Loving Our Devices

When Does Attraction Turn into Addiction?

Magazine Issue
July/August 2017
A man kisses his cell phone

In the mid ’90s, back in the infancy of the internet age, a psychologist named Kimberly Young heard a disturbing story. A friend’s husband had become obsessed with AOL chat rooms and, at a time when internet providers charged by the hour, was spending up to 60 nonwork hours a week on AOL. Not only was that taking a toll on the couple’s finances, but it soon became clear that the husband was going online to meet women. He didn’t stop, and the marriage didn’t survive.

Young, who’d studied computers as an undergraduate, began to wonder if others were getting similarly hooked on the temptations available on the internet. Using criteria for a gambling addiction, she posted a small survey online, substituting the word internet for gambling. Stories poured in about the connection between internet overuse and ruined marriages, devastating debt, lost jobs, teenagers who’d stopped sleeping, and college students who’d dropped out.

Then an assistant professor at the University of Pittsburgh, Young soon expanded her survey into a study that she submitted to the annual meeting of the American Psychological Association, suggesting that a new breed of addicts could be emerging. Her research ignited a controversy that remains to this day.

Young’s internet overusers, she’d insisted, showed all the hallmarks of a substance or behavioral addiction. Maybe they weren’t smoking cocaine or blacking out after drinking, but they couldn’t resist this new kind of craving. They lied about how much they used it, they thought about it when they weren’t on it, and they felt loads better when they were. They’d put in 40 to 80 extra online hours a week binging on games, porn sites, online stock trading and gambling, and falling into online affairs. Attempting to control their use, they’d unplug their modems and hide their monitors, only to give in to their need for an online fix and assemble their connections again. She thought this behavior, which she branded “internet addiction disorder,” warranted its own clinical classification.

Twenty years later, the debate over whether the internet is addictive is still going on. Young and other proponents of the diagnosis say it’s not a vice for most, and that those of us who use the internet for work or reasonable periods of escape aren’t at risk for addiction. Instead, potential addicts lose themselves in salacious and addictive online content, even as their real lives fray.

Today’s conversation about the psychological impact of the internet is expanding beyond the question of addiction, with researchers warning that we’ve entered a state of internet immersion that’s fundamentally affecting how we relate to each other and the quality of consciousness we bring to the rest of our lives. Now that people can go online on phones, watches, tablets, and laptops, they’re melding more than ever with the internet. They can sleep with it at their bedsides, eat with it by their plates, and sit with it on the toilet. It can hike with them in parks, fly with them on planes, and follow them underground into subways. Via search engines and social media, the ever-present internet now relentlessly curates itself to offer clients what they most want to see and hear, pinging its new possibilities at them day and night.

Psychologist Catherine Steiner-Adair, in her book The Big Disconnect, bemoans the rising use of portable technology in the home and suggests that having tech-distracted parents can be as damaging as having narcissistic or psychologically neglectful ones. Pediatricians concerned about the effects on learning and attachment are warning parents to keep portable internet devices away from infants—30 percent of whom are in front of screens for four or more hours a day—and from young children. Experts are cautioning that teens, whose social lives have migrated online and become open to critique, are at an increased risk for depression and suicide.

For more and more therapists, regardless of how they feel about internet addiction as a diagnosis, understanding clients’ attachment to their digital devices and advising them about healthy use is becoming an unavoidable part of practice. Practitioners around the world are now finding themselves in need of resources to explore our relationship to technology—an issue that’s been percolating in the minds of experts for decades, but is still hotly debated throughout our field.

Addicted to the Old Internet

In the late ’90s, the internet had made its way into only about half of American homes. It had about it a gloss of newness and magic, a kind of genie that answered every conceivable question, instantly sent messages to friends who quickly wrote back, and helped us innocently chat with far-flung strangers about the right food for our marigolds. Cultural commentators of the time even suggested that the internet was a mental health boon, facilitating new social connections and allowing people to express themselves freely under assumed names and as avatars while supportive strangers cheered them on.

