Out-of-control gaming behavior is no small problem. A well-done 2009 nationwide survey of youths between 8 and 18 by Douglas Gentile of Iowa State University and the National Institute on Media and the Family found
“8.5% of video-game players exhibited pathological patterns of play as defined by exhibiting at least 6 out of 11 symptoms of damage to family, social, school, or psychological functioning.”
via Pathological Video-Game Use Among Youth Ages 8 to 18: A National Study
Clearly, the question of what to do is both timely and important. As a psychologist who treats college age and older patients, one who also has a reputation as a technophilic shrink, I have encountered many patients for whom video game play has transformed from an engaging source of epic fun into a serious problem, a time-sink into which they pour their youthful potential.
Some say the problem is an addiction. Pathological gamers are as addicted to gaming as a drunk is to liquor or a junkie to smack. Consequently, the clinical approach should be first to get them away from the screen and second, well, second is also to get them away from the screen. Send them to rehab. Get them into a program.
But not everyone, me included, thinks the addiction model applies. In the approach that makes sense to me “addiction” is metaphor not diagnosis. "Video game addict" works as metaphor because it captures the out-of-controlness and abject misery of the experience. But as diagnosis it over-simplifies, prematurely closing off further inquiry and mis-directing clinical interventions. Because addiction is taken to be the explanation, the need to really understand what is going on gets lost. Among the questions the addiction model oversimplifies is what might keep someone glued to the screen when life beckons, how they got to such a place, and what might be done about.
We need to do better than prematurely closing off inquiry. One way to open questioning is by viewing pathological gaming behavior as a failed solution, a trap that won’t open until both the problems that led to the pathological gaming are addressed along with the negative consequences of the pathological gaming.
One way to think about what I am saying is as a clinical extension of the argument Jane McGonigal makes in her excellent book Reality Is Broken: Why Games Make Us Better and How They Can Change the World and her 2010 TEDTalk. Simply stated, as she does at the 3:35 point of her TEDTalk, in general for all gamers “we feel we are not as good in reality as we are in games.” And for some people that difference is so large as to drive significant pathology. Some people have a reality, be it from trauma or shame or depression or some other wellspring of human suffering, that is far more broken than for others. For them, for those caught in “game world,” until they get the help they need to participate in ordinary broken reality they remain entrapped by the simulation of life they find on their screen; in comparison to gaming, life is simply unbearable.
Of course, the addiction-modelers will say it is the gaming addiction that broke their life. Two lines of evidence suggest otherwise.
First, we have clinical anecdotes. Anecdotal evidence, things like clinical experience, is the weakest evidence of all. At best it points to research that needs to be done. While it’s value should not be over-estimated, it should also not be ignored. And what I’ve learned from treating pathological gamers is that they can be helped to find their way back to life by finding out what broke their reality so as to make life on the screen the best option available and then helping them fix it, as well as deal with the problems caused by the out-of-control gaming.
Second is the experimental evidence starting to emerge. While much data is consistent with the addiction model, as would be expected, there is also evidence that pathological gaming is symptomatic of other problems. A 2011 report published in Computers and Human Behavior titled “Psychosocial causes and consequences of pathological gaming” is an excellent example. Studying Dutch teens and using some pretty high-powered statistical methods, the researchers found:
• lower social competence, increased loneliness, and lower self-esteem all predicted increases in pathological gaming six months later
• more gaming led to more loneliness, so that loneliness as both cause and consequence of pathological gaming can fuel a negative feedback loop
• more boys than girls develop patterns of pathological gaming, but for both genders the same combination of lower social competence, increased loneliness, and lower self-esteem predicted increases in pathological gaming six months later.
The authors concluded,
adolescent gamers with pre-existing psycho-social vulnerabilities, such as loneliness, low social competence, and low self-esteem, are more likely to become pathologically involved with games, and pathological gaming will increase adolescent gamers' feelings of loneliness.
via Psychosocial causes and consequences of pathological gaming
And that just makes sense. It gets at the complexity. Pathological gaming is both symptomatic and a failed solution creating it’s own problems. Understanding and explaining how people get caught on the screen requires us to go beyond the allure of a convenient addiction metaphor.
Games are far too important to leave to metaphor.
