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By Kimberly S. Young
University of Pittsburgh at Bradford
Posted by permission of Dr. Young. Copyright by Dr. Young. Originally posted at https://www.netaddiction.com/articles/habitforming.htm
ABSTRACT
Research has identified pathological Internet use (PIU) which has been associated with significant social, psychological, and occupational impairment. Prior research in the addictions field has explored the addictive qualities sustaining drug and alcohol addictions, pathological gambling, and even video game addiction. However, there exists little explanation for what makes computer-mediated communication (CMC) habit forming to the determent of one’s personal well being. Therefore, this exploratory study classified 396 cases of dependent Internet users (Dependents) based upon an adapted version of the criteria for Pathological Gambling defined by the DSM-IV (APA, 19950. Qualitative analyses attempted to identify the psychological reinforcement underlying CMC. Results suggested that information protocols were the least addictive functions and that interactive aspects of the Internet such as chat rooms were highly addictive, creating an atmosphere for Dependents to seek out companionship, sexual excitement, and alter identities. Implications for assessment and treatment are discussed
What Makes the Internet Addictive: Potential Explanations for Pathological Internet Use.
What Makes the Internet Addictive:
Potential Explanations for Pathological Internet Use.
While many believe the term addiction should only be applied to cases involving the ingestion of a drug (e.g., Walker, 1989; Rachlin, 1990), similar criteria have been applied to a number of problem behaviors such as eating disorders (Lacey, 1993; Lesieur & Blume, 1993), pathological gambling (Mobilia, 1993; Griffiths, 1991 and 1990), computer addiction (Shotton, 1991) and video game addiction (Keepers, 1990). Today, among a small but growing body of research, the term addiction has extended into the psychiatric lexicon that identifies problematic Internet use associated with significant social, psychological, and occupational impairment (Brenner, 1996; Egger, 1996; Griffiths, 1997; Morahn-Martin, 1997; Thompson, 1996; Scherer, 1997; Young, 1996).
Young (1996) initiated telephone surveys to formally study pathological Internet use (PIU) based upon modified criteria of Pathological Gambling defined in the DSM-IV (American Psychiatric Association, 1995). Case studies showed that Dependents classified used the Internet an average of thirty-eight hours per week for non-academic or non-employment related purposes which caused detrimental effects such as poor grade performance among students, discord among couples, and reduced work performance among employees. This is compared to non-addicts in this study who used the Internet an average of eight hours per week with no significant consequences reported.
Subsequent research on PIU based upon a self report determination of addiction were conducted utilizing on-line survey methods. Brenner (1996) received 185 responses in one month to his on-line survey regarding behavior patterns associated with the Internet. His survey showed that 17% used the Internet more than 40 hours per week, 58% said that others had complained about their excessive net usage, and 46% indicated getting less than 4 hours of sleep per night due to late night log ins. Egger (1996) received 450 responses to his on-line survey. Self-professed addicts in this study often looked forward their next net session, felt nervous when off-line, lied about their on-line use, easily lost track of time, and felt the Internet caused problems in their jobs, finances, and socially. Steve Thompson (1996) developed the “McSurvey” which yielded 104 valid responses. Among respondents to his on-line survey, 72% felt addicted and 33% felt their Internet usage had a negative effect on their lives. Surveys conducted on college campuses (Morhan-Martin, 1997; Scherer, 1997) also supported that students suffered significant academic and relationships impairment due to excessive and uncontrolled Internet usage. Formal Computer/Internet addiction treatment centers have even been established at such clinical settings as Proctor Hospital in Peoria, Illinois and Harvard affiliate McLean Hospital in response to the serious impairment caused by PIU.
Despite the increased awareness that PIU is a legitimate concern, little is understood about what makes computer-mediated communication (CMC) habit forming and often times “addictive.” Therefore, using case studies collected as part of Young’s original 1996 study, this paper discusses the potential explanations of PIU and offers implications for future evaluation and treatment.
