Digital Diagnosis Duo for DSM

I have found that turning ideas upside down often leads to truth. An example from my personal experience follows while another pokes fun at those who thrive (and even profit from) labeling any activity they deem excessive an addiction, then claim to offer treatment for it. (Nothing here should be interpreted as making fun of anyone who suffers from any psychiatric or substance use disorder or any professional or program intending to help such individuals.)

Digital Gaming Aversion Disorder (DGAD)

About two years ago, while sitting at my desk, I realized that there was really nothing I wanted to do. A friend had been playing solitaire on her computer, and that was all it took to get me going. Within a few days I was hooked. Almost every time I got done with whatever computer task I had been engaged in, I started playing solitaire. After a couple weeks I realized my skills were improving gradually. I began to develop winning strategies. Maybe I wasn't addicted yet, but I certainly might have been headed in that direction.

Then one day I noticed that some of the pleasure had gone. I almost had to force myself to finish a game. Next time I thought about starting another game I simply could not do it. I have not played solitaire since. When I see my friends playing, the screen looks totally two dimensional, unlike previously when it was as though I could see into the game. I cannot even imagine myself starting a game. The thought of how it works, the different suits, the different colors, the different numbers, all are blocked from my mind.

To be honest I cannot say this has interfered substantially with my social or occupational functioning. I cannot say that I am particularly distressed about this aversion to solitaire. However, should I want treatment, I have two approaches to propose, both probably requiring double blind studies to prove their effectiveness.

Psychotherapy of Digital Gaming Aversion Disorder

Cognitive behavior therapy will be the first line psychotherapy for this disorder. I believe a sufficient and appropriate reward will quickly overcome the aversion. I suggest rewarding the patient with $1000 for each game played to conclusion will rapidly reverse the aversion. I of course expect this to be covered by medical insurance.

Pharmacotherapy Of Digital Gaming Aversion Disorder

I believe a similar approach to that proposed for psychotherapy will lead to rapid resolution of this disorder using cocaine as the first line agent. A small dose after completing each solitaire game should lead to rapid resolution.

Digital Media Avoidance Disorder (DMAD)

For years now people have admonished those who, in their minds, use computers and/or the Internet "too much," calling these behaviors, like almost any other behavior they can label excessive, "addiction." It occurs to me, however, that those who engage in this "addiction addiction" simply want to deflect attention from their own dysfunction. This clever but pathological strategy, based on severe denial, has enabled them to avoid needed treatment, often for many years, for the condition I address below.

Today we must all face the fact that we can only experience true reality through digital media, using devices like computers, smart phones, and other devices, regularly, if not continually, connected to the Internet. Avoidance of this reality can be compared to intoxication with drugs or alcohol, which we all know provides an escape for the user who wants to avoid the realities of day-to-day life.

To address this problem first we must confront the denial, rejecting the notion that we can experience reality without digital media. This dangerous idea will certainly lead to impairment of social and occupational functioning and probably distress as well. In particular, avoidance of social media can lead to digital social isolation. A disturbing percentage of the population may have never communicated with another person via email or texting with resulting alienation from digitally connected friends and family!

Treatment of Digital Media Avoidance Disorder

Due to its similarity to chemical dependence, treatment requires admission to inpatient rehabilitation where a holistic approach involving staff of numerous disciplines will immerse the patient in (digital) reality with gradual elimination of escape into non-digital media euphoria. Cell phones with non-removable ear buds will start the detoxification process. Only in the first hours will staff allow patients gradually diminishing access to analogue devices such as harmonicas, nose whistles, and, for more severe cases, ukuleles to ease the transition. At first specially trained staff even engage in face to face conversations with them. Motivated patients will work the (binary) 1100 step program. They will gradually learn that  ordinary feelings associated with life in the real digital world are normal and they they can tolerate them or even to appreciate them, that feeling them affirms life. They will learn to turn them over to Google (as they know it, their higher power). Patients who can tolerate tweeting and blogging while simultaneously listening to streamed audio, playing computer games and shopping on ebay will participate in a ritual upload to YouTube of a digital video showing their dysfunctional pre-digital escapest functioning followed by scenes showing them leading a fully sober digital life one virtual day at a time. They are ready for discharge. Most will continue working the binary 1100 steps in video-conference meetings for years after discharge, starting with 1001010 meetings in 1001010 days. After working the program for a year or more, some individuals can play World of Warcraft non-stop for 11000 hours without face-to-face contact with another human. Rarely do such individuals relapse.