Initially, Kimberly Young might have been a rare voice of dissent in this brave new world, but she wasn’t alone for long. A handful of clinicians soon echoed her findings that a subsection of Americans could be addicted to the internet, and they took their concerns to major media outlets. The debate that rose up was newsy but easy for the public to deride. After all, the counterargument went, hadn’t previous generations moaned about the advent of new technologies like television, radio, and even the printing press?

In the middle of this debate, with research on the topic still in its infancy, Young formally proposed that the APA’s Diagnostic and Statistical Manual (DSM) be revised to include internet addiction disorder. Some therapists, already familiar with compulsions and behavioral addictions to gambling, sex, and shopping, accepted the premise that one could be addicted to the internet, but plenty dismissed the idea. This collective clinical shrug had to do with the paucity of research and an uncertainty about the role digital technology was playing in behaviors that were being reported. After all, porn use or gambling might intensify via the more accessible and private web, but didn’t the reward system for the addiction lie within the hit from the activity, not the technology? In a dramatic survey from the early 2000s, the American Academy of Matrimonial Lawyers said 63 percent of their lawyers reported online affairs were a leading cause of divorce cases. But were these infidelities so different from standard, in-person affairs?

Some therapists at the time had seen their clients’ engagement with online temptations spike but then level out—a sure sign that they weren’t addicts at all. And then there was the issue of access: for any addict, access to and the speed of a hit are fundamental to feeding an addiction. As wired therapists could attest, internet connections for the less than half of Americans who were actually online were often frustratingly slow. How reliable a hit could they expect to get?

Is It Addictive After All?

Twenty years later, access and speed of delivery have been perfected. Internet hits, no longer contained in a box on a desk anchored by a modem, are available most anywhere. But despite what parents of teens might assume, the internet itself is still not, nor was it ever, invariably addictive. As with most other forms of addiction, prevalence rates reflect a minority of the population.

According to the Substance Abuse and Mental Health Services Association’s nationwide drug and alcohol abuse survey, the subset of the US population addicted to substances is currently about eight percent. Proponents of an internet addiction diagnosis cite studies suggesting similar rates of true addiction for US internet users—around 8 to 12 percent. Researchers at the University of Hong Kong published a global prevalence study in 2015 that put the internet addiction rate at six percent worldwide. Studies looking at teens and college kids in some other countries have estimated percentages to be as high as 14 percent, or even higher. The range in these percentages may be more a reflection of a lack of consistent diagnostic criteria for internet addiction than a true measure of prevalence. The World Health Organization has officially recognized that the internet can be addicting for some, and the governments of South Korea and China—countries that lead the world in connectivity and high-speed internet access—are concerned enough to fund research, diagnosis and treatment, and public education campaigns. Australia and some European countries have followed suit in their own ways.

After considering the studies of internet overuse published since the last iteration of the DSM, the APA stopped short of calling it an addiction in 2013’s DSM-5, instead adding internet gaming disorder as a topic for further study. It also replaced the nomenclature of “substance-related disorders” with “substance-related and addictive disorders,” widening the addiction category to include behavioral addictions like gambling disorder and internet gaming disorder.

Allen Frances, who chaired the DSM-IV task force, told CNN in 2013 that there was little doubt that some people truly suffered an internet addiction, but, he said, “The concern is that there will not be a clear, bright line in between a true internet addict and the rest of us, who are using it recreationally.” Then in 2015, Charles O’Brien, chair of the substance-related disorders work group for the DSM-5, told a colloquium at the National Academy of Sciences that his committee continues to review data about internet addiction for the DSM, including brain-imaging studies “that show some fairly specific changes in brain reactivity to internet stimuli.”

