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To all the people staunchly in denial:

If you're trying to argue that gaming isn't addictive without having experienced it yourself there is no way you can understand the motivations and feelings of people who are addicted. Many people can drink alcohol, have sex, go to a casino or even use drugs in a recreational way but other people, due to circumstances and their life experience means that they can and do become addicted to particular activities for whatever reason. Just because there is no 'mind-altering' substance involved does not mean that the chemicals in the brain do not change. With gambling, excessive exercise and sex, there are hormones, pleasure chemicals, endorphins, adrenaline that are all produced simply from enjoyment of an activity and these can become addictive the same way alcohol, nicotine and dopamine are.

Everyone is different and something that gives pleasure to two people, such as a game, can cause one to be addicted and the other bored because the game can provide some enjoyment or other psychological benefit that a person becomes dependent on and can even abuse. It comes down to personality, self-control, emotional well-being and life circumstances. I was addicted to WoW. I would never ever even consider trying to use alcohol or drugs as an 'escape' from the problems I was experiencing at the time but gaming seems so harmless. I spent two and a half years of my life hopelessly dependent on a game because it provided me emotional support, social interaction and an escape from the responsibilities and problems of my life. Just like a substance addiction, I became irate, irrational and even filled with rage if my precious, successful characters were taken away from me because I had nothing else to stop me from facing reality. I missed family vacations, I failed subjects at university and then dropped out altogether, I lost friends and my job. But I didn't care because I still had my little slice of the WoW-verse.

Now, do not think that while I was ruining my real life that I was not aware of it. I was horribly aware of it and that is a very painful thing. How does one deal with that? Try and forget about it for a while playing the game. Forget about losing your job. Forget about family always being angry at you. Like a junkie needing a fix to escape facing reality. My family didn't know what to do and every time they spoke to me it would be about the game and how I should stop playing which would cause me to be irate.

Let's not forget that I began my addiction in depression (just like say, an alcoholic) and it certainly did not cure it. If anything it made me worse. A continuous cycle of regret, shame and escapism; I destroyed my life for WoW and so WoW became my life. I was lucky enough to eventually have the courage to quit cold turkey and let my subscription run out. I did get 'cravings' to play and I felt like I was 'missing out' on something. Even though I haven't played WoW in over three years I still have dreams in which I am playing it. I still remember in great clarity many details about the game. It's very unnerving.

My life is back on track and I'll be graduating a bachelor degree in Criminology this year with an honors degree next year. I look back on those years of my life and I don't actually remember any 'life'. All I did was WoW. It changed my personality; I became very angry all the time. If I wasn't playing WoW I didn't feel alive, it was just killing time until I could get back to an alternate reality with friends I'd never met. Now I can look back and say how silly it all was but the pain was real, the addiction was real.

Just because you can't envision yourself becoming addicted to a game doesn't mean it can't happen to other people. I can't envision myself becoming addicted to alcohol but I know it effects other people. I understand the worry behind "Breaking News: video games ruin lives" sort of things as well as the role of violence in video games but staunchly denying something that psychologists can measure and that real people experience is not going to help anyone. I still play games, even an MMO but now I know how to balance the game with my life by making sure I have everything in my life that I need so I don't try and get it out of a game.

Mark J Kline:
I can say that you might benefit from a decent shrink.

You know, most doctors would have found the very use of that word offensive and off-putting. I appreciate how accepting you are in reciprocating the vocabulary of that very moving post. I'm not in an official capacity to declare anything, but I wanted to tell you that I think you're a welcome addition to Escapist front-page. I'm looking forward to reading your column.

One thing missing from this movie--the impact of intensive gaming on younger and younger people. I see many young teenagers who get involved. Just as you would expect, some can handle it and some can not.

Some can learn to handle it at earlier ages, some cannot. My personal view is that kids are going to game far more readily than kids are going to have sex, so best to get the addiction bug out of their system early and often. One who breaks away from addiction at an early age is far better equipped to handle other temptations down the line.

Mark, I deeply respect the fact that you're addressing the video game issue as a clinical psychologist, as no doubt you're one of the first among your field to do so. The last thing we need is another raft of 'experts' who read only trade journals. Sadly ran into one of them today, at a church dinner no less.

