I’ve been loathe to give any additional attention to the tiny treatment center in Washington state that says it’s treating “Internet addiction” in a “first of its kind in the US” treatment program, seeing as it’s already had over 350 media mentions in the past few days, including the one below in none other than the New York Times. Apparently when you start a media snowball rolling downhill, it’s hard to stop for a moment and do any actual reporting on the topic. It is much easier to eat up the PR and repackage it with no critical eye on the claims made.
One of the problems with the mainstream media’s reporting on the topic is that it’s acting as though this is the first treatment center to treat this mythical condition (I say “mythical” since the research is definitely mixed on its existence, and it’s not recognized by any diagnostic system nor insurance company as a legitimate mental disorder). Indeed, my good colleague whom I admire and respect, Dr. Maressa Hecht Orzack (on the Harvard Medical School faculty, no less), has been treating this condition for 15 years at the famed McLean Hospital.
Oh, but wait, you say. Dr. Orzack’s program is outpatient only. This surely must be the first inpatient treatment program for people with “Internet addiction,” no? I mean, all the media is reporting the exact same claims made in the press release by the company. Apparently, no one in the media spent 2 minutes on Google to verify the claims.
For instance, in this article entitled Internet addiction may be one click away on July 29, 2008, the reporter notes:
Coleen Moore, coordinator of resource development at the Illinois Institute for Addiction Recovery, said she has clients from college age to early adulthood who spend 14 to 18 hours a day online. […]
At the Illinois Institute for Addiction Recovery, some patients need 30 to 90 days in-patient treatment, followed by a continuing care program. But Internet addiction recovery, as any other addiction, requires lifelong treatment, experts said.
So in two minutes of Googling, I find that one of the primary components that made this story ostensibly “news” was that this was the first such inpatient program to treat “Internet addiction.” Wrong.
And one has to wonder — for 15 years, professionals have been treating this condition in outpatient settings. One hopes they’ve been treating it in outpatient settings successfully, but again, the research isn’t strong here. Why the need for more inpatient settings for something that the professional community doesn’t even recognize as a legitimate disorder?
Is the Internet like crack or heroin, where you need to seclude someone in a residential inpatient treatment center at $14,000 for 45 days while you teach them the cognitive-behavioral strategies they need to learn to better mediate their Internet use? I don’t have an answer for this question, and neither does the research, which is moot on inpatient treatment for “Internet addiction.” Without research supporting such a treatment strategy, you might as well as start selling herbal supplements to help with this concern.
Isn’t it interesting that when it came time to re-purpose an old treatment center, they settled upon an “in vogue” diagnosis?
Cosette Dawna Rae, a psychotherapist, has owned the bucolic retreat center since 1994, and was searching for a new use for it when she teamed up with Ms. Cash.
So despite the lack of any clinical evidence supporting the efficacy of inpatient treatment for a mythical condition, that doesn’t stop the press from fawning all over this slick new business. I rely on mainstream reporting to at least pretend to give equal time to the other side on controversial issues like this. And if nothing else, check out the claims made in a press release to see if they are actually true before simply reporting the claim itself. Anybody can report claims; journalism is supposed to take one additional step and see if the claim has any merit.
“Internet addiction” makes an appearance in the media about twice a year, usually for some reason like this. What doesn’t make news headlines is the actual research that calls into question this proposed diagnosis and the serious methodological flaws that exist in virtually all the research to date on this concern.
Read the full article: Center Tries to Treat Web Addicts
I was also interviewed for a segment on NPR’s “All Things Considered” on this topic, which aired yesterday evening.
23 comments
I did hear this piece on NPR and I have to say that I knew this was not the first inpatient treatment of internet addictions. I do believe that the internet can be addictive in the sense that it can take over someone’s life and that intense cravings to get back onlinee hard to fight. The young man in the piece was missing out on basic life experiences that should be occuring at this age. As for journalists not researching and repeating themselves, I think it happens all the time..there aren’t that many new topics and new stories.
Does insurance cover this treatment? That would be an interesting thing to find out!
Inpatient services for this matter is fairly ridiculous, that I will agree. But, it is an addiction and needs to be treated as such an entity. The one problem is, since abstinence is the preferred model for recovery, can someone go without access to the internet for the rest of one’s life?