Despite the APA’s decision, counselors in US schools have been working on internet addiction protocols, and a fair number of college campuses share internet-addiction resources with students and faculty. The diagnosis is relatively high among college students, with a few studies suggesting some correlation between internet addiction and majoring in a hard science. The American Counseling Association provides resources for school counselors to assess students routinely for internet addiction and to intervene accordingly.David Greenfield is one of the pioneers from the ’90s who first recognized internet addiction as a clinical issue. He partnered with ABC News to conduct the first large-scale study of internet use in 1999, collecting about 17,000 online questionnaires and getting an addiction percentage of just under six percent. His book Virtual Addiction came out the same year. Today, he runs the Center for Internet and Technology Addiction in West Hartford, Connecticut, and estimates he’s treated about 1,000 internet addicts in the last couple of decades. His cases include teens and young adults who can’t stop gaming and usually require out- or inpatient detoxes and computer monitoring. He also treats middle-aged men whose destructive internet overuse is sex-based, younger people whose uncontrollable social media use is destroying their in-person relationships, and those who can’t stop online shopping or stock trading despite ruinous debt.

The BBC reported on one of Greenfield’s cases, a rugged 10th grader with ADHD named Nick, who was an honor student until his school handed out laptop computers to all the kids in his class. Having a laptop of his own meant easy access to online video games, and his playing soon got out of hand. He’d stay online for six hours a day after school, while his grades sank and he complained that being away from his computer made him feel panicky. When his parents stepped in and set limits on his time online, Nick grew aggressive and followed them around the house, demanding they give him back his computer. His mother confronted him about his “scary” behavior, telling him, “Look at yourself! You’re like a crack addict.” Finally, he went to his mother crying and saying he was sick and he didn’t know what to do. With a combination of EMDR and traditional addiction-recovery protocols, Greenfield helped Nick stop playing video games and start reengaging with his schoolwork, practicing with the high-school football team, and working on cars with his dad, no longer using the internet to, in his words, “get out of life.”

Greenfield says he’s concerned that some therapists may misunderstand what internet addiction looks like. He’s not treating people, he says, who “walk in off the street and say I use my smartphone too much. They’re coming in because their life has become unmanageable in some way.” According to him, going online is like pulling a lever over and over at a casino. “Addiction is basically a disruption of reward and motivation,” he explains. “It can involve behavior or substances, but once you activate the circuits, they’re highly sensitized and operate on a variable-ratio reinforcement, which is essentially an unpredictability of the reward. This kind of unpredictability is part of what makes it so hard for addicts to stop.

He gives the example of getting addicted to something like social media, where you’re constantly driven back to the site, hoping your posts have been liked or shared, or that you’ll see something new from someone you like. “Your brain is guiding you toward rewards that you either imagine or hope will be there. It’s not conscious, like ‘Oh, I’m gonna go on and see everything I want.’ It’s that you get rewarded intermittently, and you don’t know when the reward will be there, or what it’s going to be. That’s the same with pretty much everything online. There’s so much variability and that’s what creates the slot-machine effect. If it were the same every time you went on, it wouldn’t be addictive.”

We may all feel a little quickening and then a moment of happy distraction when we check our social media sites, but an addict, who loves that feeling and may not be getting it elsewhere, needs to check furiously to keep it going. “You can’t really have an internet addiction unless you’re spending an excessive amount of time online,” Greenfield says. “It de facto requires you to elevate the dopamine levels by excessive use.”

Greenfield points to mounting evidence of this neurochemical reaction. “We have numerous neuroimaging studies that have shown activation in the nucleus accumbens, and the central segmental area of the prefrontal cortex,” he says. “They light up the same dopaminergic pathways as cocaine or other drugs or alcohol. All addictions light up that mesolimbic reward circuitry in the midbrain; it doesn’t really matter what the activating drug is.”

“If Everybody’s Doing It, How Can It Be an Addiction?”

Thousands of people have been treated for internet addiction concerns over the last couple of decades, but vocal critics of the diagnosis like John Grohol, who runs the website Psych Central, remain unconvinced. On the editorial board of the journal Computers in Human Behavior, Grohol spends a lot of time reviewing and interpreting research to offer up-to-date advice on his site. He insists that none of the recent research has swayed his opinion that there’s no such thing as internet addiction.

