Jan 5 2010
Heavensfield is a nerd-only rehab unit. If you’re worried about the tingly feeling in your left arm after New Year's, then look elsewhere. No, Heavensfield – as the first ever in-patient internet addiction clinic outside of the Far East – concerns itself chiefly with dorks who slay orcs.
Seattle psychologist Dr Hilarie Cash first became interested in computer addiction 15 years ago after treating a guy who was addicted to text adventures. Since she set up the centre in September, she’s had clients from right across the US. Some of them wielded knives in attempts to get their precious PCs back. Others lost their jobs, flunked out of college, created complex webs of deception, and rang up massive credit card debts to feed their habits. Some even barricaded themselves in one-bed apartments 23 hours a day for five years before they found help. Most incredibly of all, some of these people had girlfriends.
Dr Hilarie Cash has been to the bottom. She’s glimpsed the lowest depths of nerdy depravity. She knows only one thing for sure, and it’s that the internet is a nasty piece of work that’s bent on destroying every fibre of your sad little life.
Vice: Away from the negatives of addiction, in your professional opinion, isn’t there a flipside? Have you noticed instances of computers actually making people smarter?
Dr Cash: In certain cases you can have people who are raised with computers who are smart and worldly. But what I tend to see is people are physically at a deficit because they’re chronically sleep-deprived, they’ve got carpal tunnel syndrome and they’re socially uncomfortable in the real word, as the only place they’re comfortable is in cyberspace. Remember that many of my patients have never dated – they’ve handled their sexuality with pornography, which means that their sexual template is divided out between sex and intimacy. That’s a recipe for an intimacy disorder – they don’t know how to bring sexuality and social things together.
What’s the most extreme case you’ve treated so far?
There are two that are especially interesting to me, because these were both young men who weren’t diagnosed with any problems that a clinician would have spotted before they became addicted. One of them was 25, and had been the star of his high school in a small town. He was extremely smart, had an active social life, was involved in athletics, had a girlfriend. He got accepted into an Ivy League school. He was a gamer, but he just played very moderately. Then, in fairly short order, he flunked out of this university because of this addiction and moved to Seattle. Once there, he made a commitment to his wife not play games anymore. He did OK for a year. But then he gave in to his cravings, secretly – unknown to his wife. As he plummeted down the rabbit hole of addiction, he had to be increasingly deceptive. So he created this amazing house of cards to hide his problem. He would come to bed with her, then sneak up in the middle of the night. In the morning, he’d get dressed, and pretend he was going to work, but instead go off and play the game. So after a while, he was fired from his job. But he still never told his wife. He kept up the charade by paying his bills with credit cards, driving himself deeper and deeper into debt.
Jesus, and the other?
The second case was a young man who, again, was not clinically diagnosed with anything. Again, he had dated before, although it was an illicit relationship, because his parents were very strict, and didn’t want him dating anyone. He had been bullied at school, so he had rage from that, and he had rage towards his father, who was very strict. When he got to college, the first thing he did was hook up with all the other gamers. But in that environment, he completely let himself go: he managed to squeak through the first year, then flunked out every year for three years – he’d sign up at the start, then not go to any classes. He even created a false transcript to fool his parents. Of course, once his parents found out, they stopped supporting him. Then he had to live on his meagre savings, which he did for almost five years; he was as poor as a church mouse and almost never went out of his little one-room apartment, or left the screen. His existence was all online. He was suicidally depressed, but refused to abstain from gaming. He absolutely wouldn’t stop. So we had to work on strategies to limit his use to appropriate times and amounts. Eventually, he got himself back into college after he wrote an essay about what had happened to him. But when he’s not studying, out of term, he still binges – I mean, I consider it bingeing – and then he has to pull himself out of that. He’s maybe a bit of an extreme, but in some respects he’s very typical.
Is gaming the only sort of internet addiction you’re treating? Do you have many internet-porn addicts?
