Caught in the net

Problem Gambling Foundation counsellor Thomas Moore. Photo from ODT files.
Problem Gambling Foundation counsellor Thomas Moore. Photo from ODT files.
Internet use and connected devices are proliferating, but so too are the casualties. With internet addiction about to be listed as a probable mental illness, Bruce Munro discovers lessons that could help us all in this brave new online world.

In the end it was just him, alone, with his video games, computer and cannabis.

Caleb (not his real name) had been becoming increasingly isolated for about a year, his mother Liz (53) recalls, her eyes sunk deep and brow creased with worry.

Most nights of the week, her 18-year-old son would stay up all night in his Dunedin bedroom playing first-person shooter games, smoking dope and chatting online before falling asleep, only to wake and begin the cycle again.

Then one month ago, the bubble burst. Until then Liz had seen the drugs as the main problem. But the intensive mental-health services counselling Caleb has had in the past month has opened her eyes to the world of internet addiction.

''I don't think anyone had suggested the gaming was a problem,'' Liz said.

Clinical psychologist and addiction researcher Dr Phil Townshend. Photo supplied.
Clinical psychologist and addiction researcher Dr Phil Townshend. Photo supplied.
''My son's had problems with cannabis addiction, so I haven't really focused on it [the gaming]. But in retrospect I think it's been a really big part of it.''

Unleashed after 30 years of gestation in university laboratories, it is only 20 years since the internet loomed large on the public horizon; a seemingly endless digital tsunami relentlessly reshaping the technological and social landscape.

In the past 12 years, the percentage of New Zealand households with an internet connection has risen from 37% to 75%. Now more than four-fifths of connected households have a wireless router.

And Statistics New Zealand surveys reveal last year more than half of all New Zealanders made an online purchase, two-thirds engaged in social networking, and three-quarters of people aged 15 to 24 used the internet to listen to or download music.

The internet has gone way beyond mainstream. It is seeping into all the pores of our existence. Wherever and whenever, we plug in to be entertained, informed, to connect and escape.

Gambling and addiction counsellor Chris Watkins. Photo from ODT files.
Gambling and addiction counsellor Chris Watkins. Photo from ODT files.
It is everywhere, essential and ever-expanding but is still, in many ways, brand-new, unknown, and ever-changing.

Who, even two years ago, would have imagined online currency would be giving taxmen jitters, or that websites would be the gathering place for ordinary people evaluating others' illnesses and betting on the likelihood of a correct diagnosis?

But emerging just as quickly are an increasing number of stories of damage and harm. A new term has been coined, internet addiction.

Chris Watkins, who is a Dunedin-based gambling and addiction counsellor working for the Salvation Army, tells of two recent cases of local women obsessed with the social network game FarmVille. One woman, a single worker, was missing meals and neglecting self-care in favour of playing the Facebook game up to eight hours a night.

The other, a stay-at-home mum, was ignoring housework and family relationships in order to access the fantasy world ''which seemed better than her own life''.

Online poker is becoming a growing problem for often bright and competitive young men who repeatedly spend all night, and all their rent money, gambling on their laptops, Problem Gambling Foundation Dunedin branch counsellor Thomas Moore says.

''Even Trade Me can be compulsive. We are hearing that strongly,'' Mr Moore says.

''And then there's the elephant in the room - pornography.''

Blondie Ngamoki, who is kaiwhakahaere (manager) of Mirror Services youth day programme, says about 95% of the Otago young people she sees for drug and alcohol addictions also have online addictive behaviours.

Local and overseas experience suggests no group is immune. Research published last year by Edith Cowan University, in Perth, Western Australia, revealed a fifth of Australian children had ''gone without eating or sleeping because of the internet''.

The oldest problem online video-gamer the Problem Gambling Foundation has seen was aged 60.

Reports also indicate internet addiction has become a serious public health concern in China, Korea, and Taiwan.

It is no surprise therefore that the latest edition of the worldwide psychiatric profession's bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), will include a possible new addiction, ''internet-use disorder''.

In recognition of the threats posed by over use of these seemingly indispensable technologies, DSM-5, which will be released next weekend, will list internet-use disorder as a condition ''recommended for further study''.

It is such a new phenomenon that it is difficult even to talk about, clinical psychologist Dr Phil Townshend says.

''We don't yet have the right language for it,'' Dr Townshend, who is also the Wellington-based research director for the Problem Gambling Foundation, says.

''There's nothing about the internet itself that is addictive. The internet is just a mode of access. It's like a syringe. It's what's in it that counts.''

And because it is so new, everyone from parents and counsellors to digital natives who have only ever known a connected world, are still trying to figure it out.

''I had a young man turn around to me and say, well how much time do you spend on the computer?'' Dr Townshend said.

