When Computer-Game Addiction Calls For In-Patient Care

Let it go
Let it go
Jens-Peter Hiller

HAMBURG - Jan Heusinger’s day was always the same: wake up, shower, have breakfast – and then spend the rest of his hours playing computer games. Four years ago, when he was 14, he'd bought World of Warcraft, an online role-playing game. By 2011, he'd stopped attending school to spend his days as an Orc warrior.

He’d had problems with youth welfare authorities; his parents were divorced; and he was bullied in school because he was overweight. Gradually, computer games took over his life. Heusinger is computer-addicted.

The 18-year-old is by no means alone. Just in his native Germany, 1.7% of all 15-year-olds are addicted to video games, spending a minimum of four and a half hours daily in front of their screen. A further 2.8% are considered at risk. The problem is far more prevalent among boys than girls.

Jan Heusinger lives with his mother. For years, she tried in vain to get him to accept therapy for his addiction. However, early this year Heusinger himself began to realize that he had to do something. Looking back, he says, "something just went click” and he contacted a psychologist who referred him to the Schön Klinik in Bad Bramstedt near Hamburg.

The idea was to get Heusinger out of the house, away from his usual surroundings. The Schön clinic is one of the few in Germany that treat computer-addicted patients as in-patients. Psychologist Tim Aalderink started the addiction program there a year ago. He says the fun of playing the games is not the only reason for computer addiction.

"Addicts have problems with their family, job or partner,” he says, and are afraid to deal with them in the real world, so they hide in a virtual one.

In view of this, patients undergoing therapy are asked to talk about their social problems. Heusinger underwent group therapy with six other computer addicts, all of whom had problems similar to his. "We identified with each other," he says. Together they went wall climbing and car racing. The activities were geared to giving them positive feelings and a real-life adrenaline kick.

Addiction or sign of depression?

Computer addiction has not yet been recognized as an official illness. But Heusinger was in luck: his health insurance company paid the full amount of his treatment. Aalderink says there is substantial disagreement among experts about where to situate the problem. Some agree it's an addiction, similar to alcoholism. But others say it is a behavioral problem, symptomatic of depression. Either way, those suffering from the condition lose control over the amount of time they spend on the computer.

Addicts get edgy when no computer is at hand, during a vacation for example. And they develop progressively higher tolerance levels, so they have to spend more and more time in front of the screen. Soon enough, physical problems manifest, whether these be neglected bodily hygiene, or forgetting to eat or sleep.

Rudolf Kammerl, an education expert at the University of Hamburg, says the situation is like the proverbial chicken and egg -- what comes first? Problems with everyday life or flight into the virtual world? "During puberty, young people should be building a sense of control over their own lives,” Kammerl says. So it is particularly harmful when during such a crucial phase they lose themselves in a computer world.

Christian Brehm of the German Trade Association of Interactive Entertainment Software (BIU) says he doesn’t think it’s unusual if computer games take on a greater degree of importance during specific life phases. "But the problem is when they supplant social life and other interests," he says.

Brehm says the industry recognizes the problem, and is considering developing games that shut down automatically after a certain period of time has elapsed.

Psychologist Aalderink advises young people who spend too much time playing computer games to seek out a psychologist. Extreme cases -- mostly young men -- end up in his clinic. There are on average 10 in-patients and they mostly stay for eight weeks. Computer addiction can take different forms, Aalderink says. Not all addicts play games: some patients surf the Internet compulsively, while others gamble online. The latter problem, unlike so-called pathological computer use, is a recognized addiction.

The final goal of the therapy is for patients to be able to use their computer at work and at home in an non-compulsive way, says Aalderink. After his therapy, Heusinger is now at that point. When he got back from the clinic, he uninstalled World of Warcraft. He has vowed not to play the game again. Next month he’s going to move into a residential unit at a youth center where he hopes to reestablish balance in his daily routine and then go back to school.

He says his professional goal is to work at a manual job -- “something that does not involve the use of computers.”

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Where Lockdowns For LGBTQ Meant Moving Back In With Homophobic Relatives

The confinement experience could turn brutal for those forced to live with relatives who would not tolerate a member of the family living their sexual orientation openly as a young adult. Here are stories from urban and rural India.

At a Rainbow pride walk in Kolkata, India

Sreemanti Sengupta

Abhijith had been working as a radio jockey in the southern Indian city of Thiruvananthapuram when the COVID-19 pandemic hit in March, 2020. When the government imposed a nationwide lockdown, Abhijith returned to the rural Pathanamthitta district , where his parents live with an extended family, including uncles, cousins and grandparents.

Eighteen months later, he recalled that the experience was "unbearable" because he had to live with homophobic relatives. "Apart from the frequent reference to my sexual 'abnormality', they took me to a guruji to 'cure' me," Abhijith recalled. "He gave me something to eat, which made me throw up. The guru assured me that I was throwing up whatever 'demon' was possessing me and 'making' me gay."

Early in 2021, Abhijith travelled back to Thiruvananthapuram, where he found support from the members of the queer collective.

Inspired by their work, he also decided to work towards uplifting the queer community. "I wish no one else goes through the mental trauma I have endured," said Abhijit.

Abhijith's story of mental distress arising from family abuse turns out to be all too common among members of India's LGBTQ+ community, many of whom were trapped in their homes and removed from peer support groups during the pandemic.

