It's Not an Addiction

Two years back, a rehab center in Amsterdam made news headlines because they started a treatment program for video game addicts. They saw gaming problems as analogous to substance abuse and used similar treatment techniques.

But today, the founder of the program has come out and said that they no longer think that gaming problems are an addiction and they are changing how they help these gamers. Some choice quotes from the founder:

"But the more we work with these kids the less I believe we can call this addiction. What many of these kids need is their parents and their school teachers - this is a social problem."

"This gaming problem is a result of the society we live in today," Mr Bakker told BBC News. "Eighty per cent of the young people we see have been bullied at school and feel isolated."

"In most cases of compulsive gaming, it is not addiction and in that case, the solution lies elsewhere."

It's good to hear other people saying this too. As I noted in Daedalus also two years back, taking away the game doesn't solve the problem because gaming problems are not fundamentally rooted in the technology. Calling it a "gaming addiction" distracts us from the real problems.

Comments

[Chris]

1.

Nick:

Thanks for reposting this! It must have slipped through my usually tight watch of the BBC newsfeeds. :)

This makes a lot of sense to me from what we've seen in our case studies. As my wife (who is a nurse) says: it's not that the compulsive players are suffering from an addiction akin to substance abuse, it's rather that the videogames are a prop to hide behind.

Oh, also, thanks for your help in finding me a statistician for our last round of research. We didn't turn up much, but the finding that 40% of our sample were not willing to tolerate games that made them feel angry was an eye opener (since many Hard Fun games do precisely this).

Best wishes!

Chris.

[Laura]

2.

Many, many thanks for this. I had just finished reading and reviewing The Trouble with Boys by Peg Tyre, which has a chapter on video games. She, too, comes to the conclusion that excessive gaming is a result of inadequate social support, mostly at school.

As an avid gamer myself and a mother to a son who games to excess much of the time, the issue of whether gaming is or is not problematic is front and center at our house. Thanks again for the links and discussion.

[Neils Clark]

3.

Thanks for the link and the post, Nick. A few ideas follow.

Even if only society were to blame, there are societies in games. And even if we’re just talking about children, plenty of them get bullied (and perform bullying) in games. If this journalist wanted to know how gaming too much could be a uniquely social problem, then they should have interviewed Florence Chee – not Keith Bakker. Bakker has been quoted in some of the same articles as me, so I’d hardly say he’s credible.

Playing to excess has qualities that are unique – the four hour, eight hour, or fourteen hour binges we enjoy over the weekends. The peer pressure that some players exert on one another to continue their long hours online. The social, but also the physical effects of leaving children (at their various stages of development) to be babysat by a playstation or PC. The time loss – and its effects on pain relief, loss of bodily awareness, changed brain function, etc. Many of these qualities are tied to the culture online, the culture offline as well as the technology.

A game’s effects, whether social, psychological or so forth, may not all be fundamentally rooted in technology; and yet the technology is what enables the complex new forms of interaction available through something like an MMO game. Even single player games are offering experiences the likes of which are unique in human history. Go to foundational media scholars like Marshall McLuhan or Neil Postman and it seems hard to refute: technology is nothing if not two-sided. Look at Ian Bogost – how games are used socially and culturally will be tied to the technology of the platform.

Is Bakker arguing specifically that technology isn’t tied to a game’s effects? I’m not so sure. Even if he is, I’d counterpoint with another therapist: software engineer and medical doctor Jerald Block, M.D. He noted that pathological gaming, while largely correlated to co-occurring issues, can cause substantial self-sustaining problems in its own right. So while the technology probably plays a role in excess gaming, so too can our games when improperly understood.

The word addiction, as you pointed out two years ago, is loaded. In my view it has so many conflicting connotations that arguing for or against it doesn’t have much substantial meaning. There’s never been a venue of drug or alcohol treatment that hasn’t disagreed on its definitions or applicability. For games, Nick, your work is key in overcoming that kind of back and forth, because you’ve statistically show specific beneficial elements to exist in the cultures grown through online spaces. But I’d suggest that those positives aren’t solely rooted in the individual or their world outside technology – they’re also rooted in the individual’s interaction with their technologies. From game design, to server architecture, even the speed of your computer or connection – these things both enable and shape our experiences in games. Ever try healing for your five good friends when the wireless keeps cutting out? Or when the healer isn’t your main? When it's a major source of social support in your life? When they insist you stay for one more level?

