When conflict and problems occur in real life, compulsive users tend to immerse themselves ever deeper in the virtual world, where they are powerful, respected and in control. In those moments when the patient surfaces and allows himself to feel anything in the real world, he often feels rage and despair. The computer is the one solution, perhaps the only solution, that makes him feel better.

As people become more immersed, their use of language also changes. The virtual and the real worlds begin to blend together. As a therapist, it becomes increasingly difficult to discern virtual and real experiences. A typical example might go like this: a patient describes being frightened by a past girlfriend. The two had briefly experimented with sex before breaking up. Now the patient was being stalked. “Did you call the police?” the therapist asks. No, the patient does not know what his ex-girlfriend looks like. It made no sense until one realises the sex (and maybe the stalking) all occurred in the virtual world. To the patient, there was no distinction. Increasingly, all of life is a digital construct of ones and zeros.

An Oxford University philosopher, Nick Bostrom, has written that there is perhaps a one-in-three chance that our concept of reality is a lie – that we are all actually just electrons (or the equivalent) in virtual simulations. Are we merely imitations of life, programmed to be unaware of our status? Many compulsive computer users seem to believe so. To them, the virtual and the real have become equally important and interchangeable. We are all avatars. Avatars playing with avatars in the game World of World of Warcraft. A cosmic joke. I find Bostrom’s theory profoundly disturbing and shockingly relevant. In his papers, he tries to argue that, even if we are avatars in some larger simulations, that does not mean “all the bets are off and you would go crazy”. I find this unconvincing.