I must confess, I am a sucker for a good story, especially one’s I can actively participate in. When a game comes out that has the ability to draw me into its narrative, and sometimes in pretty deep, I’m impressed. The writing and detail that now goes into characters, interactions, and the feeling of achievement when you work something out are pretty satisfying. Obviously, someone somewhere has been able to create a believable world that on some level appeals to me and thousands of others. Now, new research in the field of mental health is starting to turn toward new technologies and narratives in video games and immersive worlds to create a therapeutic environment for healing.
Could this be the start of a new form of therapy? Or is this a dangerous escapism that stops us from really addressing our problems? Also with so much data being produced, sometimes far beyond realistic sample sizes in psychological experiments, could we possibly learn something new about human behaviour?
Video games have had a pretty bad rep since the 90’s, when psychological studies like this, and court cases like this one seemed to pin video games to violence and aggressive behaviour. The media sort of took hold of this and painted across the entire medium, and therefore video games were seen in a bit of a bad light. Now it’s perfectly plausible to see how violent video games cause aggressive behaviour, especially with their favouring of quick reaction times and players being rewarded for low inhibitory control. But that isn’t the whole story, and there is a myriad of genres which have been touched upon less until recently, especially those that encourage cooperation, prosocial, and puzzle-oriented tasks.
An epidemiological study – a form of study that deals with how often and why diseases occur in a population – published this year presented evidence that was quite promising. Often, studies like this will try to remove things that might get in the way of a relationship between factors in question. For example, what is the relationship between the use of Pokémon Go and social anxiety? Studies like this will do something called ‘adjusting’, where a fancy stats analysis will try to reduce or remove other factors that might effect a relationship, and mean that establishing cause and effect between factors might be easier. These factors that might get in the way of a relationship are called confounding factors, and in the example I gave, one confounding factor between the use of Pokémon Go and social anxiety might be an individual’s anxiety before playing Pokémon Go. Once ‘adjusted’ for, i.e. once we have taken into account the frequency of pre-existing anxiety within our population, we might see a clearer picture between Pokémon Go and social anxiety.
Is this the new face of anxiety?
Ok, after a quick detour there let’s get back to my main point. After adjusting for factors like gender, education, age, and psychological distress, individuals who played video games frequently were observed to have 1.75 times higher high intellectual functioning compared to others in the sample and was associated with lower mental health issues. On top of this, video games were associated with lower peer relationship problems and decreased anxiety and depression.
Now, while this looks like a great finding, there are a few issues. We have no idea what video games these kids were playing, nor whether they were playing alone or in a group. Therefore, it’s pretty tough to specify whether some video games are more beneficial than others, or whether it’s just video games in general. But, a recent meta-analysis (gathering lots of data from lots of different studies, and looking at the associations between then all) looking at video games, violence, and prosocial behaviour with lots of pooled participants (36,965) found that aggressive games increase short and long term aggressive behaviour and decrease prosocial behaviour. However, non-aggressive, prosocial games actually have the opposite effect.
I’d definitely like to see some more longitudinal research (one sample measured over a period of time) and some content specificity in the research before I made some solid conclusions. But still, sound’s promising so far, and also throws up lots of interest into what video games are doing exactly, and that maybe we need to take a closer look at this potentially useful tool.
Ok, so now to the even more interesting bit. A recent paper suggests the use of video games for therapeutic means. Essentially, Gilbert Franco suggests that because meaningful intellectual and emotional connections can be made in a virtual world, this can be used to therapeutic means in the hands of a skilled therapist. He cites a couple of interesting studies which used individuals with traumatic brain injury and bulimia nervosa, and found that video games improved the effectiveness of therapy, such as improving social skills and self-awareness, and emotional dysregulation, respectively. Even horror games have been suggested to give complex and transformational forms of pleasure.
Lets hope you got the ‘squeak’ out of those new shoes.
Franco also suggests that the use of video-games can give an insight into client’s values, beliefs, and tastes. He also suggests the possiblity of using video games cathartically, and cites a professional example of a memory experienced by a client while playing a video game in the session who was able to recognise and experience the sadness it produced with the therapist.
An interesting avenue might also be the use of virtual reality (VR). Tapping into the fact that our mind can believe its surroundings when they are properly and seamlessly presented, this presents lots of opportunities to guide individuals through a safe and controlled environment. I recently had a go on a VR game, and even though the environment was stylistic and artistically generated, my mind was pretty happy to accept it and believe it. All of the sounds and sights were seamlessly changing as if I was walking around in a new strange universe. This throws up a lot of interesting questions about the validity of our own reality outside of a virtual world, and basically if you have watched The Matrix you have all the building blocks of the discussion, but that’s for a different blog.
So, do video games just present a means of dangerous escapism? Well as with anything, it has the potential to, and obviously a practical approach must be taken so we don’t get totally immersed so that we lose our everyday real-life interactions. But video games have demonstrated that the very normal and human need to make meaningful connections can be made in a virtual world, and for some this might be an essential platform. After all, in film, TV, and books we identify with characters that might incite our own emotional response and give us the means for reflection, and often without us even realising it. So why not then apply this to a virtual world? Therapists may be able to provide a controlled and simulated environment to develop prosocial and empathetic relationships, or improve cognition and self-awareness.
Riley and Ellie from ‘The Last of Us’
On top of this, there are some new enormous games that give players literally an impossibly big area to explore with multiple play styles and hundreds of different ways to interact with the environment. This might generate a tonne of data, way more than is possible through the average psychological study, to look at the epidemiology of individual and group behavioural interaction in a virtual world. This holds huge potential for our understanding of human behaviour. Does everyone do the same thing? What can we add into this environment that might totally change everyone’s behavioural interaction? All of this in a safe and controlled space.
Technology and video game narratives are definitely surprising me at every turn. I am personally quite excited to see how it can be used for mental health interventions, and how tech companies and developers may provide a platform to advance our understanding of human behaviour. Game on.