FARAI CHIDEYA, host:

This is News & Notes. I'm Farai Chideya. When people wait outside the Apple Store for hours to get an iPhone, you know technology is hot. For many of us, it helps shape our identity. We also have more ways than ever to connect online and interact with virtual worlds through gaming. But when does using technology cross the line into addiction?

We're going to talk in a few minutes with a woman who says she lost her son to a technology dependency, but first we've got psychologist Hilarie Cash. She's the cofounder of Internet/Computer Addiction Services, which runs treatment programs for people, including video-game addicts. She also wrote the book "Video Games and Your Kids: How Parents Stay in Control." Hilarie, thanks for coming on the show.

Dr. HILARIE CASH (Cofounder, Internet/Computer Addiction Services): Nice to be here.

CHIDEYA: So, has the evolution of technology created technology addicts as well as people who are just fans?

Dr. CASH: It has, indeed, because through a process of intermittent reinforcement, it is often a very pleasurable activity that generates the neurochemistry which is generated by other addictive activities, and so people can, indeed, become addicted to it.

CHIDEYA: Now, when you say neurochemistry, are we talking about endorphins and other chemicals that your body produces that basically make us feel good?

Dr. CASH: Exactly so. Dopamine, the opiates, these are the chemicals of pleasure and addiction.

CHIDEYA: So, some people have questioned whether or not there really can be something like technology addiction. What makes you so sure that there is?

Dr. CASH: Well, there are certain signs and symptoms. All addictions have certain patterns. They - it really involves somebody being able to feel high from engaging in the activity, beginning to lose control over that, and find themselves really behaving in a compulsive way with it, and going into withdrawal when they are not able to engage in that, and then engaging in the behavior in spite of negative consequences. So, that general pattern holds for all addictions, and it holds very much so for these high-tech addictions as well.

CHIDEYA: Let's talk about the whole idea of withdrawal, because if you have a chemical addiction, withdrawal, you know, for example, from heroin can include things like sweats and, you know, body aches and all sorts of physical symptoms, but what do you really mean by withdrawal from technology?

Dr. CASH: There actually are physical symptoms that go along with that as well. I've had clients come in, these are often young men who've been very addicted, let's say, to video games, and play them sometimes 10, 12, and more hours in a day, and they've had a steady diet of that for a very, very long time. And when they go cold turkey, and maybe they're at home and their parents have pulled the plug and aren't allowing them access to the computer and to video games anymore, they will literally report that they get shaky, and they feel slightly nauseous, and then definitely on the psychological side, they feel agitated, irritated, and generally restless and upset.

CHIDEYA: Now, let's talk about what the threshold is. Let's say that I'm a gamer and, you know, the average age of gamers is in the 30s. We're not just talking about kids, although I do want to get to that in a second. But let's say I'm a grown woman who likes to come home from work and spend three hours a day with a video game. Is that addictive? What is that?

Dr. CASH: Well, there is research that has shown that there is a strong correlation with those signs and symptoms of addiction and playing video games, let's say, or other Internet activities, for two - more than two hours a day. So, a person who's got a steady diet of three hours a day, if they really never go beyond that, well, maybe they are just kind of not really addicted, but they are certainly close to a tipping point where an addictive process could take hold. So, we recommend no more than two hours a day of Internet or video-gaming activity that is for entertainment purposes.

CHIDEYA: What about people who are constantly on and off technology? I mean, you know, you've got BlackBerry-itis, and you know, people with their cell phones, and there are some people who may not be on for two or three hours at a stretch, but over the course of the day, it's five minutes here, five minutes there. Can there be an addiction to constantly being connected?

Dr. CASH: Absolutely, there can be. And again, I hear this reported to me a lot, that somebody is, let's say, they want to they have their BlackBerry or whatever their iPhone is, and every time it beeps, they're like Pavlov's dogs who begin to salivate. They've got to go check it out. They've got to see who has been contacting them and read the email that's been sent to them. And they feel powerless over that. And so, the inability to set a boundary around personal time is one of the - perhaps it's not an addiction, but it is this lack of boundaries is also something that can really interfere in people's lives.

