«A day without a smartphone is a disaster for teenagers»

Mr Eidenbenz, you advise those affected and their families when being online becomes an addiction. Aren't we all a bit addicted to the internet?

In 1999, I was confronted for the first time in my practice with adults who described themselves as internet addicts. At the time, it was still unclear whether this was really a serious disorder or a passing trend. However, it soon became clear that these people had a serious addiction problem, similar to gambling, alcohol or nicotine addiction.

So far, the WHO only recognises gaming addiction - is this also a priority for you?

Computer games have a considerable potential for addiction. In addition, computer game disorders are easier to define and diagnose than, for example, disorders associated with social media applications. In the meantime, however, the problematic use of Instagram, Tiktok, Snapchat and YouTube as well as series on streaming services is far more common in practice among children and adolescents.

Why is being online so addictive?

Digital applications use sophisticated reward mechanisms with the aim of keeping users occupied for as long as possible. This is particularly tempting for children and young people. The applications also specifically cater to human needs such as the desire for recognition, success, uniqueness and entertainment. Many people find it as difficult to resist as they do with chocolate or shopping, for example. They consume more than planned.

When virtual offers meet corresponding, mostly unconscious needs, a connection is created like two perfectly fitting pieces of a puzzle. A fascinating hobby can then develop into an online addiction. The danger increases if users are not doing well overall and there are many problems in real life.

However, being online all the time has become an integral part of our lives.

The smartphone with internet access is an epochal development that can be compared to the invention of the hand axe - it increases efficiency and is incredibly helpful. But it can also become a dangerous weapon if used incorrectly.

Parents should think about this before the child has its first device.

Today, we can no longer choose whether we want these new opportunities or not. It's more about how we deal with them. The aim must be to exploit the positive aspects and minimise the risks and negative effects. And our children and young people are particularly important here. Smartphones are very easy to use, but evaluating and understanding the content can be overwhelming. Healthy use is only possible with clear rules and when parents work together with their children.

What would you say to parents who would like a guide? How do I introduce my child to the device so that they benefit but don't become addicted?

It is important that parents think about this before the child has their first or a new device. It should be agreed beforehand: What should the device be used for, when and how? The simplest possible rules will help. For example: We put the mobile phone away during mealtimes, in the evening we switch it off half an hour before going to bed or at least switch off the screen. However, finding and adhering to rules that are suitable for everyday use is a challenge because the device combines so many functions.

And how can you deal with it?

For example, you can make an exception if you want to look at photos you took during the day together at the dinner table. That's okay - but gaming or anything for which you use your mobile phone alone is taboo at the table. Parents should therefore set clear boundaries and at the same time take an interest in what the children like to do with their devices. Discussing this helps parents to understand what interests and needs their children have in the virtual and real world.

If the device is so strongly linked to everyday experiences, a time limit on consumption probably no longer makes much sense.

The question of how many hours on a mobile phone is still healthy is often asked. Statistically speaking, the duration of use is constantly increasing and children have a smartphone earlier and earlier - on average at the age of ten. The length of time is not in itself a criterion for addiction. More important is the question of how the devices are used and whether control over consumption is lost.

Children and young people need parents to take them away from screens.

If someone does a lot of programming or plans a leisure project on their mobile phone, if they play online with friends but also meet up with them in real life - if consumption is embedded in life in this way, the duration is of secondary importance. As the real and virtual worlds increasingly overlap, it is important to learn a healthy approach. The aim must be for children to be just as distracted by other children, an animal or nature as they are by a mobile phone.

Does reality even stand a chance? The algorithms are programmed to give us constant dopamine rushes.

That is indeed a challenge. The quick rewards that are available online mean that many young people's tolerance for frustration decreases. However, it should be noted: If there is a choice between success and recognition in real life or online, people choose reality. Even successful influencers want to be successful in the real world - online attention alone is not sustainable. We need social, real contacts that we can also feel.

That's good news! So parents don't have to come up with the big counter-entertainment programme, but simply give love.

It is almost impossible to offer as much variety in reality as is possible in the virtual world. And that is not the goal. What parents need to do, however, is set limits and guide children into real-life experiences where it can be boring for a moment. Because it is only when some time has passed and peace and quiet has returned that nature, for example, can really be experienced.

Enduring boredom is certainly a big issue in your practice.

Young people are no longer used to enduring boredom. For media addicts, it is a great achievement to actively do something. This is surprisingly difficult and therefore only comes at the end of therapy.

In the beginning, the main aim is to resolve conflicts and differences of opinion fairly. This also involves understanding the concerns of the children and young people and taking them seriously. In practice, I often find that parents say: «Sure, you can have your say and we'll listen to you.» But as soon as the children express criticism or formulate their point of view, the parents intervene.

Where could parents respond more specifically to the needs of their children?

Gamers are often late or don't come to dinner at all if their parents announce it at short notice. A certain lead time is needed to finish a game. Young people say: «If I only know five or ten minutes before dinner that I have to be ready, that's too little time. I don't want to let my friends down during a fight.»

So good rules should be negotiated together?