While a lot of good work has been done on the beneficial elements to gaming, from cultures online to pleasant immersion, too many of those studying detrimental elements frankly appear to have not understood what happens in a videogame (though there are notable exceptions). Explaining observed problems of excess, introducing a balanced specificity, will be the first baby step in killing ‘addiction.’

[William Lederman]

4.

While games may not be addicting, they are habit forming. Especially MMORPGs. The positive feedback a player receives from an MMORPG is a major reason players will put so much time into the game. While it makes sense that you would have to address the demand for this stimulus there is also reason to address the supply of this type of stimulus.

Everyone wants positive feedback and there is no question that MMORPGs are built around not only supplying it but supplying it in a way that keeps the players coming back for more.

[Shavaun Scott]

5.

Just a quck comment: There are many addiction treatment professionals (meaning licensed psychologists) who would disagree with some aspects of Mr. Bakker's new position. There has always been some disagreement in the professional community on the definition of "addiction" and how to diagnose. Personally, I have never considered Mr. Bakker, who is not a mental health professional, to be any sort of authority on the topic. Anyone can open a 12-Step based program.

As I often say, the issue of addiction to substances or behavioral processes is always complicated. There are often co-occurring factors to be considered, and we must be very careful about labeling. Diagnosis is best left to qualified professionals.

Bottom line for most of us in the treatment field: our concern is about helping people live the best life they can, and that takes us beyond arguments about jargon.

[Nick Yee]

6.

Shavaun - Thanks for clarifying Mr. Bakker's lack of official credentials in the mental health profession. For some reason, I had always thought he had clinical training.

And you're absolutely right. It's always a complicated process and we need to focus on how to best help the people who are having gaming problems regardless of what we call it.

[thoreau]

7.

I think we might be talking about the difference between physiological addiction and psychological addiction.

What's troublesome is this paragraph:

"By offering compulsive gamers a place where they feel accepted and where their voice will be heard, the clinic has found that the vast majority have been able to leave gaming behind and rebuild their lives."

This seems to assume that hanging out at the local Y for 8 hours a day is 'better' than playing Call of Duty 4 for the same length of time. To be sure, someone might get more physical exercise (or maybe not) I'm not sure if there is any data to show that the social network at the local Y is healthier than a close knit group of friends on line.

The entire approach seems flawed because they are starting out from the viewpoint that games are bad - and exactly who decided that?

[gordon.calleja]

8.

I m glad someone pointed that out thoreau. The implication running through the whole article is that gaming is a problem:

"This gaming problem is a result of the society we live in today"

The issue is what SORT of problem it is. Aaaaah now Mr Bakker has enlightened us that its a social problem not one of addiction.

Of course, framing games as a problem fattens Mr Bakker's pockets, but assumptions like these publicized through venues like BBC undermine our hard work in understanding games and the experiences they provide.

[Tim]

9.

You know, he doesn't say he no longer thinks games are addicting, he says ninety per cent of the young people who seek treatment for compulsive computer gaming are not addicted.

[Altug Isigan]

10.

The journalist of the BBC article uses the expression "the influence of games on impressionable minds" and I find that very loaded. This sounds a lot like the 'omnipotent media' theories of the 1920s :). Any medium deserves a better critique than that.

Considering that commercial games are hugely a middle-class entertainment and that examples of extreme consumption are rather rare, it is clear that the moral panic does not reflect most of what is going on in society in regard to games. It is important to fight back the conservative rhetoric that wants to make use of this panic. But on the other hand, if there are cases in which people go to extremes, then the industry itself should maybe stop saying that "this is just a problem of a few stupid guys who can't control themselves". For me such shoulder shrugging is the counterpart of the moral panic approach and equally silly, to be honest. Politicians blame industry, industry blames addicts, addicts blame politicians. That cycle needs to be broken at some point.

