academic access). It were as if affairs are somehow one of the defining reasons why the Internet is dangerous. But it is clear that affairs happen in the real world too. People have affairs at work, while playing golf, and while shopping at the mall. Young states that "at an alarming rate, once long-term and stable marriages are destroyed by a cyberaffair". I would like to point out that long-term and stable marriages are destroyed by affairs, period. Just because they are more likely to occur now over the internet rather than over the phone or over written letters is simply a shift in communication modality. Besides, do we really know how many marriages are ruined by affairs carried out via traditional means (telephone, mail, water coolers at work, the gym, etc.)? Do we know whether people are simply having more affairs regardless of communication modality? To argue that the internet is to blame for cyberaffairs is akin to blaming kleptomania on shopping malls.

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Fun

Do spouses of golfers never feel estranged from their loved ones leaving them to go to a golf course every weekend? Do they never worry that a romantic affair may spark on the golf course? Do they never complain that their romantic partner plays too much golf? Or what about the investment banker who grinds 60-80 hour weeks and has no time to be with their family? Why do we stigmatize and pathologize certain activities when other similar activities are unquestioned?

Society is in the habit of legislating what we should and should not have fun doing, even when it comes to love and the bedroom. Not so long ago, homosexuality was diagnosed as a pathology. And sodomy laws were and are an attempt to criminalize sex among men. The variation in what constitutes wholesome enjoyment across cultures shows that certain kinds of fun can be deemed pathological, but that these decisions are inherently tied to the local culture and belief system. Labeling certain activities as addictive and potentially pathological is society's way of marking what it deems to be unacceptable forms of fun.

We live in strange times. Watching TV for almost 30 hours a week in passive lethargy next to family members who barely talk to each other is considered to be socially acceptable. But if you play an interactive game instead of just watch a passive display for that same amount of time, and if you actually talk with people around the world instead of ignoring the people around you, then you may have the chance of developing a psychological disorder. It is ironic that apathy and laziness will never be questioned as psychological disorders, but a bit of passion can get you in deep trouble. Personally, I think apathy and laziness are far bigger problems.

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Ending Note

People can develop dependencies on many substances and activities. Creating new psychological disorders for every substance and activity seems like overkill if behavioral dependencies are more tied to the person rather than the specific activity that the dependency tethers to. And singling out only a few activities as potentially addictive seems disingenuous and arbitrary. Indeed, why do we not just have a general diagnosis called "behavioral dependency" rather than picking and choosing which behaviors are addictive? Language shapes how we think about technology use as well as our role as technology users. The notion that "video games are addictive" frames us as the helpless victims, whereas the notion of "developing a dependency" frames the excessive behavior as a function of the individual's state of mind.

By calling it "online gaming addiction", the media encourages us to think that we're dealing with a very new problem. But if behavioral dependency is a general problem that tethers to many different kinds of activities, then "online gaming addiction" is actually a very well-understood problem because clinicians have treated depression and anxiety for a long time. If people can develop behavioral dependencies on any activity, then why are we surprised that some people develop dependencies on online games? Why is it news? I contend it is mostly because we've always used the word "addiction" to mark out deviant social activities in a way that treats them as unique predators, as emergent problems which we've never seen before. But once we shift our framework to one of general behavioral dependencies, then we have to abandon this view. What we're seeing is actually a very old problem.

See Also (more recent articles listed first):

- The Trouble with "Addiction"
- A Q&A with a Therapist
- Problematic Usage
- The Seduction of Achievement
- Addiction
- Understanding MMORPG Addiction