In The News

[The article below is reprinted here by permission of the publisher.]

Addico, ergo sum

What does the word "addiction" mean? "Addiction" means to devote oneself toward something, toward someone, toward some activity, or toward some experience. It means "to say yes to", "to consent to". The word "addiction" shares the same Latin root, dicere, as the words abdication, dictator, and dictation.

Addiction is a choice. It refers to something a person does, not to something a person has. It refers to behavior, mode of conduct, or deportment. Addiction is, by definition, voluntary, arising from one's own free will. Addiction is a socially constructed concept - like "the economy." There is no such thing as the economy. There is no such thing as addiction. The word "addiction" describes nothing. It is often used to prescribe something - a behavior, a way of life. This means that while many people use the word "addiction" as if they are describing some behavior, they are really prescribing how a person should or shouldn't live. In this sense, they are being moralistic.

Addiction is not a disease. It is not something someone has. It is not a lesion, or a seizure. Addiction is not involuntary. This distinction is important because since addiction is not a disease, it can be neither diagnosed or treated.

Despite the fact that behavior and disease are different, many people who believe addiction is "treatable" equate the two. Smoking is a behavior. Cancer is a disease. Drinking is a behavior. Cirrhosis of the liver is a disease. Smoking is not cancer. Drinking is not cirrhosis.

Scientists abide by certain rules to identify and treat diseases. If we are to take seriously the assertion that Internet addiction is a treatable disease, it is necessary to inquire as to whether the rules for diagnosis and disease classification are applied and abided by in responsible and meaningful ways.

Diseases are physical. They are diagnosed by symptoms (complaints) and signs (lesions), or by signs alone (asymptomatic diseases). They are rarely diagnosed on the basis of symptoms alone (there are a few exceptions, such as migraine headache). "Addiction" is not listed in standard textbooks of pathology because it does not meet the nosological criteria for disease classification. This is because addiction is "diagnosed" solely on the basis of symptoms. There are no signs of addiction. All pathologists agree: Addiction is not a disease.

What do people mean by the term "Internet addiction?" They are, first and foremost, referring to a behavior, an activity, that is, something that people do. What do these people do? They log on to the Internet and read words written by other people. They write words to other people. They may engage in this activity at the expense of other activities, such as being with one's wife, being with one's family, going to work, working on the job, sleeping, etc. The activity of logging on to the Internet may upset other people. People choosing to log on to the Internet may be happy with themselves or they may not be. While there are diverse ways in which people spend their time on the Internet, those who are allegedly "addicted" to reading the words of others, and to writing words to others, are expressing an interest in contact and intimacy with others. This is obvious.

On this basis alone, Internet addiction does not qualify as a literal disease. When people pronounce Internet addiction a "treatable" disorder, that is, a disease, they are confusing metaphorical and literal disease. When "patients" in psychotherapy confuse symbolic (metaphorical) with literal reality psychotherapists diagnose them as "psychotic." The fact is this: Internet addiction does not meet the nosological criteria for classification as a literal disease, therefore, it is treatable in a metaphorical sense only.

The diagnosis of literal disease is objective. The diagnosis of metaphorical disease is subjective. The diagnosis of literal disease is value free. The diagnosis of metaphorical disease is value laden.

To assert that Internet addiction is a "diagnosable" condition is to make a meaningless pronouncement. Anything is "diagnosable." The "diagnosis" of Internet addiction is a moral judgment of a mode of conduct masquerading as objective assessment of an inanimate object. This is not the case for real disease. We must follow certain and objective rules for accurate diagnosis. People who insist that Internet addiction is a real and treatable disease do not abide by a valid and reliable scientific methodology for disease classification. They are not scientists, they are charlatans. Real diseases are treated with real (literal) medicines by real doctors. Fake diseases are "treated" with fake (metaphorical) medicines by fake doctors.

This is not to say that people don't engage in behaviors that are self destructive - nor is it to say that talking to someone cannot be helpful or useful. It is just that when we speak of disease and treatment, we must carefully differentiate between literal and metaphorical disease and treatment.