I don't know if you agree, but I believe that game design is about creating a fun experience whereas "addiction" seems to be rather connected with business models and their inherent visions about ideal consumer behavior (which of course play an important role in the way designers are asked to approach designs issues). Maybe it's not really games that are the problem, but the way in which games are commercialized.

[Morgan Ramsay]

11.

Altug Isigan:

Maybe it's not really games that are the problem, but the way in which games are commercialized.

Interesting supposition. Would you please elaborate?

[Altug Isigan]

12.

Morgan,

basically it's a competition for consumer attention in order to make a profit from the "air time" that you create through your product. Therefore it won't be completely wrong to assume that (online?) game developers desire their designers to come up with "aggressive" contingencies and reward schedules to keep players busy playing and renewing their subscriptions. Ideally (ideally in terms of the business model that puts constraint on the product design), you'd like to eliminate the risks that could come with choice and would try to (pre-)occupy all of the time that the player has available for him(including his future). Addiction or compulsive play could be maybe formulated as a situation in which this "ideal consumer behavior" has been achieved in an extremely successful way (in connection with other factors, for example those which Bakker mentions).

[Ben]

13.

Glad you found a use for that BBC link, Nick.

[Jane]

14.

Let's say everyone comes to agree that a good solid social support and parenting is what going to address this issue. Then doesn't the issue become the fact that parents and other adults in this society are not available (or unwilling) to provide exactly that... and may use excessive online gaming to shirk their responsibilities? How do we call it and how do we deal with that? Simple finger-pointing will not do.

In the end, it does not matter what it is called as long as it is acknowledged to be a widespread phenomenon, and not just isolated incidents.

[Morgan Ramsay]

15.

Altug Isigan:

developers desire their designers to come up with "aggressive" contingencies and reward schedules to keep players busy playing and renewing their subscriptions.

Dare I say that video games as services are akin to casino gambling games; however, these video games do not legally satisfy the definition of gambling games and therefore are not treated as such (in the United States.)

One should note that even psychologists are at odds with how the concept of "gambling addiction" is treated, even to the extent of renaming said addiction to "problem gambling" since the condition does not completely match the definition of psychological addiction. I wouldn't expect any less of a debate where "video game addiction" is of concern.

With that in consideration, I can't agree that games-as-services business models are responsible for creating "video game addiction". Similar models are used in other industries, including magazine publishing. The most significant difference is pricing. Games as services are far more expensive (in terms of dollars and time) than magazine subscriptions, so the problem of poor impulse control rears its ugly head sooner.

I think that one of the issues that encourages the assumption of a "video game addiction" is the conditioned belief that video games are not useful in the long run. There is no such belief with regard to newspapers, magazines, and books, so even if an individual were to spend on such items as is spent on games as services, the individual would not be said to be addicted. Instead, the individual would labelled a "bookworm", described as having "book smarts", and his/her purchases would be elevated as an "investment" in his/her education.

[Dan T]

16.

Great discussion, guys. I've been lurking for a while, but I'm compelled to post in on this one. Be gentle.

thoreau made a great point earlier about how the powers that be have placed value judgments on other activities over gaming, and for reasons apart from just physical fitness. I agree wholeheartedly, and I would take his arguments even farther. The time is rapidly approaching where we won’t be able to make value judgments on mediums of social contact anymore, either. Ask most psychologists (or anyone) and they’ll tell you that face-to-face social contact is better, in a number of ways, from computer mediated contact. Years ago, this may have been true, when people grew up with only face-to-face, and their notions of what social contact was got cemented in that medium. As we speak, that is on its way out. The fact that people are currently starting and ending romantic relationships via text messaging may be indicative of this trend. If one child has 4 friends who live in his neighborhood, and another has 4 friends on World of Warcraft, can those two children get just the same amount of social benefit?

To bring this idea back to the discussion of gaming addiction, I think that William Lederman made a good point much earlier in the thread. Often, the most “addictive” (which is to say highly desirable, at least) qualities of games are that they satisfy the innate human need to belong. So when I read a comment like Laura’s that states (in paraphrasing Peg Tyre’s The Trouble with Boys) “excessive gaming is a result of inadequate social support, mostly at school,” I find myself asking if it might be better to look at gaming as a way to gain social support from another social system. Strip away the value judgment, and you’re just replacing one medium for social support with another. It would be like saying, “spending a lot of time with your coworkers is a result of inadequate social support from your baseball team.” Social support has to come from somewhere, and if it comes from gaming, then so be it.

