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Games and Addiction: Are We There Yet?

How closely studied is so-called game "addiction?" What are its possible causes? Is the media providing balanced reports on this phenomenon? Do we really understand it yet? Neils Clark answers these questions and more, in this exclusive Gamasutra feature.

Ignorance is No Longer Bliss

The recently slashdotted 2006 Mediawise Report Card noted that, “the solutions to the problems presented by video games lie in eradicating ignorance on both the scientific-technical and the parental knowledge levels. Simply put, parents need to step up to the plate and the experts need to conduct more and better research.”

The National Institute on Media and the Family, a watchdog organization which releases these annual report cards, is most usually concerned with games and children. The lack of knowledge surrounding game “addiction” isn’t just about children. It impacts everyone involved: parents, game players, game developers, policy makers - everyone.

Some people do have problems playing too much. Whether or not a new kind of “game addiction” is behind excessive play, its portrayal is creating a great deal of social apprehension. Bill O’Reilly, always an interesting factor when it comes to bringing thoughtfulness and sophistication to a discussion, recently said of people interacting inside of game worlds, “I know there are people who are absolutely addicted to this like drugs and alcohol.” He also likened gamers, and to a lesser extent people who use technology, to zombies.

The best way to address the misrepresentations surrounding game “addiction” is through understanding. Not a 30-second soundbyte understanding, but rather information, preferably research information, that is contextualized for real people so that they can get a real use out of it. When clear research work becomes readily available, it then filters to the media, informative resources, and the people providing treatment. Right now, in the absence of good research, it really isn’t too hard to see why a little bit of information would be a very good thing.

Where Can I Learn More About Ignorance?

In the Media

The current state of the media coverage for excessive gaming sucks, and very few people are pulling their punches when it comes to blaming games. While you don’t have to look far for anti-game coverage in the media, the naming conventions for titles of ‘game addiction’ articles mercifully refuse to jump to any conclusions. Oh, wait, what about, “Playing with death,” (24 hours, Toronto ) “A Dangerous Diversion,” (The Washington Post) or “Video gaming is like crack for some kids” (The Columbus Dispatch, Ohio)? Wow, well at least the coverage is balanced, right?

Not usually. Some journalists really and truly want to present a balanced take on problem gaming, but there just isn’t great material for them. Many articles are simply a quick list of anecdotal game-related deaths. News based purely off anecdotes is still a big problem here, since many of these anecdotes are often shocking, sensationalist and sad. While many of these anecdotes are likely isolated cases, we still have to take them seriously. On the one hand, a single case may not represent the millions of people playing the myriad types of games. On the other, it’s never a good idea to make light of people who have gone through extreme loss. Many anecdotes reference online or massively multiplayer online games, but the bulk of the people out there probably don’t have enough knowledge to sort out anecdotes from single player, multiplayer, or massively multiplayer online games.

Aaron Ruby, writing for BusinessWeek in September 2006, confronted the blatantly anti-game legislation, media coverage and research surrounding game violence and ‘addiction.’ He noted that, “fear of new technology, anxiety about cultural change, and the desire to confirm our own prejudices can cause even the most dogmatically anti-scientific among us to turn hungrily to natural philosophy for ‘evidence.’”

Ruby lambasted the one-sided ‘addiction’ coverage given by the August NewScientist cover story ‘Hooked: Why your brain is primed for addiction.’ He additionally addressed areas of the NewScientist article which he saw as intentionally misleading, particularly where an ominous pictures of gamers playing violent games was transposed next to the story of an alleged computer addict who “might not have been an addict at all.”

In the Information

Wikipedia, normally a cornerstone of knowledge for both the general populace and superheroes alike, hasn’t had much to offer lately in the way of information on “game addiction.” The neutrality and factual accuracy of this article have been called into question, as off and on it portrays hotly debated speculations and blatant opinions as fact. The medical information site WebMD offers an article which takes a cogent look at a few major information sources, making some valuable points. Unfourtunately, WebMD still pulls from some of the more heavily disputed sources on the topic.

