Break­ing the web of In­ter­net ad­dic­tion

Mil­lions of teenagers caught in web of com­pul­sive online game play­ing, Yang Yang re­ports in Bei­jing.

China Daily (Canada) - - FOCUS -

On an early Novem­ber morn­ing, 18-year-old Cheng Hang and his mother stepped down from the train into the cold Bei­jing air af­ter trav­el­ing more than 800 kilo­me­ters overnight to the cap­i­tal.

It was the third time they had vis­ited the city in six months from Huai’an, Jiangsu prov­ince, trav­el­ing to hos­pi­tals they hoped would be able to cure Cheng’s “disease”.

This time around, they went to the Med­i­cal Ad­dic­tion Di­vi­sion of the Gen­eral Hos­pi­tal of Bei­jing Mil­i­tary Re­gion, which houses a center for In­ter­net Ad­dic­tion Dis­or­ders, known to ex­perts as IAD.

Roughly 95 per­cent of the center’s pa­tients are ad­dicted to online games. The regime is tough. Part of the treat­ment is based on mil­i­tary train­ing tech­niques, which means the ad­dicts rise at 6 am and spend an hour form­ing rows, stand­ing to at­ten­tion and march­ing.

“Dur­ing the past year, we have been see­ing doc­tors in Huai’an and nearby cities. Dif­fer­ent doc­tors gave dif­fer­ent di­ag­noses. Some pre­scribed an­tide­pres­sants, while oth­ers in­sisted that my son is com­pletely nor­mal. But he of­ten has headaches and can’t stop him­self from play­ing com­puter games,” said Cheng’s mother.

The young man, dressed en­tirely in black, said noth­ing for a long time. He stood in the cor­ner of the hos­pi­tal of­fice and stared va­cantly at his mother as she re­lated the story.

When he even­tu­ally spoke, Cheng, who should have been pre­par­ing for the na­tional col­lege en­trance exam in June, ex­plained his prob­lem self-con­sciously and briefly. He first be­came ad­dicted to com­puter games al­most two years ago af­ter flop­ping a math test.

“I scored zero. I dared not tell my par­ents. But I was so frus­trated and dis­ap­pointed. So I went to an In­ter­net bar with some class­mates, kind of aban­don­ing my­self to com­puter games,” he said. Grad­u­ally, he stopped go­ing to school and spent days and nights at In­ter­net bars, caus­ing his par­ents great anx­i­ety.

Cheng is one of 70 IAD pa­tients at the hos­pi­tal. China has 24 mil­lion In­ter­net ad­dicts, most are aged be­tween 12 and 18, ac­cord­ing to Tao Ran, the di­rec­tor of the med­i­cal ad­dic­tion depart­ment, one of 40 spe­cial­ist in­sti­tu­tions of­fer­ing help and treat­ment for the con­di­tion. A fur­ther 28 mil­lion Chi­nese teenagers use the In­ter­net ex­ces­sively and dis­play ad­dic­tive ten­den­cies, he said.

Al­most all the ad­dic­tions are re­lated to com­puter games, es­pe­cially those played online. Ex­perts say the con­di­tion can of­ten be as­cribed to an in­ap­pro­pri­ate fam­ily en­vi­ron­ment — where par­ents are ex­ces­sively strict, or con­versely not strict enough — and the heavy so­cial pres­sures heaped on young peo­ple. Ground­break­ing dis­cov­ery

Psy­chi­a­trists world­wide have long de­bated the sta­tus of In­ter­net ad­dic­tion and ques­tioned whether it can be clas­si­fied as a men­tal dis­or­der. Ear­lier this year, the Amer­i­can Psy­chi­atric As­so­ci­a­tion in­cluded In­ter­net Use Dis­or­der in the fifth edi­tion of its Di­ag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders: “In­ter­net Use Dis­or­der is cur­rently pro­posed for in­clu­sion in Sec­tion 3, an area of DSM-5 for con­di­tions re­quir­ing fur­ther study be­fore they should be con­sid­ered dis­or­ders,” ac­cord­ing to the as­so­ci­a­tion.

In Jan­uary 2012, a re­search team led by Lei Hao of the Wuhan In­sti­tute of Physics and Math­e­mat­ics of the Chi­nese Academy of Sciences in Hubei prov­ince, scanned the brains of 35 males and fe­males aged be­tween 14 and 21. Seven­teen of the sub­jects were ad­dicted to the In­ter­net. The scans re­vealed that the changes in the white and grey mat­ter in the brains of In­ter­net ad­dicts are sim­i­lar to those dis­played by drug ad­dicts. It was a ground­break­ing dis­cov­ery in the study of IAD.

“We sus­pect that the changes may af­fect the ad­dicts’ be­hav­ior. For ex­am­ple, they are un­able to con­trol them­selves and act on im­pulse. Many know it’s wrong to miss school to play online games but they just can’t con­trol them­selves. At the mo­ment, though that just a hy­poth­e­sis,” said Lei.

The team plans to con­tinue the re­search by col­lect­ing at least 30 brain scan sam­ples from among Tao’s pa­tients to see if they will in­di­cate changes in the brain be­fore and af­ter treat­ment.