All this said, I’m going to end by calling out one more excellent post from above, this one by Shavaun Scott. Shavaun’s post ended by reminding us that, for people in the treatment field, the point of all this isn’t to nail down a diagnostic label, it is to help people who have experiencing genuine distress and impairment. So my final thought would be this: try as hard as you can to put aside the value judgments and think for a moment about what people are getting from the time they spend gaming, and what they’re missing out on. If you decide that someone is spending too much time online, it should be because he or she is missing out on important things in their lives, not simply that you think social support doesn’t work as well as text.

[Altug Isigan]

17.

Morgan: "I can't agree that games-as-services business models are responsible for creating "video game addiction"

Neither do I. I think I have been very cautious while I pointed at a possible connection between rationales behind business models and cases of "extreme" consumer behavior.

Each of the new media has been subject to criticism inspired by 19th century mass society theories. You can see the traces of such theory in phrases like "impressionable minds". The problem with it is not just that it demonizes media, but that it also de-personalizes the individuals that make up the audiences.

But when game developers marginalize users that suffer from "compulsive gaming" by saying "that these are just a few guys that can't manage their lives", then they basically repeat the argument of de-personalisation. Only on a narrower frame. Still it's striking that the media doesn't theorize its audience much different from the way its own critics do it.

I see an important shift in Bakker's attitude. As he steps back from the "addiction" notion, he probably also starts to see the individuals that have the unpleasant experience. It's no longer "baaad games vs a healthy life" based on a notion of rather homogenious "faceless" people. But "life with games", where the outcomes sometimes need a special care depending on the individual that experiences them. IMHO he takes an important step away from the de-personalisation that seems to rule the addiction debate (on both camps). I believe that game developers or industry advocates will not learn from this when they just feel relief from the abundance of the concept and think now they were right. As Bakker broadens his view from a simple cause-effect model to a more sophisticated approach, maybe the industry could dare to review the role of its own ambitions while individuals try to live a life with games but find themselves sometimes in difficulties because of it.

My 2 cents.

[Keith Bakker]

18.

I read your article. I took a risk by going public with my "shift in Thinking". Reading your post confirms my decision to do this.

Thanks

[Shava Nerad/Shava Suntzu in SL]

19.

About a month ago China officially pathologized Internet addiction -- which in China is personified by the young man in the Internet cafe.

This remains controversial.

And now reports are coming thru that one major city in CN is forcing cafes to switch to the far less game-friendly linux. Not only that but a homebrew Chinese linux. (personally, probably also full of backdoors and keyloggers, but I used to be execdir at torproject.org, so I'm jaundiced...).

I think this might be a cultural revolutionary experiment as a foray against internet addiction and the loss of productivity to games. But who knows...

ComputerWorld is parroting the official party line that this is about licensing -- but reports are that (a) you can't use another form of linux and you have to pay for Red Flag at the commercial rate; (b) even if you can prove your legit M$ XP license, you have to change.

Worth tracking...

[Methamphetamine Addiction]

20.

Methamphetamine treatment is all about instructing the abusers how to feel good exclusive of drugs. Constant monitoring is compulsory for fulfillment to the treatment program. http://www.addiction-treatments.com/>Methamphetamine treatments means the sufferers requires getting honest and get on a religious trip to God. Honesty, helping others and a religious trip gives the abusers peace and with this peace the aspiration to not to use drugs. There are various rehab centers for the troubled teens effected with the methamphetamine addiction. http://www.addiction-treatments.com/

[Chris]

21.

But when game developers marginalize users that suffer from "compulsive gaming" by saying "that these are just a few guys that can't manage their lives", then they basically repeat the argument of de-personalisation.

The fact that someone is a game designer doesn't make them immune to the Overton Window.

My personal favorite is the people who urge gamers to log off and hang out with real people - as if people on the other end of a computer connection are somehow not real people. Did people used to think that way about telephones?