However, as a conservative by temperament, I like to aim at root causes whenever social problems (hereby defined as: 'Any problem where a large number of people have pretty much exactly the same story') come up. And the root cause of endless videogaming is that even after I 'cured' myself, became outgoing, made friends easily, excelled at work, school, and employment, went to war, and acquired enough money to support any married life, I took one look around at the options and fired up a Steam account. And haven't regretted it since.

Kalico_Lynx:
To all the people staunchly in denial:

Hrrrm, not a great way to start.

Just because you can't envision yourself becoming addicted to a game doesn't mean it can't happen to other people.

Just because you believe you have doesn't mean you have been. Being a teenager is a stretch on the sanity of every last one of us here. A lot of people, and I'm not including you in this, like to exaggerate their "symptoms" into a full-blown DISEASE OF THE MIND.

A lot of doctors/psychiatrists also like to treat a DISEASE rather than just a product of the environment.

I do know a lot of people who look back on their teenage years and ask "Why did I do that?" and not remember that THEY WERE TEENAGERS. Every teen in the world has a story of hating their parents, hating themselves and being moody. Not all are addictions or illnesses. And every last one of us have been irate, distracted and stupid at sometime when the hormones take control.

I fully agree with Kalico_Lynx up there (despite that first sentence :p ).

Gaming can be addictive in the same way many other things can be, there's simply no sensible way to deny it. Banning video-games on this basis however is another debate entirely. That would mean we should ban tabacco and alcohol as well for example.

Furthermore, we live in a world where people have been diagnosed as being addicted to exercise. People who get extremely irrational if they're prohibited from running for an hour each day. Given that, can anyone claim gaming can't take the place of something like exercise for some people?

I also argue the opposite point with my mom now and again as she seems to think gaming is the worst invention of humanity. No really, she said that, not the atomic bomb or biological warfare agents or PCB's but video-games...

The_root_of_all_evil:
So are you saying that gaming can't be addicting or that a load of the current fuss about it is scaremongering or that lot's of kids like to imagine all kinds of reasons for their state of mind or are you putting questionmarks to the whole psychological field around the topic?

Or all of it at once? :)

Oh, nevermind, just read the preceding pages.

Without gaming I would be unbelievably stressed.

I'm just finishing my exam period. My parents confine me to my room and expect me to do 24 hour revision, and obviously I know I need to do work, but I need breaks also. Without the Xbox in my room, I would have no escape from stress in these situations.

Interesting article.. but, forgive me for saying, it seemed a little bit awkward, as if it were grabbing for what little empirical support was available or something.

Maybe it's because gaming and the psychological effects thereof are so little studied as yet (and so many studies sensationalist rather than setting out to really learn, or create useful evidence for further study), or maybe the two are less than compatible, like trying to discuss the addictive qualities of reading books - more relegated to the (still true) 'people can get addicted to anything' line than a genuine, regularly addictive substance.

We'll see, I guess - and the concept of someone putting themselves in the position of Dr. Mark here is certainly an interesting one, and one I might very likely send an E-Mail or two to myself, at some point, should I think of a good way to phrase my thoughts and queries.

.. Actually I just thought of something.

Very good article. I look forward to reading more about the psychology of gaming.

The_root_of_all_evil:

theSovietConnection:

But what about the gamer that takes every possible step to prevent from removing himself from the main source, as you say. What if a stash isn't needed because they just don't stop unless absolutely necessary, and even then there are examples of people who game themselves to death.

That isn't gaming himself to death. That's basic ignoring his body functions. People have been doing that since time immemorial. If you game past your insulin treatment, and you're diabetic, the diabetic seizure won't be caused by the game, will it?

Most people agree gambling is addictive, so can't video games be as well?

It's a different field of addiction though. Addiction primarily stems from the body needing to continue it's vice which shorts out the body. Gambling and gaming are vices, sure, but they're not addictions as much as they're the symptom of a higher mental crisis, I.E. Obsessive Compulsive Disorder.

If you treat gaming as an addicting substance, then you have to treat any pleasurable substance as an addicting substance, which, at the last count, included a good portion of living.

Gambling differs in that there is a specific trigger (to whit: money) which causes the rise in dopamine (the "high") and the deterioration in performance (the "low" - from losing). Gaming doesn't cover that as there is no specific trigger relevant to all addicts. Take an "addicting" game like Starcraft, for instance. What drives you is the wish to be rewarded, but unlike gambling, that wish can be completed multiple times and on multiple formats. That means it's less of a stimulus and more of a symptom of a larger dysfunction of the brain.