Subjects
Participants were volunteers who respondent to: (a) nationally and internationally dispersed newspaper advertisements, (b) flyers posted among local college campuses, (c) postings on electronic support groups geared towards Internet addiction (e.g., the Internet Addiction Support Group, the Webaholics Support Group), and (d) those who searched for keywords “Internet addiction” on popular Web search engines (e.g., Yahoo). For a detailed discussion of the self-selection bias inherent in this methodology and limitations of these research findings, please refer to my paper entitled “Internet Addiction: The Emergence of a New Clinical Disorder.”
Materials
An exploratory survey consisting of both open-ended and closed-ended questions was constructed for this study that could be administered by telephone interview or electronic collection. The survey administered a Diagnostic Questionnaire (DQ) containing the eight-item classification list. Subjects were then asked such questions as : (a) how long they have used the Internet, (b) how many hours per week they estimated spending on-line, (c) what types of applications they most utilized, (d) what made these particular applications attractive, (e) what problems, if any, did their Internet use cause in their lives, and (f) to rate any noted problems in terms of mild, moderate, or severe impairment. Lastly, demographic information from each subject such as age, gender, highest educational level achieved, and vocational background were also gathered..
Procedures
Telephone respondents were administered the survey verbally at an arranged interview time. The survey was replicated electronically and existed as a World-Wide-Web (WWW) page implemented on a UNIX-based server which captured the answers into a text file. Electronic answers were sent in a text file directly to the principal investigator’s electronic mailbox for analysis. Respondents who answered “yes” to five or more of the criteria were classified as addicted Internet users for inclusion in this study. A total of 605 surveys in a three month period were collected with 596 valid responses that were classified from the DQ as 396 Dependents and 100 Non-Dependents. Approximately 55% of the respondents replied via electronic survey method and 45% via telephone survey method. The qualitative data gathered were then subjected to content analysis to identify the range of characteristics, behaviors and attitudes found.
Demographic Data
Means, standard deviations, percentages, and coding schemes were utilized to analyze data. The sample of Dependents included 157 males and 239 females. Mean ages were 29 for males, and 43 for females. Mean educational background was 15.5 years. Vocational background was classified as 42% none (i.e., homemaker, disabled, retired, students), 11% blue-collar employment, 39% non-tech white collar employment, and 8% high-tech white collar employment.
Addictive Applications
The Internet itself is a term which represents different types of functions that are accessible on-line. Therefore, before discussing addictive nature of the Internet, one must examine the types of applications being used. When Dependents were asked “What applications do you most utilize on the Internet?”, 35% indicated chat rooms, 28% MUDs, 15% News groups, 13% Email, 7% WWW, and 2% Information Protocols (e.g., gopher, ftp, etc.,). Upon examination, traditional information protocols and Web pages were the least utilized among Dependents compared to over 90% of respondents who became addicted to the two way communication functions: chat rooms, MUDs, news groups, or email. This makes the case that the database searches, while interesting and often times time-consuming, are not the actual reasons Dependents become addicted to the Internet.
Chat rooms and MUDs were the two most utilized mediums which both allow multiple on-line users to simultaneously communicate in real time; similar to having a telephone conversation except in the form of typed messages. Over 1,000 users can occupy a single virtual area. Text scrolls quickly up the screen with answers, questions, or comments to one another. Privatized messages are another available option which allow only a single user to read a message sent.
Multi-User Dungeons, more commonly known as MUDs, differ from chat rooms as these are an electronic spin off of the old Dungeon and Dragons games where players take on character roles. There are literally hundreds of different MUDs ranging in themes from space battles to medieval duels. In order to log into a MUD, a user creates a character name, Hercules for example, who fights battles, duels other players, kills monsters, saves maidens or buys weapons in a make believe role playing game. MUDs can be social in a similar fashion as in chat room, but typically all dialogue is communicated while “in character.”
When asked about the main attractions of using these direct dialogue features, 86% of Dependents reported anonymity, 63% accessibility, 58% security, and 37% ease of use. Young (1996) previously noted that “clear differences exist among the specific Internet applications utilized between Dependents and Non-Dependents. Non-Dependents predominantly used those aspects of the Internet which allow them to gather information and to maintain pre-existing relationships through electronic communication. However, Dependents predominantly used those aspects of the Internet which allow them to meet, socialize, and exchange ideas with new people through highly interactive mediums.” Consistent with these findings, content analysis classified three major areas of reinforcement pertaining to these two way communication features: social support, sexual fulfillment, and creating a persona. Each of these will be discussed in more depth.