Nowadays the idea that your social life is less real if you conduct it by telephone would be met with incomprehension, perhaps followed by derision after you got the other person to understand what you were saying and that you actually meant it. Yet the same "arguments" are still advanced against computer-mediated social interaction.

By offering compulsive gamers a place where they feel accepted and where their voice will be heard, the clinic has found that the vast majority have been able to leave gaming behind and rebuild their lives.

Well, first of all, if your guild isn't a place where you feel accepted, you need a new guild. Seriously. Isn't that one of the benefits of online social interaction - the ability to find people you get along with regardless of their rarity or how widely they are scattered through physical space? (If you get along easily with the majority of human beings you will probably miss this point completely, or think it is unimportant. This is what social consciousness-raisers call "privilege".)

But "compulsive" gamers? Exactly who or what is compelling them? If it were a more "mainstream" hobby like football watching (either side of the pond, the game being watched is different but the behavior of the fans is pretty much the same), nobody would describe it as "compulsive". As it is it looks like "They want something different than what I would want in their position? What could possibly be making them so sick and unnatural as to be different from me?"

As for "leave gaming behind and rebuild their lives" - by what right does anyone *impose* that goal on them? That they abandon an activity they enjoy and replace it with one someone else approves of? If they walked in and asked for help quitting gaming the way people ask for help quitting smoking, fine. But I kind of doubt that's what's going on here - at *best* the "patients" were roped in by propaganda.

My life does not require rebuilding, and I'll treat the suggestion that it does with *exactly* the amount of respect it deserves.

[shander]

22.

Gee. I wrote an essay but its all been hashed out before.

Basically, I'm prone to types of addiction...activities that fuel delusions flattered a disproportionate sense of self worth, disperse dopamine, and do so while not making me concentrate too hard.

I also had a problem with alcohol that progressed to the point where only complete abstinence works.

MMorgs are risky behavior for me. They "suck me in". Do I have problems without the games? Yes but if I don't recognize that the games themselves pose a risk to me I can hurt myself with them.

Part of the design that makes the games fun is what makes them risky for me. Heroic music...a continued and persistence sense of accomplishment, random rewards and the dopamine and a social context of real other people who can act as "coodependants" making me feel like grinding rep killing the same beast for hours or farming shards etc was all kinds of normal.

The games aren't self limiting for me. Watching football is self limiting for me. Watching TV is self limmting for me... reading novels is self limmiting for m. Drinking beer or playing a MUD or WoW are not self limmiting for me.

I need to watch what I do..we all need to watch what we do, but we need to be particularly wary about things that we want to do that we know aren't good for ourselves.

Its harder to stop doing something that is deliberately designed to keep one interested.

And thats the rub and the danger that ever better games can prove to ensnare me even more completely in the future.

[Suzanne]

23.

Wonderful exchange and so many hot spots to jump in on. I'll follow up though on shander's more personal story with my own. I spent 11 years "clean and sober" in 12-step programs through the 80s and early 90s. I moved to Europe in the early 90s, where the whole addiction discourse hadn't quite taken hold yet. After a lot of thinking on it, I tried drinking again, (afterall when in France...) and continue to this day to drink "non-addictively." I don't consider anything I do addictive actually, and yes I'm one of those people who's attracted to altered states, etc. and using the rhetoric of the day I suppose I'm one of those so-called "addictive personalities."

I have the utmost respect for people struggling with this stuff and doing whatever they need to to find peace within themselves.

What I'm completely at odds with is ubiquity of the discourses of addiction framing everything from buying too much soap to playing WoW all weekend. They make it nearly impossible to have meaningful public discussions about why individual s and societies behave they way they do.

I love Foucault on issues of pathology, medicine and illness (Madness and Civilization and Birth of the Clinic).

P.S. I think we (in the U.S) live in a completely insane, relentless, dog eat dog society that'd drive anyone to buy too much soap or wanna hang out in fantasy world when she could.

Mazal tov!

[Thomas G.]

24.

To Suzanne, as Baumeister and Vohs said :« U.S. are addicted to addiction, the disease of the century is loss of self-control".

