Out of This World | Standpoint

August 2008

But is any of this important to therapy, or does discussing it border on voyeurism? It is very relevant. To take but one example, in this virtual world, people sometimes prostitute out their avatars. They participate in sex for virtual money. What if someone only selected virtual prostitutes that were designed to look like children? Certainly this is an enactment of which a therapist should be aware. Would this suggest a risk of paedophilia in real life? Or does discharging the impulse in the virtual world in effect prevent it from emerging in the real world? We can theorise, but we do not actually know. This is not some thought experiment; it happens and we need answers.

Recognition is one issue, treatment is another. Very little is known about what cures PCU. Essentially, two different approaches have been tried. The first approach advocates setting firm limits. If a patient exceeds his time limits online, the computer is powered off. If covert use continues, the computer is unplugged.

Finally, if the patient continues to misbehave, he is sent off to a wilderness camp or a rehab-like setting. Usually this is the approach used with children.

This method is not without risk. After restrictions are lifted, many people seem to binge. In South Korea, one-week retreats without electronic access were tried. These camps were discontinued after the children became disruptive and binged when regaining access to technology. It seems a longer disconnection is needed – at least two weeks. More importantly and by all accounts, when the computer use is restricted, rage often erupts. If parents or administrators are the ones setting limits, they are often the target for that anger. It is not trivial and can, at times, be dangerous.

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JoDoe

September 1st, 2008
3:09 PM

This is an excellent, interesting and informative article. It makes many interesting points, with there being one point that I want to comment further on. As far as becoming immersed in a virtual world by allowing our perception of the real world to start coming from what we see on the screen, that can potentially happen to some extent with any video game. Although games like MMORPGs (e.g., WoW) are much more immersive than regular video games, I have found that I can focus so intently on certain simple video games (e.g., 3-D Pinball and Minesweeper) that I can almost completely ignore the real world with this very limited "virtual world" that I see in front of me. I believe that is what largely made video games, rather than other things like alcohol and drugs, be addictive to me as a way to temporarily escape reality. Part of my recovery was to really, truly admit to myself that this did not solve any of my real world troubles since they usually just got worse. Instead, as difficult and unpleasant as it was at times, I had to spend time and energy in the real world to deal with these problems.

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