"Wii Admitted We Were Powerless Over Video Games -- That Our Lives Had Become Unmanagable."

Given the choice between, oh, say, saving his life by fleeing a burning building or staying a bit longer to reach the next level in whatever video game he was playing at the time, I'm reasonably sure my younger son would, reluctantly, flee. Lower the stakes, however, and the video game would almost certainly win. So, is he addicted?

At least for now, the American Medical Association is saying no. That's the right call, which is no guarantee it will remain the AMA's position and that Video Game Addiction won't find itself next to alcoholism and drug addiction in the next edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) in five years.

Whatever one thinks about the science underlying the notion of addiction as a medical disease or disorder, it is unlikely that the supposed Video Game Addiction "sufferer" will be affected greatly one way or the other by the medical experts' decision. What would change is that "[s]uch a move would ease the path for insurance coverage of video game addiction." Follow the money, in other words.

With the usual disclaimer about how, among the myriad other things I'm not, medical expert is high among them, here's my take. Issues of actual chemical dependence aside, and we'll get back to that later, when you strip the concept of addiction of any sort from its negative connotative baggage it reduces to little more than the notion that people like doing what they like to do and, as a corollary, when they like doing something very, very, very much it is hard for them to refrain from doing it. So hard, in fact, that in many cases those who have decided they would be better off not doing it so much find it much easier not to do it at all rather than trying to try to do it in moderation.

I'm not arguing that a life spent shooting heroin or smoking crack cocaine or drinking a quart or more of whiskey a day or gorging on food constantly or betting the rent money or even playing video games for six to eight hours a day is a life well spent. It is unquestionably dysfunctional by any reasonable objective standard. Also, some addictions are more dysfunctional than others, posing serious health and even life threatening risks.

But we don't manage our own lives by reasonable objective standards, though. We might think we do, but the best we can do is to view ourselves by reasonable subjective standards, the reasonable part being our adaptive success at learning from our own and others' experience and changing, when necessary, accordingly. I can't say how much satisfaction you get from your preferences, you can't really know how much satisfaction I get from my preferences. We can, of course, figure out what each other's preferences are and maybe even what their ordinal value to others are by how they in fact behave' but it doesn't follow that your number one preference, say, smoking crack, isn't so far ahead of number two and the rest that you're not making a rational decision by hanging out at the crack house no matter what I may think of your decision.

That said, many people who come to believe that their lives are being ruined by their alcohol or drug habits or whatever, can and do manage to stop. They probably need help doing so in most cases, but I don't know of a single person who stopped what others deemed an addictive habit solely because those others wanted him to do so. Society -- family, friends, employers, etc. -- can raise the stakes, but that's it. As the old psychology joke goes, the light bulb has to want to change.

Chemical dependency, a reality in some addictions despite what some naysayers claim, isn't really the issue. If it were, alcoholics and drug addicts could quite cheaply and quickly be detoxed and that would be that. It is the psychological dependence that is the far tougher nut to crack. No doubt that, too, is physiological. Perhaps the brain gets hard wired with "memories" of how much fun the alcohol or cocaine or, let's not forget, nicotine is. That's why the patient has to want not only to quit but to keep quit. That, too, is why there is some logic to lumping, say, a gambling addiction into the same psychiatric category as alcoholism or drug addiction. The problem is, the logic leads to precisely the wrong conclusion. What we should be learning from our ever expanding list of "addictions" is that, medical assistance with the chemical dependence aspect of certain such addictions during withdrawal aside, they are no different than the rest, which is to say that they're not really diseases or, in the medical sense, disorders at all.

Which, in turn, is why it isn't ongoing (expensive) medical treatment but recourse to Twelve Step programs and their like that tend to be the most effective method for people who want to quit and keep quit of whatever their addiction may be. My title here is a play on the First Step of such programs: substitute "Wii" with "We" and "Video Games" with "Alcohol" and you have the version of the granddaddy of all such programs, Alcoholics Anonymous. What they claim, at least for themselves, is that coming to believe that they really did have a problem and couldn't fix it by themselves was the first, essential step toward its solution. There may be many other ways for people who want to stop drinking or gambling or playing video games incessantly to do so. But at least in this one celebrated and successful (and, sure, highly criticized and controversial) way we're back to the psychologist and the light bulb; that is, it is the individual, himself, who must want to change; otherwise, all is for naught.

Meanwhile, my son is indulging his "addiction" at the moment playing some sort of video game in the other room and temporarily safe from being clinically labeled even as I type this (indulging in my, um, computer "hobby"). Just as we don't set out a big bowl of candy in the living room and tell our kids to help themselves as much as they want, we limit his access to the video games. He plays other, i.e., non-electronic, games and sports, does his homework (grudgingly) during the school year and so forth. I'm sure he'd rather play video games than do his math homework and, left to his own devices, would do precisely that. But he's a child, our home is ruled by (benign) despots and he doesn't get that choice. Not yet. Libertarianism is for grown-ups.

It would be bad enough in the case of adults that we infantilize them by telling them they can't do what harms only themselves because they have a disease that gives us power over them "for their own good," but it's worse than that. It doesn't even work until, ironically, they want to change anyway. Unlike light bulbs, there's little point in screwing with them until the light has already come on.