Social Support
Social support can be formed on the basis of a group of people who engage in regular computer-mediated communication with one another for an extended period of time. With routine visits to a particular group (i.e., a specific chat area, MUD, or news group), a high degree of familiarity among other group members is established forming a sense of community. Like all communities, the Cyberspace culture has its own set of values, standards, language, signs, and artifacts and individual users adapt to the current norms of the group. CMC creates the opportunity to disregard normal conventions about privacy (e.g., by posting personal messages to public bulletin boards), and the removal of time and space separations between work and play, office and home, all communicate and reinforce the norms associated with this subculture beyond all boundaries (Kielser et al, 1984).
Once membership into a particular group has been established, a Dependent relies upon the conversation exchange for companionship, advice, understanding, and even romance. Rheingold (1996) explained that the ways in which people use CMC always will be rooted in human needs, not hardware and software and states how “words on a screen are quite capable of moving one to laughter or tears, of evoking anger or compassion, of creating a community from a collection of strangers.” The ability to create virtual communities that leave the physical world behind such that well known, fixed, and visual people no longer exist form a meeting of the minds living in a purely text-based society.
Despite that such interactions are purely text-based conversations, the exchange of words empower a deep psychological meaning as intimate bonds are quickly formed among on-line users. In Cyberspace, social convention of rules of politeness are gone, allowing personal questions about a person’s marital status, age, or weight to be asked upon an initial virtual meeting. The immediacy of such open and personal information about oneself fosters intimacy among others in the community. Upon a first meeting, an on-line user can tell a complete stranger about his personal life – leaving him feeling close. Through this immediate exchange of personal information, one can easily become involved in the life of others who they have never met – almost like watching a soap opera and thinking of the characters as real people.
As they become more involved in the virtual group, Dependents were able to take more emotional risks by voicing controversial opinions about religion, abortion, or other value laden issues. In real life, Dependents were unable to express these opinions to their closest confidants or even their spouses. However, in Cyberspace, they felt free to express such opinions without fear of rejection, confrontation, or judgment since the presence of others was less readily available and their own identities were well masked. For example, a priest who was active and well respected in his parish disagreed with aspects of the Catholic faith such as not allowing women to be priests and mandatory celibacy. Yet, he would never voice his reservations about the Catholic faith publicly to his congregation. He kept his views to himself until he discovered the “alt.recovery.catholicism” discussion group for former Catholics, where he openly voiced his opinions without fear of retribution. Beyond the airing of deep rooted feelings, the Internet allows the exchange of positive and negative feedback elicited from a quorum of other users. Those who shared his views comforted the priest, and those who challenged him provided a dialogue to debate such issues without revealing his vocation or identity.
The formation of such virtual arenas create a group dynamic of social support to answer a deep and compelling need in people whose real lives are interpersonally impoverished. In particular, life circumstances such as home bound caretakers, the disabled, retired individuals, and homemakers limit access to others. In these cases, individuals are more likely to use the Internet as an alternative to develop such social foundations that are lacking in their immediate environments. Furthermore, the need for social support may be higher in our society due to the disintegration of traditional community-based neighborhoods and the growing rate of divorce, remarriage, and relocation. Lastly, individuals with a prior history of psychiatric illness may be more reliant upon CMC to satisfy social support needs. For example, Young (1997) found that moderate to severe rates of depression co-exist with pathological Internet use. It is plausible that depressives who suffer from low self-esteem, a fear of rejection, and a higher need for approval use the Internet in order to overcome these real life interpersonal difficulties through such social community building generated through CMC.
Sexual Fulfillment
Erotic fantasies can be played out such that people can engage in novel sexual acts commonly known as Cybersex. Chat areas with titles such as “MarriedM4Affair” “The Gay Parade” “Family Time” “SubM4F” or “Swingers” are designed to encourage on-line users to engage explicitly in erotic chat. There are hundreds of sexually explicit rooms entailing submission, dominance, incest, fetishes, and homosexual fantasies. These rooms are easily available on-line, with a little experimentation of various channels to select from, an on-line user can review such titles and with a click of a button be inside one of these rooms. Furthermore, erotic handles can be created to express the type of sexual fantasy being sought such as “Ass Master” “Golden Shower” “M 4 hot phone” “daddy’s girl” or “Whips & Chains.”