That seems a bit extreme. But, supervised use seems appropriate to consider.
Why is this such a bug up your pant’s leg, Dr Grohol?
I think it’s a bug up his pant’s leg because he is ‘human’?
And, because he is a researcher?
Oh, and I guess it’s like with food addictions, when abstinence doesn’t work.
I thought about this whole thing with Internet addiction a lot.
I can easily spend 8, even 10 hours a day on the Internet although it doesn’t make me feel great, but i don’t have an addiction.
It’s a big part of my life and my world. I write, read, learn, talk, help, have a social life, photography, draw…e-mail is the most important.
I have a variety of interests just like in my other life, but what I love most about it is the plus of ‘access’, and the plus of less ‘wasted time,’ and the plus of ‘control’, not to mention access to information. Money is a big plus also.
I do not watch TV, mostly, but not exclusively because I refuse to deal with commercials. I don’t speak on the phone if I can at all help it and only briefly. I don’t have a cell phone either.
I don’t go to movies.
With the Internet, I can visit without having to commit myself, (like a dinner date) without having to deal with traffic and waiting and restaurants and all that.
I can do it whenever I want to and am not a slave to someone calling me and holding me up on the phone. it’s all pretty much ‘normal’ activities for me. I also have access to people and things I would otherwise not have to, or, I would have to travel and I hate traveling. (like support groups)
You can only have an addiction if you have access, right? Like, to all the food, and porn, etc?
I don’t think addiction is that sick actually, but sometimes normal. I think it is more normal to be limited in access to stuff, and a main reason why people are prevented from addictions/not. If there are no cigarettes available you cannot smoke. If food it scarce, you cannot eat too much.
Many people, or men, would screw every woman if they could and weren’t married, or whatever.
But with the Internet, porn is right there, and if you have an addiction on the Internet it’s not to the Internet but something on it, like gambling or games, or sex.
You won’t have Bulimia on the Internet, but you may have a shopping problem, but only if you can afford it?
Anyway, just some thoughts.
The problem with Freedom is that it goes hand in hand with Responsibility. For that reason, many would prefer not to have too much freedom, or otherwise don’t do well with too much of it.
No bug. Just wish the media would do their job before giving free publicity to a business which is not doing anything new, innovative or interesting — especially in regards to a disorder that doesn’t even exist. How does focusing on a single 6-bed treatment center help anyone? Or provide new information we didn’t have previously (which is one of the ostensible purposes of news)?
I’d love to see as much media attention given to a new research study showing the effectiveness of 12 sessions of CBT for depression. Such treatment has the potential to affect far more people than “Internet addiction.” But despite the fact that studies like this come out at least once a year, you get nary a peep.
Hello Dr. Grohol~
I appreciate your thoughtful comments and dialogue on this important topic.
Our claim is based on the fact that we are the first 45-day retreat center program designed “solely” to treat the symptoms of internet addiction as our primary concern. What each of our clients have in common is an active dependence on Internet and digital technologies.
Integrative treatment at the ReSTART center focuses on a client’s presenting problems (e.g., job loss, academic failure, homelessness, relationship conflicts, and health concerns) as well as any underlying co-existing mental health issues they may be struggling with (e.g., depression, anxiety, and PTSD, for example).
Our vision is to bring about increased awareness to this important social issue, offer support and assistance to both the person in recovery and those who care about the health and wellness of their loved ones, and to further the knowledge base and research in this emerging field through healthy dialogue.
I look forward to speaking with you sometime in the near future as time allows.
What about my thoughtful comment?
( I don’t know how to place a smiley face)
I think what Cosette Rae means, is that Internet addiction is rarely an isolated problem but that it happens when other problems in life are not dealt with. (like dual diagnosis, at least until triple diagnosis is invented.)
So, a patient who is admitted to the clinic may be suffering, along with the Internet Addiction, with bipolar, PTSD, divorce, job loss, cancer, and being confined to a wheelchair, and in that case they do address the whole person, and not just the addiction like in AA?
Re Katrin:
If you are referring to your “thoughtful comment” as the Sept 9 404PM one, I interpret this as possibly reflective of addiction. You seem to comment on many of the posts here, which could show an excessive interest in the subject matter. But hey, that is my opinion, I could be wrong.