Grohol likes to point out that New York psychiatrist Ivan Goldberg, the man who first proposed the idea of internet addiction, invented the term in a post on his website in 1995 to parody how the DSM can medicalize any excessive human behavior. But colleagues, not getting the joke, wrote to Goldberg, admitting to having the disorder and asking for help. Hundreds of self-diagnosing internet addicts soon began using the term on sites across the web to describe their problem, and the label and self-identification spread.

“I do literature reviews every couple of years,” says Grohol, “and I can say with some amount of certainty that we still don’t have the solid foundational research that one would expect for a diagnosis that continues to be so popular in the mainstream media. There’s a huge disconnect between the research literature and the people who are thinking, I spend too much time on my smartphone, so I must be addicted. If everybody’s doing it, how can it be an addiction?”

According to Grohol, “The whole idea that people are addicted to this tool, this technology that we all take advantage of today, like running water and electricity—it’s just hard for me to wrap my mind around. And apparently it’s hard for researchers to wrap their minds around as well.” He cautions that not only do online shopping, stock trading, online porn, and social media not fit together under a research category, but to place them under the umbrella category of internet addictions is to lose their distinctions for treatment. And he says issues aside from internet use are usually in play.

“When therapists see a couple in counseling and the husband is complaining that the wife is always on the phone and Facebooking and Instagramming, it’s not because the wife is addicted to the internet: it’s because the two of them haven’t worked out their relationship boundaries of ‘when we’re talking, let’s respect each other and put down the phones.’ There’s no value in labeling that as an internet addiction. It doesn’t help you conceptualize the problem or lead you to solutions or treatments for the problem.”

Grohol likens the internet to a huge spigot that you can run anything through. Whether that thing turns out to be reinforcing and seductive doesn’t depend on the action of the spigot. “We have problems with gambling in the real world, so the fact that you can take that online doesn’t seem all that different,” he says.

Grohol questions whether generational paranoia is playing a part in internet-addiction fears, arguing that when you survey young adults rather than older adults about internet use, you get lower levels of concern. “Back when I was growing up we’d be on the telephone day and night,” he adds. “No one ever came up with the idea of a telephone addiction disorder. But I think any new technology scares people because they tend to overindulge in it and don’t understand how to put controls on their usage. It’s just like anything you do in life. You work too hard, they call you a workaholic. But we don’t have workaholism disorder.”

Kimberly Young and the Rest of the World

After presenting at countless conferences and publishing more than a dozen books since she first stuck her neck out at APA in 1996, Kimberly Young is less concerned that psychologists in the US are still arguing about the term addiction and more worried about our slow national response to a problem that we’re loath to try and understand.

Now a professor at St. Bonaventure University in western New York, she collaborates with internet addiction experts around the world who’ve fully adopted the idea of the diagnosis. Among them, she sees real progress. “I think we should be doing public health campaigns in this country and we don’t,” she says. “The Korean magistrate orchestrates a plan for prevention and smartphone treatment over there. Here’s Korea, one of the most wired countries in the world, advanced in so many ways, saying we don’t have to be afraid of technology, but we do need to learn how to use it wisely.”

She thinks that in the US, ultimately, it might take an internet-addicted celebrity to wake people up to the cause. “Nobody thought for a long time that alcoholism was real until Betty Ford got up and said, ‘I’m an alcoholic.’ It didn’t matter how much research there was or how many case examples there were. Until we find a big spokesperson, I think there’s not going to be acceptance,” Young says.

Like Greenfield, she continues to see clients who are addicted to the internet. But she also sees people who are wary of their own and their family members’ chronic checking of phones and tablets. “When you’re talking about addiction, there needs to be a major negative—you get fired from your job, you get kicked out of school. But when you’re talking about chronic checking, we all probably suffer from some of that. The essence of the issue today is that it’s time to find a healthy balance in our use of technology.”