All of the "deaths" from gaming have been from individuals in poor health who have pushed their bodies past breaking point for the competitive element, rather than any set stimulus; that means it's a learned behaviour pattern rather than an induced behaviour pattern.

Treating the "addiction" will only remove the symptom, rather than the root cause. Our Starcraft gamer will probably be bored stiff with The Sims, but a poker addict will jump at the chance to play roulette.

Addiction is primarily a deterioration state, gaming can easily be development state - let's face it, we all play games when we're learning. What we need to treat is the OCD response that leads to game focussing, rather than the games themselves.

Like I said before, look at the "normal" individuals who imbibe dangerous amount of toxins, suffer violent mood-swings, dress up in strange ritual dress and are unable to rationalise it - just because their country is playing in a big tournament.

Cognitive therapy rather than substance therapy. Most of these people who die have already suffered from extreme cycles of stress and it may be that the game is helping them cope, rather than deteriorating their life.

On behalf of the gamblers and casinos being...somewhat unfairly taxed at the moment;

Poker is a game of skill, not purely of chance in the same way as Roulette is. You can't get the same rush playing Roulette (Russian or otherwise) as you can from outsmarting a human opponent. You can't reeeeally lump them together in the same class. Perhaps Blackjack (with a semi-decent counting system) would be a better bet (hahahaohkillme).

OT: I really like the considered approach of the OP. Regardless of whether I agree with the argument, the article was considered and informative. I don't know enough to commit to one side or the other, and I'm happy with that at the moment - this issue is unlikely to significantly impact upon my life, after all, any legislation would only restrict MMORPGs from Korea, that emphasise grinding and promote addictive behaviour.

The argument that ensued was a little bit disgusting, with insults flying almost from the start. That helps no-one, edifies no-one, illuminates no-one.

I do wish that Godwin's Law applied instead to the first person to call someone else a sheep or some variant there-upon. It's getting more and more common, and I've seen it used to defend bogus arguments from Truthers, Birthers, Autism-MMR-link fanatics, Holocaust deniers, pro-lifers, pro-choicers - the list goes on. That doesn't mean that being independently minded, or challenging authority, is necessarily misguided, of course. It just means you don't have to be a total dickhead about it.

It's nice to finally see an article compiled by py

Ralvuimego:

RetroVortex:
Is it weird that the first thought that came into my head when I saw this article (particularily Mark's portrait!) was: "MEDIC!!"

Funny thing is, I don't even play Team Fortress 2 very much.

Hang on...

image

Yep. I do see the resemblance.

I do look forward to seeing more of these articles though.

So much win!
I want this guy as the medic for my heavy in TF2.

The_root_of_all_evil:

Any pleasurable substance can lead to OCD around that, but that's not necessarily an addiction, rather an outlet for a mental state that's already there.

Hi, I know I'm late to this, but I feel I must remind you about the O part of OCD. Its not compulsion by itself.

The old me would have argued my points in a thread about addcition to death, but I lack the energy today. So I'll just provide some very very brief OCD info.

khaimera:

The_root_of_all_evil:

Any pleasurable substance can lead to OCD around that, but that's not necessarily an addiction, rather an outlet for a mental state that's already there.

Hi, I know I'm late to this, but I feel I must remind you about the O part of OCD. Its not compulsion by itself.

The old me would have argued my points in a thread about addcition to death, but I lack the energy today. So I'll just provide some very very brief OCD info.

Yeah, the sun is killing the brain cells at the moment.

I think we agree (feel free to prove me wrong if we don't) but the difference between Addiction and the OCD is the effect of the substance involved.

Addiction is an Obsessive Compulsion caused by the substance. OCD is a Obsessive Compulsion whose outlet is the substance.

Gambling, as our friend above says, isn't the actual addiction, but the gain of money is. I could have an "addiction" to Everquest, say, but not to World of Warcraft.

That means the suffering part is actually the latent OCD within me that's focussing on the game, rather than the game causing the OCD. It's a subtle difference, but I think it's a relevant one.

