Nerd, interrupted: Inside a smartphone addiction treatment center

Those who suffer from nomophobia--the fear of being without a mobile phone--need a special type of rehab therapy

By Leah Yamshon, TechHive |  Mobile & Wireless

Ashley loved her fiancé, Dave, but he was committed to another--his phone. Sharing her story with an online support group for cell phone addicts, she explained that their problems started out innocently enough. (Names changed for privacy.)

At first he was constantly texting on his dumb phone. Then he moved on to a BlackBerry, and never ignored a single call, text, or email.

But soon enough, the BlackBerry failed to provide enough of an information rush. The quick high of each incoming message didn't last, and Ashley always found Dave jonesing for his next fix. He finally found that relief in his first Android phone, which let him mainline a steady stream of tweets and Facebook updates.

Ashley and Dave were soon sleeping in separate bedrooms. Dave's phone left his hands only when he needed to sleep, and sometimes not even then: Ashley remembers peeking into his bedroom to find her fiancé curled up, fast asleep, with his phone clutched in his fist. And just when Ashley thought it couldn't get any worse, it did.

"Then... the iPhone 5 came. And I no longer existed," she told her support group.

We often joke about being addicted to our phones, but it's a problem that actually affects thousands of people worldwide. How can these people get real help when the culture itself is so deeply influenced by the smartphone and the mobile Internet? People addicted to these central accoutrements of the digital age need a dedicated type of rehab therapy and wellness programs to bring them back to reality. Backing away from an obsession with always-on, always-connected gadgets can be as hard as backing away from cigarettes or heroin.

Charlene deGuzman's short film gives a sadly accurate portrayal of how our phones are a central part of our social interactions.

'No-mobile-phobia'

There is a name for the feeling of anxiety caused by separation from one's smartphone. Nomophobia--literally, "no-mobile" phobia--is the fear of losing or being without a cell phone. It's not an official, clinical diagnosis, and you can't find an entry for it in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but there is reason to believe that it is a growing problem.

A 2012 study by two-factor authentication developer SecurEnvoy found that 66% of participants suffered from nomophobia, up 13% since 2008. In a different study, mobile security company Lookout reported that 73% of participants said they felt panicked when they lost their phone. Nearly 60% said they don't go an hour without checking their phones.

And we're using our phones everywhere. Credentials management company Jumio found that one in ten smartphone owners admit to using their phone either during religious services, at a child's school or function, in the shower, or during sex. Roughly three-quarters of participants said they were usually within five feet of their smartphone at all times.

That data shouldn't come as much of a shock. We are deeply dependent on our phones, as they provide quick access to information, entertainment, and communication with other humans. As we access more and more types of information on our phones, the more socially acceptable this kind of behavior becomes. And the more our society accepts this behavior, the harder it is to tell whether--and when--such actions are becoming a cause for concern.

"People don't realize the negative consequences of tech use, because we consider [mobile phones] a necessary, integral part of our lives," says Hilarie Cash, a specialist in Internet and tech addictions. Cash is the cofounder of the Restart Internet Addiction Recovery Center in Fall City, Washington, just 15 miles east of Microsoft's main campus. She treats patients with a variety of tech addictions, and believes that nomophobia and addiction go hand in hand, with the Internet playing a major part.

"Mobile phone addiction is an Internet addiction," she says. "People are not getting addicted to their dumb phones."

Elizabeth Waterman, a therapist at Morningside Recovery in Newport Beach, California, agrees, adding that most of her patients with nomophobia have a larger, underlying issue. "Usually, nomophobia is a symptom of multiple diagnoses," Waterman says. "It's never just a phone addiction."

Both Cash and Waterman say their patients suffer from a wide range of disorders, such as depression, obsessive-compulsive disorder, post-traumatic stress disorder, attention deficit disorder, or Asperger syndrome. Some come from a broken home life; some have a paralyzing fear of being alone in public. Whatever the background, the phone attachment is usually just the tip of the iceberg.

