Trapped in the Web

More and more people are discovering the joys of the Internet. But
once they arrive, some find it nearly impossible to sign off. Here's what
you can do to prevent on-line excursions from taking over your
life.

Frustration with the sluggish speed of a browser is the about the
most serious psychological pitfall that most of us face when surfing the
World Wide Web. But for as many as five million Americans, experts say,
the Internet has become a destructive force, its remarkable benefits
overshadowed by its potential to disrupt the lives of those who can't
resist the lure of round-the-clock social opportunities, entertainment,
and information. For such people, work, friends, family, and sleep are
replaced by a virtual world of chat rooms and games.

Take Judy and Bob, a Seattle couple who were saving to buy their
first house -- until monthly credit card bills started arriving with $350
charges for online services. Bob was "pissing away all our money on the
Internet," says Judy. And soon he was doing likewise to their marriage.
Every evening Bob came home from work and headed straight for the
computer, he stopped joining Judy for dinner or helping with household
chores. At 10 P.M. each night Judy hit the sack, while Bob stumbled to
bed some five hours later. Before long he was sucked into cyberspace 40
or 50 hours a week. When it became clear after six months that Bob had
chosen his on-line world over his real one, Judy left.

Such tales became increasingly common in the early 1990s, when the
growing popularity of commercial providers made the Internet affordable
and accessible to anyone with a personal computer, modem, and phone. Only
recently, however, have psychologists begun devising strategies to wean
on-line addicts from their endless browsing and chatting. And while it's
too soon to say how successful their efforts have been, their hope is
that the extent of the problem will be recognized before it becomes even
more widespread.

Cybertrouble

One of the first experts to notice the some people were spending an
unhealthy amount of time on the Internet was Kimberly Young, Ph.D., an
assistant professor of psychology at the University of Pittsburgh,
Bradford. In 1994, Young launched the first major study of the problem,
surveying nearly 500 avid Internet users about their online habits.
Because there was no formal definition for the disorder -- which she
quickly christened "Internet addiction" -- Young classified study
participants as "dependent" or "nondependent" Internet users based on
their answers to seven questions she adapted from those used to diagnose
pathological gambling. (Sample question: Do you experience withdrawal
symptoms -- depression, agitation, moodiness -- when not on-line?) Those who
answered "yes" to three or more questions were classified as
dependent.

On average, Young found, dependents spent an astonishing 38 hours a
week on-line, compared with just five hours a week for nondependents. And
usually they were not cruising the information highway to enrich their
knowledge of El Nino or the Russian space station. Instead, dependents
sought contact with other people: their favorite activities were chat
rooms (35 percent) and Multi User Dungeon games (28 percent), while
non-dependents were most likely to use the Internet for electronic mail
(30 percent) and searching the World Wide Web (25 percent). Similarly, a
1996 survey of 530 college students by Kathy Scherer, Ph.D., a
psychologist at the University of Texas at Austin, found that dependents
and nondependents spent similar amounts of time exchanging email and
searching the Web, but dependents spent twice as much time in chat rooms
and playing games.

None of the non-dependents in Young's study reported academic,
personal, financial, or occupational problems caused by their Internet
use. But about half of dependents reported problems in all of these
areas. Yet many dependents insisted they couldn't give up the Internet; a
few even tossed out their modems, but their Internet cravings led them to
buy a new one to get their cyberspace fix. In fact, the smokers in the
study reported that their cravings for the Internet were stronger than
the urge to light up a cigarette.

Who's At Risk

Most Internet users don't become addicted. Among people who gamble
or drink alcohol, about 5 to 10 percent develop problem behaviors, and
Young believes that the figures are similar for pathological Internet
behavior. With an estimated 47 million people currently on-line, as many
as two to five million could be addicted. Especially vulnerable, Young
believes, are those who are lonely, bored, depressed, introverted, lack
self esteem, or have a history of addictions.

Perhaps the most surprising -- and widely reported -- finding in
Young's original study was that the majority (60 percent) of dependent
users were middle-aged women, particularly housewives, not young male
computer geeks. But this has not held up in later studies, which give men
a slight edge. Young suspects a bias occurred in her first study, perhaps
because women are more likely to admit and talk about their problems.
Still, she understands the appeal that chatrooms hold for these women and
others in her sample. "You never worry about how you look or how nice a
house you have, and you talk to people all over the world. It's instant
gratification without having to reveal yourself." Lonely housewives or
shy sophomores can feel like exciting people when on-line. "It's novel
and unique, and they get attached to the people they meet on-line," Young
says.

Indeed, like alcoholics with favorite drinking buddies, Internet
addicts form close bonds that fuel their compulsions. Dan, a college
student, earned a 3.2 grade point average his freshman year. Then he
moved in with roommates who played an interactive Multi User Dungeon
computer game as a team from separate computers, and soon began logging
on 50 to 60 hours a week. Dan's grade point average nose-dived to 1.6.
His fiancee began to complain that he spent too much time with his
computer friends; they, in turn, griped when he signed off to spend time
with her. Faced with the reality that he might not graduate or get
married, Dan tried to cut back, a goal that grew easier after his
roommates graduated. A year later, his use was down to 1.0 hours per
week. "I still get high on the Internet," he admits, "but I'm in
control."

Get high? Internet addiction? Time was when the word "addiction"
referred to drug and alcohol problems -- period. Today, so-called
addictions are everywhere: sex, exercise, work, chocolate, TV, shopping,
and now the Internet. Have we been, well, abusing the word?