Young continues, “I compare it to eating. If you have a food addiction, you’re not going to abstain. It’s about finding a healthier relationship to food. These days, we need a lot of education in school systems and with kids directly on healthy ways of using screens. We need to be careful and conscious about our behaviors. Every one of us should be doing a 48-hour detox. Put the phone away for 48 hours and just see how you feel.”

Approaching Internet Use in Practice

Even if an addiction isn’t suspected, Young thinks when therapists see clients clutching their phone for a full session, it’s time to ask about the “other” relationship in their life—the one they’re having with their devices. She says sometimes it’s useful to start assessing whether there’s a problem by just inquiring, “How much time do you spend using devices? Do you think that impairs anything?”

If an addiction is suspected, Young suggests using a combination of questionnaires and internet-addiction tests to assess the extent of the problem. She also advises that comorbidity is common with internet addiction. The behavior often occurs with depression, anxiety, social phobia, and ADD/ADHD. “A lot of times clients will present as depressed, and then if you talk to them a little bit, you find all they do is spend their time online. There’s a high correlation,” she says. “It’s not unlike alcoholism and depression. Which comes first? Well, we know they’re both worth treating.”

According to a recent literature review in the World Journal of Psychiatry, comorbidity for internet addiction is the norm. It’s especially high among gamers, some of whom may also have antisocial personality traits. Young argues that certain general personality traits are consistent with the diagnosis. She sees the deeply introverted and socially phobic gravitating toward computers. Her clients might not be socially competent in real life, but they can lead armies in a multiuser video game online. In these cases, she says they’re motivated by a longed-for break with reality. A similar kind of escapism is at work in online porn and chat rooms.

When this behavior becomes an addiction, Young involves the entire family, just as she would if she were dealing with a drug or alcohol problem. “Say I have a 22-year-old gamer who lives at home because he failed out of college, having spent all his time gaming, and his parents bring him in. That’s a typical scenario. I want to meet with the parents and the identified patient separately, and find out how everybody’s interacting at home. What have they tried? What worked? What didn’t work? Was he also depressed or anxious? How does the behavior affect him? How does it affect the school relationship?”

Because these addicts have lost the ability to control their internet use, Greenfield usually starts treatment with a detox. “We remove as much access to the technology as we can,” he says. “It’s a little harder to control on an outpatient basis, but we employ an IT specialist whose job it is to block and monitor patients’ internet use. We block problematic sites at the router, in their homes or offices, and we block on their devices. We then use EMDR and general addiction treatment methods, which include managing urges, relapse prevention, trigger analysis, desensitization. We work to change the behavioral patterns and use a variety of medications. All addictions involve the same neurobiological circuitry in the brain. So we basically treat this addiction very much like any other addiction—which tends to be effective overall.”

Young’s treatment is based in CBT, which she favors partly because it can generate measurable outcomes for a diagnosis that’s still under scrutiny. Part of her CBT for internet addiction (CBT-IA) approach includes scheduling activities that will prompt people to log off their computers. She establishes usage goals (how much time they can be online), gets them off apps they’re addicted to, and has them inventory all the things they once did before the internet took over their lives. They then use handwritten cards as reminders of the costs of internet addiction and why they’re breaking it.

Greenfield notes there’s no abstinence option for internet-addiction treatment. Clinicians can’t take away people’s ability to use GPS or email or texting: those technologies are too integrated into normal, everyday life. He focuses instead on establishing a pattern of moderate use for when treatment concludes, and then encourages his clients to continue getting support. Of course, support groups are lacking in some areas. “It’s not as ubiquitous as AA or NA or Al-Anon,” he says. “So sometimes we’ll send them to general addiction meetings instead of internet- or technology-based groups. There are some meetings, believe it or not, online, which we’ve used, and that’s not necessarily a bad thing.”

For clients concerned about their tech use and for full-blown internet addicts, Young suggests digital diets and digital nutrition. Instead of counting calories, clients on a digital diet are counting hours spent online. Their digital nutrition is about refining what they click on. A teen can’t click on every social media site, but he can do homework for school.