Mobile phone and Internet addictions start just as other addictions do.

"All addictions have certain things in common," says Cash, "like the feelings of pleasure or release, the development of tolerance, and an experience of withdrawal when access is lost."

The next time you get excited over a phone notification or someone posting on your Facebook wall, you can blame it on human psychology. Interacting with our phones stimulates the release of dopamine in our brains, and addicts anticipate the pleasure of the next tweet, text, or quick search on their phone in the same way a drug addict anticipates the next fix. If the device is taken away, addicts miss out on the feel-good response and experience withdrawal symptoms, including anxiety to the point of a panic attack.

Depression, however, is the most commonly shared result of nomophobia. When we have face-to-face interaction with other humans, we experience something called limbic resonance. According to Cash, human interactions stimulate the release of specific neurochemicals in our brains, which are necessary for full emotional and physical well-being. "Without enough limbic resonance in our lives, over time, we function and feel less and less well. This is why isolation is bad for us. We are social animals; we need one another."

Although we think we're socializing when we're voraciously texting and sharing info with friends on our phones, we're actually denying a crucial piece of our genetic wiring. People deep in their dependent relationship with their phones need a serious shift to interrupt the artificial stimulus the device affords, and must relearn how to get their interpersonal stimulus from other human beings.

"Recovering addicts are like newborns," says Cash. "They must grow, adjust, reset, and redevelop basic functioning skills."

Next page: Digital rehab

Digital rehab

If someone truly has a debilitating phone dependency, they won't be able to kick the habit alone. They need straight-up rehab in a monitored clinic.

Some rehab and recovery clinics offer specialized programs for combating mobile addictions. Restart and Morningside are two of them, with Restart's patients usually being men between the ages of 18 and 28, whereas Morningside treats mostly females aged 35 and younger.

Restart's entire facility is designed for treating tech addictions. Patients check in for 45 to 90 days, and then spend the first three weeks detoxing with no access to their phones or personal technology of any kind. It's quitting, cold turkey. They work on fixing their basic life skills--they eat healthy meals, get lots of sleep and exercise, and do chores around the facility. But most important, they undergo lots of psychotherapy and group sessions to get to the core of their dependence.

Morningside has a similar procedure, but before clients check in for their extended in-patient stay, Waterman monitors their typical phone usage to determine just how attached they are. She does so by asking her patients to write a tally mark on a piece of paper every time they look at their phones.

The in-patient program involves a 30- to 90-day stay, and clients work with therapists to identify why their phones interfere with their everyday lives. "We treat it partially as an addiction, and partially as an impulse-control issue," says Waterman. "They have the inability to inhibit the impulse." Once the root of the issue has been found, she works with patients on effective coping skills, such as deep breathing, distraction techniques, and getting comfortable with face-to-face interactions with other people.

The final step at both centers focuses on integrating tech back into the patients' lives in a healthy way. The therapists set strict usage boundaries, and patients practice using their devices at specific times of the day in certain circumstances. They also learn how to recognize when their usage is becoming problematic again.

When patients finish up mobile rehab, they still have a lot of hard work ahead. Restart patients head to a halfway house; both Morningside and Restart patients continue with group and individual therapy sessions. Depending on the severity of the case, a patient continues to meet individually with the therapist one to three times per week. Patients also attend group therapy sessions, and Restart patients attend biweekly ITAA meetings--that's Internet and Tech Addicts Anonymous, a 12-step program specifically for tech addicts. The transition back to normal life takes time, but both centers tailor after-care and continued therapy to each patient's needs to give them the best possible chance at succeeding back in mobile-centric reality.

Detox with a device-free weekend

A tech fast, Cash believes, is the first step toward healing a mobile addiction. It's hard at first, but participants eventually start to feel better after they go through the withdrawal period and readjust to using their phones in a healthy way.

Even if you're not a full-fledged addict, disconnecting every so often could prevent the dependence from getting worse. A weekend retreat in the woods without your phone might be just the right medicine.