An Addiction? Really?

"Addiction," notes Young, "is a layman's term, not a clinical one."
In fact, the DSM-IV doesn't even mention the word. Young chose the label
"Internet addiction" because it's readily understandable by the public.
When writing for clinical journals, however, she refers to "pathological
Internet use," modeling the term after that for pathological gambling in
the DSM-IV.

Other experts shun the term addiction altogether because it means
too many things to too many people. "It's a sloppy word," says
pharmacologist Carlton Erickson, Ph.D., head of the Addiction Science
Research and Education Center at the University of Texas at Austin. In
the drug abuse field, he notes, "dependence" has replaced "addiction".
"In dependence, people can't stop because they have developed a brain
chemistry that does not allow them to stop," explains Erickson. Excessive
behavior that hasn't quite reached full-fledged dependency, meanwhile, is
called "abuse". If Internet abusers cannot stop for a month, suggests
Erickson, then "Internet dependence" would be the appropriate term.
Others believe that the problem is best described as a compulsion,
suggesting the phrase "compulsive Internet use". And many psychologists
question whether excessive Internet use should be pathologized at all:
John Grohol, Ph.D., who directs the Web site "Mental Health Net," says
that by the same logic, bookworms should be diagnosed with "book
addiction disorder".

Perhaps the controversy will be definitively resolved when
researchers determine whether behaviors like pathological gambling or
Internet addiction produce chemical changes in the brain similar to those
found in drug abusers. In the meantime, Young believes that the often
severe personal consequences of Internet addiction justify popular use of
the term. "Internet addiction does not cause the same physical problems
as other addictions," she says, "but the social problems parallel those
of established addictions."

Treatments for Internet addiction are beginning to emerge. Trouble
is, not all mental health specialists recognize the problem or know how
to treat it. Internet dependents have been told by uninformed therapists
to simply "turn off the computer." That's like telling a heroin addict to
just say no to drugs -- and just as unsuccessful. What's more, HMOs and
insurance companies do not pay for Internet addiction therapy because
it's not recognized by the DSM-IV.

Among those developing treatments for the problem is Maressa Hecht
Orzack, Ph.D., a psychologist at Harvard University's McLean Hospital in
Belmont, Massachusetts. Orzack founded Harvard's Computer Addiction
Services in Fall 1996, after seeing first hand the fallout from
Intemet-related problems: divorce, child neglect, job termination, debt,
flunking out of school, legal trouble. One client, she says, had
separated from his wife but couldn't afford to move out because he spent
so much money on computer services. He moved his bed into the computer
room and started an affair with an on-line sweetheart.

A cognitive therapist, Orzack likens Internet addiction to such
impulse control disorders as pathological gambling and kleptomania.
However, "gamblers have a choice to gamble or not," she notes. "People
addicted to the Internet often do not have that choice, since so many
activities require people to use a computer."

Like Binge-Eating

So the best approach for excessive Internet use, Orzack believes,
will be to treat it like binge eating, where the individual frequently
engages in the activity to be restricted. She treats both by teaching
clients how to set limits, balance activities, and schedule time, without
having to go cold turkey. "People often change in six or eight sessions,"
she says.

Unfortunately, the affflicted rarely admit to the problem, and it
usually takes a crisis with a job, relationship, or school to spur an
Internet addict to seek treatment. More often, it's loved ones who turn
to the experts. "Families notice things and call me," says Orzack. And
she receives letters like this: "We got divorced one year after we got
the computer. My wife was in chat rooms all the time and ignored our
young daughter. She spent hundreds of dollars on phone bills. . . [and]
had an affair on-line that turned into a real affair...Then she left. I
don't know what to do. Please help." Now lawyers and family courts call
Orzack and Young wanting them to testify about Internet addiction in
divorce and custody battles. (In October, a Florida woman lost custody of
her kids when her ex-husband convinced a judge that the woman was
addicted to the Internet and thus incapable of properly caring for their
children.)

College students are often vulnerable to Internet addiction because
many universities provide free, unlimited access. At the University of
Texas Counseling and Mental Health Center at Austin, Scherer and her
computer scientist husband Jacob Kornerup created a workshop, called It's
4 A.M. and I Can't -- Uh, Won't -- Log Off, to help students recognize
harmful Internet habits. Scherer and Kornerup recommend keeping a chart
sorting weekly Internet time into academic/professional and
leisure/personal use. If a large part of your leisure time is spent on
the Internet, she says, ask what you get out of it, what you're giving
up, and why you're finding on-line time so much more pleasurable than
other activities. Take note if your personal relationships are
suffering.

Next, set a goal of how many hours a week you want to use the
Internet. If your actual usage exceeds it, remind yourself to log off
after a period of time. Set a kitchen timer and turn off the computer -- no
excuses -- when it rings.

It's particularly important to separate work and play when on-line,
says Jane Morgan Bost, Ph.D., assistant director of the University of
Texas Counseling and Mental Health Center. Stay focused, visit only sites
needed to complete work, and don't detour. Also, she says, cut back
mailing list memberships and sort play e-mail from work e-mail.

None of the experts PT spoke with demonize the Internet; they use
it extensively themselves and applaud the benefits of rapid communication
and information exchange. But, they add, the Internet is here to stay,
and problems with excessive use need to be addressed.