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Ulrik hit his keyboard in a blind rage. His girlfriend and dog were huddling in a corner as her screams filled their cramped quarters. It was not the first time that it happened. In recent months, these explosions had become daily. "I consider myself a fairly relaxed person, not really with a lot of anger," said Ulrik, a seemingly calm 21-year-old Norwegian who asked that his last name not be revealed, Fatherly . But when he played multiplayer online League of Legends and World of Warcraft his anger rose to the surface. He became cruel and confrontational. He also made some terrible choices.
Ulrik has accumulated $ 4,500 in debt, largely because of his gambling purchases, in addition to his stack of student loans. He had no savings. His girlfriend was frustrated, as was his landlady who threatened to end his lease. "I came to the question of whether I should continue to play or be kicked out of our apartment, which meant losing my girlfriend and my dog," says Ulrik. "When you are at the bottom of the rabbit hole, you have a choice: give up or change."
Ulrik clearly had a problem. But what exactly was this problem was a bone of contention among mental health professionals. The World Health Organization recently announced that its eleventh revision of the International Classification of Diseases would include "gambling disorders" as an independent psychological condition. Experts in some corners welcomed this decision as a turning point in the treatment of a single mental health problem. But the American Psychiatric Association intentionally excluded video game disorder from its Diagnostic and Statistical Manual of Mental Disorders in 2013, simply calling it a "condition for further study" . American psychologists have largely supported this decision. From their point of view, there was and there is little difference between fixing on video games and fixing on philately. The key is the underlying pathology – often anxiety, depression or a compulsive disorder.
"This is the first time that a hobby has been classified as an illness," said Chris Ferguson, clinical psychologist studying the effects of video games at the University. Stetson Fatherly . "Almost all the fun can be overplayed by a small percentage of people.It is felt that the WHO has not really thought about all this – or is in the process of panicking morality about games. "
There is a story to this moral panic. Concerned parents (and a handful of scientists) have long treated video games as a unique form of media, capable of changing behavior in a way that television, movies and even Internet forums can not change. For each study of how play improves memory and eye-hand coordination there are two suggesting that this may lead to aggressive thoughts and behaviors . Admittedly, a study by The Journal of Adolescent Research showed that video games, such as sports and out-of-school clubs, can improve children's motivation by obliging them to perform objective tasks, but Studies suggest that children who spend the most time playing do poorly at school and suffer from more intense symptoms of ADHD
pathological gambling, the science (and public opinion) is surrounded by a miasma of suspicion that makes it difficult to have a neutral conversation. That said, Ferguson published one of the most thorough meta-analyzes of pathological gambling in 2011 and concluded that many players defined as "pathological" were, in fact, healthy. And it is true that the experts tinkered a handful of constants (1.2 billion people play video games in the world between one and seven percent players are pathological, more vulnerable than women, gamers living in East Asia may be at higher risk) a harsh clinical description of problem gambling behavior remains elusive.
"There is really no fixed place in the stone on what is considered a hobby compared to what can be considered addictive," Anthony Bean, a psychologist Clinic and author known as The Video Game Doctor, Fatherly . "The research fails to fully understand this."
Similarly, the question is which video games are most likely to cause problems. Massively multiplayer online games, such as World of Warcraft and League of Legends, were Ulrik's favorite drug. Such games include complete societies with complex combat, political and economic systems. "Genres that involve a lot of person-to-person social interaction have been identified as potentially more likely to be exaggerated," Ferguson says. "But it's a complex relationship, which may be more true for people struggling to meet social needs in other ways." In addition, the complexity of the game is not necessarily correlated to compulsive behaviors Even simple puzzle games like Candy Crush Saga were linked to obsessive behaviors .
