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Smartphone addiction: Can anything help us kick the habit?

Apple has become the latest big tech player to roll out measures to curb app addiction. How did the online tools we use become so addictive and is it really as bad for us as drug and alcohol dependence? What is the cost of smartphone addiction? Peter Griffin investigates.

You may remember it as a grim headline that fleetingly occupied your Facebook newsfeed.

In 2010, in an apartment in Suwon, the South Korean headquarters of electronics giant Samsung, a three-month-old baby starved to death while its parents were at a PC Bang – a 24-hour internet café.

The neglectful parents had become obsessed with a multiplayer fantasy game called Prius Online, in which they were raising a virtual baby girl called Anima.

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Their real baby girl, Kim Sa-rang, which means "love" in Korean, weighed just 2.5 kilograms when her parents came home and found her dead after another all-night gaming session.

Sa-rang became the poster child for the perils of internet addiction, a recognized medical condition in South Korea as well as China and Taiwan. Addiction clinics have sprung up across those countries, treating people who cannot control their internet use, as a rehab centre might treat alcoholics.

Elsewhere, medical experts are more hesitant to apply the addiction label to compulsive internet use. It is not a condition in the Diagnostics and Statistical Manual of Mental Disorders (DSM-V), the bible of psychological conditions assembled by US experts, which heavily influences diagnosis and practice here.

But the World Health Organization in January included “gaming disorder” in the draft 11th Revision of the International Classification of Diseases (ICD-11), describing it as, “impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences”.

That’s a major development as its classification could pave the way for subsidisation of treatment of gaming addiction around the world and its eventual inclusion in the next update to the DSM manual.

But video gaming has become a bigger business than the movie industry since Prius Online was all the rage in South Korean gaming parlours. It has also migrated to the smartphone with simpler but seductive games like Candy Crush and Clash of Clans that push all the psychological buttons of the most obsessive games.

Apple will roll out new tools in its next operating system update to set time limits on app usage.

Our mobile fascination

Social networks and smartphone app developers have learnt valuable tricks from gaming, creating software designed to capture our attention for longer, as former “attention hacker” Max Stossel revealed to Noted in April.

The constant ‘ping’ of Facebook Messenger updates, red flash of LinkedIn notifications, auto-playing Youtube videos and algorithm-controlled newsfeeds are grabbing more of our attention and to some experts, are driving addictive behaviour.

It has led, finally, to the world’s two largest mobile phone software makers, Apple and Google, to begin building tools into their operating systems that let users monitor and control their mobile phone use.

Last month I met with senior Google executives in Silicon Valley, who showed me the new features in Google’s Android P software that let you set time-limits on app usage and stop notifications and alerts simply by placing your phone screen-side down.

Yesterday, Apple followed suit with a series of tools that will be rolled out in the next update to its operating system due in September - iOS12.

"Some apps demand more of our attention than we might even realize,” said Apple software executive Craig Federighi at the company’s developers’ conference yesterday.

“They beg us to use our phone when we really should be occupying ourselves with something else. For some of us, it has become such a habit, we might not even recognize just how distracted we have become."

These moves are well overdue and point to the scale of the issue and the fear of regulation or growing social backlash against the tech sector.

Professor Katina Michael.

“Increasingly we are hearing about social media addiction stories,” says Professor Katina Michael, a researcher at Wollongong University who has run behavioural studies in technology use.

“We’ve all heard the toddler screaming for their iPad before breakfast, and gamers who are reluctant to come to dinner with the rest of the family.”

Underpinning some of the behaviour are age-old causes such as Obsessive Compulsive Disorder, says Professor Michael, but computer games, smartphones and social media networks are responsible for triggering a “new breed of behaviours” that she believes are cause for concern.

She got the first hint of these behaviours when conducting a study into how people use location-based services on their mobile devices. The data showed just how often people were accessing their phones – hundreds of times a day in some cases.

“I myself probably unlock my phone 50 to 60 times a day,” she admits.

“The average daily length of time people are using applications such as Facebook and Instagram is around 3.5 hours and there are increasing anecdotal accounts of work-home life imbalances.

“You have adults checking work email while on vacation or at a funeral or even during the birth of their child. When we should be paying attention to what is going on, we are floundering,” says Michael.

Social creatures

The online world, it seems, is well-suited to giving us what we crave.

Abraham Maslow’s Hierarchy of Needs was developed by the American psychologist in the 1940s to lay out our fundamental physiological and psychological needs – from food and sex on a basic level to safety, friendship, self-esteem and self-actualization.