In his mid-20s, Levi Felix thought he was living the dream. He was a big part of Los Angeles's "digital beach" scene, working 80-plus hours a week for a cool tech startup in the nonprofit sector. He worked hard, played hard, and was always connected, keeping his phone under his pillow when he slept--as a social media marketer, he had to stay on top of everything that was happening. He thought this lifestyle was fine, but while en route to the South by Southwest Interactive conference in 2010, he suddenly fell violently ill.

"A trip to the emergency room found that I had internal bleeding, and there was no specific cause," Felix says. His doctor guessed that it was stress-related. Felix quit drinking coffee, smoking cigarettes, and eating spicy food, and then took a month off of work to recover. But shortly after he dove headfirst back into work, he got sick again.

It was this recurring illness that caused Felix to reevaluate his priorities. He realized that his always-connected life was--slowly but surely--killing him. "I couldn't live like that anymore," he says.

Felix quit his job, kissed his smartphone and Facebook account goodbye, and traveled the world with his girlfriend for the next two and a half years. He took this time to meditate, to eat healthily, and to build a better connection with himself and other people without actually being connected.

"Just because you're not sharing doesn't mean you're not experiencing," Felix says.

With this new mindset, he returned to the United States, and was shocked by how bad our mobile-obsessed culture had become. "I almost couldn't believe it," Felix says. So, he decided to bring the tech-free serenity he found abroad to the San Francisco Bay Area. Felix began studying the effects of information overload and constant tech use, and used this knowledge to create an inviting program to educate others.

"The goal is tricking people into realizing how important it is for one's health to slow down and disconnect," Felix says. And thus, Digital Detox was born.

Digital Detox runs meet-up events all over the Bay Area, weekend-long retreats in a serene lodge in Ukiah, California, and a summer camp in Anderson Valley where people interact completely without personal technology. No cell phones, no Internet, no TV, no cameras. Participants meditate, do yoga, keep journals, have group discussions, work on arts-and-crafts projects, and spend plenty of time on self-reflection. Felix shares the latest science and research on the effects of tech use to tell how it is changing our programming, and then participants discuss. "We address this giant elephant in the room head-on," he says. 

Digital Detox is not for diagnosing or treating addicts. Rather, it's designed to bring awareness about why we need time for ourselves without our devices. Think of it as a learning center for coping mechanisms, and solving a problem before it becomes a problem.

Maintaining control

Felix believes that we are all mildly addicted to our phones and technology, but that most of us aren't completely powerless over it. The first step is recognizing whether our habits surpass just being rude and instead indicate a larger issue.

"If you're checking your phone a lot, but everything else in your life is fine, then you don't have a problem," says Waterman. Using your phone at inappropriate times is one big indicator.

To keep yourself from becoming too phone reliant, there are a few things you can try. Waterman suggests starting by making some rules. Set limits and boundaries for your phone use, such as not using the device in the bathroom, while driving, or at the dinner table.

Felix recommends turning off social media and email notifications, so that you can check your accounts on your own terms instead of as soon as you get a new ping. Then, designate certain parts of your day for checking your phone for new messages.

According to Cash, one of the worst habits we have is using our phones late at night or in bed. Staring at a screen prevents the brain from releasing melatonin, our natural sleep chemical, so our bodies don't register that we are tired. If you sleep with your phone right next to your bed, any late-night texts or alerts will disrupt your sleep patterns, even if you don't fully wake up to respond. An easy fix? Go back to using a regular alarm clock, and keep your phone outside of your bedroom.

Finally, tell your relatives and friends that if it's an emergency or if they really want to contact you, they should make an actual phone call instead of a text.

And try--try--to keep your phone hidden during social activities. Focus on the conversation. Take a mental picture instead of an Instagram shot, or write down a tweet idea on a piece of paper and save it for later. Initiate eye contact instead of screen contact. Whether we realize it or not, we aren't as great at multitasking as we think we are. So if you're going to spend time with friends, spend time with them. As Waterman says, "[Experiences] are more rewarding that way anyways."

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