Internet Addiction

It has come to my attention, both in my practice, and in a recent review of results from a large survey, that many people are using the internet so much that other areas of their life are suffering.

For university students in particular, a high percentage of individuals report that their internet use is adversely affecting their grades.

The internet can gobble up time in numerous ways: if you are bored, you can find an endless stream of connections that can keep your mind absorbed with new tangents.

Many people use the internet to communicate with others. The internet can be a wonderful technological aid which fosters closeness, expands our community of friends and peers, etc. But it can also cause us to be so absorbed in the activity itself -- of talking to friends, or perhaps to strangers -- that hours of time pass by. Sometimes these hours are spent online when they might otherwise have been spent visiting a friend in person, doing a healthy activity outside, studying, etc. Sometimes these hours are spent in the middle of the night, instead of sleeping.

There are other addictive lures that may snag people's attention, including games, gambling, and porn. Perhaps all of these activities allow people to enjoy certain aspects of life with greater freedom and discretion. But they can be very addictive, in the sense that a relationship can be formed with the activity, at the expense of other life relationships (e.g. with other friends or loved ones, with work, with school, with other interests, with physical self care and exercise, etc.).

So I'm not saying that the internet is bad. But I encourage people to be careful not to be involved with a computer in an addictive way, in a way that is interfering with other life activities and relationships.

To some degree this is a cultural issue -- our modern culture is changing, and the computer is becoming increasingly a part of it. This may be integrated in a way that is healthy and part of a new "normalness", just as any new technological innovation changes behaviour and culture (from the invention of the wheel or of fire, to the printing press, to the automobile, to the TV, etc.). There are those who resist any cultural change, or pronounce it to be unhealthy. So the internet is here to stay, and I hope can remain an enhancement to our culture -- but we need to learn ways to participate in the culture in a way that is safe and healthy, and to be aware of its dangers (just as we need to be aware of the dangers of fire, wheels, or the automobile).

As a formal challenge, I encourage people to try a month without using the internet at all, and to assess how life is different during that time.

I have made a similar challenge to people about TV, to turn it off completely for a month, then to review any differences in the way they feel.

I recognize the irony that I am making these statements in a forum only available on the internet!

Addictions

The area of addiction and substance abuse is challenging for me.

One simple definition of addiction is "continuing a behaviour despite harm".
In this sense, I suppose a broad range of human activities could be considered addictions.

The more obvious examples of addiction include more specific symptoms:
-developing tolerance (one has to do more and more of the addictive behaviour to get the same effect from it)
-withdrawal symptoms (discomfort--physical or emotional--if the behaviour is stopped)
-feeling psychologically or physically dependent upon the addictive behaviour
-wanting or trying to stop or cut down, but feeling powerless or unable to do so

One core aspect of addiction in my opinion involves a relationship analogy. The addictive behaviour is a relationship. An addictive relationship is one in which other relationships become less and less important or enjoyable, while the addictive relationship consumes more and more time, energy, commitment, and money. In severe addiction, all of the person's other relationships (with people, work, hobbies, other pleasures, and with self) atrophy, while the addictive behaviour monopolizes. Associated relationships may foster the addiction (e.g. the addict's only social supports may eventually only be fellow addicts). An addictive behaviour often starts off being pleasurable, but eventually the pleasure usually fades. It is a trap. Once inside the trap, it is hard to get out. One of the most powerful, exquisitely difficult aspects of the addictive trap can be that the person entangled in it might not be aware of being in the trap; or so much identity or will may be bound in the addictive relationship, that the person might not want to take any steps to escape, and may angrily reject offers of help.

I have often felt that various symptoms of depression and other mental illnesses have addictive features: in depression, for example, there can be behavioural habits, or habits of thought, that can monopolize a person's life, sapping energy that could otherwise be directed in healthier directions. Like other addictions, these habits can be very hard to change without external help.
In chemical addictions (alcohol or drug), the addictive trap can have an overtly pharmacological aspect, which may need to be treated medically. For example, severe alcohol withdrawal can cause death if it is not treated medically.

Aside from treating withdrawal symptoms, pharmacological treatments for addiction have been less successful or useful, although there are some new medications that are showing some modest benefit.

In heroin addiction, one of the most effective treatments of all is not to "escape the trap" at all, but to provide a continuous supply of the addictive agent or analog (e.g. methadone), so that the addict does not have to live a life of desperation, constantly battling with withdrawal symptoms, or needing to engage in dangerous behaviours to seek the daily supply of heroin.

Treatments for addiction need to address a variety of factors:
-the behaviour itself needs to either stop or be reduced substantially (abstinence)
-or the addictive need has to be provided continuously ("harm reduction")
-Once these changes have taken place, the relationships outside of the addiction need to be rebuilt -- if there are no such external relationships left, then an addicted person is isolated, and understandably drawn quickly back into the familiarity of the addictive behaviour.


One common resource for addictions is a "12-step group". I think the greatest strength of such groups is the mutual understanding among members, and the daily community support. Addictive behaviours have a magnetic allure, that often draws a person back into the addiction on an hourly or daily basis, and so a therapeutic resource that is available on an hourly or daily basis can be extremely important and necessary. A problem with 12-step groups can be that they may be quite dogmatic, they have a specific belief system not unlike a religion, and the views may conflict with other resources (e.g. some groups may be strongly opposed to the use of psychiatric medication).

Yet, in approaching addictive problems, I encourage people to give 12-step groups a try, to try repeatedly, perhaps to try several different groups to find one that suits them best.

There are other resources out there as well, and once again I think that finding good primary medical care (a gp) is an excellent first step. In severe chemical addictions, a detox centre may be needed to discontinue the addiction in a medically safe setting.

A day away from an addictive behaviour is a powerful start. A week away is a path away from the trap of withdrawal symptoms. A month away is the start of rebuilding healthy relationships. And a year away seems to be a qualitatively powerful and significant period of abstinence; rates of successful long-term abstinence are much higher for those who can be abstinent for a year. But a single day at a time is a good place to start. And you may need help to get through that day, don't be afraid to seek it. Here is a link to the Vancouver AA meeting schedule:
http://www.vancouveraa.ca/directory.pdf