Yes, and good rules are simple and can be counted on one hand. For example: From 9 p.m., mobile phones are no longer in the room - or the WLAN is switched off. Lunch is served without mobile phones on the table. Rules should be reviewed regularly and redefined depending on the situation. It is normal that they are not adhered to perfectly. However, compliance should be positively rewarded and non-compliance should also have consequences.

The mum of a 13-year-old told me that she leaves it up to her son to stick to the rule of «one hour of FIFA a day». Can a teenager do that?

Young people and children who have a great affinity for media are generally unable to structure this themselves. This also has to do with the fact that the frontal brain only matures in adulthood. And this is responsible, among other things, for self-discipline and assessing consequences. Children and adolescents need parents to help them detach themselves from screens and limit their time. Many parents know this from themselves: they «quickly check a few emails» and in no time at all more time has passed on the mobile phone than they had planned.

I would add the rule «one hour of Fifa per day». When is that? Perhaps not just when your son is at his fittest to do his homework well, but only after he has done his homework. And not just before bedtime either. And doesn't it make more sense for him to be allowed to play longer when his school mates are there to play with him? And then less on another day? This is exactly what you should discuss together.

And when the parents then say: «That's enough», the house is once again a mess.

Parents should know that it is normal to have conflicts about media consumption. Arguing about screen consumption does not mean that there is a pathological addiction. Resolving conflicts fairly and setting boundaries at the same time is a challenge for many parents, but also for young people. Children need guidelines and boundaries against which they can rebel. This is the exciting, but also exhausting part of the parenting job. Especially as you usually only hear years later that you've done a good job.

Because children only realise this later?

Children generally appreciate their parents, even if they rebel against them. When I ask the children in therapy whether they would like to change their parents after many conflicts, they all say that they basically think their parents are okay. Parents should memorise such positive feedback.

When do we talk about online addiction?

When control over consumption is lost and consumption is not restricted - or even increases - despite obvious negative effects on performance and social contacts. In other words, when media consumption becomes more important than other leisure activities, more important than school and more important than socialising with the family. Ongoing and escalating conflicts with verbal abuse or assault are also a clear warning sign.

So what is the next step?

Addiction counselling centres for young people or the paediatrician or family doctor are good first points of contact. The first step will be to establish exactly what the conflict issues or causes are. For example, we talk about what exactly the consumption looks like, whether sports or homework are still being done and where the parents and the young person see the problem.

Parents should be a good role model for their children and stick to the rules themselves.

I personally suggest that the parents attend the first session with the young person and possibly also with their siblings. It is often the parents who see a problem, whereas the adolescents see their behaviour as normal. In many cases, the parents suffer more than the affected child - and the child doesn't want to come at all.

How can the affected child be brought to the practice?

It is important that the father and mother - even if the parents are separated - pull in the same direction. This needs to be clarified first. I recommend that the parents sit down with the child at a good moment and say the following: «We have a problem that is really bothering us and that we can no longer solve on our own. But we can't solve it without you either, so it's necessary for you to come to counselling with us.» This almost always works.

As a parent, how can I intervene before addiction occurs?

First of all, parents should talk to each other and find out whether they are setting sensible and reasonable rules, whether they are being overcautious or too generous. Of course, it is also important for parents to be a good role model for their children and to stick to the rules themselves, such as putting their mobile phones to one side at the table.

And what happens when parents realise that their own self-regulation is not so good?

Then they should clarify for themselves: Which applications are time wasters and which are unproblematic? The problematic ones should be limited or avoided. It's also about enduring short breaks or boredom, such as waiting for the bus, without reaching for your mobile phone. This is a gift of time in which we don't have to do anything. Make sure that you socialise enough. And make sure that nature and your surroundings are just as important or more important than your smartphone. If those around you comment that you are on your mobile phone too much or at the wrong time, try to take this seriously. The aim is to find a healthy «digital life balance».

And how do I make the balance palatable to my child?

Don't spend too long arguing about media consumption, but try to do something that is attractive to children. Go to the zoo, have a barbecue outside, paddle in a rubber boat on a river...

Could you take a playful approach and ask: «What would you like to do on a day without your mobile phone?»

A day without a mobile phone is a disaster for many young people. Asking them to leave their mobile phones at home on an outing can lead to considerable conflict. Holidays without WLAN and a network are a no-go for many young people. Frequent contact with the peer group via mobile phone is very important. A realistic goal should be to leave the mobile phone alone for a few hours.

What do you think of artificial intelligence such as Chat GPT?

These are fascinating and sometimes uncanny developments. And they cannot be stopped. We have to learn how to use the new technology sensibly. We also need to create framework conditions to minimise the risks of negative effects.

During testing, I realised that Open AI was able to produce texts in my subject area that were so good that I could use them as a template for a presentation. Students can have papers written for them and these are not easily recognisable as the product of AI. Educators have to come up with something. We can also use AI to encourage our children to engage with their media consumption ...

How so?

Let's ask young people Chat GPT how they can recognise that they are addicted to the internet and what they can do about it. The young people can then look at the answer with their parents and discuss it: Is this reasonable or is it true? And what can we do about it?