Mindfulness, too, may have a part to play in treatment. It’s proved helpful for substance abusers and gambling addicts, and therapists and treatment facilities are now trying it with internet addiction. In a recent study in the journal Mindfulness, researchers reported that having a higher level of mindful awareness decreased the preference for online versus in-person interactions, and for using the internet to regulate moods. The authors suggest that “emphasizing key mechanisms of mindfulness, such as increased self-awareness, identification of feelings and thoughts, and acceptance, may significantly contribute to the prevention and treatment of problematic internet use and addiction.”

Since teens who practice mindfulness have experience with acknowledging negative emotions and then watching them pass, some think they’re less inclined to turn to the internet for distraction and comfort. In Mindful Tech: How to Bring Balance to Our Digital Lives, David Levy, who now teaches in the Information School at the University of Washington, recommends that all internet users do mindful exercises around their technology use. Levy himself takes a weekly, one-day digital sabbath, and pays mindful attention to how it feels to go online. How, for instance, are we breathing while using email? Is our breath shallow? Are we holding it? Are we stressed by the email experience? What changes might we make if so?

What Digital Detoxes Can Do

Linda Graham is a marriage and family therapist who gives workshops on digital dependence and detoxes. She believes that for many clients, phones are a useful tool for avoiding emotionally challenging issues. She cites a couple who came in because they were arguing too much. In their first session, both kept their phones out on the couch. Says Graham, “So I asked them how much time they spend talking together without their phones on.”

Shocked to learn the answer was zero, Graham got them to turn their phones off for 10 minutes a day and set them in another room. Almost immediately, other issues started floating to the surface, and each began to share how often the other had seemed to avoid or criticize them. In the second session, when Graham asked them to take it up a notch and block out 30 phone-free minutes a day and a chunk of time on the weekends, things got even harder. How could they shut off the phone that long? What if their son had an emergency? The wife thought maybe she didn’t need to be so constantly available to their child, but her husband disagreed. More unaddressed differences in parenting philosophies followed.

Because they were working through their reliance on their phones, the general topic of addiction was suddenly before them as well. The wife said that when her husband drank at parties, he became angry, rude, and abusive. When pressed to face this behavior and asked to cut back, he refused, arguing, “This is who I am. Don’t ask me to change.” That refusal extended to the phone. He was suddenly unwilling to put it away to spend device-free time with his wife, and he ultimately withdrew from therapy while she kept on. “In a sense,” says Graham, “part of her continuing engagement with therapy was due to her willingness to spend time off her devices and confront her issues, while he was unable to separate his phone use from his defended way of being.”

Because issues around our relationship to our devices—including the problems they often mask—consistently come up in practice, Graham suggests detoxes for all her clients. “People need to detox enough so their brains are strong enough again to override the impulse to respond to every ping of the phone. They can begin to make choices about how much time they should be away from the phones in their homes—perhaps setting limits like ‘not in the kitchen, not in the dining room, not in the car, not before you go to bed.’”

She’ll encourage clients to try being without their phones for short spurts and replacing the dopamine hit with other, nondigital experiences, like being in nature, talking with a friend, making a meal, playing with a puppy, reading a book. “It isn’t about doing nothing and being bored,” she says: “It’s about cultivating interests that don’t require the internet.”

Doubling Down on Resistance

We all get a certain kind of relief and release from giving ourselves over to an internet-based life. Constant access to the web can offer an alternative to the tedium in our days, help us dodge our worries, and most of all, distract us from our insecurities and uncertainties. In fact, clients’ attachments to their online life can be a means of resisting full engagement in therapy. If cases aren’t coming along, if clients aren’t truly present in session, this new, digital avenue of resistance might be one of the primary culprits.

Graham is concerned that some therapists may be too put off by the internet-addiction debate or so uneasy evaluating its use without prompting from the client that they ignore the issue of internet use altogether. “Therapy needs to be a safe place for people to talk about issues that impact their lives, and this is one of those issues,” she says. “But many clinicians in our field still believe that they need permission to bring internet use into the therapeutic spotlight.”

