The Griefing Games

Internet addicts in China have a mixed time; while government-run centres provide some of the most up-to-date treatment in the world, patients who check into the wrong clinic might find themselves getting electroshock therapy, or being beaten to death.

In a new twist, it was reported this week that a Mr Feng, exasperated by his son spending hours online in preference to getting a job, had hired assassins to kill his slacker offspring. OK, these were virtual hitmen, who repeatedly offed the boy as he tried to play World of Warcraft, but still, that’s tough love. (If you believe the story; there is some scepticism.)

I doubt that this approach would work with Second Life addiction (if one accepts that such a thing exists), since anyone who puts up with the frustration of SL long enough to develop a problem is unlikely to be deterred by a bit of low-level griefing. In fact I’m not sure that having a couple of hired killers tracking me, like I was in some sort of exciting spy story or something, wouldn’t make me more likely to log on, though I guess it might get a little irritating after a while.

There might be a business opportunity here – for a fee operatives could stalk a resident around the grid, befriending them and winning their trust, before unexpectedly delivering a virtual whacking, a bit like the CRS Corporation did to Michael Douglas in The Game.

I think there could be quite a bit of demand for such a service, playing as it does on the paranoia and narcissism that are such prominent features of the Second Life experience. On the other hand, the revenue model might be undercut somewhat by the fact that there are plenty people in SL who are willing to provide unsolicited harassment free of charge.

Off the wagon

So, that’s me back from my digital sabbatical, though, to be honest, it wasn’t really one of those straight-edge digital sabbaticals that one reads about, since I took my cellphone (though I did manage to cut down my usual rate of calling and texting), and I only gave up the mobile internet because I was in a region remote enough to have no wi-fi hotspots, and prohibitively expensive data roaming charges.

Still, I’ve come back with a renewed appreciation of life off the grid. I was a bit restless for the first couple of days, but after that I hardly missed it at all, and passed my time at a leisurely pace, reading books, listening to music, thinking, writing a little, and even doing some exercise.

I had just about convinced myself that I wasn’t really addicted to the internet after all, but, I’m sad to say, I hadn’t been home more than a few hours before I succumbed to the temptation to quickly check my blog stats, then while I was online I thought I might as well see what people were saying on Facebook… and it was all downhill from there. Last night I spent three hours watching Beavis and Butt-head clips on YouTube. Rapid reinstatement indeed.

Strangely enough I haven’t had any notion to visit Second Life yet. Perhaps the pleasures of SL are too rarefied to give me the quick fix I’m looking for; it’s a fine malt compared with the bathtub gin of social media.

The wrong move at the right time

Regular readers will know that I have an interest in internet addiction, but I came to that via impulse control disorders in general, and pathological gambling in particular.

The BBC reported this week on the release of the British Gambling Prevalence Survey 2010, produced by the National Centre for Social Research for the Gambling Commission. It’s a fairly hefty document, and I’ve only managed to read the executive summary, but even that contains plenty of food for thought.

The headline figures are that 73% of the adult population gambled in the last year, up from 63% the last time the survey was done in 2007. Problem gambling, as measured by the DSM-IV criteria, was up from 0.6% to 0.9% in the same period, though it hadn’t risen significantly on the Problem Gambling Severity Index (0.5% in 2007 and 0.7% in 2010). These numbers are similar to the rest of Europe, but lower than the US and Australia.

One thing that surprised me was that the prevalence of online betting hadn’t increased much in the last three years. Excluding online purchase of lottery tickets, which they didn’t measure last time, the rate was 7%, up from 6% in 2007; 81% of gamblers place their wagers exclusively offline. Within this certain types of online betting are more popular though; 39% of casino gamers play on the internet.

The betting landscape has certainly changed a lot since I was a child. My grandfather liked to play the horses, which back then involved visiting the local bookie, a sinister establishment next to the pub, with blacked-out windows and a permanently smoky atmosphere, frequented by the shadiest-looking characters in the neighbourhood. He used to take home the little pens to give to me, which my mother would immediately confiscate, lest I take them to school and shame our family with the association of vice. I take after my grandfather in a lot of ways, but I must have internalised some of his daughter’s disapproval, because to this day I have never set foot inside a betting shop. I’m rather ashamed of this, as it feels like I’m betraying my working-class roots in favour of a notion of bourgeois respectability, but my mother’s scruples have probably saved me a lot of money over the years.

