Q&A with Dr. Orzack

Computer Addiction Services

I welcome questions regarding computer addictions and will answer as many as I can. You can email me directly at Orzack@ComputerAddiction.com.

Here is a list of questions and answers regarding computer addiction and its treatment.

1. What is computer addiction?

Addiction to the computer and/or Internet is a complex problem which is developing due to the rapid spread of computer use around the world. Computer addiction, like other addictions, is the use of computers in order to change an individual's mood. Computer use becomes abuse when it interferes with one's work or school, or disrupts personal and family relationships, and becomes increasingly necessary in order to feel good.

2. Who are the people who come to see you?

I see students, professionals, housewives, the retired, everyone. Computer addicts can be people who are depressed, lonely, afraid to go out, in high family conflicts, and, generally, people in trouble because they can't leave their computers. They are men, women, and children referred by other family members, self-referred, or referred by other professionals.

3. Why is computer addiction now a problem?

Computer technology is the fastest growing industry in the world. Increased dependency on computers for information, games, fun, diversion, entertainment, and wide ranges of legal, financial, health and social services, can create problems for all of us. From computer games for kids to CHAT links to surfing the NET, computers have become increasingly important in our lives. But these tools may become problems when we allow them to dominate rather than serve our lives.

4. How did you identify computer addiction syndrome?

Initially I noticed that I was spending too much time on computer games such as solitaire and cruel. I became so absorbed in games that I neglected or delayed meeting various personal obligations. I stayed up too late. This led me to realize that behavior of this kind could be an addiction.

I have had 15 years of experience with treatment of addictive behaviors/impulse control disorders using Cognitive Behavior Therapy and 10 years in studying and interviewing "recreational drug users". I made a connection between my own computer experiences and my research in addictive disorders and treatment of addictive behaviors and impulse control disorders.

I started seeing computer over­use in patients who are recovering alcoholics, procrastinators, and depressed or lonely. The common thread was an emotional dysregulation of some type. I became aware very shortly thereafter that serious problems with pathological implications characterize others whose personal control of their computer use has become seriously diminished.

Medline searches yielded no references to Computer Addiction but Impulse Control Disorders provided some leads. DSM­IV lists many disorders; Pathological Gambling and Compulsive Shopping for instance. Unlike gambling people must be able to use their computers in work or school. Therefore, they must learn how to normalize their computer use just as those individuals with Eating Disorders need to learn to eat in order to survive.

5. How did you start Computer Addiction Services?

I started discussing my idea with colleagues and friends who sometimes laughed at first, but then invariably provided examples of persons "glued to the NET" or continually playing games.

They provided many examples of persons other than computer abusers who suffer as a result. Significant relationships with spouses, children, parents, fellow students, and coworkers can become impaired. Neglect, separation, isolation, or abandonment constitute extremes.

I heard of family counselors who received complaints about emotional relationships deteriorating. One colleague, an expert in paraphilias, started sending me information about cyberaddiction in many of his patients. Many of his patients became addicted to pornography on the Internet.

All of these stories led me to create Computer Addiction Services.

6. What are the functions of Computer Addiction Services?

Our purposes are multiple because the uses of computers are complex.

Our services provide the following:

We have heard of no other similar service facility associated with an accredited Mental Health center within the United States or elsewhere. McLean Hospital is a leading clinical treatment center and is well known for treatment of addictions and impulse control disorders as well as for research in both of these areas.

I originated the concept as part of my private practice as a Licensed Clinical Psychologist and am Founder and Coordinator of this service at McLean.

7. How do you diagnose computer addiction?

Diagnosis has been well described by a number of authors using a DSM model. For the moment there is no diagnosis acceptable to insurance carriers unless they come to accept Impulsive Control Disorder NOS (Not Otherwise Specified).

Computer Addiction may also be considered as a behavior learned in a periodic reinforcement schedule.

Diagnosis is not to increase the pathology as some suggest. Diagnosis helps formulate the specific problems and allows appropriate use of psycho­educational methods and Cognitive Behavior Therapy techniques.

8. How do you treat computer addiction?

Computer misuse is so complex and its ever increasing prevalence so challenging that a comparison with Eating Disorders is necessary. The basic approaches in treatment is to teach people how to normalize their behavior. Normalizing eating behavior is a key goal in treatment of eating disorders.

Normalizing computer uses is more and more a requirement in our modern society. The challenges that face the therapist are manifold. The lines between work and home, work and play, are unclear and vague. Therapists must help individuals conflicted by the many demands of society to learn effective coping skills that will allow them to normalize their behavior.

9. Who needs treatment?

I agree that most addicts are either game players or CHAT users, but I have known some who spend hours searching for information till they are physically exhausted, and others who spend hours file managing. These are reported by their families often as my husband disappears for hours every night into his study to hit the computer. The nature of a Web page is designed to draw you into more and more contact with a subject to be studied or learned. If they neglect their family and friends, spend too much time disappearing at work, or neglect studies, they too may be addicts. The American Psychological Association recently gave a page to a discussion of Computer Addiction. They pointed out that both students and professors can show this behavior.

Feel free to email me for further clarification or with your comments.

Computer Addiction Services

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