“We want to find out whether In­ter­net ad­dic­tion changes the struc­ture of the brain. If that’s ac­tu­ally the case, our study will pro­vide solid ev­i­dence for the di­ag­no­sis and treat­ment as­sess­ment for IAD,” said Lei.

In­ter­na­tion­ally ac­knowl­edged meth­ods of di­ag­nos­ing IAD are now widely used. De­pres­sion is seen as a key in­di­ca­tor. Many ad­dicts are de­pressed and anx­ious, and are un­able or un­will­ing to com­mu­ni­cate mean­ing­fully with other peo­ple, in­clud­ing their par­ents.

One fre­quently asked ques­tion is whether de­pres­sion leads to In­ter­net ad­dic­tion or vice versa. There is no def­i­nite an­swer, but based on his 10-year ex­pe­ri­ence at the hos­pi­tal, Tao be­lieves that two thirds of the pa­tients suf­fer from de­pres­sion ini­tially and their In­ter­net ad­dic­tion ex­ac­er­bates the con­di­tion. Poor self im­age

Bei­jing Qide Ed­u­ca­tion Center, a 60-minute drive from the cap­i­tal’s down­town, is home to 70 “prob­lem teenagers” from a num­ber of prov­inces. Their bad be­hav­ior had prompted their par­ents to take des­per­ate ac­tion. Roughly 70 per­cent of them use the In­ter­net ex­ces­sively.

Liu Ran, from the In­ner Mon­go­lia au­ton­o­mous re­gion, looks like a typ­i­cal Chi­nese school kid. A con­spic­u­ous green hair­pin holds her fringe in place, ex­pos­ing her fore­head, but she wears the rest of her hair in a high pony­tail.

But, when­ever she thinks peo­ple are look­ing at her, she tries to cover her fore­head and eyes with her hand, even though the teach­ers keep telling her not to.

“I think I am too ugly to let peo­ple see my face. Be­fore I came here, my fringe hid my eyes com­pletely. When­ever I walked to­ward a group of peo­ple, I thought they were star­ing and laugh­ing at me, and dis­liked me. I wished I could dig a hole in the ground and hide,” she said.

Liu is one of the most ta­lented stu­dents at the center. She ex­cels at paint­ing and is ex­tremely in­ter­ested in learn­ing to play­ing the pi­ano. At one point, she sat down at the in­stru­ment in the center’s mu­sic room and hes­i­tantly picked out the be­gin­ning of Beethoven’s Fur Elise.

“I can barely re­mem­ber the score be­cause I only stud­ied it for a few days and it’s re­ally a long time since I touched the keys,” she said, be­fore turn­ing to the mu­sic teacher and beg­ging, “Please, Mr Gan, teach me how to play the pi­ano, be­cause it has been my dream since I was small.”

Liu’s mother, a teacher, sent her to the center be­cause the 16-yearold of­ten pre­tended to be sick and even­tu­ally stopped go­ing to school al­to­gether. She be­came ad­dicted to an online rac­ing game QQ Fly Car, and, over a pe­riod of 20 days, asked her par­ents for more than 4,000 yuan ($660) to spend on fancy clothes, ac­ces­sories and makeup for her online avatar. Her ex­cel­lent skills as an online racer and at­trac­tive online ap­pear­ance soon won her many cy­ber ad­mir­ers.

“They told me that I was beau­ti­ful and awe­some and they loved me,” she said, “I felt so sat­is­fied and happy be­cause I was be­ing praised and loved. If my par­ents re­fused to give me money, I would fight with them.”

The se­nior mid­dle school stu­dent should be pre­par­ing for her high school en­trance exam, but she stopped go­ing to school be­cause she had no friends there. Last se­mes­ter, her mother trans­ferred Liu to her own class so that she could su­per­vise her stud­ies more closely.

“If I napped in class, she just came by and slapped my head in front of the whole class, leav­ing me with no dig­nity at all. The only friend I had dis­owned me be­cause she was wor­ried the other kids would think she was pre­tend­ing to be close to me to gain pref­er­en­tial treat­ment from my mother. Why would I stay at school when I had no friends there?” Liu asked.

Mat­ters were made worse when Liu’s mother in­sisted that she at­tended an af­ter-school learn­ing center at the week­ends and dur­ing the hol­i­days. The daily sched­ule cov­ered all the ma­jor sub­jects fea­tured in the high school exam: Chi­nese, math­e­mat­ics, physics, English and chem­istry. “It was suf­fo­cat­ing,” said Liu, “be­cause of that, I had to give up pi­ano.”

Guo Xianghe, the psy­cho­log­i­cal coun­selor at the Qide center, said many of the stu­dents sim­ply lack fa­mil­ial love.

“In th­ese cases, chil­dren look for com­fort else­where. Online, they can be very pop­u­lar, but in re­al­ity, they are lonely,” she said. “More than 30 per­cent of the chil­dren here come from sin­gle-par­ent fam­i­lies. Their par­ents have ei­ther di­vorced or sep­a­rated.”