My grandfather’s other flutter of choice was the football pools; a sacred ritual in our family was gathering around the television at about ten to five on a Saturday to listen to the classified results. As eldest grandchild I had the responsibility of recording the scores as they were announced; the mention of lower-league English teams like Huddersfield or Gillingham still takes me back to cosy teatimes all those years ago. I was sad to see that the explosion of alternative gambling opportunities in recent times has all but killed off the pools; only 4% of the population put on a coupon now.

The change in social attitudes to gambling can be traced back to the introduction of the National Lottery in 1994; overnight gambling became a government-approved leisure activity rather than a disreputable habit looked down upon by polite society. The whole industry was deregulated, with bookies allowed to put signs in their windows advertising what went on inside, and to install seats to encourage their customers to linger; a far cry from the dens of ill-repute my grandfather used to frequent.

Card gaming, poker in particular, has had quite a makeover too. It used to be a game associated with cowboys and gangsters, or at best the idle super-rich in places like Monte Carlo. I do remember, in my youth, being quite taken by Steve McQueen’s character in The Cincinnati Kid, but “professional poker player” was never going to be among my career choices. The advent of internet and televised poker tournaments has changed all that, and now the game is played by a whole host of perfectly respectable, and decidedly unglamorous, doctors, lawyers, accountants and the like.

A year or so ago I was seeing a client who had a bit of an issue with internet poker, and, out of curiosity, I registered with one of the online casinos and tried playing for a while. I’d like to say that this plunged me into a House of Games-style maelstrom of underworld intrigue, but since a) I limited myself to a $10 roll and nickel-and-dime tables and b) I am a dreadful poker player and lost all my money in short order, nothing nearly so interesting happened.

Every so often, usually when I am bored at work and daydreaming about alternative income streams, I return to the virtual tables, generally with the same result. This last month was different though; despite playing my usual ham-fisted game I went on a pretty good run, boosting my $10 stake up to over $60, before enduring an equally persistent losing streak, which had, by yesterday, reduced my stack to $15.30.

This experience has given me a bit of insight into some of the psychological phenomena associated with gambling that I had previously only read about. Simple arithmetic tells me that my latest session has been much more successful than previous forays, since I have ended up 53% ahead rather than 100% behind, but that’s not how it feels, and the temptation to chase my “losses” by playing more, or moving to a higher-stakes table has been pretty strong. It’s also been interesting to note how my feeling for the game mechanics, particularly the balance between luck and skill, has changed as my fortunes have varied; when I was hot I was convinced that I was playing masterfully, but as the money ebbed away I found myself cursing the bad cards I had been dealt.

I guess I should be happy that I’ve received some valuable professional education, and been paid $5.30 into the bargain, but I can’t help thinking about the $45 that got away, and how, if I just kept playing a little longer, the law of averages would throw a few good hands my way again…

Panorama on video game addiction

Tonight’s edition of the BBC’s flagship current-affairs programme Panorama covered the topic of video game addiction. I had been looking forward to the show but it was rather disappointing; it contained no information that anyone with even a passing interest in the subject wouldn’t already be familiar with.

After featuring the usual suspects – reformed addict, concerned parent, industry spokesman, academic (Mark Griffiths in this instance) – and taking the obligatory trip to South Korea, the reporter did come to a reasonable, if uncontroversial conclusion – games are fun, most people have no trouble with them, a few develop problematic use, this might become a significant issue as more people play.

I guess it was a good enough introduction, but it felt like a missed opportunity to discuss some of the more controversial aspects of the issue, like the exact nature of the disorder, and treatment approaches, in greater depth. A half-hour TV show has its limitations I suppose.

Anyone who is looking for a (slightly) more substantial review of the topic could do worse (I would humbly suggest) than to refer to this article that we posted earlier this year.

Internet addiction update

In my last post on internet addiction I mentioned a few of the treatment options available; in a new development the Capio Nightingale Hospital in London has started offering a Young Person Technology Addiction programme. This is as far as I know the first specialised therapy programme for IA available in the UK, though I’m sure there are other people like me who are interested in the subject, and have been seeing cases as they come up in our routine work.

The Capio programme offers inpatient and outpatient therapy, and is only available privately, though I guess it might be possible to get it paid for by the NHS via an extra-contractual referral. The therapeutic model they are using seems to be a mix of CBT, IPT and behavioural interventions. I did train in IPT a few years back, but I’ve only ever used it in depression, so I don’t know how effective it might be in IA, though, now I think of it, it does seem likely it would be useful in cases where lack of confidence in interpersonal relationships is an issue. It’ll be interesting to see if they publish any outcome studies.

