Recovery:
Social Isolation,
Internet Addiction
and Technology Abuse
Social isolation, internet addiction, and technology abuse are all implications of something we normally take for granted. Are you addicted to the internet? Do you not spend time socializing in person as much as you used to? Are you tied to your smartphone, tablet, or portable devices? Recovery from internet addiction and technology abuse is important. It is a root of occupational, relational, and personal problems. It’s an unhealthy outlet for some. It creates problems in the workplace. It can stir issues with living situations. It even deters physical fitness.
Schools and even corporations prohibit the use of cell phones on the job and in the class. They are distracting and hindering education and profit. When people choose to live in a cyber world they detract and detach themselves from reality and sometimes become too invested to hold jobs and take care of themselves. In addition, people spend hours at a time tied to a screen rather than out in fresh air exercising or visiting with friends and family.
Social isolation, Internet addiction, and technology abuse is real. It’s an emerging field of study. Unlike substance abuse, it’s a pathological issue. Because it exists, some form of treatment must also exist. Like most addictions, there has to be some form of will to kick it. Habits can be reformed.
Different types of treatment are emerging. Cognitive Behavioral therapy is most widely used. E-Therapy is new and is rooted in the use of technology. It uses the convenience of the internet to help advise and help support people in their endeavors. Support groups and personal desire goes a long way. Finding people to support you, as in substance abuse groups, helps. Logging your time and effectively using your time on the internet and with technology goes a long way. There’s a time and place for everything. Moderation is important.
In some cases technology abuse and internet addiction literally become the end for some people. In China, a man died after a three day video game binge. Cyber cafes in Korea are popular and many spend a great deal of time glued to screens rather than focusing on developing a career or education. Youth internationally become acquainted with technology and learn to use the internet very quickly, but are often not taught to use the internet or technology responsibly. I, as well as many others, can claim victim to that.
Who’s at risk at what are the demographics? Young men under the age of 30 are highest at risk. So how do we stop this? What prevention measures can be taken in order to prevent internet addiction and technology abuse?
Cognitive Behavioral therapy is a type of psychotherapy that involves both the clinician and patient to actively seek out solutions to the problem at hand. It’s relationship dedicated to examine the relationships between thoughts, feelings, and behavior (cognitive thinking). By examining patterns of self destruction, activities can be initiated to counter hindering thoughts. Cognitive behavioral therapy also encourages activities to be done outside of sessions to help ameliorate negative behavior and thoughts. By reflecting it is possible to develop new ways of thinking.
Cognitive Behavioral Therapy is most often used with mood, anxiety, eating, substance abuse, sleep and psychotic disorders. It’s a form of antidepressant. It’s goal is to restructure negativity to positivity. It helps regulate sleep patterns. It encourages positive activities.
In anxiety disorders CBT decreases the amount of panic attacks in relation to specific triggers the patient has identified and aims to conquer. It aids in the treatment of Obsessive Compulsive Disorders as well. CBT is the first line of treatment for people with OCD, PTSD, and anxiety. It has also been tested to help with schizophrenia. Cognitive behavioral therapy for psychosis (CBT-P) is a specialized form of CBT. It’s the exploration of delusional and paranoid beliefs. Patients are asked how these types of thoughts negatively impact their lives and taught to recognize certain patterns in order to take control of their lives.
What does this mean for the field of treatment for Social Isolation, Internet Addiction, and Technology Abuse? Dr. Kimberly Young was first to identify internet addition in the US. She proposed this in her widespread paper Internet Addiction: the Emergence of a New Disorder.” Now, in 2014, Internet Addiction has become known to be a problem around the world. Earlier this year Milan held the first international congress on internet addiction. It was addressed that Korea was first to establish a comprehensive national prevention and reeducation for people afflicted with pathological internet use and technology abuse. Fasting camps have emerged in both China and Japan as well as other places around the world. In our backyard, Dr. Kimberly Young founded the first inpatient treatment center in Bradford, PA: the Internet Addiction Treatment and Recovery Center at the Bradford Regional Medical Center.