Tao said IAD in chil­dren is usu­ally the re­sult of two dis­tinct types of fam­ily en­vi­ron­ment: par­ent-ori­ented, where the par­ents are very strict and de­mand­ing, or childori­ented, where spoiled off­spring

It is in­ter­na­tion­ally ac­knowl­edged that chil­dren aged around 16 are prone to de­pres­sion, be­cause at that age they have come to un­der­stand the gap be­tween childhood dreams and adult re­al­ity, but are tem­po­rar­ily un­able to do any­thing about it, said Tao. He added that 48 per­cent of his pa­tients are high school stu­dents, 20 per­cent are col­lege stu­dents and the rest are at mid­dle school. The youngest is an 8-year-old, whose “nanny” was a se­ries of com­puter games.

“When they’re young, chil­dren are en­cour­aged by their par­ents and teach­ers to build up rosy fu­ture dreams, such as be­com­ing a great sci­en­tist or a hero in another pro­fes­sion. But for some, their poor per­for­mance at school is dis­ap­point­ing and frus­trat­ing. In the most ex­treme cases, some chil­dren who lack con­fi­dence will re­ject re­al­ity and re­treat into an imag­i­nary world,” he said.

“That’s why some chil­dren be­come ad­dicted to online games where they can play the hero. Oth­ers read fan­tasies in which they can imag­ine them­selves to be the hero,” he said. “Once they are sep­a­rated from the games or fan­tasies, they feel de­pressed and anx­ious.”

Cheng Hang loves read­ing comic books and play­ing com­puter games based on the sto­ries about Three King­doms (AD 220-280), his fa­vorite pe­riod in Chi­nese his­tory.

Be­fore 2008, Tao’s center of­fered one-on-one treat­ment, but fol­lowup re­search found a fail­ure rate of 70 per­cent once the pa­tients had left the hos­pi­tal. Since then, the center has or­ga­nized group treat­ment ses­sions, in which eight to 12 pa­tients form a small class for lessons, in­clud­ing growth ed­u­ca­tion. The pa­tients also share and an­a­lyze each other’s sto­ries.

The re­cov­ery rate grad­u­ally im­proved, ris­ing to 50 per­cent, and in 2009 the center in­tro­duced the con­cept of “com­pan­ion par­ents”, where the par­ents stay with their chil­dren as a form of com­fort. That saw the re­cov­ery rate rise as high as 75 or 80 per­cent. Par­ents also take lessons in ed­u­cat­ing their chil­dren.

In Septem­ber, Brad­ford Re­gional Med­i­cal Center in Penn­syl­va­nia launched the United States’ first hos­pi­tal-based In­ter­net ad­dic­tion treat­ment and re­cov­ery pro­gram. Kim­berly Young, the pro­gram di­rec­tor, has been study­ing In­ter­net ad­dic­tion since 1995. In an e-mail re­sponse to ques­tions from China Daily, she wrote, “We in the US now of­fer the same type of clin­i­cal ser­vices of­fered in China.

“Our pro­gram is a 10-day in­pa­tient regime that can be ex­panded to 21 days, de­pend­ing on the needs of the pa­tient. It is a dual-di­ag­no­sis clinic, so peo­ple must have a sec­ond dis­or­der such as de­pres­sion or anx­i­ety, and it is based on my model Cog­ni­tive-Be­hav­ioral Ther­apy for In­ter­net Ad­dic­tion.”

Young’s CBT-IA model has proved ex­tremely suc­cess­ful and vari­a­tions of it are now used in ad­dic­tion cen­ters around the world. The dif­fer­ence is that in­stead of the quasi-mil­i­tary train­ing used at Tao’s center, ad­dicts in Ger­many take on part-time jobs, while in other coun­tries they raise an­i­mals, for ex­am­ple, dogs in Ja­pan and horses in South Korea.

“We don’t have enough space to keep pets, but mil­i­tary train­ing pro­vides the pa­tients with a rou­tine, get­ting up at 6 am and go­ing to bed at 9 pm, which is sim­i­lar to keep­ing pets,” said Tao.

Af­ter meet­ing Tao at the center, Cheng and his mother de­cided to stay and un­dergo a six-month course, which costs 8,400 yuan a month for treat­ment plus 900 yuan for liv­ing ex­penses. Par­ents are al­lowed to stay with their chil­dren free of charge.

“My son al­ways re­treats when faced with dif­fi­cul­ties. I re­gret that I was too strict with him when he was lit­tle. I don’t know if the treat­ment will work, but I can’t give up on him,” said Cheng’s mother. Con­tact the au­thor at: yangyangs@chi­nadaily.com.cn

PHO­TOS BY ZOU HONG / CHINA DAILY

Sev­enty ‘prob­lem teenagers’ re­ceive spe­cial treat­ment at Bei­jing Qide Ed­u­ca­tion Center, where they hope to find a cure for their ad­dic­tion to the In­ter­net. From left to right: Play­ing bas­ket­ball on cam­pus. Stu­dents take turns to pre­pare three meals a day, which is con­sid­ered an im­por­tant part of the treat­ment. Ad­dicts at­tend a Chi­nese cul­ture class. Be­low: A group of teenagers un­der­take mil­i­tary-style train­ing dur­ing their course of treat­ment.

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