CHIDEYA: What are the downsides of being constantly connected? I mean, I think a lot of us know the upsides, you can get information quickly, you can be reachable, but should people try to unplug for a certain amount of time each day?

Dr. CASH: I think it's very important for people to unplug. Setting aside the whole question and dangers of addiction, let's assume you're not somebody who is addicted, but you are still constantly plugged in. The downsides are likely to be, first of all, no time to think, no time to just reflect on what you feel, what you think, what you've been experiencing. And wisdom really comes to us through the process of reflecting on our experience and our feelings and thoughts. So, I think people are in danger of not being able to become wise if they don't take time to think.

Plus there is this huge factor of engagement with other people. We are we're social animals. We need to be connected. There's something called limbic resonance, which is kind of an energetic resonance that gets set up between two people when they are engaged in a positive and constructive way with each other and they are able to develop the relationship. And we know that when people do not have enough of that engagement with each other, they suffer depression and they suffer in other ways. So, getting unplugged allows you to get reengaged with real people in your life that matter to you.

CHIDEYA: Let's talk a little bit about how online addiction can work in tandem with other addictions. I'm thinking about gambling. There's now all sorts of online gambling. There's also pornography.

Dr. CASH: Right.

CHIDEYA: And some people would argue that technology has become the facilitator for people who already have problems with issues like that.

Dr. CASH: I think that's true.

CHIDEYA: Yeah. I mean, what do you see in your practice, in your work? Since you are counseling people, do you see people who have kind of, like, these cross addictions that intersect with the technology?

Dr. CASH: Yeah. We have an outpatient program called No More Secrets, which is for sex addicts, and these sex addicts all are using the Internet to play out their addiction. And there are many people who are really joining their ranks just because of the availability now of pornography through, you know, their online connection.

So, I think it's - I think more people are getting hooked on activities that they might avoid if it was not so accessible. And gambling certainly is part of it, the chatting, video gaming, pornography, all of these things that are - online shopping would be another one. These things are made so easy by the availability, accessibility, anonymity of the experience, that I think more and more people are drawn in, and people who might not be drawn in to overindulging, if it were not for the Internet.

CHIDEYA: Before we let you go, let's talk about two things. One is, how do you keep kids healthy? The other one is. how do you stay healthy as an adult? Let's start out with kids. You wrote this book, "Video Games and Kids: How Parents Stay in Control." Give us just a couple of tips for how parents can keep their kids from becoming overly attached.

Dr. CASH: Our recommendation to parents is that they not allow children to have Internet access on computers in their bedrooms. And two, for parents to make clear to their kids that computers are not a private space. So, keep the computer in a public part of the house, and we highly recommend, I highly recommend, that parents keep monitoring software on those computers so they can be checking up on what their kids are doing, what they're saying, who they're talking with, how much time they're spending.

So, monitor what your kids are doing. Make sure you have a way of doing that. Don't let them have Internet access in their bedrooms. Keep their entertainment-related activities to less than two hours. Monitor content as well as time. So, parents need to be highly - need to educate themselves about what video games their kids want to play, and make sure they themselves are comfortable with the content of those video games. There are many video games that - whose content is very antisocial. And parents, if they were staying a little more informed, might not want their kids to be practicing these antisocial behaviors in the video games.

CHIDEYA: All right. What about adults? Just give me one tip, one tip for adults, for us to understand how to stay healthy around technology.

Dr. CASH: Limit your technology activities that are entertainment-related, personal-related, not work-related, to less than two hours a day.

CHIDEYA: All right. Hilarie, thank you so much for the advice.

Dr. CASH: My pleasure to give it. Thanks.

CHIDEYA: Psychologist Hilarie Cash is the cofounder of Internet/Computer Addiction Services. She is also the author of "Video Games and Your Kids: How Parents Stay in Control."

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