Dr. Young includes in her site and blog that treatment for internet addiction is necessary. People are becoming socially isolated and removed. Internet addiction provides a view for underlying preexisting conditions such as depression, anxiety, substance abuse, and phobias. Treatment is available for those with severe cases of internet addiction. Treatment is necessary and development for criteria was made for it’s implementation into the DSM-V. Addiction is addiction, and for some it’s the root of uncontrollable behavior that destroys or negatively impacts one’s life.
In order to determine underlying conditions, Dr. Young tested her theory with depression. She found a relationship between internet addiction and depression. her research included two tests that provide a concrete relationship between the both. The Zung Depression Inventory (ZDI) proves severe depression coexists with PIU. The Beck Depression Inventory (BDI) supports the data from the ZDI.
The research shows impairment, significant impairment in social, psychological, and occupational development. An average of 38 hours a week was dedicated to internet for non-academic or non-employment use for those dependent on internet use. Here it’s shown that there is a correlation between an individual various problems he or she may have developed. For example, reduced academic performance, marital or couple discord, and reduced work performance. Whereas non-addicts have no such problems associated with internet use and average internet time as low as 8 hours a week.
Internet addiction is most relatable to pathological gambling. In addition, little research has been done to examine underlying psychiatric illness contributing to internet abuse.
The results of this particular study shows occupational level shows correlation to internet use. Non-tech or high tech workers are more likely to become addicts. Blue collar workers are less so. Socioeconomic status also plays a role. Who can afford to become internet junkies will more likely become internet junkies. Both the BDI and ZDI suggest that depression is a significant factor in pathological internet use, internet addiction.
For treatment of internet addiction, Dr. Young established criteria based on the model for Pathological Gambling. Pathological Internet Use (PIU) is an impulse control disorder. Her criteria is as follows:
- do you feel preoccupied with the internet (think about previous online activity or anticipate the next online session)?
- do you feel the need to use the internet with increasing amounts of time in order to achieve satisfaction?
- have you repeatedly made unsuccessful efforts to control cut back or stop internet use?
- do you feel restless, moody, depressed, or irritable when attempting to cut down or stop internet use?
- do you stay online longer than you originally intended?
- have you jeopardized or risked the loss of a significant relationship, job, educational, or career opportunity because of the internet?
- have you lied to family members, therapists, or others to conceal the extent of involvement with the internet?
- Do you use the internet as a way of escaping from problems or relieving a dysphoric mood (feelings of helplessness, guilt, anxiety, depression)?
By responding yes to five or more of these you are classified as dependent and the remainder classified as non-dependent.
In her seminal research paper, Internet Addiction: the Emergence of a New Clinical Disorder, her results show problems from students experiencing academic problems to sleep issues. Families have stated such problems as neglect and social withdrawals. Other issues with internet addiction include, but aren’t limited to fees and bills associated with internet abuse as well as avoiding bills and fees associated with living expenses. Physical problems include disrupted sleep patterns such as fatigue and even as far as deprivation. Carpel Tunnel, back strain, and eye strain have also been associated with internet addiction.
Treatment strategies implemented for PIU and internet addiction include CBT modeled from Pathological Gambling, SSRIs, Mood Stablizers, Exercise, Motivational Interviewing, Reality Therapy Acceptance and Commitment therapy, and multi-modal treatments.
