[MUD-Dev] Retention without Addiction?

[Sasha Hart]

[Dave Rickey re: the DSM IV alcohol dependence definition, perhaps
as applied to MUDs]

> The problem is, too many of these are subjective and/or very
> elastic.

Yes!

The DSM IV has no particular monopoly on true or useful definitions.
Moreover, it has no particular authority to me.  So we can get that
right out of the way - I am not thumping the DSM IV or making any
kind of argument from social authority.  It is just a manual which I
am hoping might provide good starting points (and this can include
very bad ideas that we can judiciously throw out, but in the process
learn why).

The question is, what's better? The everyday use of the word
'addiction' is all over the place. People use "I am addicted to" to
talk about liking something or doing it a lot or wanting to do it,
even when it's not harmful or serious, or if they could stop if they
wanted. Even worse is the sense of addiction which is used as if it
meant something quite precise but in fact not coherent (like demonic
possession; unless, of course, you believe in demons). That opens
the door to witch-hunts: people (whether they are earnest or not)
can declare that something is 'addictive' and really do a great deal
of harm, even if nothing is actually at stake, because people are
certain they know what it means but in fact have no firm connection
between anything of real concern and the judgement that the thing is
addictive.

It is not a settled matter whether you can literally be addicted to
a MUD or not. I think we should be cautious before going on a witch-
hunt and categorically trashing reasonable ideas; at least we should
have standards better than "burn it if it floats."

To that end, I wanted to provoke discussion of what precisely we
were trying to fix and how we can fix it (the latter perhaps being
easier if we know more about the former).

So, I brought up some ideas verbatim from the DSM definition of
'alcohol dependence.' What I will say for this is that it is a
common reference and that it gets used out there. It definitely has
problems. On the other hand, it is even too conservative to cover
MUDs, so it only gives ideas, not any kind of authority. But yeah,
the people writing the criteria had an interest in correct
diagnosis, not overdiagnosing and not inflating the problem, and
maybe we can get some of that to rub off.

I also brought up a couple of other ideas: namely, that we are
really concerned with harm that is caused by MUDs, and people who
want to stop or reduce playing but can't without help.  I think
focusing on harm is essential to not eliminating things for no
reason, and focusing on people's control is the most pleasant way to
keep them selectively out of a harm and not out of things that are
good and natural too. I think these are the good points of the DSM
IV treatments of drug dependence. At any rate, I am attempting to
get specific and avoid witch-hunts unless there really are witches
and there is no better way to deal with them.

> MMO's qualify as an addiction under the DSM IV definition, which
> is used by the psychiatric community as the definitive source."

My understanding is that diagnoses ultimately have to be carried out
by some kind of licensed professional to be at all official. It is a
unique (perhaps very bad) feature of the DSM that diagnosis is not
at all mechanical, I think it relies on some other training to some
extent. In part this is probably because our understanding of the
etiology of the problems in DSM is poor, and in part it is probably
because some of the problems are just problems and not actually
well- defined, disease-like disorders. But again, I'm no clinical
psychologist, it's not even my area.

I must point out that the DSM IV deals with drug dependence and not
addiction. It also has a separate category for abuse, which is
distinguished (and is more dependent on harm, less on inability to
control, withdrawal symptoms, etc.) Neither does the extant DSM IV
cover MUDs without some pretty heavy metaphors; it gets specific
about the drugs. There is a particular category for alcohol
dependence and others for other drugs or 'families' of drugs.

I am much more interested in the content of the definitions than
which words are used, because the former guide our discriminations
and our actions (if we accept them) while the latter pretty much
only guides what letters we type.

> And to someone with an axe to grind, MMO's qualifying for all 7
> isn't much of a stretch (they'll hear what they want to hear).

Or they won't care about the criteria and insist on whatever it is
they want, which is basically the same outcome. But at least they
will be wrong (at least in the cases where quitting a MUD does not
cause grand mal seizures and severe vomiting).




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