The anonymity of the online world, where cyber sex is a Google search away, the social network where we can instantly share our food porn pics with hundreds of friends, the excitement and camaraderie of massive online games – deliver the feedback and interaction we thrive on as social creatures.

Some are particularly sensitive to it.

“People seek validation through replies and likes,” says Professor Michael.

“In time, if they are not getting 30 or 100 likes, they need to up the ante, take it to the next level. It might be planking, or revealing part of their body or divulging something very personal or confessional.”

Does that sound like any of your Facebook friends?

Driving our behaviour is one of the most studied substances in the human body – dopamine. Tens of thousands of studies in animals and humans have been conducted on the organic chemical that helps regulate our movement and emotional responses, and enables us to identify rewards and take action to move toward them.

That thrill you get as the white ball bounces around the roulette wheel before finally landing on a number is the biochemical release of dopamine. We remember what it feels like and we do things to get that pleasurable hit again and again, even when we know deep down that gambling is a mug’s game.

Dopamine in the context of drug and alcohol addiction is now reasonably well studied. But there’s a dearth of literature about the relationship between dopamine and our use of technology, like the social networks and smartphones that have become ubiquitous in our lives.

That’s what led developmental cognitive neuroscientists Dr Lauren Sherman to design the first study of brain responses during social media use among adolescents.

At UCLA’s Ahmanson–Lovelace Brain Mapping Center, she and her colleagues created a photo-sharing app similar in design to Instagram and populated it with 148 photos, including 40 submitted by the study’s subjects – 32 teenagers aged 13 – 18.

Accompanying each photo was an icon displaying the number of “likes” each had received – supposedly from the other teenage participants, but actually assigned by the researchers. The teenagers then lay down in a functional magnetic resonance imaging (fMRI) machine, which monitored their brain activity as the images flashed up on a computer screen in front of them.

Dr Lauren Sherman.

“When the teens saw their own photos with a large number of likes, we saw activity across a wide variety of regions in the brain,” says Dr. Sherman, who after working as a postdoctoral fellow at Temple University in Philadelphia, joined Facebook in April to advise on user experience design.

The section of the brain that really lit up is the nucleus accumbens. This is part of what neuroscientists call the brain’s reward circuitry, which is where all those dopamine-releasing neurons fire. The nucleus accumbens is thought to be particularly sensitive during adolescence.

“We showed the exact same photo with a lot of likes to half of the teens and to the other half with just a few likes,” says Sherman.

“When they saw a photo with more likes, they were significantly more likely to like it themselves. Teens react differently to information when they believe it has been endorsed by many or few of their peers, even if these peers are strangers.”

The study offers some interesting insights into peer pressure in the digital age – offline, teens might read signals from their friends and make up their own minds.

On social media, the like rules, whether it is friends or strangers giving a photo the thumbs up. It didn’t matter whether the photos were ‘neutral’ – a beautiful landscape or ‘risky’ – cigarettes and alcohol.

The teens’ willingness to conform manifested itself at the brain level as well as in what they chose to like.

But this is what neuroscientists call normative functions going on in the reward circuitry of the brain – which is named that way for a reason – it responds to what is generally good for us – like having a friend nearby,  seeing a picture of someone you love, or smelling a delicious food.

But can we detect through biological science the point when people are getting too much of a good thing?

“Nothing inherent in the fMRI signal can diagnose addiction,” says Dr Sherman.

“So our work cannot shed light specifically on what constitutes ‘overuse’. That said, researchers increasingly believe that a variety of different types of addiction all implicate the brain's reward circuitry.

“So, to the extent that someone feels that they have trouble putting down social media, or that it interferes with their ability to enjoy life, it's reasonable to assume that reward circuitry is involved.”

If internet addiction is a real thing, one thing is clear – it doesn’t involve a physiological addiction in the same way addiction to drugs or alcohol does.

“Consider that, were an alcoholic to quit alcohol cold turkey, they would experience physical symptoms as a result of going through withdrawal. The same thing does not happen with social media. This to me is a very important distinction,” says Dr Sherman.

With no large-scale, longitudinal work done in this area to date, Dr. Sherman has aimed to fill in some of the gaps in our knowledge.

“I know that many parents are curious and worried about the effects of smartphone use on the developing brain. My hypothesis is that the way that teens use their devices will be important.”

Costly fixes

In the meantime, addiction counsellors are on the front line of dealing with the various behavioural issues immersion in the digital world can produce.

Christchurch-based psychotherapist James Driver knows addiction first hand – his university studies were derailed in the early 2000s by obsessive online gaming that saw him spend up to 16 hours a day gaming.

