BROOKE GLADSTONE: This is On the Media. I'm Brooke Gladstone. In November of 2008, the Chinese Health Ministry recognized Internet addiction as a medical diagnosis. That country, one of the first to establish treatment centers for the disorder, now has hundreds of clinics set up to help people get offline. Here in the States, we're more skeptical of the diagnosis, but now we do have one treatment program, reSTART, which calls itself “an Internet addiction recovery program.” Hilarie Cash is the executive director of reSTART. Welcome to the show.
HILARIE CASH: Glad to be here, thank you.
BROOKE GLADSTONE: So define “Internet addiction.” Is it a clinical term?
HILARIE CASH: It’s not an official clinical term, yet. We do know that in the next version of the DSM they are going to have a category for non-substance-use addictions, and we know that that gambling is going to be there. What other behavioral addictions make their way into that is entirely dependent on the weight of evidence. But all behavioral addictions have certain things in common with substance addictions – loss of control, or compulsivity about engaging in it, the development of tolerance, the experience of withdrawal, and the engagement in it in spite of negative consequences.
BROOKE GLADSTONE: Now, you already have your first patient, who right now is undergoing treatment at the facility. Can you tell me about Ben Alexander?
HILARIE CASH: Ben, I think in many ways, is going to be a typical client. He’s 19. He has social anxiety. He found that going online to socialize was where he preferred to be rather than sort of out in the world and dating and hanging out with friends. It didn't matter too much while he was still under the structure of his family, but once he went off to college he really just fell right down that rabbit hole into an addictive pattern where he barely went to classes and slowly over time began to fail out.
BROOKE GLADSTONE: Can you tell me what Ben’s treatment has been like? I mean, I understand that when you’re dealing with alcoholics or people who suffer from a gambling addiction, the tendency would be to go cold turkey. Can you prescribe cold turkey to your clients?
HILARIE CASH: We do prescribe cold turkey. This really is an opportunity for them to spend 45 days free of the Internet. It gives their brains a chance to kind of detox and begin to rewire into more normal patterns. So he'll get up in the morning, have breakfast. He'll be involved then in house chores, cleaning up, gardening, care of animals, that kind of thing. After that, there’s physical exercise. Many of the activities in the afternoon are centered around vocational therapy. They're working right now on developing his carpentry skills. And then in the evening, there’s mindfulness training, 12-step work and other addiction-related work.
BROOKE GLADSTONE: Now, I know Ben is your first client, but if he is, as you say, typical of who you expect to come into your program, aren't his problems really separate from the Internet? I mean, if you were to, say, treat him for his social anxiety disorder and whatever other problems that he takes with him to the Internet, then he wouldn't need to be cured of an Internet addiction. Isn't that much more of a symptom than it is a cause?
HILARIE CASH: What people often don't understand is that addiction becomes its own problem. You do indeed need to address those root problems, but actually it becomes very difficult to address them effectively as long as the addiction is active.
BROOKE GLADSTONE: Hilarie Cash is executive director of reSTART, an Internet addiction recovery program in Washington State. Ben Alexander has just completed the 45-day treatment and he joins me now. Ben, welcome to the show.
BEN ALEXANDER: Thank you.
BROOKE GLADSTONE: Tell me about your drug of choice, World of Warcraft.
BEN ALEXANDER: Well, it’s a massively multiplayer online roleplaying game, which basically means that you play with people from all around the world, and you have this kind of character that you create that represents you in the world.
BROOKE GLADSTONE: What about it did you find so addictive?
BEN ALEXANDER: Well, part of it was the social aspect. It’s a very social game, and a lot of working together with other people to complete objectives and things like that. And I've always dealed with a lot of social anxiety –
BROOKE GLADSTONE: Mm-hmm.
BEN ALEXANDER: And it was just a lot easier to, to be comfortable socializing online than it ever was in real life for me.
BROOKE GLADSTONE: You didn't feel like the kind of ease that you had in the game could translate to the real world?
BEN ALEXANDER: Not at the time, no. I've been doing a lot more getting out and meeting people in real life, and it’s been easier than I thought it would be.
BROOKE GLADSTONE: Can you describe what the moment was, if there was a moment, when you realized that you really had a problem?
BEN ALEXANDER: Yeah, it was about halfway through my first semester in college, and I realized that if I kept doing what I was doing, which was pretty much play World of Warcraft all day every day, I was going to flunk out of college.
BROOKE GLADSTONE: But you couldn't stop?
BEN ALEXANDER: No, I couldn't. My dad tried to help. I went to him and asked for his help and he tried to help me set up rules about when I could play, and, I mean, none of it worked.
BROOKE GLADSTONE: How many days since you left the center?
BEN ALEXANDER: Three days.
BROOKE GLADSTONE: Three days. And are you nervous? Are you pretty comfortable? Are you confident?
BEN ALEXANDER: I am. Right now my parents have it set up where I have access to their computer and I can get online for work-related things and also for reconnecting with friends that I had kind of lost contact with.
BROOKE GLADSTONE: So, Ben, good luck.
BEN ALEXANDER: Thank you.
BROOKE GLADSTONE: Ben Alexander is a former patient of reSTART, the first Internet addiction recovery center in the United States.