Addicted to the internet

DW: What criteria do you use to ascertain an internet addiction?

Dr. te Wildt: You can't diagnose an addiction based purely on the amount of time a person spends on the internet. Rather, you use criteria that have proven reliable in diagnosing other addictions and which always cover two areas. Firstly you look to see whether there is an addictive behavior, involving a loss of control, an increase in the dose and withdrawal symptoms, and secondly you ascertain whether at least one area of life is being negatively impacted by this dependency. These areas include social life, working life or school/studies and treatment of one's own body, which can also be affected.

DW: Lots of people use the internet without becoming addicted. What needs to happen for an addiction to develop?

Dr. te Wildt. Just like with other addictions, the mere existence of the addictive substance is not in itself decisive for whether a person develops an addiction or not. Other factors play a role here. In the case of internet addiction, we know that people who suffer from fears related to social interaction, who are lonely, withdrawn or have a tendency to depression are more likely to be affected. In addition to these individual factors, there are social factors that also play a role, i.e. internet addiction often affects people who for whatever reason haven't managed to succeed in society or in their surroundings or who have been marginalized.

DW: How do you treat people with an internet addiction?

Dr. te Wildt: When it comes to the treatment, you first of all need to look very closely at what kind of internet addiction you're actually dealing with. In most cases there are three different kinds of internet addiction that we can identify: online games, cybersex and social media networks. Once you've identified one or more areas, you try to persuade the patient to completely avoid these areas. But in the therapy, which is mostly an outpatient group therapy based on a behavioral therapy model, the focus is not on all the things patients are no longer allowed to do but above all on what they can do instead. Some patients have been spending up to 16 hours a day on the internet, sometimes over a period of months or even years. If they want to stop doing that all of a sudden they will need to fill all that time with life, and that's a very decisive aspect in the therapy. It's especially important for young people to reactivate social contacts, to do sport and to get the feeling that they are appreciated in the society in which they live.

DW: How can those affected manage to give up their addiction?

Dr. te Wildt: First of all, it all works on a voluntary basis. And avoiding the internet completely is not possible because we need it in our everyday life and work. So the issue more is on which areas of the internet to avoid as far as possible. The percentage of people who suffer a relapse is quite high, as with other addictions, and like with alcohol addiction you can pretty well say - especially when it comes to cybersex and online games, which are the most common types of internet addiction - that it's best to abstain from them permanently. Anyone who has been addicted to these things in the past can suffer a relapse at any time, even years later - although admittedly there are still no long-term studies in this area yet.

DW: How can we prevent children and young people, or even adults, from becoming addicted to the internet?

Dr. te Wildt: Anyone who is at risk should consider how they can limit both the amount of time they spend in front of the computer and what content they look at. And then, how they can structure their life in such a way that they are able to resist an addiction. It's particularly important to achieve that with children and young people. They still need to become established and settle down in the real world, and in their own body too, before they spend too much time too fast in front of a computer screen. What applies to everyone is that we need to create periods of time, where media play no role at all, i.e. to have one day a week without any internet at all, or to do a so-called "media fast" for a certain period of time. Young people need to have learned by a certain age to take a responsible approach to digital media by themselves. That would be the best prevention. Media competence has to include the ability to cope with media abstinence.

Private tutor Dr. Bert te Wildt is a doctor and psychotherapist and works for the LWL Clinic for Psychosomatic Medicine and Psychotherapy, at the Ruhr University of Bochum

Interview: Marita Brinkmann