Shay Jacobson, RN, MA, NMG, LNCC, CNLCP
Martha Kern

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Katrina was living in an alternate world.

There, in an online fantasy game environment, she was powerful.  She had control over her own life and those of others.  Success in this world was fully achievable for her, and it felt so good to win.

In this alternate world, Katrina was not mentally ill or depressed, and there was a legitimate use for her aggressive tendencies.  Where the real world failed her and offered so much disappointment, this world presented the illusion of friendship and the delicious thrill of self-determination.

The fantasy world became Katrina’s everything.  But it was expensive, and she was threatening her real-world parents if they didn’t give her the money to play, all day and all night.  Like the virtual enemies in the game, Katrina’s parents were the objects of her wrath, and it was a dangerous proposition for them.

In the real world, Katrina’s obsession with the game was not a game at all.

The Very Real Risks of Virtual Reality
The emergence of virtual environments has elicited concern from many parents.  They understandably worry that their children, still in their formative stages, will become too immersed in modes of thought and behavior that have no place in the real world.

Katrina’s parents had even graver concerns.  Their daughter was a young adult who was plagued by an array of psychiatric issues.  She didn’t function well in the real world.  She saw no reason to keep her environment clean, to keep herself clean, to bother with socialization.  The world was just a hard place for her.  It made sense in many ways that a fantasy world would hold immense appeal for her as it required none of the “work” that goes into functionality.  It was there when she wanted it, and she wanted it all the time.

Katrina employed a variety of tactics to gain her parents’ cooperation in funding the game.  She would bang on drums outside their bedroom at night to deprive them of sleep.  She pulled food from their hands when they tried to eat.  She called them at work more than 30 times a day.  Katrina’s parents had to barricade themselves inside a gardening shed in the yard to eat a meal in peace.  They locked their bedroom door at night and made sure to secure their cash and credit cards.

It could be said that Katrina and her parents were imprisoned by her obsession.

Escape from Escapism
Lifecare Innovations met Katrina and her parents when their attorney became deeply worried for their safety.  Katrina was violent when she was allowed to play the game (she couldn’t emotionally manage the occasional defeat) and she was violent when she was prohibited from playing the game.

Katrina was hospitalized to stabilize her condition.  In the meantime, we sought placement options.  Because Katrina would routinely refuse to engage in activities or even get out of bed if her game was not available, it seemed unlikely that partial day programs would be effective.

Residential settings were explored.  Katrina resisted.  Her tantrums could be of such magnitude that facility personnel would refuse to keep her.  Katrina understood these treatment centers were equipped with internet, and she was determined to coerce them into allowing her access to the game.

There were multiple tries and multiple failures.  The journey was wearying for all concerned.  Perhaps even Katrina grew tired of the fight.  We persisted with the effort.  The longer she was separated from the game, the looser its hold on her became.

Today, Katrina is successfully placed in a residential environment where there is no access to the internet.  It took time, but she finally realized that protests and tantrums over internet access would be meaningless in this place.  She would have to find other things to do with her time.  She would have to engage with real people, follow rules, and reacquaint herself with the real world, shortcomings and all.

Katrina recently sustained a minor injury at the facility.  Although we were sorry to learn she was hurt, we appreciated the larger picture: Katrina was out of bed, playing a game in the real world, with real people.  Katrina sprained her wrist playing volleyball.

 

© Lifecare Innovations