Conflicting views

When a person becomes dependent on the euphoria he experiences playing video games, he is addicted, said Cash.
“They’re preoccupied with gaming; they get irritable when they are not gaming. They play convulsively – that is, they play even though they know it hurts” their emotions and health.

The stereotypical gaming addict is a male teenager with low self-esteem, but anyone with money to buy a computer system can become addicted, Cash said. People going through an emotional time, or who are lonely, bored, or shy, may be particularly vulnerable.

One of Cash’s first gaming-addiction cases was in 1994: a normal, successful, married man working for Microsoft. Before he recovered, the man’s addiction cost him his marriage and his job. In another case, a teenager pulled a knife when his father tried to take away the computer, she said.

Yet the prevalence and seriousness of Internet addictions remain the subject of debate. Dr. Joseph McGlinchey, a postdoctoral fellow in psychiatry at Brown University, says the issue gets more attention than it deserves.

As a graduate student at the University of Washington, he did his dissertation on Internet addiction, focusing on college students, a group he thought most likely to have excessive Internet use.

“The rate of those who had major problems with using the Internet –like thinking their use was out of control or failing classes because of it – was overall very low,” he said.

Dr. Donn Marshall, chief psychologist of counseling at the University of Puget Sound, disagrees that concern is overblown and sees Internet addiction leading to other problems, such as depression.

What makes the Internet so potent, he said, is the variety of and easy access to stimuli.

“If gaming is your vulnerability, games are available via the Net 24/7,” he said. “If you are drawn to anonymous sex pornography, it is at your virtual disposal at the click of a mouse. If you are a compulsive shopper, this store never closes.”

Getting out of the game

Getting gaming addicts to log off is a long process and not always successful, Cash said. She figures about 50 percent of those she treats recover.

The therapy is often particularly difficult because many people need computers and the Internet in their jobs, Marshall said.

Cash’s methods very from one-hour personal sessions to two-hour therapy groups that include family members. For children and teens, McDaniel suggests family therapy coupled with participation in community service projects and team sports to reinforce the sessions.

The length of treatment varies; but is typically between two and eight months. Cost varies by case. Cash says insurance may cover treatment, and cost concessions are sometimes made.

Whatever shape it takes, the aim of therapy is always the same: to teach addicted gamers how to set limits on computer use and to help them develop the social and stress-management skills to overcome their addictions, Cash said.

Ironically, there are self-help forums, Web logs and Web sites designed to help people overcome video-game and Internet addiction, but Cash isn’t a fan.

“Going online for help is like conducting an Alcoholics Anonymous meeting in a bar,” she said. It might be a start, she said, but nothing can replace personal interaction.

Osborne started seeing Cash last year. His dad made addiction treatment a condition for Osborne to live at home.
Today, Osborne says he needed an uninvolved third party such as Cash to listen as he vented his frustrations and problems. The therapy gave him the opportunity to scrutinize his life. His parents’ concern was warranted, he said, “but it was hard to see without 20/20 hindsight.”

Offline problems

Osborne started playing video games at age 4. Eventually, he used them to cope with real-life problems: depression, painful conflicts with friends and a high-school environment that didn’t challenge him. At 18, he had what he calls a nervous breakdown that lasted three months.

“I was absolutely incoherent… I literally did nothing. I just stared at the wall. I didn’t care if I lived or died.”
He slowly recovered and later graduated from high school.

For the next six years, Osborne moved often, staying with friends and family, unable to cope with his lingering depression and lack of motivation. After he moved in with his dad in February 2004, his gaming increased dramatically.

As his problems and community collage grades worsened, he pursued other distractions, like reading, but the bulk of his time was spent online.

“It was escapism,” he said. “But instead of getting away from my problems, it put me right in the thick of it.”
An offline introvert, Osborne was an online extrovert, creating friendships in multiplayer games that were as meaningful and real as those away from the computer. He felt comfortable talking to people from around the world, baring himself through the keyboard. He even met some online people in real life.

The games were utterly absorbing and offered a measure of control he didn’t have offline.

“You will not run into unexpected situations in games,” he said. “There’s a set of rules that you know the game will not break. You choose to fight your battles on your grounds and your terms.”

In contrast, “Life picks the battles for you. Life does not have to make sense,” he said.

“Sticky factors”

All video games, but multiplayer online games in particular, have features that keep gamers coming back, said Wendy Kays, a consultant to Reality Quest.

Opinions differ on specifics, but the primary traits, called “sticky factors,” are the increasing difficulty levels, the increasing amount of teamwork required to play, and the involved relationships that develop with other players, she said.

Another enticement, McDaniel said, is the “God effect”.

“You can step into a world and decide who lives and who dies and what to create and what to destroy,” she said. It represents a semblance of control in life. That small measure of control, she said, is used to cope with the pressures of life, friends, school and growing up.

It took years before Osborne started to realize that he was going nowhere. He paid for those years with his health (at 5-foot-10, he weighs 287 pounds), poor grades, dead-end jobs, the threat of homelessness and the loss of his family’s respect.

Finally, “I began to clue in,” he said. “And I realized… I just need to do it.”

Still logging on

Osborne still plays online games, though he has internal controls – “mental slappings,” he calls them – to keep from playing for days on end. Regaining the respect of his family is an uphill battle, he admits. He’s started a job as a electronics technician’s apprentice and has begun bicycling and walking to get into shape.

Does he regret his time online?

“I’ve made friendships online,” he said. “And I’ve made close friends with people from all around the world… But… I’ve done practically nothing else with my life. I’ve accomplished nothing: There is no resume for gaming.”