"I do not think that any genre is no longer likely to help create this finale, "says Scott J., a volunteer at Computer Gaming Addicts Anonymous (which follows the official policy of the CGAA using only his first name and the date of the last release when he speaks to the press). "But maybe some games trigger disorders faster than others, just like drinking strong alcohol could trap someone faster than beer."
carefully considered his position before recommending that the CIM recognize the gaming disorder. The international body brought together a group of experts from different disciplines and regions, and formed working groups to analyze the best available data in a number of final conclusions. Yet, the WHO recognizes that there is limited evidence for diagnosis.
"Available evidence is not as strong as for other conditions, but sufficient to include gambling disorder in ICD-11," said Tarik Jasarevic, an official spokesperson for WHO Fatherly [19659010]. The current ICD-11 project, which will not be ratified until 2019, describes gambling disorder as an "altered control of gambling" that adversely affects "personal, family, social, educational, professional or other important period of at least one year
Despite the doubts of the WHO, the organization is confident that she made the right decision for patients and providers. "There are hundreds, rather thousands of scientific publications on this topic, which increases the demand for treatment in different parts of the world," says Jasarevic. "The inclusion of a disorder in the ICD should facilitate recognition and appropriate management of a health status by health professionals, facilitate international collaboration and research, and be taken into consideration." account in planning public health strategies and monitoring trends. The WHO has been cautious in pointing out that gambling disorder was a problem, just in case …
Mark Coulson, Professor of Psychology at Middlesex University in London, was at the forefront of the open debate of the researchers. proposition of gambling disorder . "Both sides have merit, as always," he said Fatherly . Coulson's professional view is that compulsive gambling is not an autonomous disorder, but there is no illusion as to the profound implications of its inclusion in ICD-11. "Psychologists take ICD seriously," he says. "You must!"
"For those who have a real problem, it can facilitate access to treatment," adds Coulson. "At the same time, I would expect an excessive diagnosis and pathologization of what is a normal part of life."
Indeed, the American Psychological Association recently issued a political statement opposing the decision of the WHO. are joined by the group of special interest of the Irish Psychological Society in the media, the arts and cyberpsychology. The dominant theme is that gambling disorder can be a manifestation of other compulsive or anxious disorders. If that is the case, isolate and treat the gambling disorders as if it was alcoholism or a gambling problem can treat the symptoms of a psychiatric disorder without providing therapy and medicines for its underlying causes. believe that they are addicted tend to have more difficulties with depression and anxiety than with play, "says Bean. "They choose video games and participate in virtual and online worlds because of the use as coping mechanisms to cope with their depression and anxiety from the turmoil in their lives. [19659048"Alotoftheevidenceisasymptomofpre-existingmentalhealthconditionsnotanindependentconditionofitsown"saysFerguson"ThereareseriousrisksthatpeoplemaybefooledbymockproviderswhocapitalizeontechnophobiaandmoralpanicaboutgamesSomepeoplewithrealproblemscangotoclinicsthatreducetheirgamblingbehaviorbutleaveintacttherealmentalillnessesdoingnothingbutanadjustmentmechanism"
This is perhaps the most important problem with a gambling disorder. Diagnosis – there is no agreed treatment for the condition." Cognitive Behavioral Therapy and Pharmacotherapy are two possibilities, "says Coulson." But I see a whole range of therapies emerging, many untested and ideologically based rather than evidence-based. "Even seemingly harmless support groups can be used to normalize unhealthy behavior , warns Coulson. "Attending any of these groups can make a habit of 80 hours a week normal, or not particularly serious."
Ferguson agrees. We do not even have an agreed list of symptoms, "he says." I would not recommend people to go to specialized clinics, but rather to look for well-established providers who use cognitive-behavioral therapy and who are qualified for tra iterated a wide range of unrest. "
out of control, he embarked on a less traditional path of recovery. After a particularly ugly explosion, he moved away from his cold turkey PC. "I left this afternoon, which was May 26," he says. That day, he rejoined Discord, a chat room for players which has more than 100 million users worldwide and began collaborating with the dynamic community of the flat StopGaming . His life quickly returned. Ulrik started his own business and started repaying his loans. Soon, he was engaged to his girlfriend.