What may bring up internet addition and technology abuse include, but aren’t limited to anonymity and convenience of escape. The level of access to such devices and even everyday use of the internet is becoming more and more affordable. There is little research done, but Winkler Dorsing accounts sociocultural factors, biological vulnerabilities, psychological predispositions, and specific attributes of the internet that are factors that lead to internet addiction and technology abuse. Neurobiological factors say addiction is rooted in the “pleasure” and reward center in the brain. increased dopamine, feel good transmitters, and opiates with other neurochemicals feed the addiction. The reinforcement and reward center has multiple layers. The internet functions on a variable ratio reinforcement schedule (VRRS). Because of this pathogical internet use is most akin to pathological gambling. The internet provides a plethora of awards. Chat, porn, games, general surfing, social networking sites, message boards, email, texts, and apps all play a part in internet addiction and technology abuse. these rewards vary and are intensified through mood enhancing stimulating context: things that are sexual, visual, social, romantic, financial, or even create in some way some sort of sense of belonging.
The only answer for any biological predisposition may be insufficient receptors or insufficient production of serotonin and/or dopamine. This means normal levels of pleasure are unmet. people with these kinds of biological factors are more at risk for engaging in more reward (higher rewards tasks) and addiction.
It has been noted that PIU or Internet addiction disorder may be a precursor to depression, anxiety, hostility, interpersonal sensitivity, and psychoticism.
there are various treatment options.
Psychological approaches have been Motivational therapy, reality therapy, acceptance and commitment therapy, and of course Cognitive behavioral therapy. Motivational Interviewing is client centered. It explores intrinsic motivation. The goal of motivational interviewing is to resolve ambivalence. It’s used with people who are hesitant with their feelings on their addiction. it uses open-ended questions, and addresses concerns about change. It has been effective in drug, alcohol, and diet/exercise problems.
Secondly, Reality therapy is a commitment for change. Treats addiction as a choice and not as an intrinsic need. It’s training in time management. It has been used in the treatment of sexual, drug, and food disorders. It has been proved to work just as well with internet usage. Korean study has proved it to be reliable treatment. it reduced addiction level as well as improved self-esteem.
Acceptance and Commitment therapy is a type of behavioral analysis like CBT; however, it’s based upon mindfulness and just accepting the negative behavior. It identifies the problem and asks for solutions to those. It has to foundational acronyms: FEAR and ACT. FEAR represents (1) fusion with your thoughts, (2) evaluation with your thoughts, (3), Avoidance of your experience, (4) Reason - giving for your behavior. ACT stands for (1) accept your reactions and be present, (2) Choose a valued direction, and (3) take action. Through research Acceptance and Commitment Therapy has helped reduced activity in 85% of people and had results with follow-ups three months later with a success rate of 83% reduction of internet use remaining.
Non psychological approaches include SSRIs, specific serotonin receptor inhibitors. The specific medications used to help treat PIU include escitalpram, which cut hours of usage of internet by nearly 50%. Bupropion helped decrease cravings for the internet. Lastly, methylphenidate helped decrease usage times significantly. Mood stabilizers are also included as well as just plain exercise.
Multimodal Treatments are also encouraged. Multimodal treatments are a characterization of several different types of treatment and discipline. A combination of treatment options essentially. Multimodal treatments should be respondent to each individual based on the complexity of the patient. They have proven to be successful, increased the quality of life, and decreased the depressive level of the individual.
An emerging field of practice that I find interesting in the treatment of PIU, Internet Addiction, Social Isolation, and Technology abuse is E-Therapy. E-Therapy is the process of interacting with therapists online in ongoing conversations. They are sessions held by professionals over the internet, E-Sessions. it is the utilization of the internet for mental health concerns. However, it does not diagnose or treat medical and mental disorders per se. It addresses many difficulties which the patient presents. It addresses specific concerns with specific skills. However, there is a lot of legal, ethical, and practical practice issues associated with E-Therapy.
By utilizing the internet to provide treatment to people across distances e-therapy can help those suffering from PIU and Internet addiction through a vessel that they are addicted to. In my opinion by using what most feels natural to the patient to help the patient. It provides convenience both synchronous and asynchronous (help in real time and not). it also is way to provide professional care for those who need access.
e-therapy is used for advice and therapy. Advice is given based on certain situations. it is provided once or on a few occasions by trained professionals. it’s main purpose is for psychoeducation, concrete advice for specific information for well-defined, specific difficulties. Advice from this platform, however, is not appropriate for complex or life situations causing great distress, long per siting problems, or overwhelming difficulties.