If you want to bring in the 10 step rule, or whatever it is, you could cure me of the "Everquest addiction", but the OCD would still be there - usually reversing the OCD to a phobia, and moving my dependency to another outlet.

By cognitive therapy, you're actually treating the latent paradigm that causes the addiction, rather than the substance, which is just a symptom.

Of the staggeringly few "addiction" deaths that have been caused against the staggeringly huge rate of people playing these games, you have to assume that the addiction rate is so low to render it meaningless.

People enjoy games because...they enjoy and learn from playing. Always have. Therefore, treating the game as an addiction is treating learning as an addiction. Something I really don't want to be cured of.

Vortigar:

The_root_of_all_evil:
So are you saying that gaming can't be addicting or that a load of the current fuss about it is scaremongering or that lot's of kids like to imagine all kinds of reasons for their state of mind or are you putting questionmarks to the whole psychological field around the topic?

Or all of it at once? :)

Oh, nevermind, just read the preceding pages.

Quotes help me see things :)

I'm saying that treating gaming as an addiction is, for 99% of cases, the wrong way to do it. There are the obvious few who will get addicted in the same way that anything will affect certain people. Watch your mum tidying the house sometimes :)

It's also a bad idea to lose sight of the fact (and it's scientifically proven) that we learn more from playing than we do from simply reading. Physical experience has always been superior to theoretical experience, but in certain cases theoretical experience is all we have.

Monopoly may not teach you a lot about business management, but it teaches you a hell of a lot about statistics, human nature and social interaction. (And grabbing the oranges as soon as possible :))

The_root_of_all_evil:

khaimera:

The_root_of_all_evil:

Any pleasurable substance can lead to OCD around that, but that's not necessarily an addiction, rather an outlet for a mental state that's already there.

Hi, I know I'm late to this, but I feel I must remind you about the O part of OCD. Its not compulsion by itself.

The old me would have argued my points in a thread about addcition to death, but I lack the energy today. So I'll just provide some very very brief OCD info.

Yeah, the sun is killing the brain cells at the moment.

I think we agree (feel free to prove me wrong if we don't) but the difference between Addiction and the OCD is the effect of the substance involved.

Addiction is an Obsessive Compulsion caused by the substance. OCD is a Obsessive Compulsion whose outlet is the substance.

Gambling, as our friend above says, isn't the actual addiction, but the gain of money is. I could have an "addiction" to Everquest, say, but not to World of Warcraft.

That means the suffering part is actually the latent OCD within me that's focussing on the game, rather than the game causing the OCD. It's a subtle difference, but I think it's a relevant one.

If you want to bring in the 10 step rule, or whatever it is, you could cure me of the "Everquest addiction", but the OCD would still be there - usually reversing the OCD to a phobia, and moving my dependency to another outlet.

By cognitive therapy, you're actually treating the latent paradigm that causes the addiction, rather than the substance, which is just a symptom.

Of the staggeringly few "addiction" deaths that have been caused against the staggeringly huge rate of people playing these games, you have to assume that the addiction rate is so low to render it meaningless.

People enjoy games because...they enjoy and learn from playing. Always have. Therefore, treating the game as an addiction is treating learning as an addiction. Something I really don't want to be cured of.

Yeah the sun, thats it. I'll go with that one. And not the fact that my life is a mess

So let me see if I understand you correctly. You are saying the the obsessive thought is the desire to play the game. So that one obsesses about playing the game, and then plays the game to alleviate said thought?

I understand OCD like this (I've attended all day seminars on the topic of OCD). Its a neurological disease in which one has repeated obsessive thoughts over which they have no control. Interestingly enough, OCD is very related to Tourettes, but teh research is in early stages. The thoughts are often of a certain type (fear of harming others, "evil" thoughts, others I can't think of). The compulsions are then performed as a distraction method but also becuase peopel delude themslves into thinking that the compulsions directly lower the probability of said thought becoming true.

The compulsions, or rituals, are generally not enjoyed at all, unlike most addictive behaviors which start off enjoyable. The person also recognizes that the behavior makes no sense. Like "How does flipping a light switch 20 times protect my son from getting into a car accident.

CBT then comes in to help the client leanr to handle the obsessive thought so that the compulsion is no longer needed.

I think the main differnce between the two is that with addiction, the thought and the behavior are correlated highly, where as with OCD, they are not at all. The behavior is used solely to deal with an obsessive thought, not because the behavior is reinforcing in its own right.

