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As I write this review, I am learning from the news media about the tragic deaths of young adolescents killed in another senseless school shooting. This brings back memories of similar tragedies, in which assailants posted pictures of themselves online, with frightening commentaries and plans for their rampage—seeking to leave indelible images and representations for the world to see after their destruction had ended. Fantasies of omnipotence, grandiosity, and unassailability likely motivated these virtual images and words, yet the all-too-real effects of these persons' behaviors permanently changed victims and their families.
Thinking about how the Internet was involved in these tragedies, I also am reminded of less dramatic, yet unfortunate, situations involving the Internet with two of my former patients—one of whom sought therapy because he was very concerned about viewing pornographic images on the Internet from work, and another who lived an isolated existence in his parents' home, playing violent videogames up to 12 hours per day, only to take minimal breaks from his intoxicating episodes. The former patient was married to what appeared to be a very labile woman, who frequently rejected sexual interaction and constantly criticized him. He came to see the Internet as a compromise solution to his need for a nonrejecting, available, woman, whom he could engage at any time he wished, all under the forbidden context of acting this way at work (in which he also was rather isolated). The latter patient had not yet completed high school, having dropped out after severe anxiety about being judged by his peers overwhelmed him. Having no friends, this young man worked in his family's business, completing tasks asked of him, and appearing to live for his time online. He could not look me in the eye and had very little to share with me about his life or his inner world. His treatment was ultimately unsuccessful when he had little else to share with me about his online gami