Among the case studies at the technology de-addiction clinic or the Service for Healthy Use of Technology (SHUT) clinic at the National Institute of Mental Health and Neurosciences in Bengaluru is that of a 21-year-old college student who took selfies every 15-20 minutes.
Doctors said her obsession with the thought that her appearance is somehow flawed was the consequence of a mental health ailment called body dysmorphic disorder. She was treated with a combination of medication and behaviour change strategies, mainly focussed on restructuring the thinking process at Nimhans.
“There was improvement in two months,” says the case report. “The outcome of the therapy was positive. 15 sessions were carried out with the client. Mirror use reduced to 5-6 times per day. Mobile use reduced to 2-3 hours a day,’’ says the report.
Since 2014, the SHUT clinic at Nimhans, set up by clinical psychology professor, Manoj Kumar Sharma, has devised strategies for its treatment and care of “technology addiction”. It is a model that could soon become the standard for treatment at more places in India.
Last week, the psychiatry department at the King George Medical University in Lucknow decided to start a similar clinic. “Seeing the number of patients coming to us with such issues rising, we felt the need for a similar clinic in Lucknow. We get at least ten cases every day related to excessive use of technology,” says head of the department, Dr P K Dalal. The clinics, named “Services for Problematic use of technology” will likely start next month.
In Bengaluru, the SHUT clinic has covered gaming, Internet, social media, shopping and pornography to the more recent addiction — streaming on Netflix and Amazon Prime.
A series of studies carried out in the city, which revealed high levels of technology addiction especially in the 15 to 30 age group, prompted Prof Sharma to start the clinic to help people break technology’s control over their lives.
“Since 2008, I have been carrying out some research or the other in this area to understand the phenomena of technology use. Why people use technology and what its consequences are. Though it has benefits we are looking at it from the mental health perspective and we are trying to see how technology use affects mental health of an individual,” he says.
A study carried out on 300 people in the 18-25 age group, revealed that 17 per cent were in the category of excessive to severe use of the Internet. Also, a study on social media usage among another 300 people showed 5.7 per cent were using Facebook and other social media platforms excessively and a larger door-to-door survey of 2,750 people funded by the Indian Council of Medical Research (ICMR) revealed 5-9 per cent in the 15 to 50 age group were addicted.
“Internet addiction is diagnosed using screening questions based on craving, control, compulsion, and consequences and Young’s criteria for internet addiction (salience, excessive use, neglecting work, anticipation, lack of control, and neglecting social activities),” he says.
In 2014, when he started, the clinic saw just one or two clients every fortnight. “But after awareness spread, we began seeing two to three cases a week in the second year and this has now increased to seven to eight cases a week,” he says.
“We see young people in the age group of 15-20 which is the predominant age group. Sometimes, we get a few 11-year-olds. There are also older people in the 21-30 age group who also come in mostly for pornography addiction.”
Most of the time it is parents who bring their children to the clinic. “We don’t work on the technology usage at the start. We work on lifestyle changes – sleeping patterns, physical health, family communication,” he says.
“In a recent case, a single boy child was gaming 8-9 hours a day and was very irregular to college. The only issue was excessive technology use and lack of interest in other activities. We worked initially on lifestyle changes and communication. We made a contract for him to go three to four days to college but did not break his link with technology,” he says.
There is no standard duration to treat technology addiction and there is no hospitalisation involved. “An eight-session program spread over two months could be standardised. The main focus of the program is behaviour and lifestyle change. Yoga is also a key component of the treatment,” he says.
Sharma is now working on coming up with a standard protocol for assessment and treatment of technology addictions that can be replicated anywhere.
In Lucknow, Dr Dalal says there is no term for the condition yet. “So let’s not call it a disorder or a disease. I feel it is a problem which needs to be addressed. The patients are mostly children and young adults, some as young as 4 or 5. Parents bring them here with some other issues like headache, backache, anxiety, depression and irritability, frustration, fall in grades at school etc. Here, we tell them that these problems are arising due to the excessive use of technology.”
“It is important that parents, teachers and children are made aware of the harms excessive use of technology has. We can’t ignore technology because it is indispensable,” he says.
(With Asad Rehman in Lucknow)