What a mouthful. I apologize in advance for spelling errors, I don't have spell check at work.

khaimera:

So let me see if I understand you correctly. You are saying the the obsessive thought is the desire to play the game. So that one obsesses about playing the game, and then plays the game to alleviate said thought?

Mostly, yes. There's obviously the few that devolve totally, but that's usually a symptom of a far-greater problem.

The compulsions are then performed as a distraction method but also because people delude themselves into thinking that the compulsions directly lower the probability of said thought becoming true.

The compulsions, or rituals, are generally not enjoyed at all, unlike most addictive behaviors which start off enjoyable. The person also recognizes that the behavior makes no sense. Like "How does flipping a light switch 20 times protect my son from getting into a car accident.

Does the word "grinding" come to mind here?

CBT then comes in to help the client leanr to handle the obsessive thought so that the compulsion is no longer needed.

More difficult here. CBT comes in to understand why the thought appears in the first place, and attempts to pacify that thought.

What a mouthful. I apologize in advance for spelling errors, I don't have spell check at work.

S'ok, your point came across well.

The_root_of_all_evil:

khaimera:

So let me see if I understand you correctly. You are saying the the obsessive thought is the desire to play the game. So that one obsesses about playing the game, and then plays the game to alleviate said thought?

Mostly, yes. There's obviously the few that devolve totally, but that's usually a symptom of a far-greater problem.

The compulsions are then performed as a distraction method but also because people delude themselves into thinking that the compulsions directly lower the probability of said thought becoming true.

The compulsions, or rituals, are generally not enjoyed at all, unlike most addictive behaviors which start off enjoyable. The person also recognizes that the behavior makes no sense. Like "How does flipping a light switch 20 times protect my son from getting into a car accident.

Does the word "grinding" come to mind here?

Sort of, except that grinding has a logical consequence or purpose to it. OCD, not so much.

CBT then comes in to help the client leanr to handle the obsessive thought so that the compulsion is no longer needed.

More difficult here. CBT comes in to understand why the thought appears in the first place, and attempts to pacify that thought.
I disagree totally on this one. The "why" the thought is there is always a combination of learned behavior and beliefs adopted from childhood or adult experiences. CBT does not concern itself with why, thats one of its main differences form odler more tradional forms of therpay. CBT asks if the thought is useful or rational, and then works to replace the thought with a new one, which is then repated until its adopted fully.

What a mouthful. I apologize in advance for spelling errors, I don't have spell check at work.

S'ok, your point came across well.

Thanks, I had hoped so. Now you see why I was hesitatnt to get into this thread. I knew that once I started I would go on forever.
As you can see my skill in splitting up quotes is weak, so I just used bold type.

Look, the effect WoW has on ones mind is UNIQUE TO THEM, just because one guys loses his job, another is inspired to go to college, or another to do nothing it has less to due with the game and more to our psychological reaction to it, that said it can have negative effects on the right person.

khaimera:

The_root_of_all_evil:

Does the word "grinding" come to mind here?

Sort of, except that grinding has a logical consequence or purpose to it. OCD, not so much.

Does it? Consider it to the person that's doing it. He's obsessing about a series of keypresses, repeated at least 100 times, which can lead to a brief burst of pleasure "DING"...followed by more stress and more repetitions.

And he's going to have to pick a place to complete all these repetitions as well.

CBT then comes in to help the client learn to handle the obsessive thought so that the compulsion is no longer needed.

More difficult here. CBT comes in to understand why the thought appears in the first place, and attempts to pacify that thought.

I disagree totally on this one. The "why" the thought is there is always a combination of learned behavior and beliefs adopted from childhood or adult experiences. CBT does not concern itself with why, thats one of its main differences form odler more tradional forms of therpay. CBT asks if the thought is useful or rational, and then works to replace the thought with a new one, which is then repated until its adopted fully.

This is the real problem, whether the thought needs removing or repairing - and whether it's nature or nurture (two more whole threads that could be done).

But I'd never say "Always" in psychiatry. "Mostly" is the best we can do at the current level of understanding. Sometimes a pipe is just a pipe.

It's nice to see some even handed discussion in this area, YOU MAKE GOOD DOCTOR!