On Second Life and addiction

I wasn’t going to say anything on the sad story of the Korean couple who allegedly left their baby to starve while they spent time in the virtual world Prius Online, because, you know, it seemed a bit exploitative, but I noticed that a few other blogs had referred to the issue directly or indirectly, and of course I couldn’t resist putting my two cents worth into the comments, (though it turns out that last post wasn’t inspired by the Korean incident after all), so I thought I might as well draw a few thoughts together and post them here.

Actually I’m not going to address the Korean story directly, since all I know about it is what I’ve read in the papers, and in cases like these one really needs to have all the facts before formulating any opinions. Instead I’ll say something more general about the concept of internet addiction – whether it exists at all, and, if so, what can be done to help those suffering from the problem.

My personal opinion is that problematic use of the internet should be regarded as a pathological behaviour, and that it is best thought of as an impulse-control disorder. I first became interested in the topic after reading Caught in The Net, by Kimberly Young, who did a lot of the early work in this area, and who runs the Center for Internet Addiction. Her book is aimed at a lay audience – she does tend to throw around terms like “obsession”, “compulsion” and “addiction” a bit freely – but her conceptualisation of dysfunctional online activity, drawing on the model of pathological gambling, is basically sound.

The existence and nature of internet addiction is still the subject of academic debate though. I thought Jerald Block made a good case a couple of years ago in an editorial in the AJP, Issues for DSM-V: Internet Addiction, but the draft DSM V, out last month, fails to include it. Interestingly the draft also proposes to move pathological gambling out of “Impulse-Control Disorders Not Elsewhere Classified” and into “Addiction and Related Disorders”, a move that has been labelled one of the “The 19 Worst Suggestions For DSM5“.

This argument about classification may seem a bit arcane, but it reflects a division of opinion that was also evident in the discussion of the Korean case; to what extent does labelling a particular behaviour an “addiction” absolve the person concerned of responsibility for their actions?

When it comes to MMORPGs (which for the sake of this argument we’ll take as including Second Life) there is a tendency among pro-game writers to deny that virtual worlds have any addictive properties at all, and to focus instead on the personal characteristics of the “addicts”, and especially their “personal responsibility” or lack thereof, when seeking to explain the problem. This is evident in the posts I linked to above, and more so in the comments, and is understandable when one considers that politicians and the media are quick to stir up moral panics about the supposed corrupting influence of games on society.

It’s true that impulse-control disorders are rooted in individual psychopathology, which in turn develops from the complex interaction of neurobiology, psychodynamics, cognition, social factors and environment. However I think it has to be acknowledged that games, and especially MMORPGS, have features which may promote problematic use in vulnerable people.

What are these elements? The ability to produce feelings of mastery, to increase confidence in social interaction and to explore hidden aspects of personality, which can combine to boost self-esteem. (These are of course the same things that make the worlds attractive in the first place.) Add in the variable reward schedules that are designed into the games to a greater or lesser degree, and you have the potential to set up cycles of dysfunctional behaviour.

This doesn’t mean that games are inherently dangerous, since clearly the vast majority of players manage to use them without coming to any harm. It does suggest though that there is a particular subset of players for whom over-use of games might become a problem, and raises the question of whether game developers like Linden Lab should be responsible for raising awareness of the possible hazards among residents of their worlds. I would argue that there should be some material about recognising the signs of internet addiction included in the orientation process, and perhaps a timer built into the viewer that that pops up after, say, two hours on the grid and suggests that it might be time to take a break. I can’t see this happening though, since steps like these could be construed as an admission by the Lab that they are aware of the potentially harmful nature of their product, which would presumably expose them to some sort of liability.

What of treatment? In general terms, my experience of treating this sort of problem has convinced me of the importance of taking a non-judgemental approach. Although therapy for impulse-control disorder does focus on the choices that the client makes in certain situations, with the aim of helping them regain a feeling of control, over-emphasising “personal responsibility” is usually not helpful. These clients start with low-self esteem, and the condition further erodes their confidence in their ability to take charge of their lives, so reminding them that they could have avoided the mess by making different choices tends not to make them feel any better. Instead it’s more useful to focus on the positives, the areas of their lives that they feel they can manage sucessfully, and try to build on these.