One of the most disputed of these sources has been Kimberly Young. While to her credit she has raised awareness for the idea that the Internet and online games may be problematic in unique ways, her criteria for identifying these problems is not actually unique. John Grohol, the founder of the mental health site PsychCentral, critiqued Kimberly Young’s criteria for Internet Addiction Disorder, which imported criteria from almost exclusively from gambling addiction, "I don't know of any other disorder currently being researched where the researchers, showing all the originality of a trash romance novel writer, simply 'borrowed' the diagnostic symptom criteria for an unrelated disorder, made a few changes, and declared the existence of a new disorder. If this sounds absurd, it's because it is."


In the Treatment

Programs and clinics have opened in order to help “game addicts,” specifically in China, the Netherlands, the United States, and most prominently in South Korea, where apparently “Hundreds of private hospitals and psychiatric clinics have opened units to treat the problem.” If Korea is any indication of what’s to come, then our dearth of research in this area should strike a deeply troubling chord. While there’s varying amounts of information on how each clinic will be treating game-related patients, to date there’s no accepted data on how to conduct that care.

While it’s good that nobody has jumped to that conclusion, it also begs a few questions. If there’s enough demand that treatment centers are opening, then why aren’t we seeing more serious research? Now that these clinics are accepting people, what new kinds of treatments will be used, and how will we judge their success?

What about intervention? A recent episode of A&E’s reality TV show “Intervention” featured a 21-year-old college graduate and gamer. The synopsis reads that, “Peter is so addicted to video games that he identifies himself as the characters in the games he plays and refers to other characters as people he hangs out with.” A writer in the syndicated gaming blog “Kotaku” replied to this, saying that this type of behavior wasn’t too big a deal. It’s very hard to tell by A&E’s description whether an intervention was warranted, or if this man was just exhibiting behavior which is standard and accepted among gamers.

We don’t have research data to tell us how the particulars of problem gaming work, let alone how to treat it. In the American Journal of Psychiatry, Allison et al. documented a case study of one gamer, noting that, “When it came to recommending treatment, the evaluation team was faced with the fact that there was no evidence base from which guidelines could be developed.” While these doctors and clinicians opted for an encouragingly nuanced approach to their patient, not all clinicians are currently willing or able to grasp the real nuances of treating problem gamers. While there is a lot of work yet to do, it would be really exciting to start seeing clues about problems and treatments which actually reflect the unique nature of games.

On Poking Badgers With Sticks

Our lack of research and knowledge isn’t the only problem. Technology is moving faster than it ever has before, which is causing far more anxiety than ever. As Dr. Aaron Delwiche points out in his must-read article, You Can and Must Understand Technology Now, we all need to ask ourselves, “a very simple question: ‘Am I willing to learn new things?’ And, if so, ‘Am I willing to continue learning new things for the rest of my life?’” If you have the time to read my article on “addiction,” then you have the time to read Aaron’s article on technology. No, really. Check it out.

So will people choose to learn new things, choose not to, or refuse to choose? How ever you slice it, there’s a fear and anxiety that’s closely tied to ignorance. With this in mind, we can start to see where a lot of this game-related anxiety comes from. It’s tied, in part, to more broad social fears of technology. Stanford University’s Nick Yee has been looking at the trouble with calling games “addictive,” and noted that, “the level of social acceptance for technologies, objects, and people influences how likely we blame them in analogous scenarios, and how likely we take on holistic as opposed to narrow perspectives in trying to explain the problem."

So not ‘getting’ games is like a stick. The mass of people who don’t understand technology, they’re like an angry badger. The badger is already pretty feisty, but give it a poke or two with the ignorance stick and it's seething. Let’s suppose, for the moment, that one particular badger is completely unwilling to understand technology or games. If somebody close to that badger, say a friend or family member, plays games, it would be a lot more difficult for the badger to tell if that person actually had a problem. The badger may very likely drag a perfectly healthy gamer away from a perfectly healthy hobby.

Most people have no desire to be a badger. They know that a lot of people just play for fun. They want and need to become informed, but right now the information out there is ridiculously bad. To turn the analogy in a slightly different direction, gamers face incessant stick-poking by questionable, even laughable information on game “addiction.” With enough harassment, they’d be well within their right to become badgers, except with the major difference that they “get” games, and to varying degrees technology. They’re becoming badgers because they keep getting poked by other people’s ignorance. If good information were available it would be one more area where society could get informed and move on.


