“Can I Kill You Again Today?”: The Psychoanalysis of Player Modes

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In 1947, Virginia Axline published the first edition of what  was to become a seminal work in the field it was named for, Play Therapy.  In her book she championed the concept of non-directive play, the form of play therapy where the therapist takes in some ways a very Rogerian approach of reflecting rather than directing the play either overtly or subtly.

This is easier said than done, as I learned when I started using it as an intern.  I recall watching a youngster play and describe a family in a horrible car accident.  My first comment was, “are they all right?” covertly signalling to the child that I was anxious in the presence of such violence and the possibility of death.  The child reassured me that the family was okay, and I am convinced that I had essentially ruined that session’s treatment.  Fortunately I was lucky to have an amazing supervisor, Linda Storey (great name for a therapist too!) who helped me to learn how to truly be non-directive.  Over the next year and since I have greeted tornadoes, murder, floods, monster attacks, plane crashes, burning buildings and other disasters with “what happens next?”

Non-directive play therapy is still at it’s heart a two-part invention between the therapist and the patient.  However, unlike some other forms of treatment, it requires the therapist to be able to tolerate a lot of violence and anxiety.  Trying to direct children away from their aggressive fantasies and desires is often rooted in the therapist’s own anxiety about them.  Let’s face it, for many of us death and destruction are scary things.  It isn’t just a rookie mistake to ask the child to make the story turn out “okay,” and yet I think it has never been more urgent for therapists to be able to tolerate violent fantasy and encourage it to unfold in the play.

21st Century Play

Virginia Axline never had to contend with Call of Duty Special Ops, Modern Warfare or Battlefield 3.  What was different about 20th Century play therapy was that the games in the consulting room usually resembled the ones from the child’s everyday life at home or school.  The therapists therefore knew how to play them, and didn’t necessarily need to learn them as they went.  But now we are in the 21st century, where the therapy office often has games from our childhoods rather than those of our patients, and they are very different.

If you are a therapist and never intend to learn to play video games and play them with your patients, you should probably stop reading here; the post won’t be useful to you and I’ll probably annoy you.  But if you don’t plan on using video games with your young patients I hope you’ll consider stopping doing play therapy with children as well.  Certainly stop calling yourself a non-directive play therapist, because you’ve already directed the child’s play away from their familiar games and away from this century.  I actually hope, though, that you will lean into the places that scare you and try to meet your patients where they are at in their play, and for 97% of boys and 94% of girls that means video games.

Video games like Call of Duty and Minecraft are both very useful in both diagnosis and treatment of patients, as I hope to demonstrate by focusing just on one aspect here, that of player modes.  Most video games have a range of player modes, and what the patient chooses can say a lot about their attachment styles, selfobject needs, and object relations.

Solo Play is OK

Like other forms of play, sometimes patients want to play alone, and have me bear witness to their exploits.  They may do so out of initial mistrust, or a yearning for mirroring.  Solo play is looked down on by some therapists, who often think kids using “the computer” are austitic and/or “stuck” in parallel play.  I’d refer you to Winnicott, who taught us that it is a developmental achievement to be alone in the presence of another.  (I’d also refer you to my colleague and therapist Brian R. King who has a lot to say about a strengths-based approach to people on the autistic spectrum, on which he includes himself.)

The Many Reasons to Collaborate.

Some patients want to play with me on the same team in first person shooter games.  The reasons for this can vary.  Some patients want to protect me from their aggression because they are afraid I’ll be scared of it like parents, teachers and other adults may have been.  Other patients want to be on the same team because they want  to have a merger with an idealized parent imago to feel more powerful and able to take on the game.  Still other patients, seen in their daily lives as oppositional or violent, want to play on the same team so they can revive me and have me experience them as nurturing and a force for good in the world.

Some patients  want to have their competition framed by overall collaboration, meaning that they want to get the most or final “kills” but remain on the same team.  Some patients secretly yearn to play on a different team, and may need to “accidentally” change the settings to put us on opposing teams and passively want the game to continue.

Let’s Bring On A World of Hurt.

On the other hand, there are a lot of reasons patients want to compete.  They may want to see if I can stand their aggression and/or desire to win without being annihilated.  They may want to express their sadism by tormenting me for my lack of skill, or alternately project their yearnings for recognition by praising me when I kill them.  They may want to see how I manage my frustration when playing, and interpret that frustration as investment in the game and therefore my relationship with them.  They may be watching very carefully to see how I act when I win or lose.  Do I gloat when I win?  Do I make excuses when I lose?  How might these behaviors be understood by children and adolescents who often feel like they are chronically losing and behind their peers in the game of education?

More questions arise:  Does the patient ask me what mode I want to play or simply decide on one?  Do they modulate their anxiety by playing a combat mode but expressing the desire to stay away from the zombie mode?  By allowing them to do that am I helping them to learn that sometimes life is about choosing the lesser of two anxieties rather than avoiding anxiety altogether?

Multiplayer and Uninvited Guests

In terms of settings, there is some direction on my part, which is part of maintaining the therapeutic frame.  I make it a requirement that we play either locally or in a private game.  And of course this sometimes go wrong, with a random player joining us.

What to do then?  What if we are on an extremely high level and just terminating the game will do more harm than good?  In that case I make sure we are on mute and the our conversation can’t be heard by the added player, and then things get even more interesting in the therapeutic conversation:  Does the patient have any feelings about the new player’s arrival?  What do they imagine the usertag “NavySeal69” means anyway?  Do we help them when they are down or try to ignore them?  How do we feel if they are ignoring us?  Do we team up against them?