''And I thought, well actually, a lot of time. It's a new area for all of us. We don't know what the new norms will be ... and how to handle it appropriately.''

What is known is that what is addictive in the real world is just as addictive in the virtual one.

Visceral arousal - that bodily feeling of anticipation triggered in pokie addicts by the sights and sounds of a gaming lounge is the same as that experienced when playing the slots online.

And the same goes for all the other addictions. It is that feeling of needing to have just one more go, or one more look, often followed by the desire to take or do something more extreme the next time to get the same kick.

At a chemical level it is all about dopamine. This chemical messenger (neurotransmitter) helps control the brain's reward and pleasure centres. It enables us to see rewards and creates the sense of desire that helps us pursue those rewards.

''As a species we are hunter-gatherers who are hard-wired for rewards in order to survive,'' Dr Townshend says.

What is becoming apparent, however, is that the internet has a distinctive feature - almost unlimited opportunity.

And how this plays out online is no more evident than in the world of first-person shooter games, in which the player is often one of a small group on an armed mission against overwhelming odds.

The sense of purpose, comradeship, danger and accomplishment all trigger feelings of anticipation and pleasure.

But whereas if you drink too much you eventually become unconscious, or if you play the pokies for too long you eventually run out of cash, with gaming ''while you still have a functioning index finger you can keep playing ... and your brain keeps basking in dopamine'', Dr Townshend says.

The problem with the internet is there is no natural end point. In the virtual world most things are just a tap of the finger away and instant gratification is offered as a perpetual state of being.

The concern is compounded when online games and activities are deliberately designed to exploit their addictive potential, Mr Watkins says.

The internet has enabled the ''democratisation of knowledge'', but gambling advertisements on social media websites and games that allow players to pay real money to enhance their online status are just two examples of what he terms the ''unethical use of it by people trying to make money out of addictive stuff''.

IT is important not to view every child on a computer as a problem, but there is a typical pattern emerging, counsellors and psychologists say.

Parents provide their young child with a computer because ''that is the way of the future''. They start to use it as a surrogate babysitter. Then as the child grows and spends more time online, they ask for a faster and more powerful computer and other connected devices to enable them to do more online more often.

Before the parents know it, their child is an adolescent who is increasingly disconnected from family and the world around them and who becomes extremely grumpy and even aggressive if attempts are made to ''unplug'' them.

Caleb started playing video games as a 10-year-old, shortly after Liz's marriage ended and she moved to Dunedin with her son.

He was tall, athletic and loved all sports. The video games were just a seemingly healthy social activity.

''He would have his friends over. You could hear them laughing and joking,'' she recalls.

Then the cartoon-character games gave way to games with more adult themes.

''It did used to worry me,'' Liz says.

''But he'd say it's only a game. I can tell the difference between real life and games.''

The gaming got serious when Caleb was about 15. For Christmas, Liz bought him a new video console that gave him the capacity to play online.

The friends he used to play with dropped away and all his focus went into the online gaming, where he considered himself quite an expert.

All-night weekend gaming sessions led to truancy. There were changes of school, and a short bid at polytechnic study.

Caleb had been seeing counsellors to try to address the cannabis addiction.

''But by then everything was a bit overwhelming for him,'' Liz said.

He retreated to his bedroom.

''It's terrible ... but you feel you know where they are. They're in their room ... they're under the roof, so you feel, well, they're safe. But they're not, because it's taking them to another place in a way.''

Professionals are still trying to work out how best to respond to internet addictions.

One counterintuitive response in Nelson is to openly encourage online gaming in the school environment.

Face-to-face competitions are organised for pupils of Nayland College who are interested in gaming, Dr Townshend says.

''They're trying to bring it out of the closet and make it a sport. It's a great approach because it is too easy to catastrophise this. We need to embrace it but learn how to manage it.''

And what has already been learned from working with people with internet addictions has the potential to help all of us ''embrace it but ... manage it'' in a safe and healthy way.

Warning signs to watch for are a ''narrowing of behavioural repertoire'', Dr Townshend says.

''If this is all you do, it is probably a problem. But if it's one of a variety of activities then it's probably not.''

The same goes for the priority given to the activity.

''If it's after other things have been done, then perhaps it's OK.''

The key safeguard with internet use - the one step it certainly will not take for us - is establishing limits.

''People will need to learn to put in those end points.''

Liz concurs. Caleb has been told structure and routine, including limits on his gaming, will be crucial for his recovery.

The past year has been ''a really, really rough ride''.

It has left her with regrets and ''a lot of guilt'' which she would like to see other parents avoid.

''I know at heart he's this lovely boy.

''It's very easy when they're little to sit them in front of something that entertains them, so you can get on with your day or whatever you have to do.

''But as parents we really have to take responsibility and think about what that thing's doing for them.''


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