E-therapy, however, a service that is also provided, is. E-therapy’s goal is to define and form a relationsp between a trained counselor and patient. Sessions are given over time. The main methods of conducting e-therapy is through the use of email, secure web-based systems, real-time text exchange (chat) during the convenience of both patient and counselor, video conferencing, and voice IP.
the range of services provided are psychoeducation, emotional support, and self-guided help. Clinics do exist for e-therapy. Sites such as HelpHorizona, Here2Help, and eTherapy are existing internet based therapy clinics. specialists exist to help aid in the treatment for particular disorders or specialists who are spiritual consultants such as Christian Counselors.
However, implications such as ethical, practical, and legal issues also exist. It is important that those seeking help for providers on the internet follow strict codes implemented by the American Counseling Association, National Board for Certified Counselors, and The International Society for Mental Health Online. It’s important that you are being maintained by professionals and not private practitioners that aren’t qualified. This leading into legal and ethical concerns. Legal concerns such as jurisdiction may be breached from one professional offering services to a state he or she may not be licensed to. Or the possibility of malpractice in some cases.
Furthermore, issues that are addressed with e-therapy are, but again not limited to, no appointments required (good or bad depending on individual situation). response times are between 24 and 72 hours. Insurance providers and avoidance of health insurance plans. Affordability is a concern for most. There is lack of credibility and/or research for e-therapy. Anonymity may effect the behavior of the clientele. Interactions dissolved into text create disadvantages in assessment. knowing what are appropriate e-therapy topics. Literacy amongst individuals. Hacks and breaches in a cyberspace world. authenticating identities of both clients and providers. lastly, providing information as accurately as possible.
I find e-therapy useful for the treatment and support for those afflicted with PIU/Internet Addiction.
As far as the United states goes, we are behind on identifying internet addiction, social isolation, and technology abuse as major concerns for mental health. Korea is leading in this particular field of study. In 2013, Korea ranked number one in smartphone addiction. The causes for the addiction were noted as convenient mobile functioning, portable media player, high speed internet, apps and games. Each of these having causes and symptoms leading to one more factors such as the specific characteristics of the internet, personal psychological and emotional characteristics or social environmental characteristics. They have established a master plan to prevent and treat IAD. They provide testing, have initiated re-education programs for those at risk, and have specialized inpatient treatment. Governments internationally such as in Germany, Japan, and China backs internet fasting camps. This should lead groundbreaking studies as well as further awareness into implementing more support in the united states.
Social isolation, Internet Addiction, and Technology Abuse are considerable problems and action is needed. The problems that arise are, but not limited to: occupational, educational, relational, and social. There are various types of treatment, but little research has been done in the united states. The most effective type of treatment for pathological internet use cognitive behavioral therapy. Dr. Kimberly Young’s research most related internet addiction disorder with pathological gambling and therefor her model is based off of that as a way of diagnosing whether or not an individual is addicted to the internet. Other psychological ways of treating IAD are motivational interviewing, reality therapy, acceptance and commitment therapy, and multimodal treatments including more than one treatment and even the use of pharmaceuticals. SSRIs and mood stabilizers have proven effective in the treatment of PIU. from a neurobiological standpoint there is insufficient levels of feel good neurotransmitters such as dopamine and serotonin. This may be due to the correlation between internet addiction and depression. However, addiction is addiction whether or not due to preexisting conditions and mental health concerns. Internet addiction may, in addition, be a precursor to other addictions to substances and alcohol, or even anxiety and sleeping disorders. If internet addiction and technology abuse is not treated it could leave to death in the most severe cases. Youth and behavior could forever be altered by the we see, use, and learn about technology. It’s important for the well being of society to let the tools that help them learn create an uncontrollable urge to be slave of their desires and pleasure.
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