When the network becomes a problem. Psychopathologies from the internet (first part)

young beautiful hispanic internet addict woman in pajamas on bed

It's been 22 years since the American psychiatrist Ivan Goldberg, wanting to prank the members of the PsyCom.Net site, invented a disorder called Internet Addiction Disorder (aka "Internet Addiction Disorder") by sending everyone a parody of the DSM (Manual Statistical and Diagnostic of Mental Disorders) in which this new disorder appeared for the first time. Since then hundreds of sites have appeared that offer information, professional services, the possibility of comparison between users, listening points, names of specialized online libraries, but above all patients.

In fact, thousands of people are now diagnosed as "addicted to the Internet" ... but do they know it? Before answering this question, let's take a step back.

At its appearance, the Internet was for years considered as an alternative world distinct from reality: traditionally it was believed that through the Net it was possible to carry out numerous activities (seeking information, communicating, chatting ...) without however approaching the relational and communicative possibilities of the world. external, made of flesh and bones and concrete individuals with a "license" of true reality.
But all that is believed is real and, as such, has effects, for which the construction of a reality based on the Internet, increasingly complex and rich in interactions, has brought a world, at first submissive and alternative, to levels of dignity and of importance at the beginning unthinkable.
Failed marriages, job loss, failed exams, school failures, bullying, media pillories, squandered wealth are just some of the experiences reported in the literature, and in our clinical studies, as an effect of using the Internet.

The scientific literature has already demonstrated for several years that the presence of a technological means does not cause the cancellation of the emotional-cognitive aspects of a situation. Indeed, the reality of the Internet seems to have become an all too successful "as if", a virtual one that has emancipated itself and has become real by freeing itself from the role of series B artifacts. The virtual, with its personal and interpersonal effects, is it is replacing reality more and more and we are comparing ourselves with this also in the clinical setting.

At Strategic Therapy Center of Arezzo we had dealt with cases related to the use of the Internet even before the pathology itself existed in the academic field. This allowed us to publish in 2002 a first experimental study of 79 cases linked to the pathological use of the Internet, defining specific therapeutic maneuvers for specific pathological dynamics.

Perhaps wrongly from a commercial point of view, we had precisely titled it "Perversion on the Net" (authors Giorgio Nardone and myself, Ponte alle Grazie) to underline also in the title our distance from the concept of dependence, structured on the principles of tolerance, abstinence and craving (mania).

The reader who is already familiar with our model will notice what distinguishes us from an approach of this type, which for us can only be applied to the use of substances (and not all of them !!). In fact, what allowed us to treat a pathology that was still "non-existent" at the time is its resemblance to a disorder that we have always treated successfully: vomiting.

In fact, if in addiction the mechanism that leads to the repetition of dysfunctional behavior is the need to attenuate the withdrawal syndrome, in vomiting the repetition of the eating-vomiting sequence (only initially implemented in an attempt to control one's weight) becomes, gradually, an increasingly pleasant ritual, that is, a perversion.

Even in the use of the Internet we noticed right away that it is not actually the need to mitigate the negative feelings given by the suspension of its use (abstinence), to keep the user trapped in the Net, but rather the search for pleasant sensations which, depending on the type of dynamics, make the presence on the internet not only inevitable but constantly increasing. It is therefore true that we can speak of compulsive behavior (as many point out), but with the important difference that this type of compulsion is based on pleasure rather than fear. And it is precisely because it is based on a fundamental sensation like pleasure that it is so difficult to eliminate it.

Each pathology has its own attempted solutions, both personal and family, and even those related to the use of the Internet are the first lock in which we insert the key to start working. Being the area of ​​pathologies in which the patient is the least aware of having the problem, it is also the one in which the dynamics created by the family are the most important.

In fact, it is the family (or in general the person most closely linked to the trapped person) that first perceives the situation as problematic. The most frequent dynamics are based on constant conflicts, failed attempts to stop or at least reduce “excessive or unhealthy” behavior, punishments (especially in the cases of parents and children), sabotage, etc.

It is impossible here to go into the specifics of each individual maneuver that can be implemented in each specific case, but it is important to underline that without working on communication and relationships within the family dynamics it is practically impossible to work on this type of pathology, precisely because of the aspect unconsciousness of the patient, who, as never before in this case, can oppose and resist the idea of ​​change. Therefore, guiding the people involved, whether one or more, to "strategically" manage the patient is an integral part of the therapeutic process that sees most of the work having as main protagonists those that in reality in the patient's life have come to be of the extras!

We will then briefly describe three types of ailments related to the use of money online, to refer to a second article all the "relational" part of the disorders linked to the use of the Internet, including the aspect of online sex.

Wanting to go into the details of the aforementioned specific pathologies, the compulsive shopping online, commonly described in the literature as a disorder characterized by an uncontrollable impulse and a growing tension relieved only by buying, presenting itself from the beginning as something fun and pleasant, sees its pathological escalation precisely in not being able to do without it anymore. The elective maneuver in fact relies precisely on making something pleasant unpleasant: in fact, the patient is usually asked to spend mandatorily and daily a small amount of money in online purchases. The pleasant ritual thus transformed into daily torture is usually gradually abandoned in the course of therapy.

THEonline gambling (online betting) with the advent of the Internet it can affect anyone. Indeed, if once the image of the player made us think of Dostoevskij or De Sica, today the pathological gambler can be a high school kid, an employee, a retired elderly person, etc. in fact represent a problem both for those who have discovered the thrill of the game thanks to the Internet, and for those who, from before, frequented places dedicated to betting. In fact, the Internet facilitates access and amplifies its enjoyment. As in shopping, making it unpleasant, forcing the patient to make a small daily bet, becomes the keystone of the therapy which, however, unlike the previous case, will often have to then proceed with the reconstruction of the affective-relational level, usually damaged by the pathology.

As in most things, psychopathologies are not without prejudice either. Being the game on the stock exchange (online trading) an activity that requires skills and competences that are not within the reach of anyone, does not seem to be considered a problem even in obvious cases of loss of control. The mood of the pathological "trader" constantly fluctuates between two extremes: fear and greed. The fear is linked to the loss of the sum of money invested, but is undermined by the anxiety of losing a good business. Overcoming fear creates the right degree of excitement which, combined with the often achieved possibility of earning large sums of money, result in the irrational.

Here, "victory" takes on meanings linked to one's abilities and skills far more important than simple luck, resulting in a feeling of omnipotence. At the same time, the Internet increases the feeling of control of reality, in fact monitored 24 hours a day. There are therefore two sides of the disturbance in this case: that of pleasure and that of control that makes you lose control and you need to work on both at the same time. bearing in mind that patients arrive in therapy only after the damage is done.

Dr. Federica Cagnoni (Official Psychotherapist of the Strategic Therapy Center)

Nardone, G., Cagnoni, F. (2002) Perversions on the net, psychopathologies from the Internet and their treatment, Ponte alle Grazie.


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