Oppressive home situations

As India continues to reel from a pandemic that has claimed more lives (235,524) in three months of the second wave (April-June 2021) than in the one year before that (162,960 deaths in March 2020-March 2021), the LGBTQ community has faced myriad problems. Sexual minorities have historically suffered from mainstream prejudice and the pandemic has aggravated socio-economic inequalities, instigated family and institutionalized abuse, apart from limiting access to essential care. This has resulted in acute mental distress which has overwhelmed queer support infrastructure across the country.

Speaking to queer collective representatives across India, I learned that the heightened levels of distress in the community was due to longstanding factors that were triggered under lockdown conditions. Family members who are intolerant of marginalized sexual identities, often tagging their orientation as a "disorder" or "just a phase", have always featured among the main perpetrators of subtle and overt forms of violence towards queer, trans and homosexual people.

Calls from lesbians and trans men to prevent forced marriages during lockdowns.

Sappho For Equality, a Kolkata-based feminist organization that works for the rights of sexually marginalized women and trans men, recorded a similar trend. Early in the first wave, the organization realized that the existing helpline number was getting overwhelmed with distress calls. It added a second helpline number. The comparative figures indicate a 13-fold jump in numbers: from 290 calls in April 2019-March 20 to 3,940 calls in April 2020-May 2021.

"Most of the calls we have been getting from lesbians and trans men are urgent appeals to prevent forced marriages during lockdowns," said Shreosi, a Sappho member and peer support provider. "If they happen to resist, they are either evicted or forced to flee home. But where to house them? There aren't so many shelters, and ours is at full capacity."

Shreosi says that the nature of distress calls has also changed. "Earlier people would call in for long-term help, such as professional mental health support. But during the pandemic, it has changed to immediate requests to rescue from oppressive home situations. Often, they will speak in whispers so that the parents can't hear."

Lack of spaces

Like many of his fellow queer community members, life for Sumit P., a 30-year-old gay man from Mumbai, has taken a turn for the worse. The lockdown has led to the loss of safe spaces and prolonged residence at home.

"It has been a really difficult time since the beginning of the lockdown. I am suffering from a lot of mental stress since I cannot freely express myself at home. Even while making a call, I have to check my surroundings to see if anybody is there. If I try to go out, my family demands an explanation. I feel suffocated," he said.

The pandemic has forced some queer people to come out

Sumit is also dealing with a risk that has hit the community harder than others – unemployment and income shortage. He's opened a cafe with two other queer friends, which is now running into losses. For others, pandemic-induced job losses have forced queer persons from all over the country to return to their home states and move in with their families who've turned abusive during this long period of confinement.

Lockdowns force coming out

According to Kolkata-based physician, filmmaker and gay rights activist Tirthankar Guha Thakurata, the pandemic has forced some queer people to come out, succumbing to rising discomfort and pressure exerted by homophobic families.

"In most cases, family relations sour when a person reveals their identity. But many do not flee home. They find a breathing space or 'space out' in their workspaces. In the absence of these spaces, mental problems rose significantly," he said.

Not being able to express themselves freely in front of parents who are hostile, intolerant and often address transgender persons by their deadname or misgender them has created situations of severe distress, suicidal thoughts and self-harm.

Psychiatrist and queer feminist activist Ranjita Biswas (she/they) cites an incident. A gender-nonconforming person died under suspicious circumstances just days after leaving their peer group and going home to their birth parents. The final rites were performed with them dressed in bangles and a saree.

"When a member of our community asked their mother why she chose a saree for someone who had worn androgynous clothes all their life, she plainly said it was natural because after all, the deceased 'was her daughter,'" Biswas recalls.

The Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling

David Talukdar/ZUMA

"Correctional" therapy

In India, queer people's access to professional mental healthcare has been "very limited," according to community members such as Ankan Biswas, India's first transgender lawyer who has been working with the Human Rights Law Network in West Bengal.

"A large majority of the psychiatrists still consider homosexuality as a disorder and practice 'correctional therapy'. It's only around the big cities that some queer-friendly psychiatrists can be found," Biswas said. "The pandemic has further widened the inequalities in access to mental health support for India's LGBTQ community."

Biswas is spending anxious days fielding an overwhelming amount of calls and rescue requests from queer members trapped in their homes, undergoing mental, verbal and even physical torture. "We don't have the space, I just tell them to wait and bear it a little longer," he said.

Medical care is dismal

Anuradha Krishnan's story, though not involving birth family, outlines how the lack of physical support spaces have affected India's queer population. Abandoned by her birth family when she came out to them as a trans woman in 2017, Anuradha Krishnan (she/they), founder of Queerythm in Kerala who is studying dentistry, had to move into an accommodation with four other persons.

Isolation triggered my depression

"I am used to talking and hanging around with friends. Isolation triggered my depression and I had to seek psychiatric help." Living in cramped quarters did not help with quarantine requirements and all of them tested positive during the first wave.

What is deeply worrying is that the Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling, placing more and more pressure on queer collectives and peer support groups whose resources are wearing thin.

During the 10 months of the first wave of the pandemic in India in 2020, Y'all, a queer collective based in Manipur, received about 1,000 distress calls on their helpline number from LGBTQ+ individuals. In May 2021 alone, they received 450 such calls (including texts and WhatsApp messages) indicating a telling escalation in the number of queer people seeking help during the second wave.

As India's queer-friendly mental health support infrastructure continues to be tested, Y'all founder, Sadam Hanjabam, a gay man, says, "Honestly, we are struggling to handle such a large number of calls, it is so overwhelming. We are also dealing with our own anxieties. We are burning out."

Sreemanti Sengupta is a freelance writer, poet, and media studies lecturer based in Kolkata.

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