As a french psychologist specialized in behavioral addiction and as a researcher working on problematic use of MMO, I would first thanks Nick Yee for his work and especially his field work (daedalus) as it shows how usages are wide and differents. And to name 'problematic use' instead of 'addiction' as it is a really loaded terminology.

In France, thanks to the psychoanalysis theory and authors such as Foucault, Olievenstein and Canghuilem, psychopathologists tend to have an less 'hygenical' or 'normative' approach. For example we don't treat without enlighted agreement and our only solid and validating criteria for addiction is the personnal feeling of alienation: "the loss of freedom to abstain".

But on the other hand, our political system, definitely republican, influence negatively the ideological point of view about addicts as these people are considered to abandon their citizenship by cutting themselves from society. They don't do their political and social duty. About the mediatic and political considerations about video games, the attacks are based on their supposed anti-social potentials such as violence and addiction. I mean that these social fears from the social body and specifically the elite must be understood as a fear of failure in the social and cultural transmission.

Another thing is to see this "video game addiction" as a market or a business for therapists and researchers. K. Young can be considered as a prototype. These so-called experts are fueling and feeding on this fear.

I'm actually using the term "overuse" to describe the specific problematic use of MMO as clinically, no other type of video games are used in such way. The way I see it, video games have potentialities to be used in different manners, because a game is what happens in the space/link between a man and the object and not the object itself. Therefore we can use these designed objects i.e. play in order to meet people, to have some fun, to escape boredom or to avoid contacts and to shelter oneself. Some games allows easily such a use, others less. MMORPG as they are limitless, reassuring, 'alive' or inhabited and hermetic in a sense, allows all the variety of the uses described.

The problem to ask industry to limit their products may be to subscribe to the idea that the problem comes only from the objects. And that what's happening similarly in the process of addiction and the mediatic discourse about it: The object masks or covers the subject/the individual. 'It's not me it's the product'.

Last but not least, physical and psychological or now even social dependance should not be treated seperately as they are all interconnected. They have been seperated because of the specialization of the scientific disciplines studying or treating them i.e. biology, psychology and sociology. As we are going through a multi-disciplinary process, we come to the idea of considering human as a whole. Similarly, individual and social can't be so simply separated as the impacts of society are filtered differently by each groups and then by each individual.
IMHO video game overuse is both a social and psychological problem as all the humanities problems are.

Thanks all and happy new year !

[Drug Addiction Treatment]

25.

Residential treatment and inpatient treatment is the same thing, in these treatments addicted people must stay in accommodation provided by rehab centers. All the academic facilities and therapeutic treatment are provided in exclusive http://www.drugrehabscenters.com/>residential care drug treatments program. They organize recreational activities, boot camps, encouraging events and many out door and indoor games. This is necessary to identify them selves for personal growth.
http://www.drugrehabscenters.com

[Exteteodo]

26.

http://easymeds.com.ua/ | easymeds

[Deepak]

27.

Drug addiction is the obsessive dependence on a legal or illegal drug. Drugs can include prescription medications, illegal drugs, and alcohol. While an addict may use more than one drug, he usually has a “drug of choice” -- his strongest addiction to break

[Deepak]

28.

Heroin is a highly addictive drug derived from morphine, which is obtained from the opium poppy. It is a "downer" or depressant that affects the brain's pleasure systems and interferes with the brain's ability to perceive pain.

[Deepak]

29.

Use of alcoholic beverages to excess, either on individual occasions ("binge drinking") or as a regular practice. For some individuals-children or pregnant women, for example-almost any amount of alcohol use may be legally considered "alcohol abuse," depending on local laws. Heavy alcohol abuse can cause physical damage and death.

[teen addiction treatment]

30.

In this matter addiction or compulsive play could be formulated in the situation "ideal consumer behavior" .You have very informative blog.

by: dick

[Deepak]

31.

Video game addiction, or more broadly video game overuse, is excessive or compulsive use of computer and video games that interferes with daily life. Instances have been reported in which users play compulsively, isolating themselves from, or from other forms of, social contact and focusing almost entirely on in-game achievements rather than broader life events.