Practice the Opposite

A reorganization of how one’s time is managed is a major element in the treatment of the Internet addict. Therefore, the clinician should take a few minutes with the patient to consider current habits of using the Internet. The clinician should ask the patient, (a) What days of the week do you typically log on-line? (b) What time of day do you usually begin? (c) How long do you stay on during a typical session? and (d) Where do you usually use the computer? Once the clinician has evaluated the specific nature of the patient’s Internet use, it is necessary to construct a new schedule with the client. I refer to this as practicing the opposite. The goal of this exercise is to have patients disrupt their normal routine and re-adapt new time patterns of use in an effort to break the on-line habit. For example, let’s say the patient’s Internet habit involves checking E-mail the first thing in the morning. Suggest that the patient take a shower or start breakfast first instead of logging on. Or, perhaps the patient only uses the Internet at night, and has an established pattern of coming home and sitting in front of the computer for the remainder of the evening. The clinician might suggest to the patient to wait until after dinner and the news before logging on. If he uses it every weeknight, have him wait until the weekend, or if she is an all-weekend user, have her shift to just weekdays. If the patient never takes breaks, tell him or her to take one each half hour. If the patient only uses the computer in the den, have him or her move it to the bedroom.

External Stoppers

Another simple technique is to use concrete things that the patient needs to do or places to go as prompters to help log off. If the patient has to leave for work at 7:30 am, have him or her log in at 6:30, leaving exactly one hour before its time to quit. The danger in this is the patient may ignore such natural alarms. If so, a real alarm clock or egg timer may help. Determine a time that the patient will end the Internet session and preset the alarm and tell the patient to keep it near the computer. When it sounds, it is time to log off.

Setting Goals

Many attempts to limit Internet usage fail because the user relies on an ambiguous plan to trim the hours without determining when those remaining on-line slots will come. In order to avoid relapse, structured sessions should be programmed for the patient by setting reasonable goals, perhaps 20 hours instead of a current 40. Then, schedule those twenty hours in specific time slots and write them onto a calendar or weekly planner. The patient should keep the Internet sessions brief but frequent. This will help avoid cravings and withdrawal. As an example of a 20-hour schedule, the patient might plan to use the Internet from 8 to 10 p.m. every weeknight, and 1 to 6 on Saturday and Sunday. Or a new 10-hour schedule might include two weeknight sessions from 8:00 - 11:00 p.m., and an 8:30 am - 12:30 p.m. treat on Saturday. Incorporating a tangible schedule of Internet usage will give the patient a sense of being in control, rather than allowing the Internet to take control.

Abstinence

Previously, I discussed how a particular application may be a trigger for Internet addiction. In the clinician’s assessment, a particular application such as chat rooms, interactive games, news groups, or the World Wide Web may be the most problematic for the patient. If a specific application has been identified and moderation of it has failed, then abstinence from that application is the next appropriate intervention. The patient must stop all activity surrounding that application. This does not mean that patients can not engage in other applications which they find to be less appealing or those with a legitimate use. A patient who finds chat rooms addictive, may need to abstain from them. However, this same patient may use e-mail or surf the World Wide Web to make airline reservations or shop for a new car. Another example may be a patient who finds the World Wide Web addictive and may need to abstain from it. However, this same patient may be able to scan news groups related to topics of interest about politics, religion, or current events.

Abstinence is most applicable for the patient who also has a history of a prior addiction such as alcoholism or drug use. Patients with a premorbid history of alcohol or drug addiction often find the Internet a physically "safe" substitute addiction. Therefore, the patient becomes obsessed with Internet use as a way to avoid relapse in drinking or drug use. However, while the patient justifies the Internet is a "safe" addiction, he or she still avoids dealing with the compulsive personality or the unpleasant situation triggering the addictive behavior. In these cases, patients may feel more comfortable working towards an abstinence goal as their prior recovery involved this model. Incorporating past strategies that have been successful for these patients will enable them to effectively manage the Internet so that they can concentrate on their underlying problems.