"Leaving the games was uncomfortable," he recalls. "I lost what seemed to be hundreds of my friends, I lost my main source of entertainment and relaxation, I lost something that I had found valuable for years." years. "But his determination inspired others. players in the DiscGame StopGaming community. Users leaving sign in to seek advice from veterans like Ulrik; Others ping the group to celebrate StopGaming milestones, such as a month or a year without video games. The salon reads as a poorly organized AA meeting. There are introductions, discussions, triumphs and relapses, all without judgment. Everyone on Discord was once a player.
There are more structured approaches. Computer Gaming Addicts Anonymous offers daily online meetings, where members share their game histories and work on solutions. "Meetings usually have a subject or two," says Scott. "People take turns, one at a time, without any back and forth or direct advice.We find it very liberating to be able to speak honestly and openly about our problem behavior without fear of judgment or ridicule."
The goal of CGAA is that compulsive gamblers end up giving up gambling. "If moderation were possible, none of the recovery programs would be needed," says Scott. "Compulsive gamblers try each strategy carefully. moderation. We fail with each one of them.
Ulrik briefly considered returning to video games last May after refraining from a full year, but he said he was reluctant. "An alcoholic must stay sober until the end of his life, just like an addict," he says. "I consider myself as someone in this boat, so if I start down this road, it will probably mean that I will go back to my addictive habits, and if I can help it, I will not let that happen."
The experts, however, warn that most problem gamblers do not need to leave the game – and that the controller can do more harm than good. As obsessive play is usually the symptom of larger mental health issues, the elimination of the PC or console may only serve to leave intact the psychological challenges of a player while suppressing a useful adaptation mechanism. "If your child does poorly at school, does not spend time with real-life friends, does not do physical activity, then there could be a problem," says Coulson. "But talk to them about it, not the game they're doing.There's a good chance that they like the games, that they're having fun and that it helps them to Another mechanism to help-do not remove the one they already have. "
And when parents ask for professional help for gambling problems their children, choosing the right professional is the key. The best clinicians "do not go immediately to the idea of addiction, but learn about other areas of a person's life," says Beard. "They know specific video games, they can speak the language, the client does not feel judged, and the parents trust the person by talking to him, they talk about limits and can use the virtual world to reinforce them." [19659048"It'sthebiggestproblemoverall"saysBeard"Withoutabasicunderstandingofculturehowcanonemakeanassumptionanddiagnoseaconditionthattheydonotunderstand?"
This is a salient point. When pundits bemoan "a generation of young men" lost in video games for example, their implication is clear: the game is a unique toxic environment and, if the boys simply put their controllers, their health problems mentality would evaporate. First of all, it goes against overwhelming evidence that, regardless of the gambling disorder, it is certainly part of a legitimate mental health crisis. The games are not drugs or alcohol. They are not the problem. Instead, it's the human spirit, who yearns for escape, who falls into an MMO.
When activists focus on the ills of video games as a means rather than on the legitimate mental health issues that attract young men like Ulrik, this is a strangely gendered refusal to tackle men's mental health problems. They reject male depression and anxiety like so many boys playing pixilated soldier. The general consensus, from the WHO to the APA, is that they are absolutely wrong.
Two years after starting his business without professional help, Ulrik is now happy. He runs his own tutoring business, stays away from MMOs, and gives his opinion to problem gamblers who reach out almost every day, hoping to get their lives back. When he heard about the World Health Organization's decision to enroll gambling disorder in the ICD, Ulrik had mixed feelings.
"I know that you qualify this addiction is not fun. Addressing the company as an addict, whether it's about poker, video games or heroin, everything is stigmatized, which makes the task difficult, "he said. he. "My hope is that the decision of the WHO can at least give us some acceptance, maybe it will even give someone like me the chance to get it. help elsewhere than in a Discord discussion.This may help to give someone who is fighting for video games a place, a real physical institution. "
" This is an honest admission from a disease, "says Ulrik. "We waited a long time for recognition."
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