Reality Testing & The 7 Billion Rule

In this video, I discuss the ego function of reality testing, how it affects us, and ways to cope with distortions in it.  This is also another example of how I use technology, in particular YouTube as a transitional object for patients, allowing them to continue to remember our work together without compromising any of their personal health information.

This will be the last post for 2013, have a good end of the year and I’ll see you sometime in late January!


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Real Life, Ego Defenses & You

Anna Freud, Sigmund Freud’s daughter, greatly expanded on her father’s theories of psychoanalysis.  Perhaps one of the most memorable ways she did this was in her exploration and cataloging of the ego’s defenses.  In her work “The Ego and the Mechanisms of Defense” in 1937, Anna laid the groundwork for understanding the ways we cope with internal conflicts between the way things are and the way we wish they could be.  She initially came up with nine general categories, which I reproduce here from a great resource on :

Ego defenses are numerous, and range from the most primitive  (repression) to the most evolved (sublimation.)  When I say primitive, I want to convey that they are the earliest we acquire developmentally, not the least useful or most pathological.  And it is important to remember that all defenses are useful, and that the ego is using the best resources it has to cope with any given problem.  Later thinkers would begin to specify and amend this list, but it was the first attempt to explain how the ego helps the human mind make the unbearable bearable.

When I assess patients who play video games, I am always very interested in which spells or actions they employ when they game.  The reason I am so interested is because many of these spells and actions are directly parallel to certain ego defenses.  If a warlock uses Fear a lot, I may wonder if they are inclined toward projecting their anxiety onto others, as a result of a world view that sees others as more powerful and scary than they are.

I also like to explain to patients the way they seem to be using their ego defenses in terms of these spells or abilities.  For example, if someone always wants another member of the therapy group to go first in checking in, I may explain this displacement in terms of the Hunter’s ability Misdirection.  Often gamers can understand the ego depenses exceptionally well, because these defenses are clearly illustrated in the way they play the game.  Therapists working with gamers would do well to ask their patients what their class is (Warlock, Hunter) and then the spells or abilities they enjoy or use the most.  Likewise, shifts in using different spell rotations or changing class can often indicate large shifts in the ego and character development of the patient.

And now a word about real life.

Real Life, is a concept used by both gamers and therapists.  Gamers talk about how they can’t raid because they have a “RL obligation.”  Therapists talk about a patient’s reality testing, and their ability to participate in real life.  Real life is a useful concept, and like many useful concepts it is often misused.

I often hear therapists describe gamers as people who are trying to avoid “real life” by using games.  The implicit judgement in this statement is that games are not a part of reality, and therefore are less than.  But this seems like a false dichotomy to me, in many ways similar to the way therapists often talk about how therapy is not real life.  Of course it is!  Therapy has distinct rules and boundaries, and it is a rarified form of relationship, but it is not of a different substance than that of “real life.” If it were truly a different thing, it is unlikely that patients would gain anything useful from it.

By the same token, games are part of real life.  World of Warcraft is inherently social, there are over 12 million real people playing it all over the world.  Gamers deploy real skills to solve real problems and their neurological responses to an “Epic Win” or “Fail” are real physiological responses.  This is not to say that the gaming part of a patient’s real life can’t get out of balance with other parts.  But it is not a given, and it is not different from the way others use their ego defenses.  We all use repression and sublimation to cope with the conflicts and anxiety that occur in daily life.  I recall a clinical professor of mine who sublimated her murderous impulses by reading murder mysteries.  Hurling fireballs in WoW is an excellent way to prevent oneself from hurling objects or insults in real life.  The defenses are there for a reason, and they are not inherently bad.

If you are a therapist and you are seeing your patient who games as someone who is not paying attention to their “real life,” ask yourself if you are not perhaps projecting.  Many therapists have a great deal of difficulty finding balance in their own lives.  They may find it easier to say that a gamer needs to “get a life,” than to realize that they are projecting their own feelings of disregard for themselves onto gamers.  By this I mean that therapists often overvalue the work they do in proportion to their family, friends, and other areas of their lives. For example therapists often will see too many patients at a sliding scale fee while their children are impacted by their lower income:  They overvalue their therapist role and their parental role suffers.  Other therapists may have a difficult time making time for friends or having conversations that go beyond 45 minutes, they may listen but not share of themselves.  And still other therapists may neglect exercise and meditation because they don’t have the time, but overbook their work schedules.

Before we can help gamers appreciate the need for balance in their lives, we need to empathize with what they are doing.  They are relying on the areas of strength they have in themselves when they game, and are reluctant to go to the areas that need development.  We therapists do that too, if you don’t believe me just ask your spouse or child if they ever feel like you are using your therapeutic abilities on them!

Let’s be careful if we have to use the idea of “real life” at all.  It is often a veiled judgment, and veiled judgments are often projections. Let’s go with Wittgenstein here, who began his Tractatus Philosophicus by stating “The world is everything that is the case.”  Privileging some aspects of life over others is often the first step towards the oppression of others, be it race, gender, orientation, class, or I would suggest, gaming.  It certainly won’t help our patients get any better.

And it may just make our own lives worse.