Taking Away the Stick

If you’re intent on being a technology badger, then now might be a good time to cover your eyes. If you’d like to stop that pesky poking from the “game addiction” knowledge-stick, then read on. We’ll do a basic rundown on games, addiction, and the magical phrase game addiction.

Games

A lot of the comments on “game addiction” come from people who clearly don’t understand the differences between single player, multiplayer, FPS, RPG, MMO, or any other game. Some people don’t even understand the possibilities inside of a simple or popular game, like Halo or Solitaire.

Videogames are more vivid and enchanting than they ever have been. Explaining or learning game basics may seem difficult, but it really isn’t hard with the right strategy. If you want to explain games to someone new, or you’re looking to understand games yourself, then I suggest you guide the conversation or research with two questions.

These are two elements that you’d find in any game: How you interact with real people and what you do inside of it. The first question is usually explained with descriptors like “single player,” “multi-player,” etc. Gamers usually describe the second question with acronyms like “FPS,” RPG,” or “RTS.” While these clues will be daunting to some and challenging for many, learning the very basics of gaming can be stimulating and very self-rewarding.

Addiction

If social apprehension occurs because people don’t understand games, it no doubt happens when people don’t understand addiction, a topic hotly debated by many academics.

This is a good place for me to stop and explain my incessant use of quotations around the word “addiction.” Take heed. While addiction has a scientific meaning, it evokes a unique imagery for everyone, especially therapists working with substance abuse. Medical professionals almost always prefer the term “dependency.” The DSM-IV, the diagnostic and statistical manual used by psychologists, psychiatrists and medical professionals for the purposes of focusing treatments, never uses the term “addiction.” Unwarranted use of the word “addiction” in conjunction with games just is not a good idea.

Game Addiction

Like my old pal Captain Obvious used to tell me, rushing to judge somebody’s life is never a good idea. Technology badgers might insist on an intervention, or even harbor grudges against players whose hobbies don't harm themselves or anybody around them. They don’t want to acknowledge it, but some people can balance a healthy and productive lifestyle with a large amount of play.

Of course there are some who can’t. An excellent portrayal of these “two sides to the story,” was the popular ‘view from the top’ post. The ‘Soul Kerfuffle’ blog didn’t feature just the one player writing on how World of Warcraft negatively impacted his life. The blog featured posts which rebuffed and balanced that view against those of the larger community of gamers. A second gamer then wrote a post stating, again, what should have been obvious: many players just enjoy these games!

Surprise! He posed three questions which he felt should be asked of gamers who are thinking about leaving massively multiplayer online games, “Are you getting something out of it? Is it fun? Are you sacrificing things in real life to do it?” In his opinion the player writing the ‘view from the top’ post really had nothing to gain by playing, and he was actually the one that recommended that the player quit.

While the Soul Kerfuffle blog made a concerted effort to acknowledge and represent both sides of the argument, a number of other sites don’t. The website wowdetox.com allows people to post anonymously regarding Blizzard’s World of Warcraft, prompting them: “Tell the world your reasons for leaving the addicting game!” This website has pros and cons. It gives problem gamers an outlet and a venue where they can see that other people might have the same problem. These people need support, and the recognition that they get from sites like this may not be available from friends, family, or even therapists in their geographic area.

This is a novel idea with potential, but for the time being we have to examine such sites with a critical eye. How qualified are the people giving advice on mental health? Basically, do sites like this have the potential to cause harm? If so, is this harm mitigated by the service they’re doing? As in, do these sites help people cope or do they just use different sticks to poke different badgers? There are many other such sites, for instance gamerwidow, olganon, and gamingsucks. If the ultimate goal really is to take away the ignorance sticks, then it’s going to be pretty interesting to see how these sites evolve.


Are We There Yet?

Research has the potential to combat ignorance and problem play, but it needs to be organized and sustained over a number of years. Right now there are so many problems in the foundations, and so many faulty “addiction” checklists disguised as “criteria” for identifying patients, that a simple blitzkrieg of knowledge will set us back far more than it will send us forward.

