We have played ourselves into oblivion with the game addiction ...

«It was love at first sight,» says Benjamin Marbach and laughs. «The first time I picked up a Gameboy, I was hooked.» Over time, the Gameboy was replaced by Nintendos, Playstations, later computers and even later the smartphone. Today, Benjamin Marbach is a patient on the new ward for behavioural addictions at the University Psychiatric Clinics (UPK) in Basel. One day, he pulled the emergency brake. He spent every waking minute in front of the screen: no job, no time, just playing, for months on end. Today Benjamin Marbach is 34 years old.
Gabriel Bernet is 23 years old. He has been in therapy for five years. For him, too, computer gaming has developed into an addiction. An addiction that takes over him completely if he gives it space. Throughout his teenage years, Gabriel sat in front of the computer for hours on end, day in, day out. «I used to go out with friends a lot,» he says. «That gradually changed until I was even lying to my friends and making excuses when they asked me to come out.»

«Gaming disorder» - a recent phenomenon

Gabriel Bernet and Benjamin Marbach share a room on the behavioural addiction ward at UPK Basel. In their youth, the two developed something that is becoming an issue for more and more young people: They are addicted to computer games. Scientists have not known for long that games can be addictive. However, the phenomenon has been thoroughly researched in recent years, and this year a new diagnosis was added to the World Health Organisation's (WHO) diagnostic manual: «gaming disorder». A person is affected if they can no longer control their gaming behaviour and gaming becomes more and more of a priority in their life until it completely crowds out other activities.
In order for this diagnosis to be made, this behaviour must severely impair the social functioning of the person affected for at least one year, in the family context, at school, at work or in their social life. In adolescents, it is often their academic performance that suffers first.

One fifth of 12-19 year olds game every day.

Results from the JAMES study

As the diagnosis is still so recent, there are no precise figures on how many young people in Switzerland are addicted to games. However, the recently published JAMES study by the Zurich University of Applied Sciences (ZHAW) shows how widespread computer games are: Around a fifth of 12 to 19-year-olds play games every day and a further fifth several times a week. There is a big difference between the sexes: two thirds of boys play games several times a week, compared to just over a tenth of girls.
Young people who are in crisis or struggling with a personal weakness are particularly susceptible to addiction. Psychiatric institutions are responding to the new diagnosis: in July of this year, a ward for behavioural addictions was set up in Basel, which is also responsible for gaming addiction.

When does the hobby become dangerous?

For Benjamin Marbach, gaming was the best thing he ever did in his teenage years, alongside his passion for inline skating. However, this hobby gradually disappeared. His mother, a single parent, kept saying at the time: «It's not good for you, playing games all the time.» Today, Benjamin Marbach says: «I think she was overwhelmed by the situation and my playing was also a relief for her - she didn't have to look after me.» Until the hobby became a danger.
«Gaming simply takes up an incredible amount of time,» he says. «And during this time, you miss out on things that you should actually learn as a teenager. Then you can't do them.» Parents need to be sensitised to this, he says. «They need to know that young people can develop a real addiction. An addiction just like alcohol. You have to deal with it for the rest of your life.»
For Gabriel Bernet, it gets really bad at 17. He is a student at a vocational baccalaureate school and is interested in a girl, as is a schoolmate. The rival frightened Gabriel and threatened him. Gabriel stopped going to school, he was too scared. After two weeks of unexcused absences, he is expelled from school.
Gabriel stays at home and plays computer games from the moment he gets up until he falls asleep. «27 hours a day,» says Gabriel and laughs. Of course, his parents talked to him. «Go outside more,» they told him, «your eyes are going to break.» The only thing is: he can game just as well outside, on his mobile phone.
When his father suggested he go to therapy, he agreed. There he learns a lot about how addiction works. And how he could deal with it differently if gaming threatened to take him over again. «If my father hadn't helped me back then, I would probably still be lost in front of the screen today,» he says.
«League of Legends» is the name of the game that mainly occupied him back then. Even today, he still receives every change to the game by email: When a hero is «buffed», i.e. gets better skills, or when new items are added to the game. Gabriel says: «I still find that very exciting. I find it difficult to switch it off.» But that is his goal, which is why he is on the behavioural addiction ward at UPK. For two months now, full-time, because he had a relapse. «That's when I told my therapist: this has to change. Now I'm here.»

How does the therapy at the UPK work?

Renanto Poespodihardjo takes long strides through the park that forms the centrepiece of UPK Basel: This marvellous place, with its small green spaces, conveys a sense of security that is felt not only by patients, but also by visitors. Poespodihardjo is the psychological head of the new ward for behavioural addictions, building U, second floor. Patients complete a very full therapy programme here: they learn a lot about their addiction, about the changes it triggers in the brain. And even more about strategies for dealing with it. And these strategies are practised, for example those that help them to stop playing computer games on their own.

«Recognising what is going wrong is not enough,» says Poespodihardjo. «After that, you have to practise and learn new strategies. You have to imagine: These patients simply didn't cope with many basic life tasks in their youth and young adulthood - because they spent that time playing computer games.» Although they could spend hours solving incredibly complex strategic tasks on the screen, he says, they would fail when trying to write a job application. Or shower in the morning. «They often don't know the simplest elements of non-verbal communication, they don't know how to make themselves feel safe in a social context - by washing themselves, putting on fresh clothes, not stinking.»
Patients spend around two or three months on the ward. After this time, however, the work is not yet done. «This is usually more of a boost to start working. After that, we recommend that patients take up a follow-up offer,» says Renanto Poespodihardjo. This could, for example, be outpatient therapy outside of the behavioural addiction ward, which can also take place alongside work.

