South Bay psychotherapist Robert Bischoff is using the Web to address a new, tough-to-crack mental condition known as

We live in an age of quick access to information of all types, in which communication happens at the speed of light and a growing number of products and services are available through the modem every day.

Like television, the Internet's recent emergence as a mass medium has won the instant admiration of millions. But unlike TV, the Internet is a two-way highway providing unlimited opportunities to interact without ever leaving the house or even getting dressed. Such unbridled power-all bundled up within a plastic box and countless miles of fiber optic cable-has the potential to consume one's personal life, dismantle relationships and ultimately become a digital monkey on one's back.

"The medium is here and it's just beginning," says Robert Bischoff, a Cupertino based psychologist. After 24 years of treating chemical dependency, Bischoff now works with individuals who have allowed the Internet to control their lives.

Bischoff maintains the first-ever Web site devoted to mental health (www.shrinktank.com), which emerged as a 24-hour bulletin board service (BBS) from the primordial digital soup in 1985. Shrinktank joined the World Wide Web in 1997 and has conducted monthly online discussions about the use of computers in the mental health field ever since.

"The term Internet addiction started as a joke, but it really isn't a joke," Bischoff states. In fact, Internet addiction-or Internet Enabled Pathology-has now been accepted as a serious clinical problem by the psychology community. Still, some critics question whether a chemical is required in order for an addiction to result.

"You don't need a substance present," Bischoff contends. "All you need is a strong psychological reaction going on and the brain will produce the chemicals." The psychological state of the individual is the important factor, according to Bischoff, since the catalyst for compulsive behavior can appear in several different forms. "It doesn't matter what it is," he says, "if your brain is stimulated and you're doing it in a compulsive way, and it's interfering with your life, it's an addiction.

The effects of an unhealthy relationship with the modem can become devastating for many computer users who connect to others and receive stimulation through chat rooms, e-mail and Web sites.

"One of the lures of an environment where you can remain anonymous is a false sense of connection," Bischoff says. Excessive involvement with pornography, gambling and video games is nothing new, but now the user no longer has to frequent a strip club, casino or arcade for access.

"We know from many years of research on gambling that one of the main factors in turning gambling into an addiction is accessibility," says Storm King, a Northern California native currently working toward a doctorate in clinical psychology at Pacific Graduate School of Psychology in Palo Alto.

King's dissertation is centered on the therapeutic value of virtual self-help groups. King sees online gambling and pornography as the two main catalysts of compulsive behavior on the Internet. He says the issue of accessibility makes it very difficult for people to break free from such behavior.

"The traditional treatment of both of these problems is to stay away from access to the source," King says. "The Internet has undermined the main coping recovery strategy because now it's in the home."

King is careful to add, however, that most people are able to maintain a healthy perspective while visiting online pornography and gambling sites. "Every single male I've talked to has checked out a porn site at least once," King says, trying not to take a moral stance for or against online gambling and pornography.

Maressa Hecht Orzack, a clinical psychologist based in Belmont, Massachusetts, says "the fact that nobody has to go out to look for pornography" makes the Internet prone to abuse.

"If someone is feeling lonely and bored, and they have had positive responses from the Net, then they're going to continue returning to that," she claims. Orzack believes that Internet pornography and sex chats are abused at least as much as Internet gambling, of which she says day trading is the worst form.

0rzack chairs one of the very few clinics set up to help people overcome Internet addiction. Central to her treatment method is determining why these people are lonely or bored, and what their expectations are when they first open their Web browsers.

"If they're sitting around being bored, we need to find out why they are boredhow can we change this?" she says. Orzack believes that Internet addiction is very much an impulse-control issue. Many of her patients, for example, turn to television when they are not on the Internet. Orzack is currently treating a man who created a persona that made him very popular in cyberspace-his Web acquaintances knew him as a teenage girl. Another patient had a history of meeting people online and getting together for risky sex. She would spend eight to ten hours a day online after a full day at work, and then sleep for three or four hours. Orzack said the patient was lonely and she believed that the Internet would change her condition.

So has the Internet created a monster of digital technology? Not necessarily, according to the experts. However the Net does represent a force so powerful that its ripple effects are extremely varied and widespread. Orzack says technology is not to blame, because the problem of Internet addiction results from yielding one's willpower to the many seductions of cyberspace.

"The computer is here to stay," she allows. "You can't deprive people from being connected to the Internet, because they need it in today's climate." Orzack says people inevitably find novel ways of using and abusing new kinds of technology. However, some of the blame in this case must be attributed to the proprietors of Web sites who work overtime to capture user "eyeballs."

"The Web itself has the enticements. Sure, it's the technology," Orzack explains. "But the key is the individual who uses the Internet." People who misuse the Internet would most likely cultivate their pathology in other ways if the medium were to disappear, she says. "What's happening is not the fault of the Net. It allows people to act out fantasies, but you wouldn't do it if you didn't need to," Orzack says.