Using CMC for Cybersex was perceived as the ultimate safe sex method to fulfill sexual urges without fear of disease such as AIDS or herpes. Further, Cybersex allowed Dependents to explore the mental and subsequent physical stimulation of acting out forbidden erotic fantasies such as S&M, incest, or urination. Unlike 900 numbers which can be traced or risking being seen at an adult bookstore, Dependents viewed Cybersex to be completely anonymous and unable to be traced. They felt free to carry out illicit sexual impulses and were able to act in ways that differed from real life conduct without fear of repercussion. In general, de-individuation among users or “the process whereby submergence in a group produces anonymity and a loss of identity, and consequent weakening of social norms and constraints” (e.g., Zimbardo, 1969) facilitated such sexually uninhibited behavior among Dependents. The ability to enter into a bodiless state of communication enabled users to explore altered sexual states of being which fostered emotions that were new and richly exciting. Such uninhibited behavior is not necessarily an inevitable consequence of visual anonymity, but depends upon the nature of the group and the individual personality of the on-line user.
Finally, for those Dependents who felt unattractive or maintained few dating opportunities, it was perceived easier to “pick up” another person through Cybersex than in real life. As one Dependent who used the handle “The Stud” explained “I am a 49 year old balding overweight man. But I tell young ladies in Cyberspace that I am 23, muscular, blonde hair and blue eyes. Otherwise, I know that they aren’t going to want to have sex with an old, fat guy.”
Creating a Persona
Each on-line user has the ability to remove the imposed constraints of real life in order to experiment with altered perceptions of oneself (Rheingold, 1996). Rheingold (1996) states that “we who populate Cyberspace deliberately experiment with fracturing traditional notions of identity by living as multiple simultaneous personae in different virtual neighborhoods.” Later research conducted by Turkle (1995) states how the Internet “is another element of the computer culture that has contributed to thinking about identity as multiplicity, allowing a person to ‘reconstruct’ their identity.” Consistent with these observations, findings in this study showed that CMC creates a virtual “stage” where a person can “act” in a new role through the creation of fictitious handles which alter physical characteristics such as gender, age, or race that cultivate a persona or false image of oneself.
Creating a persona through a fictitious handle allows one to transform himself mentally into a new person on-line. Most times, an on-line persona is a paradox of one’s real life. A purely text-based existence that is qualitatively different than the physical world. Socioeconomic status, gender, age, and race all play a role in the development of identity which build the basis of interpersonal interactions. In Cyberspace, such issues die into the background as all virtual inhabitants are created equal. This equal footing fosters confidence when interacting within CMC. Once real world inequalities enter into the picture – it becomes difficult to transfer this virtually acquired behavior without reinforcement. Therefore, such text-based identities appear to be firmly planted inside the computer screen, leaving these obtained attributes lost in Cyberspace.
One Dependent, a 50 year old construction worker described a “good life” with his wife and kids, yet found himself emerge as “Lucky” a rich entrepreneur when he entered the “Millionaires Lounge” chat room. As “Lucky” he realized that he didn’t feel the achievement and recognition he deserved as he explained, “It didn’t occur to me until I pretended to be someone else on-line, but when I look back, I wish I was more successful and financially secure.” Lucky found it exciting to be able to step out of all his roles as a husband, father, and provider only to become a completely different person on-line. His mental absorption in a new role that had nothing to do with his real life served as an amusement just like going to the movies, watching television, or playing a video game. Such amusements allow the mind to take a mental vacation from the stress and demands of the roles we play in real life. Not only does the Internet serve the same stress relief as these other amusements, but through creating a persona, a person is able to experience how others will respond to this new role.