The_root_of_all_evil:

khaimera:

The_root_of_all_evil:

Does the word "grinding" come to mind here?

Sort of, except that grinding has a logical consequence or purpose to it. OCD, not so much.

Does it? Consider it to the person that's doing it. He's obsessing about a series of keypresses, repeated at least 100 times, which can lead to a brief burst of pleasure "DING"...followed by more stress and more repetitions.

And he's going to have to pick a place to complete all these repetitions as well.

CBT then comes in to help the client learn to handle the obsessive thought so that the compulsion is no longer needed.

More difficult here. CBT comes in to understand why the thought appears in the first place, and attempts to pacify that thought.

I disagree totally on this one. The "why" the thought is there is always a combination of learned behavior and beliefs adopted from childhood or adult experiences. CBT does not concern itself with why, thats one of its main differences form odler more tradional forms of therpay. CBT asks if the thought is useful or rational, and then works to replace the thought with a new one, which is then repated until its adopted fully.

This is the real problem, whether the thought needs removing or repairing - and whether it's nature or nurture (two more whole threads that could be done).

But I'd never say "Always" in psychiatry. "Mostly" is the best we can do at the current level of understanding. Sometimes a pipe is just a pipe.

To look at in a broad sense, there really is little difference bertween grinding and OCD. Grinding has teh tangivel reward of more XPs or leveling up, which brings pleasure on some level. Where as an OCD compulsion serves to alleviate the anxiety that results from an unwanted and uncontrolable thought or urge.

I still think the "why" is [i]almost[/] never the issue in CBT. Traditional psychotherapy, i.e. psychoanalysis was only concerned with the why of behavior. Research was then performed to show that insight, another word for why, was not sufficient in producing behavior change. Then we got behaviorism and eventually CBT.

Treatment follows the path of recognizing the thought and changing it into a more healthy one. Why the thought appeared in the first place is not a concern. Thats becuase not only will it not be very helpful, but nobody will ever really know the why. We can speculate, but thats as close as we will get at the moment. The why could be based on brain chemistry, genes, experiences, parenting, etc. Cognitive theory maintains that the thought was always a result of how a situation was interpreted. The theory may be wrong, but it would use the word always when explaining its case.

And, to get us slightly back on topic, the tretament of addiction to anything would still involve finding out the thoughts that precede the addictive behavior, and correcting those thoughts. In addition to leanring new coping skill behaviors.

khaimera:

I still think the "why" is almost never the issue in CBT. Traditional psychotherapy, i.e. psychoanalysis was only concerned with the why of behavior. Research was then performed to show that insight, another word for why, was not sufficient in producing behavior change. Then we got behaviorism and eventually CBT.

I'd agree with that, and think it's a bad thing. CBT needs to understand the "why" so it can understand the implications.

Treatment follows the path of recognizing the thought and changing it into a more healthy one. Why the thought appeared in the first place is not a concern. Thats becuase not only will it not be very helpful, but nobody will ever really know the why.

Ah, now big disagreement here. First that the reason for the thought is often very important as it's an underlying thread that produces the disorder. And second that changing a thought is very difficult on a fundamental level and very dangerous. Down that road leads "curing" gay people. (or straights)

And, to get us slightly back on topic, the tretament of addiction to anything would still involve finding out the thoughts that precede the addictive behavior, and correcting those thoughts. In addition to leanring new coping skill behaviors.

But that leaves the patient still with the latent OCD behaviour, which is likely to produce a phobia against the substance that "addicted" them (See most ex-smokers/teetotalers) and leave a latent re-addiction waiting to happen.

If we can work out WHY that thought take place. For instance, it may be that they have associated pleasure with the sounds from the game because of hearing them as a child. Finding out that thought could show therapy (muting the sound while playing), progress (listening to electronica away from the machine) and cure (taking those sounds to their normal life).

That seems to me to be far more helpful overall than correcting the thought by removing those pleasurable sensations. What you've done there is nerve-stapling, to put it the Alpha Centurai way.

Nice, I will follow this column!

The_root_of_all_evil:

khaimera:

I still think the "why" is almost never the issue in CBT. Traditional psychotherapy, i.e. psychoanalysis was only concerned with the why of behavior. Research was then performed to show that insight, another word for why, was not sufficient in producing behavior change. Then we got behaviorism and eventually CBT.