King asserts that part of the problem is media hype around the term Internet addiction, but that there's nothing inherently bad about the Internet. He suggests that most people will find their Internet experience fulfilling and will be able to adjust if it turns into a counter-productive habit.

To date, researchers have had difficulty in determining the breadth and scope of Internet Enabled Pathology. Online surveys are skewed, and existing studies have failed to provide an accurate analysis. King says that none of the studies have been able to differentiate between newcomers and longtime users.

"I think it's important that people understand that none of the research has been able to substantiate the extent of the problem," King explains. "We do know the problem exists."

According to King, the important question is whether or not one is able to modify his or her use of the Internet in the face of negative consequences. "It's not a matter of how much time is spent online," he explains. Some people may have a genuine online passion that results in heavy usage, but they still manage to maintain a healthy lifestyle. "The difference between a passion and a pathology is that a passion adds value to your life and a pathology takes it away," King says. King is president of the International Society for Mental Health Online (www.ismho.org), a nonprofit organization. The group provides clinical intervention on the Web for people who cannot seem to pull themselves away from the computer screen. King perceives the Internet as a tremendous treatment tool, which begs the question: How can people who use the Internet to the point of pathology be cured by using the same medium? "Here's the bigger picture: Where are these people going to get help?" King says. According to King, addicts will most likely never seek outside counseling, so a Web-based intervention might be the only way to capture their attention and make them reconsider their lifestyles. While recognizing the initial benefits of online intervention, Bischoff opposes the use of online therapy in the absence of traditional methods. He believes, and many of his colleagues including King would agree, that there is simply no substitute for human-to-human contact.

"The notion of doing therapy over the Internet is a completely bogus idea. I can't say that strongly enough," says Bischoff, who pauses, then adds, "The counter point to that is that those people would not otherwise go out into the world and meet people." Bischoff is quick to point out that while online therapy is not true therapy, online mental health services are appropriate in certain cases. He says, for mentally or physically disabled people. "I admire and support the multitude of online support groups. Also, there are many sites that offer the equivalent of online bulletin board postings for people in recovery," Bischoff says. "To call online support or advice therapy is a disservice to the various mental health professions, and only furthers the confusion about what is a therapeutic process."

Bischoff says he responds to e-mail questions for advice free of charge. "I really like the opportunity to interact without making anything (from the exchange)," he says, countering the greedy attitude of most Internet shopkeepers. The processing and delivery of information has become a commodity in the digital world but Bischoff believes that information between two consenting parties should be shared. "That's what our democratic society is all about," he says.

"Now [the Web is] all about e-commerce and Internet business. What is nice to be able to talk about is the old days when people were first exploring this medium. There was a lot more goodwill," he recalls.

As far as the Internet itself is concerned, Bischoff displays an acute passion for the technology and a working knowledge of HTML and Java. Shrinktank continues to be updated regularly and provides a rich well of resources for mental health professionals and those seeking help. "It's all a matter of balance," says Bischoff, who believes that extending conversations through e-mail and connecting with long-distance friends and relatives can be a positive experience. He agrees with King that too much hype has grown up around Internet addiction as just another sensationalized news topic. He points out that compulsive sexual behavior can be equally damaging, but sex in itself is not the problem.

"So the level of actual interaction, whether it's someone downloading pictures from a news group versus soliciting a prostitute, my way of looking at it is that the brain's being lit up," Bischoff explains. "There are different kinds of behaviors associated with that, but if the criteria of compulsive nature undermines relationships, then yeah, that's an addiction."

Bischoff cut his silicon teeth back in the frontier days of the early 1980s when he purchased a Commodore 64 running GWBasic in read-only memory. After figuring out how to use the included billing software to help manage his accounting books, he began to leaf through the manual and experiment with code. "So I really got into it," he notes, and quickly began "a very long road" of learning other programming languages and developmental tools, including Prolog, C++, Object Pascal, BASIC, Superbase and dBase in addition to two Web codes and other lesser-known scripting languages.

Bischoff confesses that if his mathematics skills had been stronger earlier in life, he would have pursued computer programming as a vocation. "There are some things that come to people rather easily and seem very natural and logical, and for me computer programming and generally how computers work makes complete sense," says the Wizard-his e-mail handle at Shrinktank. Bischoff's knowledge of human behavior combined with his love of computer programming has produced some unique and interesting software.

"Over the years, I have moved from writing billing and scheduling programs to the more intricate programs which involve in depth interviewing of hospitalized and outpatient chemical dependency patients," he says. New software programming tools and faster processing speeds have enabled Bischoff to develop programs that employ a database to make statistical evaluations of a patient's answers to specific questions. These types of programs help mental health professionals to pursue further lines of questioning.