We treat a lot of porn addicts too, but they really are bracketed in their own category. For the most part, they are men who were exposed to porn at a young age, or were sexualised at a young age, maybe through abuse. They’re older – 30, 40, 50. But almost universally, as I said before, the gamers I work with are accessing pornography, and my concern is that it’s a real ticking time-bomb that’s being created for ten or 20 years down the road.
Is there ever a genuinely violent side to these people?
There was a young man who ended up having to have an intervention. When the parents tried to take the computer out of his room, he tried to attack them with a knife. They just backed down, gave him his computer, went away. A teenager whose parents just take the computer away cold turkey – it’ll send them into a rage, and that rage can be quite dangerous. A gentler way of dealing with these things has been pioneered by Ken Woo – he’s a psychologist in California who invented a device that fits on the computer and just controls gaming. If anyone took the device off, it would destroy the computer, but the parents can set it for just incrementally less and less time, to just wean them off gaming by, say, ten minutes a day.
Are games becoming more addictive?
All games focus on the idea of unpredictable reinforcement – you don’t know what’s going to happen when you reach the next stage, but you get "rewards" or "treats" at random points. And people who develop successful games have figured this out. In fact, many games companies hire professional psychologists these days to help them develop the best unpredictable reward payoff structures. All of this is very powerful – it stimulates the reward centres of the brain into releasing dopamine and opiates. When those chemicals are highly elevated and it’s prolonged, then you are starting to change the chemical setup of the brain. Do that over a long period of time, and people either develop tolerance or go into withdrawal – and that is addiction.
Are you a big net user too? You don’t feel much direct empathy with your clients?
I don’t. I’m not highly rewarded by using the internet, my brain isn’t wired for it. I far prefer my social interactions to be face-to-face, so it’s always been a struggle for me to understand the rewards. I just use email, really.
How does the treatment regime work when you’re brainwashing them – is it all stand-by-your-beds and dousing them with buckets of cold water?
The philosophy is to give them the opportunity to reconnect with the real world. We’re helping them plan for when they are reintegrated with the real world, building social skills, all of that. We need to re-teach them what they have unlearned – they want immediate gratification, they haven’t learned to be persistent in terms of achieving their goal. So there’s a beautiful house in the country where the centre is, and I come there once a week to do psychotherapy. There are two bedrooms with three beds each. Everybody signs up for their chores. Then they have coaching – teaching about addiction. They have ITTA meetings, which is a 12-step programme that they’ve founded there – Internet and Technology Addicts Anonymous. They’re practicing meditation all days of the week. Then there’s free time in the evening, with lights out around 10:30.
Which would you say is going to be more hazardous to society over the next ten years: gaming addiction or porn addiction?
I think they’re equally hazardous. Pornography taps into anyone’s sex drive or need for sex. I’m sure the numbers of sex addicts far outnumber game addicts. That will probably continue, but I know that the internet-based games are typically highly addictive.
A bleak future, then. You’re not a techno-positivist?
You know, I recommend to you a wonderful book called Distracted, by Maggie Jackson. She’s a reporter from the Boston area who’s talking about how a subject you and I haven’t even touched on has turned us into highly distracted human beings. How we can no longer just sit quietly and turn off our cellphones, how technology interferes with our ability to be introspective and to connect with others in a meaningful way. We’re losing our ability to stay focused: we just want to be distracted, and we don’t know what to do if we’re not distracted. When I’m in a bleak state of mind, that’s how I think it’s going to turn out – that we’re entering a dark age. On the other hand, I sometimes feel more optimistic: I think this is a powerful technology that’s very new, and we just haven’t matured, socially, enough to deal with it. We need to figure out how to build the firewalls into our lives that can help us cope with its influence. It’s much more analogous to our dealings with cars. When we first had cars, we didn’t have stop signs or safety belts. But through all the accidents that happened, they figured out what they needed, and now driving a car is pretty safe. If we figure out a social system where we understand what’s healthy and what’s not healthy, society will get better.