I'd agree with that, and think it's a bad thing. CBT needs to understand the "why" so it can understand the implications.

Treatment follows the path of recognizing the thought and changing it into a more healthy one. Why the thought appeared in the first place is not a concern. Thats becuase not only will it not be very helpful, but nobody will ever really know the why.

Ah, now big disagreement here. First that the reason for the thought is often very important as it's an underlying thread that produces the disorder. And second that changing a thought is very difficult on a fundamental level and very dangerous. Down that road leads "curing" gay people. (or straights)

And, to get us slightly back on topic, the tretament of addiction to anything would still involve finding out the thoughts that precede the addictive behavior, and correcting those thoughts. In addition to leanring new coping skill behaviors.

But that leaves the patient still with the latent OCD behaviour, which is likely to produce a phobia against the substance that "addicted" them (See most ex-smokers/teetotalers) and leave a latent re-addiction waiting to happen.

If we can work out WHY that thought take place. For instance, it may be that they have associated pleasure with the sounds from the game because of hearing them as a child. Finding out that thought could show therapy (muting the sound while playing), progress (listening to electronica away from the machine) and cure (taking those sounds to their normal life).

That seems to me to be far more helpful overall than correcting the thought by removing those pleasurable sensations. What you've done there is nerve-stapling, to put it the Alpha Centurai way.

I gotta be honest, I'm loving our thread hijack.

After reading through everything I feel like we may be debating the same points, just using different language. I think when you say the "why" the thought is there, I say that the why is the thought itself. So essentially, if we were working to help someone, we'd be doing the same type fo treatment.

I wish I understood what nerve stapling is. I've never heard that term before.

khaimera:

I gotta be honest, I'm loving our thread hijack.

I don't think it's really a hijack, just a borrowing. ;)

After reading through everything I feel like we may be debating the same points, just using different language. I think when you say the "why" the thought is there, I say that the why is the thought itself. So essentially, if we were working to help someone, we'd be doing the same type fo treatment.

Yeah, sounds a similar way to what I'd said. Just hope that Dr Mark puts his toe in as well.

I wish I understood what nerve stapling is. I've never heard that term before.

It's a wonderful term from the game Alpha Centurai that you use to quell riots. I don't think it's ever mentioned what it is, but it's so evocative.
I believe it's equivalent to a lobotomy/ECT.

The_root_of_all_evil:

khaimera:

I gotta be honest, I'm loving our thread hijack.

I don't think it's really a hijack, just a borrowing. ;)

After reading through everything I feel like we may be debating the same points, just using different language. I think when you say the "why" the thought is there, I say that the why is the thought itself. So essentially, if we were working to help someone, we'd be doing the same type fo treatment.

Yeah, sounds a similar way to what I'd said. Just hope that Dr Mark puts his toe in as well.

I wish I understood what nerve stapling is. I've never heard that term before.

It's a wonderful term from the game Alpha Centurai that you use to quell riots. I don't think it's ever mentioned what it is, but it's so evocative.
I believe it's equivalent to a lobotomy/ECT.

I wonder if DR Mark is reading this thread.

I really like that term, nerve stapling. It does sound like ECT. Which, amazingly, still works.

Anyways, I've enjoyed this discussion and I hope others here have as well.

I'll PM you with some more info.

I read all these threads. Glad you guys have had an interesting discussion of this issue.

As with anything, intelligent people can certainly disagree.

I would only add that I have worked with many people with video game problems whose primary issue was not OCD, but I can certainly accept that OCD would be a good way to describe some folks. I still think the addiction model is useful in other cases, if you define addiction not as a disease, but as an inability to engage in an activity in a controlled way leading to significant and serious negative consequences. For some folks, it is easier to acknowledge and take responsibility for the seriousness of their problem if it is defined as an addiction.

CBT is certainly a treatment of choice for OCD and other anxiety disorders, and many of us use CBT principles in lots of the treatment we do, including the treatment of addictions. Other psychotherapy approaches can also be helpful. I find it is often about the personality fit between the therapist and the client. You can do just about anything you want, but if the fit is bad, you likely won't succeed.

I'm all for nerve stapling whenever possible--I have to see if I can get the right staples for my Swingline Model 545--but I suggest ECT only for intractable depressions and some other serious conditions where medicine has proved inadequate.

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