Beyond amusement, reinventing oneself is also a way to fulfill an unmet need. The loss of a social identity on-line allows one to reconstruct an “ideal self” in place of a poor self-concept. This “ideal self” becomes a secret life carried out in the confidential surroundings of Cyberspace. Those who suffer from low self-esteem, feelings of inadequacy or frequent disapproval from others are at the highest risk for developing a secret on-line identity. Such negative self-concepts lead to clinical problems of depression and anxiety, which also may be intertwined with excessive net use and manipulated self-presentations. Persons who created a persona often times depended upon the release of their secret lives in order to block out such unpleasant thoughts about themselves and their situations. Further, they were able to meet previously unmet psychological needs by adopting an on-line identity which masked interpersonal insecurity or which cultivated a fantasy life that satisfied a personal wish fulfillment. The two most unmet psychological needs are an expression of a repressed personality trait and feelings of recognition and power.
Unlocked Personalities
Personas offer individuals an outlet to experiment with accessing different parts of their personality, allowing an individual to expand the range of emotions experienced and expressed towards others. Psychoanalytic theory examines repressed parts of oneself that are experienced on unconscious levels which reveal themselves in slips of the tongue or dreams (Freud, 1951). Our unconscious motives drive human behavior yet remain largely outside our awareness.
Dependents report a sense of being able to “unlock parts of themselves which have been submerged” in their real lives through their personas. The ability to unlock repressed aspects of the self can take on various forms. In Cyberspace, a shy person can become outgoing, a non-sexual person can be sexual, a non-assertive person can be forceful, or an aloof person can be gregarious. Dependents are able to play out parts of themselves that they fear or hate to consciously confront such aspects.
For example, Tony, married for three years with one eighteen month old daughter became addicted to DOOM-II on a local BBS. He said, “By day I am a mild-mannered husband, but at night I become the most aggressive bastard on-line.” Tony had always been a loner. When he grew up, he described how he as the middle child, was ignored by his parents. He had built up a great deal of resentment towards his siblings and hated his parents for such neglect. But on the outside, they always looked like the perfect family and no one knew of the anger and resentment that he felt inside. He was afraid to give into his anger, yet in Cyberspace, he was able to confront such a fear and dominant others allowing him to take on a more aggressive role.
Through Tony’s on-line experiences, he was able to find a safe outlet to express his anger in the form of a character is this virtual role playing game. He could beat up other players, kill monsters, slay dragons – continually releasing such pent up aggression. Tony believed that this emotional outlet was not only exciting but also filled a void. As he described “I became another person who was everything I wasn’t in real life. I became so fixed on being a good little boy for my parents, that I stifled all my other emotions.” Unleashing a repressed part of himself, Tony felt it kept him in balance so that he didn’t explode towards others such as his wife, boss, or daughter.
However, with a click of a button, Tony’s aggressive personality closed back up and he resumed his “good little boy” role of being a good husband and father. Until he became so absorbed in his DOOM role, that he neglected his family. He felt it intolerable to be disturbed when he was on-line. He soon developed a similar resentment that he felt towards his siblings towards his wife for taking time away from the Internet. Tony snapped when she needed attention, and he felt angry when she wanted him to help with their child. The potency of awakening such repressed aspects of his personality was detrimental to the quality of his family life. Now that he had “unlocked” his repressed aggressive side, he didn’t know how to suppress it again, nor did he know how to effectively channel it into his real life relationships.
Like many Dependents, what is awakened emotionally through the emergence of repressed aspects of the self are difficult to submerge back into the unconscious. Now that this material is open to the conscious, one must deal with its aftereffects. That is, one must learn to incorporate such aspects into their current personality and not limit such roles to Cyberspace.
Recognition and Power
Personas allow individuals to virtually obtain recognition and achieve power most saliently through the creation of MUD characters. Character forces exist which consist of ranking creating the illusion of leadership roles and subordinates. MUD players begin at the lowest rank and move to the next highest rank by collecting points, strength, powers, and weaponry within the game. Dependents desire to become more potent in their characters which leads to recognition as a powerful leader among subordinate players.