Ultimately, we should try to provide some preliminary research which, taking games seriously, asks why so many players seem to have problems with play. To that purpose, the following are three areas that, based on my data and personal experiences, I think might be working together in order to prompt some of the major issues in very serious gaming problems.

Agency

The difference between those who play for fun and people who might have problems, I would tentatively suggest, is between chemical motivation and chemical need. Most all of what we do in life is based off of chemical motivation, our brain’s way of keeping track of how to best navigate life’s many rewards. When you no longer just have a desire to play, but instead must play, then you have crossed the border into dependency country.

There may possibly be a number of dependency phases that a player passes through, but agency (or lack thereof), the continual navigation through a game’s interface, is the vehicle that drives someone’s experience. Psychological, neurochemical and genetic factors may slow or expedite the process by providing a larger or smaller susceptibility to crossing that chemical line.

Media Experience

But here’s a kicker. What if “game addiction” has nothing to do with chemical and/or psychological addiction? Our brains can’t tell the difference between real sight and images that we see on a television or computer screen. Anne Marie Barry, author of the book Visual Intelligence, wrote that, “Because evolution is a slow process, our brains have not yet adapted to visual experience gained via media in any special way.” If we experience something through a visual media we think that we have seen the genuine article.

Keith Kenney, a founding member of Visual Communication Quarterly, writes that the tricks are played on the eye, and not the brain. “Pictures give us the false perceptual belief we are in the presence of the subject.” Would it be such a stretch to think that sounds and interaction might compound the illusion of presence? What if games attract players not because they immediately and effectively alter brain chemistry, but because they provide a truly unique way of experiencing our world? Some people like the unique experience of hearing Australian accents so much that they move to Australia. Some people like hefting 200-pound swords and flying on the back of a Hippogriff, so they move to Azeroth, in World of Warcraft.

Neuroscience isn’t the only place where it’s difficult to separate games from real life. Dr. Thomas Malaby of the University of Wisconsin has argued that games, particularly because of their use of ‘persistence,’ and ‘contingency,’ have started to “approach the texture of offline life.” Our brains not only perceive online worlds as real, on some level. These worlds are starting to take on the characteristics of reality, and it no longer makes sense to think of them as completely separate from our everyday lives.

For an example of how this relates to excessive play, say that a person all of the sudden realizes they’ve been playing for a few hours. They weren’t self-aware while waking up, making a pot of coffee, eating breakfast, and starting to play, but they remember that those things happened at two pm. In real life, some people drive to work, order a McMuffin and coffee at the drive-thru window, go to work, and fill out 20 TPS reports before they snap into self-awareness. Suddenly it’s 2:00 pm. Where’d the time go?

Maybe part or all of “game addiction” is simply the striking similarity some games have to real life, in our brains and in the game’s texture. If you’re interested in this, you might check out a short article that I’ve written on media experience, immersion, and how the mind flits between worlds.

Culture

These aren’t just games. Even if you don’t buy the whole “media experience” thing, some games literally create worlds. Real players don’t just walk and talk anymore. They slay dragons. Even when we’re talking about the more simple 3-D games being released this year, we’ve come a long way since Chutes and Ladders. You could say that we’ve come a long way as a culture, as well (though not that all of the changes have been positive).

Ray Oldenburg was a sociologist who tried to find something that he called the “great good place,” or “third place.” This was the place that wasn’t work and wasn’t home. It was a place in-between, somewhere you could unwind. Games, even if they don’t portray a 3-D space, provide us with that. Those that do use 3-D spaces and social interaction with other humans, they really are giving most of us something that wasn’t available in temporal space.

Games are substance-free and value-free. Most every major and minor city (in the United States, anyway) will have at least one bar and one church. Games are “open for business,” to anyone with a computer, the money to pay for a game, and in some cases an internet connection. More than that, these games give us hints as to how we might eventually improve social spaces into the real world. There are a million wonderful examples of community building in these games. There are a million wonderful examples that could be used to build a stronger and more wholesome society. You just need to look at games with the right eyes. The informed ones.

Won’t the Scary Man Ever Stop Talking?

Sure. When it comes to games and addiction, we aren’t there yet, and we really ought to step on the gas.

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