Where does this permission need to come from? From peers, Graham argues. “Rather than waiting to follow the lead of the professional organizations, we can take the lead from each other.” Ultimately, she says, “Cyberculture is making it easier and easier to avoid the hard personal issues in life.” But therapists occupy a special place in this new internet order. Their offices provide the opportunity for something increasingly rare in the whirlwind of daily life—a space for meaningful, face-to-face conversations, where feelings, instead of being mollified by online distractions, can be felt. For a growing number of clients, the therapeutic interaction may be one of the few touchstones of what internet video gamers call RL—the messy state of real life.

Gaming with Addiction

Some internet-addiction treatment programs are adding material about media and tech companies to traditional teachings about the addiction process, informing clients about the tricks companies use to make their technology irresistible.Adam Alter, a professor of psychology and marketing at New York University and author of Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked, attributes part of our general rise in tech use to behavioral addictions, intentionally nursed along by tech companies schooled in operant conditioning by behavioral psychologists working in Silicon Valley. Under an edict to create more engaging content and devices, Alter says the companies use operant conditioning to stimulate dopamine dumps in our brains and intensify our compulsive use. This is true of social media displays and likes and push messages on phones and other devices, and is especially true of online game design.

Most clients in inpatient internet-addiction treatment are young gamers. (Greenfield says they make up 60 to 70 percent of his client list.) Along with courting school and career failure, addicted players may have health problems, like weight gain and type II diabetes, and they risk getting deep-vein thrombosis from long hours sitting. There have been about 20 reported gaming deaths, mostly in Asia, where play often takes place in internet cafés that never close, and players play for marathon stretches, forgetting to eat, drink, sleep, and move.

Most internet-gaming addicts today are playing massively multiplayer online role-playing games (MMORPGs), which are explicitly designed to keep people playing for long stretches and coming back. Players connect virtually to games like the cinematic World of Warcraft, and immerse themselves in characters charged with epic quests. They can play solo or fight as part of groups, and eventually they can join guilds and acquire more skills—but they’ll never leave the game a winner because there’s no end to, and no winning, World of Warcraft.

MMORPG players often develop partnerships, and sometimes friendships, with other online gamers. Online, they might have reputations for bravery or cunning or goodwill that they don’t enjoy in the real world. Not wanting to disappoint online friends can motivate players to avoid taking long breaks from gaming. Guilds require time commitments as they organize raids and plan events, and some aspects of the game require hours of group play for success.

Nick Yee, a gaming analyst with a Stanford PhD, conducted a long-running survey that captured data from MMORPG players. Yee’s survey page features stories of romance and marriage facilitated by the games, and he charts the responses of teenage players, half of whom say online gamer friends are comparable to or better than real-life friends.

While at Stanford, Yee coauthored a paper encouraging other MMORPG creators to take a close look at the success of player associations within World of Warcraft. Joining these associations compels people to play more often and for longer stretches. The paper suggests that structures dispensing rewards “after just a few more minutes of playing function as a virtual Skinner box, drawing the players deeper into the game.” The paper goes on to say that “a careful combination of addictive game design with a looser social environment can help MMOGs break the coveted one million subscribers’ barrier.” Yee now consults with gaming companies on how to up player engagement with their products.

The efforts of gaming consultants and behavioral psychologists to keep players engaged for longer and longer periods of time seem to be working. MMOPRG players consistently top the charts of internet addicts, with some studies revealing an addiction rate of 12 percent or higher.


Photo © Westend61

Lauren Dockett

Lauren Dockett, MS, is the senior writer at Psychotherapy Networker. A longtime journalist, journalism lecturer, and book and magazine editor, she’s also a former caseworker taken with the complexity of mental health, who finds the ongoing evolution of the therapy field and its broadening reach an engrossing story. Prior to the Networker, she contributed to many outlets, including The Washington Post, NPR, and Salon. Her books include Facing 30, Sex Talk, and The Deepest Blue. Visit her website at laurendockett.com.