Dependents closely identified with their characters such that they personally experienced this sense of recognition, gaining self esteem with each virtual encounter. Turkle (1995) states how “the virtual reality becomes not so much an alternative as a parallel life.” That is, an on-line player can project an altered identity and act “in character” amongst other on-line players also acting “in character.” Indeed, Dependents experience a meshing of boundaries between the virtual role and self. In particular, MUDders blur the distinctions of their own personality and the personality of their character. By reconstructing oneself, a MUDder is able to develop personal attributes not displayed in daily life. A weak man can become strong, a fearful man can become courageous (Turkle, 1995).
For example, Mark admitted, “All I do is play MUDs. I was on it 24 hours a day, every day, for a solid week. My grades fell because I skipped all my classes, never slept, and certainly never studied. But I didn’t care. All that mattered to me was MUDding.” Socially, Mark had not dated much on campus and didn’t participate in any social clubs. He was from a small town and had never traveled much outside of it. This 19 year old college sophomore immediately made it clear why he played MUDs, as he constructed a life that was more expansive than his own. Through MUDding, Mark was able to learn about European culture, command troops, and even marry a female player named “Heron” – the ceremony of course took place by the captain of one of the sea vessels.
Turkle (1995) describes a MUD as a kind of Rorschach Ink Blot in that players can project a fantasy. But unlike a Rorschach, it does not stay on the page. Virtually, Mark had achieved a position of ultimate status as “Lazarus” in the game Mega Wars. He lead the war in several attacks as Admiral of the Empire. Troops from the Coalition feared Lazarus and made that clear. Mark said “I had become a legend as I was the best leader most had seen.” Achieving a powerful position bolstered his self esteem as he earned recognition by becoming a legend in this MUD. However, upon return to his real life, Mark was still an awkward sophomore with low grades, few friends, and no date on Saturday night.
These findings suggest that information protocols are the least utilized among Dependent on-line users while two way interactive functions such as chat rooms and Multi-user Dungeons are the most utilized. This study also showed that anonymous interactive functions afford Dependents a mechanism to seek out social support and sexual fulfillment directly. Furthermore , the cultivation of new personas through the creation of fictitious handles inspired Dependents to discover repressed personality traits and heighten their experience of recognition and power. The mood states derived from such on-line stimulation ranged from reduced loneliness, improved self-esteem, and euphoria which acted as positive reinforcement for excessive Internet use.
CMC was able to comfort Dependents who were able to replicate the unmet need of confidential social support. However, on-line relationships often times are not integrated into real life situations due to the limitations of geographic disbursement among users. As Turkle (1995) notes “computers offer the illusion of companionship without the demands of friendship.” Therefore, the temporary support fix available through the Internet does not succeed the long lasting commitment formed among real life maintenance of interpersonal relationships. Furthermore, as Young (1996) noted, impairment to relationships in the form of social withdrawal, marital discord, and divorce were the leading consequence of PIU. Therefore, while Dependents maintained satisfying on-line relationships, these highly interfere with proper socialization of real life relationships. Finally, while the ability to create on-line personas provide users with a safe outlet to achieve unmet psychological needs, the mental absorption into a new character role negatively impacted real life interpersonal and familial functioning.
Young (1997) found that 83% of addicts had utilized such technology for less than one year, concluding that new comers were more vulnerable to developing PIU. In a recent survey conducted by IntelliQuest, an Austin-based research firm, Snider (1997) reported that an estimated 11.7 million plan to venture on-line within the next year. With the rapid expansion of the Internet into new marketplaces, mental health practitioners and academicians should direct more attention into the development of effective treatment protocols to handle the increased risk of PIU among the growing population of Cyberspace inhabitants.
Future research should examine accurate diagnosis of PIU and develop a uniform set of clinical criteria, such as the modified DSM-IV criteria introduced in prior research (Young, 1996). Effective evaluation of each diagnosed case should include a review of prior psychiatric and addiction history to examine the overlay of a dual diagnosis. The treatment protocol should emphasis the primary psychiatric symptoms if present because effective management of a primary psychiatric condition may indirectly correct PIU. Clinical assessment should also include the extent of use, specific on-line functions being utilized, level of impairment, current social support, interpersonal skills, and family dynamics to help determine what unmet psychological needs are being fulfilled through CMC. Lastly, a behavioral modification protocol should be implemented that best assists patients to achieve those psychological needs being met through CMC in real life.
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