Sunday, December 02, 2012

Addicted:  the medicalisation of bad behaviour

Our ancestors used religion to ward off the things that scared them.  We use medicine.  There are few better illustrations of the perverse ''medicalisation'' of society than the claim that ''video game craving is as bad as alcohol''.

We're taking the human condition (passion, obsession, desire, pleasure) and trying to turn it into a medical condition.

The story is as follows:  a PhD candidate at the Australian National University recruited 38 gamers who played an average of 10 to 15 hours of video games a week.  Those who reported feelings of withdrawal or cravings to keep playing their favourite game were classed as addicts.

All participants then did a simple test:  they were shown a series of differently coloured words and asked to name the colour, not the word, as quickly as they could.  Some of the words were related to video games, and with those words the ''addicts'' took longer to name the colour than the casual gamers.

The conclusion?  Gaming addicts are as consumed by games as alcoholics are consumed by drinking.  This is apparently ''some of the first scientific evidence that video gaming can be addictive''.

But let's back up a bit.  Ten to 15 hours of gaming a week isn't very much.  The Australian Communications and Media Authority says Australians watch about 20 hours of television a week.

Sometimes we might even suffer negative consequences from this indulgence.  (''One more episode of Homeland?  It's already 10.30, but ...'') We may get emotionally involved in a show.  We might even crave it.

But you could say the same thing about any hobby.  And nobody is suggesting the average Australian is addicted to television or fishing or woodwork.  At least, not in any meaningful, medical sense.

Addiction is a notoriously slippery concept.  In a 2000 study published in the journal Addiction Research, 20 senior addiction experts in the American Psychological Association were asked to define what they meant by the word ''addiction''.  The answers differed wildly.

Only half the experts could get on board a definition that included ''physical dependence''.  And that was the closest they came to consensus — except for a general dissatisfaction with the way addiction has come to mean more than dependence on chemical substances.

Yet this is the muddy, vague, uncertain, ill-defined concept that we seem desperate to stamp on every sort of abnormal behaviour.  Without any firm foundation, the popular use of the word addiction is creeping into the scientific world.

Excessive shopping?  Addiction.  Excessive internet use?  Addiction.

Yes, people can make a lot of money treating the choices as pathology.  There's always a pill available, or a specialist spruiking their professional services.  But we're as guilty as the medical profession here.  The medicalisation of everything is comforting.

First, there's nothing more appealing than a scientific veneer.  If someone has a few too many boozy nights in a row, they don't go easy for a while, no — they ''detoxify''.  All those cultish detox diets offer little more than clean living.  But they're dressed up in pseudo-medical jargon.

Second, if something has a medical cause, it has a medical cure.  This is an era of expertise and technological fixes.  There is no problem that money and experts cannot fix.  In January, a British MP called for the government to pay for the treatment of ''those who suffer from internet or gaming addictions''.  (But that's not remotely silly compared with the Swedish heavy metal fan who is on disability support because of his heavy metal addiction.)

Medicalisation comforts because it suggests that our bad decisions are not our fault.  Describing self-destructive behaviours as addictions is the ultimate way to shirk individual responsibility.  Rather than agents of our own choices, we become passive recipients, preyed on by our surroundings.  This is utterly dehumanising.  One could ask why we're so eager to dehumanise ourselves.

Sure, video game addiction looks a lot like a bog-standard moral panic.  When someone dies from playing a game 40 hours straight — as a teenager did in Taiwan this year — commentators pontificate about video games, not, say, depression.  Every pleasure has to have its dark side.

But society's fear of addiction — our desperation to turn everything into a medical condition — goes to something deeper.  We no longer burn witches;  we diagnose them.  Either way, we're still chasing witches.


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