This note discusses what has been characterised as 'internet dependency' or 'cyber addiction'.

It covers -

• introduction - the emergence of a new pathology
• one disorder or many - what do we mean by 'cyber addiction'?
• precedents - anxieties about broadcasting, the telephone, telegraphy and earlier 'new media' disorders
• studies and polemics - writing about "the scourge of the Internet Age"
• issues - questions about the basis, prevalence and significance of net addiction
• pulling the plug - therapeutic and management responses
• associated disorders - 'contact addiction', 'web rage' and 'sms fever'
• the therapy industry - statistics and studies

It supplements discussion elsewhere on this site regarding computer rage, sexuality, anxiety and other aspects of life online.

     introduction

Are you a "Net Addict"? A "cybersexual addict"? Or even a "cyberwidow" (apparently there are no cyberwidowers)?

In yet another glorious chapter in the US's infatuation with therapy, the media and health services discovered Internet Addiction (IA) and Pathological Internet Use (PIU) during the mid 1990s. Given their affinity for the badge of modernity, that discovery leaked across to well-ordered states such as Singapore, Malaysia, Japan and China.

In the US psychologist Kimberly Young, author of Caught in the Net: How to Recognize the Signs of Internet Addiction and A Winning Strategy for Recovery (New York: Wiley 1998) and founder of the COLA Center for On-Line Addiction (COLA), recounts stories of

dozens of lives that were shattered by an overwhelming compulsion to surf the Net, play MUD games, or chat with distant and invisible neighbors in the timeless limbo of Cyberspace

Net addiction has become a media theme, with lurid depictions such as the 2005 account -

Hong Kong Internet junkie fights to combat addiction

Anthony Chan betrays the tell-tale signs of his addiction: his skin is pallid and covered in spots, he sits nervously hunched, peering to correct his blighted vision and he has trouble communicating with friends and family.

At just 16 he is emotionally fragile, physically ill and his future has been compromised by the addiction which has him in its grip. But when the lights are switched off he gets online, he could not care less about the problems it brings. His drug is the Internet and, when connected, it makes the lonely Hong Kong schoolboy feel on top of the world.

"The computer is my friend, it's my life, my social life," says Chan, shifting in his chair and squinting in the glare of the brightly-lit office where we talk. It is one of the few times this week he has left the confines of his bedroom where he spends hours and hours every day logged onto the Internet and he is missing it already, he says.

Fortunately there are no claims that the addicts mug little old ladies or steal from toddlers to pay for the habit.

In China it has been promoted as an explanation of why unfettered access to the net is dangerous. Apocryphal reports in 2004 claimed that conscripts in Finland are using net addiction as a means of avoiding military service. Alvin Cooper gained attention through problematical research that labelled the net "the crack cocaine of sexual compulsivity", with one in 10 (self-selected) respondents claiming that they are "addicted to sex and the Internet".

     one disorder or many?

If you are not a true believer one puzzling aspect of cyber addiction is its definition. Is it one disorder or many? Is the label too broad to be meaningful? Where does 'normal' use stop and pathological use begin? What are its causes and appropriate therapies? There is no expert consensus and the disorder is not recognised in standard diagnostic manuals.

Christopher Bates, commended by one of the gurus, suggests that 'cyberaddiction' is caused by "low blood volume", presumably an advance on past explanations such as witches on broomsticks.

     precedents

Despite assertions about the uniqueness or significance of net addiction - or the insights of particular therapists - it is merely the latest of a succession of alarms about the physical, psychological or social effects of new media and new technologies.

Those precedents reflected broader social anxieties regarding virility, minorities, nationality and the lower classes.

The advent of printing saw the emergence of warnings from educators, doctors and the pulpit about the seductions of print. The pallid (and spotty) schoolboy whose overindulgence in literature resulted in death from consumption was a theme for around 400 years. It is a counterpart of claims that addiction to novels or poetry debilitated the weaker sex, leading to frigidity, stillbirths and an early grave. The development of mass markets for literature saw warnings that the lower classes - in particular girls working in textile mills and other factories - were particularly susceptible ... spending hours (and too much of their income) mooning over trashy novels rather than devotedly tending the looms.