One of Bischoff's current psychological applications uses virtual reality hardware and biometric feedback for evaluations and potential treatment. He stops himself from discussing the topic further, citing the need for secrecy required by most Silicon Valley entrepreneurs. In the early '90s, with the help of his BBS site, Bischoff met several mental health professionals-including psychologist Jerry Shapiro who were interested in his programs and realized the commercial potential for psychology-specific software. Meanwhile, two computer professionals who had benefited from psychotherapy became interested in creating software for the field of psychology. They in turn met a psychiatrist, Gary Lapid, who had a similar vision. Having already established himself as an innovator in the field, Bischoff was invited to join the team as a creative force and business collaborator.

The company was christened PsyJourn, with Shapiro serving as president and lead statistician.  "We have subsequently created some very interesting products for use primarily by individuals who are already in some form of psychotherapy. However, we are changing the focus to create selfhelp software programs for the general public," Bischoff explains. PsyJourn for Windows is the company's chief product.

Bischoff-whose current role is vice president of research and development for the company-makes it clear that these programs should never replace human-to-human treatment, but should be used as "a very effective adjunct to the treatment process."

Bischoff's interest in healing and recovery has profound personal roots. Growing up in an alcoholic family gave him firsthand insights into the dynamics of chemical dependency, from which he was not immune himself. "Since it is truly an equal opportunity disease, I have had my opportunity as well. So these days, my harmony comes from practicing the steps, a humbling process which is incredibly freeing," he says. Robert John Bischoff was born in King City, a small, Salinas County town, in 1947. He drove tractors in the summers and was exposed to "lots of hard physical labor." His alcoholic family became a primary motivator in his decision to help people with chemical dependency at the professional level. "I couldn't wait to leave home," he recalls.

Bischoff received his associate of art degree from Hartnell College in Salinas in 1967 before moving to San Francisco, where he earned his psychology degree in 1970. He lives in Gilroy with his wife Joanne and two of his three children. "I'm a person with many different interests. I get bored very easily," he says. In addition to spending time writing code, Bischoff plays electric bass in a blues band, juggles, has flown aircraft and used to go scuba diving quite often "an expensive pursuit, my wife and I agreed on that." Bischoff also belongs to the National Rifle Association and has an impressive collection of guns that he shoots for sport.

"A lot of these things don't fit with people's perceptions of someone working in mental health," he says. "In fact, most people who are friends of mine are not mental health professionals." Between academic stints, Bischoff served a tour of duty in Vietnam, which tested his ability to maintain peace of mind in a chaotic environment. Today, many of Bischoff's patients are Vietnam vets. During the medfly infestation ten years ago, in which California state helicopters sprayed malathion over orchards, many Bay Area vets sought out Bischoff's help to cope with flashbacks triggered by the sound of the choppers. "I think one of the reasons why I'm well-suited to this kind of work is that I really believe in the sanctuary of being a human being," he says.

Much has been said about the damaging consequences of compulsive behavior on the Internet, but Bischoff maintains that it is crucial to identify the root causes of such behavior and how they can be treated. He says the first step in alleviating any addiction is for the individual to accept defeat. "You lose control. You lose the ability to say `I'm just going to do this once' or `I'm not going to do this tonight.' Suddenly you find yourself doing it," Bischoff explains. The key for those individuals is to recognize that they are no longer a social user of that substance which has taken control-be it alcohol or the Internet.

"So since I've lost, I need to stop-I'm not going to let this ruin me," he says, paraphrasing an important affirmation that starts every recovery process. This admittance of defeat is the hardest part of any addiction, he says, but it is the necessary first step toward recovery. "That doesn't feel very good. People don't like to feel dominated or controlled by anything. So there's a yearning to go back and try to create some mastery over this," he explains.

Orzack, who has a background in experimental psychology, employs a wide range of treatment methods that she varies with each individual. "I decided that I needed to employ every treatment approach available and have started a whole protocol of ways to deal with the problem," she says. Orzack views gaming as one of the more heavily abused online activities. "Games are a problem," she states flatly.

She believes the recent Pokemon craze takes advantage of kids and that many games, including Pokemon, involve too much violence and teach children the wrong values. One of her patients is a teenage boy who would get drunk, play video games for hours and then become violent against members of his own family.

"Parents should know that kids can get very carried away with video games and computer use," she says. When treating a computer-related pathology, however, Orzack stresses the importance of not cutting these people off from the source, but instead helping them to coexist with the technology in a healthy way.

"Don't remove modems. People will do all kinds of risky things to get them back," she warns. Like any addiction, the problem will not simply go away with the removal of the chemicals or stimuli --- it requires a paradigm shift.

Bischoff says, "The important step in any addiction is to say It's kicked my ass and I'm done. And since I'm done, I don't have to worry about controlling it anymore, I'm free at last!"