Starting a career is difficult

Gabriel Bernet has no job. He would like to apply for a sheltered job. Because, as he says: «It's too stressful for me in real working life, I can't stand it.» Benjamin Marbach turned his hobby into a career - and then failed because of his hobby. He studied game design. «But programming, that's work,» he says, «I didn't want to do that. I preferred to play.»
Although the behavioural addiction ward is set up for adults, young people can also find someone to talk to here. "We work closely with child and adolescent psychiatry," says Renanto Poespodihardjo. «If we jointly come to the conclusion that online addiction is the main issue, a patient can come to us at the age of 17 or even 16.»
Sometimes the behaviour only becomes acutely distressing for patients at a later age. It is only when it comes to finding a job and surviving as a young adult that gaming addiction becomes a real stumbling block. However, the precursors of this behaviour usually develop in early adolescence.

«Sudden deficits at school can be a sign of a possible gaming addiction.»

Renato Poespodihardjo, psychological head of the new ward for behavioural addictions at UPK Basel

«I recommend that parents always take a close look if there are deficits in their pupils' academic performance, even though they are actually capable. These are often signs that someone is spending too much time playing computer games.»
Other signs are when young people start lying to their parents about their game consumption. Or if they can't stick to the agreed computer times and start playing half the night through, for example. It always boils down to the fact that gaming is increasingly becoming the centre of a teenager's life.

The feeling of happiness leads to a vicious circle...

«The fact that there is now a diagnosis for gaming disorder means that any doctor or psychologist can now diagnose an online or gaming addiction in a patient,» says Renanto Poespodihardjo. Researchers assume that gaming addiction has very similar mechanisms to other behavioural addictions, such as gambling addiction, but also to substance addictions.
The brain releases the neurotransmitter dopamine when a positive experience occurs - in the case of gaming addiction, for example, when a higher level is reached. Dopamine is a learning signal that positively reinforces behaviour; the player experiences a feeling of happiness that they associate with gaming and that they want to experience again.
At the same time, gaming can also become a strategy to better cope with negative feelings or to experience social relationships within the protected framework of the virtual world. This can lead to a vicious circle: Every time the addict sits down in front of the computer and has positive experiences, the addiction is reinforced.
«Of course, the treatment of gaming addiction is not at all the same as for other behavioural addictions,» says Poespodihardjo. «Therapists need to specialise so that they understand what can be behind it.» Because not all game addicts are the same. There are computer games where players organise themselves online like in a club. And others where they fight alone against the whole world.

Like an alcoholic in a pub ...

Benjamin Marbach is still battling his addiction, but today he is fighting it. It really kicked in when he was in his mid-20s: he broke up with his girlfriend, finished his studies and had nothing to do. Since then, he has lived off his savings. He never made the step into working life - the addiction always got in the way. «I always thought I had to clear up all my other psychological problems first, then the excessive gaming would go away at some point. But I realised that this addiction always comes first.»
It's like a survival strategy that has taken on a life of its own: instead of being a source of joy and fulfilment, gaming is now just a way of escaping responsibility. Benjamin suffers from this. «And at the same time, of course I would like to play. I'll always want to.» That's why it's so difficult. Because he can't do it anymore. Otherwise he'll be right back in the middle of the addiction. «When I get out of here again, I'm like an alcoholic in a pub: every time I sit at the computer, I have the opportunity to gamble.»
Gabriel Bernet says he doesn't want to give up gaming completely. Even though he knows: «The addiction will never go away.»

Here those affected can find help

• Safezone.ch: offers parents and young people seeking help easy access to counselling: by email, in forums or during consultation hours. There are also self-tests on the platform that can help to better assess the situation. There is also a lot of information on various forms of addiction, including gaming and online addiction.
• Cantonal addiction counselling centres: Almost every canton offers at least one addiction counselling centre. This can be the first point of contact for affected families. Trained addiction counsellors work here and can also point out other places to go. An overview of the counselling centres can be found here:www.safezone.ch/suchtindex.htmlwww.sos-spielsucht.ch/de/kantone
  
• suchtschweiz.ch: This portal offers a very comprehensive information and contact point for parents: suchtschweiz.ch provides a lot of information on the current research situation, further information on help centres and self-tests on online and game addiction.
• feel-ok.ch: Feel-ok informs parents and young people about a whole range of topics, including gaming and online addiction. Among other things, there is a checklist of warning signs for the development of an addiction.
• spielsucht-radix.ch: The centre for gambling addiction and other behavioural addictions offers counselling for affected young people and their parents.
• University Psychiatric Clinics Basel: The newly founded Centre for Behavioural Addictions offers intensive inpatient treatment for patients with game or online addiction for whom outpatient treatment is not sufficient.

To the author:

Read more:

• Why is gaming so addictive? An interview with the head of the Centre for Gaming Addiction in Basel

• «Social media is as addictive as cocaine!» says psychiatrist Dr Kurosch Yazdi, leading addiction specialist
• "I was someone else online " The example of Simon shows what constitutes an internet addiction and where it can lead.