Getting back to the post here at hand, I have surmised that Dr Grohol is refuting the notion of internet addiction as it could impact on attention to this site, much less the value of the medium of the internet itself. I have noted in the past that dependency is a concern irregardless of the subject that causes it, whether it be chemicals, personal behaviors, or other matters that negatively impact not just on the person with the dependency but also those involved with said dependent individual.
So, if internet addiction is a valid concept, should the person spending 10 hours a day in front of the computer/cell phone/other internet access device and not attending to daily needs and inportant functions, isn’t that a problem? And if this behavior is preventing others from accomplishing their needs and goals as the dependent person is not available or interfering with others’ pursuits, isn’t that a problem too?
This medium has benefits, but also detriments. I find those who argue this point probably have at least abuse issues in using the internet if not the poster child for the dependency issue at debate here.
In conclusion, I would hope that Dr Grohol will reply to Dr Rae in some fashion. Hope your weekend is sunnier than mine has been so far.
Dr Rae – I assume if you put enough qualifiers in a press release, one can make any claim sound unique or a “first.” But it’s not a first, and that was the basis of this entry.
skills – The minute “Internet addiction” enters the DSM-V, I’ll be happy to eat my words. Until then, it is like a lot of other theorized disorders that one can treat until one is blue in the face. It doesn’t validate the disorder, however.
I’m going to start a new addiction called “sports addiction,” which happens whenever a spouse spends entire weekends (and weeks) watching their favorite sports, ignoring their partner, chores, even work obligations. Afterward, I’m going to start another disorder called “socializing addiction,” for all those poor souls who can’t seem to stop talking to their friends on the telephone (perhaps it should be called “phone addiction”?) or in person.
And I think I’m coming down with “book addiction,” as sometimes when I start reading a really good book, I stop attending to many of the ordinary activities that define my life. In fact, sometimes I’ve read books for hours and hours every day, not even stopping for sleep!
Right, skills, I spend way too much time on the computer, and so do my kids.
But half of the time I spend on the computer I am not connected to the Internet, like when I play ‘free cell solitaire’, draw pictures on AppleWorks, write stories, and for printing and editing photography.
One of my problems is insomnia, also, and it’s not because of the computer, but the computer because of the insomnia.
You know, it’s interesting that you say about my commenting so much on Internet addiction because you are right yet I have no interest in it at all. let me think about it. I should mention thought that if you knew where else I write and comment that this internet thing is rather small, and I have only comments about it here. In fact, I don’t think john is that interested in it either, and he writes a lot about it. it’s more the annoying factor.
One time I had a serious apple addiction. I went to the orchard and dug out the apples even in the deep snow.
I had to eat at least 15 apples a day.
Last, I have a niece who is fanatically addicted to her cello. She practices like eight hours a day, and she was a horrible student in school and a couple of years ago she flunked 10th grade.
She is so incredibly gifted on the cello, she plays cello solos in major concert halls and makes people cry, I mean like half of the audience.
After she flunked 10th grade she applied to one of the finest music universities in the world in Vienna, Austria, and she flunked of course all the admitting tests.
But then she played in-front of several judges and she got accepted immediately.
Just for the fun of it, and to the horror of her parents, she insisted on competing in these youth competitions in Holland, Hungary, Austria, and Italy and she won every one.
I am wondering if she needs to go to ‘Cello anonymous’. She only just turned 18? And nobody is pushing her at all.
When a client comes to me and says, “I think I am addicted to the internet” I could spend time undoing the client’s words, explaining that while he or she thinks they are addicted to the internet they really are not because internet addiction is not in the DSM. I guess I could do that. Or I could meet my client where he or she is at, and realize as a clinician I am likely treating many underlying issues that culminate in a cluster of symptoms that have gained the label “internet addiction.” I guess in this case the unruly word is “addiction.” But those whose lives have become unmanageable due to their very very intense attachment and compulsion to technology, they might have a few things to say about whether they experience their problem as an addiction or not.