It’s interesting that discussion of addictions, and particularly process addictions (which, as mentioned above, I prefer to conceptualise as impulse-control disorders, though plenty of people would disagree with me), often takes on a rather moralistic tone, with implicit, or sometimes explicit, condemnation of addicts for failing to take “responsibility” for what they do. I tend to think that this position represents a defence against acknowledging the extent to which everyone is a potential “addict”, a projection of intolerable unconscious “irresponsibility”. I think it’s healthier to recognise that we are all fallible humans, and we can all make bad choices, and remember that when we do mess up it’s nicer if people treat us with sympathy and compassion, rather than going on and on about “personal responsibility”.

In internet addiction specifically the treatment with the best evidence base is CBT – Young published a paper on treatment outcomes in 2007. There was also an interesting paper last year from the International Gaming Research Unit at Nottingham Trent University last year looking at various treatment approaches to videogame addiction, including 12-step, CBT and Motivational Interviewing. 12-step programmes for internet addiction are widely available – at On-Line Gamers Anonymous for example – but I’m not aware that these have been rigorously evaluated. I’m not as familiar as I would like to be with the published work coming out of South Korea and China, where they take this problem very seriously, but what I have read suggests that behavioural and family therapy approaches are useful, in younger populations especially. I expect there will be a lot more research into treatment of internet addiction published in the West over the next few years, and the best therapeutic options should become more evident.

Tweetomania

I hate to admit it, but, way behind the curve as usual, I have started to view Twitter as an important part of my life, rather than a pointless irritant. When I set up our feed I was intending just to use it for publicising blog posts, but then I started following a couple of people (you know, just for kicks), then a couple more (though I could have given up any time I wanted, I just didn’t want to, right?), and before I knew it I was getting mildly agitated if I couldn’t get my tweet fix several times a day.

The tipping point came when I started following Mal Burns, who is a one-man SL newsfeed, cranking out dozens of tweets a day linking to all sorts of interesting metaverse stories. He seems to have quite a big audience, judging by the surge of traffic we have had on the couple of occasions he has featured one of our posts.

Our feed is somewhat less influential, though we do have a few followers, including one celebrity, Noreena Hertz, the vaguely left-wing economist, though I expect that by the time you read this she will have ditched us – she’s done the follow/unfollow thing on us a few times before, so I suspect that she has some sort of system that automatically follows anyone tweeting with the #economics tag, and then one of her assistants kicks us off a couple of days later when they actually read the rubbish we have written. Interestingly, our old SLS account has roughly ten times as many followers as our active feed, despite not being updated for nearly a year.

My addiction has been facilitated by my acquisition of the TweetDeck app for my iPhone, which makes it much easier to post updates and follow the general chatter. TweetDeck is part of the huge ecosystem that has grown up around Twitter, with literally hundreds of startups vying for a slice of the revenue pie, which, last time I looked, amounted to exactly US$0. Twitter head honcho Biz Stone has reportedly targeted 2010 as “the revenue year”, but even he isn’t willing to predict that the company will be profitable any time soon, so I can’t see how all the hangers-on are hoping to make any money.

I have a horrible feeling that the whole set-up is some kind of plot to get us all hooked on free produce, before they crank up the price and force us to pay big bucks to feed our habits. That wouldn’t be entirely bad news for me though, since I am qualified in the treatment of cyberaddiction, and the tweet-detox market might be worth quite a bit.

Deadly therapy

In a tragic footnote to last month’s story about the use of electroshock therapy to treat internet addiction in China, the authorities in that country are investigating the death of fifteen-year-old Deng Senshan, who was allegedly beaten to death by staff at a clinic in southern Guangxi province shortly after arriving for treatment for cyberaddiction.

Excessive use of the internet is regarded as a serious public health problem in China, with some reports estimating that nearly 40% of net users show signs of addiction, leading to a proliferation of centres dedicated to treating the problem. The more reputable clinics use modern psychological treatments, but other establishments are military-style camps offering a regime of harsh discipline, of questionable therapeutic value. Whatever one thinks the best course of treatment is, the fact that parents can be so desperate that they are willing to send their children to a place that promises “necessary approaches including punishment to educate the teenager” gives some idea of the level of distress that the condition can generate.

(Don’t) Gimme Gimme Shock Treatment

Asia is far ahead of the West in the recognition and treatment of internet addiction. While we agonise over whether the condition exists at all, the authorities in the East are already taking action; the South Korean government has made tackling cyberaddiction a national health priority, and the splendidly-named Chinese Teenager Mental Growth Base of the General Hospital of the Beijing Military Area Command of the PLA has issued guidelines on “Preventing Network Addiction at Home” (to be read in conjunction with “Basic Principles for A Harmonious Family”).

