Tuesday, March 22, 2011

The Latest "Mental Affliction": Internet Addiction

As reported in The Economist, (March 12, p. 10), some mental health specialists want 'internet addiction' to be formally included in the fifth edition of psychiatry's "bible": The Diagnostic and Statistical Manual of Mental Disorders, or DSM-V as it would be known in shorthand.

The American Journal of Psychiatry called "internet addiction" a common disorder and supported its inclusion. The American Medical Association made overtures in 2007 to have such a label formalized, then backed off. As The Economist noted (ibid.):

"Last year the DSM-V drafting group made its decision that internet addiction would not be included as a 'behavioral addiction'"

Which is just as well, since there's nothing uniquely addictive about the internet, as people spend various amounts of time for different things. I usually spend 4-5 hours a day, but most of that time is invested in blogging for Brane Space, which I regard as productive pursuit. I seek to advance the warp and woof of free thought, as well as expand the knowledge base of readers by familarizing them with a wide array of issues and topics, if they are interested.

This consumes on average about 22-25 hours a week, including research, and the remaining time I use to read news sites, such as http://www.nytimes.com/, or http://www.salon.com/, http://www.nationnews.com/ or http://www.guardian.co.uk/ to obtain some foreign perspectives. My conviction is that if I'm investing time in constructive acitivity then it isn't addictive.

In any case, I believe there has been too much effort made to expand the definition of addiction, and certainly don't want to see it applied to the net. Already, we have the idiotic concept of "sex addiction" which is preposterous given that sex involves no external addictive agents. This term seemed to have been dreamed up by some fundie screwballs back in the 90s, in order to justify "therapy" and "12 step" camps to help allegedly recovering "sex and porn" addicts. All of which is nonsense, developed purely to invent disorders and parlay them into moola...the real god of this country.

But people should not rest or relax on this issue! Evidently, Kimberly Young (a therapist cited in The Economist), is making a strong case for inclusion of net addiction in one DSM or the other and the sooner the better(ibid). She has apparenty worked in the field of internet addiction since 1994 and insists that the net, with its "powerfully immersive environments creates new problems". According to Ms. Young, people "need to learn how to navigate" these and here is likely where therapy enters, at maybe $75 an hour.

Already some poor "sex addicts" are being gamed into therapy (or taking zoloft, paxil) for their addictions compliments of sex therapists, and paying enormous bills for the privilege. Still, no objective rationalist ought to be speeding toward the addiction label. Especially as the psych community and therps have already shown themselves way too eager to put too many behaviors under an "aberration" umbrella.

As Edward Shorter, Professor oin the Faculty of Medicine at the University of Toronto put it ('Why Psychiatry Needs Therapy', WSJ, Feb. 27-28, 2010, p. W3):

"DSM-V accelerates the trend of making variants on the spectrum of everyday behavior into diseases: turning grief into depression, apprehension into anxiety and boyishness into hyperactivity"

Among the new entries or ramped up old ones with which we need to be aware:

- Intermittent Explosive Disorder (or IED) - recognized by bouts of explosive anger out of all proportion to the cause.

- Temper Dysregulation Disorder with Dysphoria (a new definition for all children with outbursts of temper, i.e. any brat or rug rat pitching a temper tantrum)

-Minor Neuro-cognitive Disorder (Betrayed by any evidence of even mild cognitive decline from a previous level of performance.) Good luck to all those over 50 for whom this is expected!

More problematic is the extension of paranoid schizophrenia to many more in the general population via "psychosis risk syndrome". (Hmmmmm.....do I really want to include a certain pastor brother in that and report him to the American Psychiatric Association, based on condemnations of Catholics, JWs, Mormons, Atheists, Eckists, Buddhists et.c)

Why this dramatic expansion of defined symptoms? Is the intent to make everyone in the country a confirmed head case or suspected one? If so, what could be the reason? Well, how about profit? In The New Yorker article Head Case (March 1, 2010) author Louis Menand observes:

"There is suspicion that the pharmaceutical industry is cooking the studies that prove that anti-depressant drugs are safe and effective, and that the industry's direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases, like shyness"

This may well apply, and one cannot discount the possibility of a cozy relationship between psych practitioners and Big PhRma's drug peddlers, any different from what we behold with medical practitioners in general. (Being wined and dined by the drug companies to entice the physicians to offer their wares as "samples", then get patients hooked.)

Certainly, one of the first lines of "attack" once internet addiction is included in a DSM edition, would be treatments, medications and therapies similar to what we're already seeing with treatments of sex addictions. (No one ever telling these forlorn folk that once they take those meds, most of which are based on serotonin re-uptake inhibition, that's basically the end of their sex lives in any form!)

But on the other hand, the rationalist must acknowledge that there MIGHT be cases of something akin to addiction, in internet porn, as The Economist notes. Their reasoning is that the internet makes it much easier to access such fare and also offers a wider variety of transgressive, over the top stuff than could be viewed in the brick and mortar world. Worse,(in certain positron emission tomography studies), when subjects are monitored while watching such porn the same brain centers light up as the ones when people take opiates (e.g. heroin).

If serious papers can be published in peer-reviewed journals showing how and why this qualifies as addiction, then a case might be made to include this narrow brand ("internet porn addiction") in one future instalment of the DMV. I just wouldn't want to see such people made the slaves of PhrMA and having to take meds forever that impair their life quality.

Sure, it's sick and sad confronting someone slouched in front of a screen and glued to rancid porno stuff for hours on end, getting so fat and lazy they're unable to even lift a fork or drive to the gas station. But it's not very far to imagine the same person converted to a de facto zombie via meds or ECT.

If we do insert these behaviors as "addictions", we have to make sure we don't go overboard and condemn them to a hell that may be worse than what they now have!

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