I submit that Internet addiction is a metaphorical or fake disease that is "treated" with metaphorical or fake medicine by charlatans. In other words, to assert that the "diagnosis" and treatment of Internet addiction is legitimate medical practice is pure quackery. The diagnosis and treatment of "Internet addiction" tells us more about the diagnostician and treatment provider than it does about the person diagnosed and treated.

If the diagnosis and treatment of Internet addiction is not legitimate medical practice, what is it? The diagnosis of Internet addiction is a strategy used by mental health professionals to stigmatize people who find meaning in conversing with others via the Internet. People who diagnose and treat others for Internet addiction use the Internet as a scapegoat to serve their own selfish interests in the name of helping others. The diagnosis of Internet addiction is a social construction serving the political, social, and economic interests of diagnosticians: Psychotherapists making such diagnoses are disingenuous, and are feigning compassion and concern for others when their real interest is in power and money. This self interest masquerading as care and concern for others is nothing new: There is no end to what can be diagnosed and treated these days, when it comes to socially unacceptable behavior.

The Internet is a fantastic tool, revolutionizing the way people communicate with one another, acquire, and exchange information. It is used to bring people closer and closer together throughout the world. Many people are trying to capitalize on this marvellous invention and it is not surprising to see psychotherapists do the same. They do this by inventing, not discovering, disorders such as Internet addiction. People engaged in such deceptive practices are like parasites sucking the metaphorical blood of others in order to survive.

Why not "reading addiction," "telephone addiction," and "writing addiction?" People have always engaged in self-destructive behaviors via those mediums. These activities are not diagnosed and "treated" as disorders or diseases because everyone knows it is ludicrous to do so. The bottom line is this: Psychologists, psychiatrists, and other "mental health" professionals addict themselves to diagnosing and treating people for metaphorical diseases in order to boost their own self-esteem, and to make money.

The Internet is neither good nor bad, safe nor dangerous. It has no power unto itself. It can addict no one. Yes, the Internet is expanding exponentially. This is a function of its utility. It's not the size that counts, but how you use it that's important. Just as there is no such thing as a typical "addict," there is no such thing as a typical Internet addict. The people we label addicts constitute a heterogeneous population. This a fancy way of saying people are individuals. They log on and off of the Internet for diverse reasons, in diverse ways, and with diverse consequences.

Pronouncement without evidence is evidence of self-assigned God-like status. There is no evidence that Internet addiction exists, much less that it is a disease. Since it is not a disease, it cannot be treated. What passes as "treatment" for Internet addiction is simply conversation characterized by different rhetorical styles. Some people find the conversations called "therapy" useful. Many people think that therapists are crazy.

The conversation labelled "treatment" for "Internet addiction" consists of political, ceremonial, forensic, base, and noble rhetoric. The therapist and the designated "patient" urge one another to do or not do something in the future (political rhetoric). They praise or censure one another or others for what they are doing in the present (ceremonial rhetoric). They attack or defend one another or others for something someone did in the past (forensic rhetoric). They lie to one another, confusing symbolic and literal reality (base rhetoric). They tell the truth to one another, separating fact and fiction, encouraging courage, autonomy, responsibility, and liberty (noble rhetoric). These are ethical endeavors, not medical ones.

If we truly seek to comprehend the nature of "Internet addiction," we must study the "addictionologists" and the social, political, and economic context within which such persons make their pronouncements. We do not need to study the Internet, or the people communing with others via the Internet, to comprehend the mythical disease called "Internet addiction." Res ipsa loquitur.

Note.

1. In considering the claim that certain persons addict themselves to the Internet in ways that are amenable to "treatment," I rely primarily on distinctions between behavior and disease made by Thomas S. Szasz, MD over the past forty years.

Jeffrey A. Schaler, Ph.D., is a psychologist and adjunct professor of justice, law, and society at American University's School of Public Affairs in Washington, D.C. He is the author, most recently, of Addiction Is a Choice (Chicago: Open Court. 2000). His home page on the Internet is www.schaler.net

Copyright (c) 2000 by New Therapist