Unfortunately I have been unable to track down a translated version of the Chinese guidelines, so I don’t know what they recommend, but apparently the treatment options don’t include electroshock therapy, since the Chinese Ministry of Health has just ordered a clinic in Shandong province to stop using the method to discourage teenagers from spending too much time on the net. As a report in the Wall Street Journal notes, the efficacy of the treatment was called into question by the fact that disgruntled ex-patients had chosen to register their dissatisfaction with the clinic by setting up an online protest group.

I do believe that internet addiction exists, though I think it is more useful to conceptualise it as an impulse control disorder than an addiction as such. In my, fairly limited, experience of managing the condition CBT is the treatment of choice, along with pharmacological therapy for any co-morbid mood or anxiety disorder.

I’m not sure that everyone would agree with that though…

Cargo cult consciousness

There was once a time when I was a regular reader of the Second Life Herald, but these days I look at it only rarely. Founded by noted metaverse pioneer Peter Ludlow, aka Urizenus Sklar, the Herald, with its mission statement “to record, observe and study the legal, social and economic implications of life in the virtual world” promises some serious commentary on Second Life culture, a window into what is going on in the minds of the grid’s most interesting residents.

In reality the Herald is a strange brew; part superficial yet impenetrable gossip, part breathless exposé . I have never been able to decide if one is meant to take it seriously, or if it is in fact some sort of elaborate joke, a parody of our shallow, celebrity-obsessed culture and insatiably sensationalist media.

The overall impression, for me anyhow, is rather exclusive; to extend William Gibson’s high-school simile, it’s like the class newspaper edited by the popular kids; the geeks, dweebs and other losers can look but only dream about joining in. Just like any non-virtual celebrity-gossip publication in fact, but with one crucial difference; while real-life celebs, at least on the A-list, are objectively attractive, and their lifestyles glamorous, their Second Life counterparts are generally not much more aesthetically pleasing than the average avatar, and the accounts of their activities are seldom other than dull. The element that gives an edge to our culture’s worship of its secular idols – aspirational envy – is missing, and in its absence there is nothing to hold the reader’s attention.

For me the Herald is a good example of cargo cult culture; the idea that, by reproducing the form of a real-life phenomenon in the virtual universe, one can appropriate its significance. This theme seems to underlie a lot of what goes on in Second Life, and its essential fallacy is why life on the grid so often seems unfulfilling.

I think that it is mistake to see the potential of the metaverse as lying in the ability to mould a more perfect version of the real world. What is created by such an effort is but a shadow of reality; instead of emerging into the sunlight we retreat further into the cave. The real promise is contained in the possibility of experiencing something that augments our perception of reality rather than trying to reproduce elements of it. I don’t know if that is going on somewhere on the grid, and I’m not sure that I would be able to recognise it if it was, let alone articulate its meaning.

The problem is that everyone who comes to SL, myself included, brings with them the baggage of conscious and unconscious expectation. I am self-aware enough to know that in visiting the grid, and especially in writing about it in this blog, I am chasing after something that is missing in my real life. Put like that it sounds a bit dysfunctional, but I think that for most people a little wish-fulfillment is a healthy thing, and reflecting on experience in Second Life can provide useful insight into what is going on in one’s life outside the metaverse. Perhaps if Freud were living now he would ditch the interpretation of dreams in favour of avatar analysis as a royal road to the unconscious. It is of course possible to overdo this, and use one’s virtual life as a way of hiding from, rather than illuminating, the problems of real life. This desire to evade harsh reality is certainly one of the factors underlying internet addiction, or indeed any sort of addiction, but even for the non-addicted majority of SL residents, in whose number I count myself, there is a downside to the escapism – by using SL as a way of relieving my frustration with the limitations of my current existence I am locking myself into a real-world paradigm, and thus missing out on the what the grid really has to offer. If I was perfectly happy with my life I could perhaps approach SL with an open mind and experience its full potential, but then if I was perfectly happy with my life I wouldn’t be wasting hours sitting in front of a computer screen.

It’s the Second Life paradox; the people who will visit regularly do so because they are, more or less consciously, trying to fill some gap in their lives; as a consequence of this they are the least likely to be able to make the most of the opportunities SL affords. Meanwhile the people whose lives are fully realised, the very ones who would be best suited to exploring the possibilities of this new virtual world, will never feel the need to come anywhere near it.