Denunciation of the telegraph featured claims that the wires altered the physiology of those in close contact (a justification for early gender restrictions in the workforce) and curdled milk or otherwise damaged cows. Women were believed to be particularly excited by opportunities to receive and send telegrams, with compulsive use resulting in catch-all symptoms such as neuraesthenia or dysmenorrhea. A few generations later we saw more subtle warnings about anomie in the suburbs or the office, with for example stereotypes about women "always nattering on the phone".

Such claims echoed warnings by clergy, civil society organisations and the emerging psychology industry about compulsive consumption of film, radio and television. Those warnings included assertions about subliminal messages, conditioning and fundamental changes to brain physiology.

Mencken satirised contemporary US hysteria about television watching, warning in 1952 that

no matter how good any given television show is, to look at that tube of lights and shadows almost invariably brings to mind such things as death, tuberculosis, cats howling on the back fence, incest, dishes in the sink, etc.

Such a reaction ... applies particularly to looking at television alone. A hair-in-the-mouth, screaming-nerves sensation comes from viewing television in solitude, an act of the same category as drinking in solitude or taking morphine while shut up in a closet, but much worse.

Furthermore ... to look at it for any length of time, even in the company of others, causes sexual impotence, shortens the life span, makes the hair and teeth fall out, and encourages early psychosis in otherwise normal people.

The more recent Television & the Quality of Life: How Viewing Shapes Everyday Experience (Mahwah: Erlbaum 1990) by Robert Kubey & Mihaly Csikszentmihalyi conceded that the term 'TV addiction' is" imprecise and laden with value judgments" but claimed that it "captures the essence of a very real phenomenon". Their 2002 article Television Addiction Is No Mere Metaphor noted that

Psychologists and psychiatrists formally define substance dependence as a disorder characterized by criteria that include spending a great deal of time using the substance; using it more often than one intends; thinking about reducing use or making repeated unsuccessful efforts to reduce use; giving up important social, family or occupational activities to use it; and reporting withdrawal symptoms when one stops using it. All these criteria can apply to people who watch a lot of television.

We have pointed elsewhere to waves of anxiety about railways, film, radio and even comics.

     studies and polemics

The literature on internet addiction is at best uneven and is often distinctly polemical, with an emphasis on anecdote at the expense of rigorous statistical analysis.

Young has been echoed in works such as Hooked On The Net: How to say goodnight when the party never ends (Grand Rapids: Kregel 2002) by Andrew Careaga - marketed as "a solid, Christ-centered take on the controversial subject of Internet addiction - written by a self-admitted Internet aficionado" - and David Greenfield's Virtual Addiction: Help for Netheads, Cyberfreaks and Those Who Love Them (Oakland: New Harbinger 1999) or In the Shadows of the Net: Breaking Free of Compulsive Online Sexual Behavior (Center City: Hazelden 2004) by Patrick Carnes, David Delmonico & Elizabeth Griffin. A historical perspective is provided by Avital Ronell's The Telephone Book: Technology, Schizophrenia, Electric Speech (Lincoln: Uni of Nebraska Press 1991).

There is a more analytical account in Richard Davis' paper A Cognitive-behavioral Model for Pathological Internet Use (PIU). John Suler's 1999 paper Healthy & Pathological Internet Use attempted to differentiate between good and bad consumption.

One outcome from early alarms was the APA paper on Sexuality on the Internet: From Sexual Exploration to Pathological Expression by Alvin Cooper, Coralie Scherer, Sylvain Boies & Barry Gordon.

     issues

Most studies of cyberaddiction are deeply problematical because they

• draw on small (sometimes ludicrously small) and often self-selected populations,
• have no independent oversight,
• involve serious uncertainties about questionnaire structure and data handling or about the interpretation of figures and answers
• are not benchmarked against widely recognised independent research.

     pulling the plug

Responses to claims of pervasive cyber addiction have taken several forms, including -

• scepticism
• provision of corporate network management services
• different therapies, some delivered online, that range from traditional talking cures to behaviourist aversion training or recourse to the power of prayer

One response has been to take addiction as a given and therefore restrict access to the medium.

Websense, an 'employee management service', for example promoted its wares in 2002 with discovery of "one of the most highly addictive activities to scourge the modern workplace", with 25% of employees supposedly feeling addicted and a mere 8% of those polled (some 305 US office workers) claiming no knowledge of workplace web addiction.

