Dr. Rosa Díaz: “Social media and video games cannot be pathologized or demonized: they are not a disorder in themselves and screens are not horrible”

Dr. Daniel Ilzarbe – Whoever designs them is very well aware of how the brain mechanisms of addiction work: the reward pathways and the dopamine that is generated when we like something. Social media timelines–using a finger to scroll down a page–work like a fruit machine:  you never know when you will get the video you like. The algorithm has a lot of information about what you like and what you don’t like because it knows how many seconds you spend watching each video. But you scroll down and you never know when the video you like will appear. All of a sudden, you get three in a row that you like, and ten you don't like.  And it is this surprise factor—the uncertainty—that is most addictive and makes it hard to stop.  The same thing happens with video games: for very little money you can buy a device that will help you to jump from screen to screen, or if you play for five minutes longer, you will get extra points, etc.

RD – First of all, we try to find out what is going on. What is behind this? What is happening to this young person? Because very often these are symptoms that hide other causes: problems at school, emotional or academic problems, disappointment, family breakdowns, etc. Environmental factors also play a very important role, and that is why we work a lot with family therapy, intervening at school and in the young person’s social environment.

DI – Sometimes we come across cases that are referred to us as addiction, and it turns out that this is just the tip of the iceberg, the visible part. But if you dig a little deeper, you will find other things. This might be the case of a girl who spends the day on social media and who has a hidden depressive disorder, for example.  Hospital admission is very rare and only for very specific cases. Wherever possible, we try to treat the young person in their environment, because this is where they have to make changes.  We also work very closely with their parents, involving them, going to their house if necessary and carrying out family sessions.

DI – I have the impression that, the way the world is organized now, the excessive use of video games and social media may be the manifestation of another underlying disorder. If you are very anxious or depressed, the way to escape from these feelings may be to spend all your time on your mobile phone.  However, in reality the primary problem is the anxiety or the depression, not a mobile phone addiction. Sometimes, it is difficult to disentangle what came first, and you have to tackle both things at once.

DI– When it comes to prevention, we always use the following as an example: you teach your child to walk down the street and explain to them where they can go, that they should always look left and right before crossing the road, that they shouldn't accept sweets from strangers, etc., don't you? Well, you also have to teach them how to surf the Internet, to use social media and play with video games: you have to explain which websites they can visit, the dangers there are, who it is safe to talk to, which times they have to stick to, etc. You have to accompany them along the way. It is also true that today’s children were born in the digital age, and we adults got on the new technologies bandwagon a bit later. So, our children are very often more tech-savvy than us parents.  And that makes it complicated when it comes to teaching and supervising them properly.

RD – There are certain strategies that we work on with parents, such as drawing up written agreements that both parties agree to comply with regarding access to passwords, activating parental control, the number of hours spent online, and the right to confiscate the device if the child does not comply with what was agreed on.  And, gradually, give them more freedom as they take on more responsibility.  It is also advisable not to let the problem get out of hand and then impose rules, especially because the older the child gets, the more complicated it becomes.

RD – Most guides for parents and educators recommend that children under two or three years old get no screen time at all. There is no need to be too rigid about this, however, and at certain times you can let them watch cartoons. But, above all they should be offered alternatives appropriate for their age and stage of development. It is also true that nowadays adults tend to do everything using electronic devices and children watch us. In these cases, the best thing to do is to try to hide what you are doing as much as possible when they are very young, and then explain what you are doing and how you are doing it: “I’m doing something important, but I’ll be finished in a moment and be right with you”. We have to bear in mind that when children reach a certain age, they tend to be highly critical.  We recommend common sense, calm, flexibility, care... and also patience.

DI – In diagnostic manuals, the only thing that is recognized as a possible addiction is gaming disorder.  Problems related to the Internet or social media use are not recognized as a diagnosis.  But even if we do not have a firm diagnosis, if we see signs of problems, we should treat them as soon as possible, so that they don’t get worse.  In children and adolescents, even if we have no diagnosis of depression, we should not wait until they are depressed before we start to act.  That is why we prefer to talk about addictive behaviours:  we don’t have a disorder, we don't have an addiction, there are addictive behaviours.

RI– I wouldn’t say damage, but transformation or adaptation of the brain. Now children are exposed to a lot of information, and I think that the great challenge for today’s generations is to filter out what is useful amongst the vast amount of information they receive.  We have to try to strike a balance, because the Internet and social media have good things of offer too.  For example, they provide lots of tools for psychoeducation and even psychotherapy. They also allow us to work on skills such as learning English, and improving attention, coordination and visual discrimination.  Not to mention the fact that young people with social difficulties can find their own space to socialize there.

RD –Neither pathologize nor demonize. These are two ideas that it is important for us to convey. Not pathologizing young people’s addictive behaviours means, “remember it’s not a disorder and screens aren’t horrible”. If there is a problem, let’s analyse it, control it, but don’t take the screens away for good.  It’s better to observe things for a while to see if, behind this behaviour, there is something that the child is trying to tell us. Maybe the problem is not just with the screens, and we can’t take them away thinking that that will solve everything.

DI –It is also true that society is constantly demanding that we use screens for everything.  This is a problem, if you compare it to other addictions: if you are addicted to cocaine or alcohol, you can consider abstinence for the rest of your life, but you can't do that with screens because you need them at work, at school and for your everyday life.  This is the difficulty with behavioural addictions: you have to continue carrying out these activities without going too far, and that is very complicated.