The debate about whether or not internet addiction is real is akin to the debate over Battered Woman’s Syndrome, a syndrome that “does not exist” because it is not in the DSM. I guess in this case it is the word “syndrome.” At any rate, the same principle applies; underlying issues and a cluster of symptoms that clued the therapist and the client in to the fact that the woman was being beaten over and over and needed help to get out of her circumstances. Women who have experienced this cycle might again have a better handle than we processionals on what to call it.
My comments are not pro or con this new treatment center- but I do continue to poke my head in with regard to the semantics of what our clients say they experience…
DeeAnna
I cannot help but respond to this last comment by DeeAnna Merz Nagel.
Don’t you think anyone who does not necessary believe in Internet addiction knows what you are talking about, and would of course, and obviously treat a client like you propose? Do you really think if a client came in with :”I have an Internet addiction”, that someone like John would respond to this client with a lecture that such an addiction does not exist nor is to be found in the DSM?
I am really baffled, and find your comment slightly insulting. Katrin
Katrin,
I did not address John specifically in my reply. John is not the only one that brings this debatable topic up. Since I know John, I would not expect he would treat any client other than with positive regard and in a completely ethical manner. My comments are about the use of the words themselves- the semantics of the argument- that sometimes when we as professionals protest too much, we are at risk of invalidating the collective clients’ experience.
DeeAnna
Ok, Thanks, it just really came across that way. I appreciate your responding.
If a client came in and told me they had an ‘Internet Addiction’, I would not merely not tell them that I may doubt they are wrong, I would take their word for it entirely. They say they have an Internet addiction and that means they do. My general little doubts are really insignificant in relation to what a patient presents with. Just wanted to say that.
What I think is a much greater therapy issue is the following.
It is assumed, that one of the greatest symptoms of a true addiction is the factor of ‘denial’, right?
And especially addiction counselors are trained to treat the denial. On top of that, addiction counselors are ‘specialists’ in addiction but they don’t know anything else about normal behavior? (I am exaggerating)
‘
So, if I go to a counselor and I tell them I have a serious addiction, then just because I am aware of this, they will already assume I don’t have the addiction at all?
Again, I am exaggerating, but there is much truth to this.
Same with other therapists. if I come in and tell them I am really sick, then it is already assumed that I am not.
This is indeed an “academic debate,” of little value to clients who need help with the problems in their life. They do, however, use the words that the professionals have given them — and it’s the professionals (back in the mid 1990s) who’ve coined this term with, I believe, little appreciation for what it meant.
A better diagnostic category, if one wanted to go down this road, would be “Compulsive behavior disorder” or something along those lines. This correctly identifies the concern and generalizes it across whatever the person is using to an extreme. Cell phones, iPhones, Facebook, TV, books, Internet, porn, heck, even sex, you name it.
I would run away from any clinician that argued about this with a client when they presented with “Internet addiction.” I suspect most clinicians would never do that.
I have to wonder when I see discussions like this why the focus is on the individual, end-point user of contemporary technologies, rather than on the cultural forces that create the climate in which s/he functions.
I mean, digital technologies are ubiquitous, and digital skills are virtually (pardon the pun) required in order to function in most productive ways in today’s western economies.
Why do we then blame the skilled user for using their skills when everything from buying underwear, to ordering a pizza, to finding a mate, to yes even counseling, is done online?
Is it the individual who is in need of help, or the outmoded, let’s-pathologize-everything mindset that’s in need of a little treatment?
Maybe both.
It doesn’t matter whether the individual is in front of a computer screen, TV screen, cell phone screen, or just sitting at the edge of a pond just staring at the water for hours a day. If the behavior is preventing healthy function and accomplishments, it sounds disordered to me.
If and when there is a terrorist strike that takes out the internet via the electrical grid, just watch how many people go into a panic because they can’t access their digital technologies. That is pathetic and inexcusable. And why do we rationalize and excuse dependency behaviors that cause impairment and upheaval? Oh, I forgot, the apologists and defenders profit from the issue not being identified and treated!
So, yeah, there is the next question. Who is dependent and addicted? The viewer or the bloggists/internet site programmers out of control?
Not directed at you specifically, Dr Grohol, but the question seems to be begged be asked after the last commenter.
hii
i was searching 4 a doctor who treat me online by chating plz i can’t go 2 anyone coz i don’t want my parent know any thing about this psycological treating of me