Websense concluded that employee personal net usage centres on news sites (67%) and shopping (37%), with 23% of employees indicating that shopping is the "most addictive" online content. 67% access news sites for personal reasons; 37% access shopping and auction sites at the office.

2% of the surveyed employees admitted accessing "pornography" and 2% admitted gambling online at work. Supposedly 70% of "all Internet porn traffic" occurs during the nine-to-five workday, up to 40% of surfing is not business-related and over 60% of online purchases are made during that time.

Websense regrettably did not benchmark those figures against employee use of telephones.

It notes a comment from Marlene Maheu ("Internet addiction expert" and CEO of an organization developing internet and telehealth aids) that

Studies have shown that from 25 to 50 percent of cyber-addiction is occurring at the workplace ... That means employees are getting paid to participate in activities that are not work-related.

There is recurrent media attention - typically at the end of the year, when news is 'slow' and editors are barrel-scraping - to claims that people suffer withdrawal symptoms when deprived of the net.

It is unclear whether going cold turkey on the net is much different from being deprived of a mobile phone (sometimes characterised as contact addiction), snailmail or a video.

We are underwhelmed by accounts of the latest clinical disorder but if you're an Oprah fan you'll probably enjoy answers to questions such as "Why is the Internet so seductive? What are the warning signs of Internet addiction? Is recovery possible?" The corollary is presumably the 'web rage' featured in a 2001 Roper Starch report: more fender benders on the digital highway.

The Singapore Straits Times reported in 2001 that psychiatrists were touring local high schools, talking to children about the symptoms of IA. Supposedly, three children per year sought help when the disorder was first 'discovered' in 1995. As of 2001 around 80 kids sought help each year.

It is unclear whether that figure is higher than demands for therapy to cure GameBoy, Pokemon or plain old fashioned vanilla-style television. It is consistent with past accounts of telephone addiction, featured in Ronell's The Telephone Book or Tom Lutz' American Nervousness, 1903: An Anecdotal History (Ithaca: Cornell Uni Press 1991).

Another response has been the emergence of the online confession sites - such as Dailyconfession.com and Grouphug ("the idea is for anyone to anonymously confess to anything") - highlighted in our discussion of mind & body in the digital environment.

     associated disorders?

It is unclear whether net addiction is associated with other ICT disorders, substantive or otherwise, including -

• SMS addiction
• contact addiction (typically characterised as compulsive use of mobile phones and electronic mail)
• cyberchondria

It is also unclear whether supposed web addiction is associated with the 'computer rage' profiled by Kent Norman or the 'computer anxiety' highlighted elsewhere on this site.

     the therapy industry

Figures about the size, shape, growth and effectiveness of the cyberaddiction therapy industry are unclear. It is thus similar to the adult content industry, explored elsewhere on this site, where there has been little critical analysis of claims and many statements are self-interested.

So far there appear to have been no successful lawsuits against software/hardware vendors and ISPs for providing the means of addiction, in contrast to cases in the US where plaintiffs sued fast-food outlets for wantonly causing an addiction to fries and other takeaway treats.

Much of the writing about web addiction might be thought of in terms of fashion and as a media phenomenon rather than a discrete pathology, one situated in a culture where there is a substantial market for Blue Water (promoted as having had "negative memories" removed and replaced with "beneficial energy patterns") and Kabbalah Mountain Spring Water (which not only tastes good but absorbs radiation, alleviates rheumatism and has anti-ageing properties).

Questions about the 'addiction industry' and contemporary anxieties are highlighted in The Culture Of Fear: Why Americans Are Afraid Of The Wrong Thing (New York: Perseus 2000) by Barry Glassner, Manufacturing Victims: What the Psychology Industry is Doing to People (London: Constable 1998) by Tana Dineen, Therapy Culture: Cultivating Vulnerability In An Uncertain Age (London: Routledge 2003) by Frank Furedi and Adam Burgess' Cellular Phones, Public Fears & A Culture of Precaution (Cambridge: Cambridge Uni Press 2004).

A historical perspective is provided by Traumatic Pasts: History, Psychiatry & Trauma in the Modern Age, 1870-1930 (Cambridge: Cambridge Uni Press 2001) edited by Mark Micale & Paul Lerner and Mind Games: American Culture & the Birth of Psychotherapy (Berkeley: Uni of California Press 1999) by Eric Caplan

 

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