“It was every waking moment. It might have been a bit less if you take out toilet breaks.”

At least he paused for relief. In South Korea’s gaming parlours there have been cases of gamers’ innards rupturing because they won’t leave their seat. Driver’s virtual drug of choice was Everquest, a relatively early example of a “massively multiplayer online role-playing game”, another fantasy title populated by wizards, beastlords and necromancers.

James Driver.

“It became the only thing in my life that gave me a sense of satisfaction,” says Driver, who loved the social validation of being a leading member of the Everquest community.

“You play so much you become known and respected. When you log in 20 or 30 people say ‘hi’.”

Later, when he undertook his training in a drug and alcohol addiction clinic, he saw the parallels between what patients were struggling with and his own earlier experience with gaming.

“It is true with most addictions, eventually the costs become intolerable. The amount of debt I’d created from student loans without having successfully graduated had piled up. I was no longer really enjoying the game, but it still felt better than the alternative.”

Driver’s experience with gaming has seen him become a go-to counsellor for problem gamers – and in many cases their worried parents. But he is increasingly being referred people who are having problems with social media and smartphone game use, online pornography, cybersex and dating apps such as Tinder, often by gambling addiction services that are not funded to deal with these issues.

“I’ve worked with a lot of couples where it emerges that one or both people see their smartphone use as a problem in the relationship. They are coming home from work and checking Facebook or apps on their phone and not engaging with each other.”

“Relationships can be challenging, so people turn to things that distract them. That’s been happening since long before smartphones.”

But the accessibility of the technology and the sophisticated techniques used to grab our attention make it easier for bad habits to form.

Driver is cautious about applying the term ‘addiction’ in relation to the rise of these types of cases. Full-blown addiction has to meet certain criteria.

“There’s a substantial psychological difference between someone who is truly addicted, who has lost control and is compelled to repeat a behaviour despite it having significant costs for them, and someone who is just doing too much of something.”

For those who really are addicted, the consequences aren’t usually as dramatic as with drug or alcohol addiction, where you could end up in the emergency room. But Driver sees his fair share of gamers who have run up massive debts and destroyed relationships in the process.

In the late nineties, an Everquest subscription cost around $15 a month. Many games are now offered for free, but with the lure of in-game purchases – upgrades and modifications that might cost two or five dollars per click.

Those purchases can add up.

“The gaming monetisation services are quite public about the fact that something like 70 per cent of in-app purchases are made by around 10 per cent of the players. In some cases it is done unethically and the developers use tactics I see as unethical,” says Driver.

The key to helping his patients, he adds, is connecting them to their own ambivalence about what they are doing.

“It is strengthening that part of them that already knows that it is a problem, the part of them that chose to seek help in the first place.”

The availability of the technology doesn’t drive addiction in its own right, but the more immersive it becomes the greater its scope for meeting our psychological needs, he says.

“Most people who have used online games as a way of finding connection with people ultimately find that the relationships they form through them feel somewhat hollow compared to the real world.”

“With holographic technology, maybe that will change.”

Our future reality

Social networking is certainly set to change. Facebook’s 2014 purchase of virtual reality start-up Oculus for US$2 billion, just 18 months after the company had been started with US$2.4 million in a Kickstarter campaign, flagged the way forward – a future where the social network takes on a 3D, physical form around us.

Last month, Facebook launched a $200 VR headset that will hasten that reality. It showed off a feature that turns your Facebook timeline into a virtual wall of images.

For Dr Leon Gurevitch, the deputy head of Victoria University’s School of Design, and a leading figure in Wellington’s virtual reality-augmented reality development scene, the technology faces the same sort of questions that greeted the arrival of cinema, then television and computer games.

“Debates will rage about the morality, the dangers of its realism, the potential impact of too much consumption, the age at which it is wise to be using such technology.”

“All new technology goes through a period of experimentation and testing of boundaries. All of this is something we will have to work out collectively.”

Professor Katina Michael believes parents carry a disproportionate part of the burden, particularly in the period of hyper-development in a child’s life between ages 2 and 7.

“Shoving an iPad in front of a kid is not going to make it smart. But the computer keeps the child quiet,” she says.

“We aren’t doing enough to talk to our kids. We teach them about hacking and phishing attacks, being ‘cyber smart’.”

But the elephant in the room, she argues, is the amount of screen time children are exposed to and the manipulatively designed digital world they are entering every day.

“We are in crisis at the moment where our children are being exposed to things they shouldn’t be and no one is really talking about it.”