Minecraft and the Repetition Compulsion.

I could probably write a whole post or paper on this, but for know let’s talk about creative mode and griefing.  In Minecraft you and other players can build things alone or together.  Other players can also “grief” you, meaning cause you grief by destroying your structures and setting you back after a lot of hard work.   What does it mean when a patient griefs my building, apologizing and promising not to grief it if I rebuild, then griefs it over and over again?  What may be being reenacted here?  Are there adults in the patient’s life who tear her/him down again and again?  When does one give up on any hope for honesty or compassion from the other?  What sort of object are they inviting me to become to them; angry, patient, gullible, limit-setting, mistrustful?

I have used the term child or adolescent here, but exploring the gameplay of adults when they describe it to me is often useful as well.  I often encourage my adult students or gamer readers to do a little self-analysis on their play-style?  What does your preferred mode of moving through video games say about you?  What questions does it invite you to explore?

The goal here is not to give you an explicit case presentation or analysis of one hypothetical patient or game.  Rather, it is to provide you with a Whitman’s Sampler of practice and theory nuggets to give you a taste of the richness you are missing if you don’t play video games with your patients, especially if you are a psychodynamic therapist.  There is a lot that “happens next” if you engage with your patients in 21st century play that has themes you may find familiar:  How do I live in a world that can be hostile to me?  Why should I trust you to be any different?  Will my badness destroy or repulse you?  Will you hurt me if I am vulnerable?  These and dozens of other fascinating and relevant themes emerge in a way that never did for me when I forced kids to endure 45 minutes of the Talking, Feeling, Doing Game.  And what’s more you don’t have to remember to take the “What Do You Think About a Girl Who Sometimes Plays with or Rubs Her Vagina When She’s Alone?” card out of the deck.

I’m not THAT non-directive.  🙂

 

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I Come To Praise First-Person Shooters, Not To Bury Them

 

I should begin by saying that I don’t personally enjoy the type of video game known as a first-person shooter (FPS) very much.  They make me jittery when I play, and I am easily overwhelmed by them.  I’m still stuck in the tutorial room with Jacob in Mass Effect 2.  If there are settings to disable gore and swearing on a game I’ll click ’em.  But as I looked back on my past posts I realized that I have neglected to weigh in on FPS, and in doing so am guilty of the same kind of dismissal I critique in colleagues.  (Note to gamers: I know there are several important distinctions between FPS and TPS or third-person shooters, but that’s for another post.)

There’s a lot to like about FPS games, and here’s a few examples.

  1. Many FPS such as Halo 2 can be collaborative as well as violent.  Players join platoons and need to learn how to coordinate, communicate and problem-solve in a fast-paced environment.  Games like Halo also provide environments for players to learn how to assume leadership roles, follow directions from other players, and think critically about stressful in-world situations.
  2. FPS encourage impulse control as well as aggression.  Crucial to success in FPS games is the ability to time attacks and maneuvers.  This requires the ability to control the impulse to pull that trigger.  Although we tend to focus on the aggression in FPS, there’s often a lot of sneaking going on as well.  In Bioshock there are actual decision points in the game where refraining from killing characters changes the entire outcome of the game.  Even though the player is not learning teamwork in single-player games, they are often learning the same sorts of forms of decision-making and impulse control in good old-fashioned “Red Light, Green Light.”
  3. First-person shooters improve hand-eye coordination.  One important component of hand-eye coordination is visuospatial attention.  Research by Green et al. suggests that video games improve visuospatial attention, and further that FPS video games do it even better than games like Tetris.  Hand-eye coordination is a skill most of us would agree is a good thing to have.  It helps improve your readiness to learn, increases your ability to excel at sports, increases your confidence and makes juggling less stressful.
  4. First-Person Shooters may increase a sense of mastery and alertness.  So many parents and educators lament how children aren’t able to pay attention.  And yet, what makes FPS games so compelling is their immersive quality.  As Grimshaw et al. discuss, the literature describes immersion in varying ways, such as ‘the state of consciousness when an immersant’s awareness of physical self is diminished or lost by being surrounded in an engrossing total environment, often artificial’  Further, in order to be completely immersed in an environment, “players ‘must have a non-trivial impact on the environment.”  Wandering around the game world may not be sufficient to immerse players into a flow-like state, and shooting people, whatever else you may say about it, does not lend itself to feeling trivial in an environment.  Imagine if classrooms could harness the ability to create such immersive qualities in the classroom.  Much more effective than saying loudly, “Pay attention!” which usually has the exact opposite effect than the statement intended.

Given the above compelling reasons to think well of FPS, why are they so often singled out as the bad seed of video games?  The answer, I would suggest, is a sociopolitical one that gamers as a whole ignore at their peril.

Science is often, maybe always, political, and has an uneasy relationship with civil rights movements.  The example that springs to my mind is the LGBTQ civil rights movement.  Back when a preponderance of science was pathologizing of all LGBTQ people, there was a more predominant solidarity amongst the various thinkers, activists, and citizens of those subcultures.  From Stonewall up through the early AIDS crisis, there was less fragmentation and more coordination, with the understanding that civil rights benefited everyone.

But within the past two decades, many members of the LGBTQ community have begun to receive recognition and acceptance in society as a whole.  At this writing 7 states have legalized gay marriage (Welcome Washington!) and more accept domestic partnerships between same-sex couples.  Bullying based on sexual orientation and hate crimes have received more coverage from media with sympathetic stances towards LGBTQ youth.  And I can’t remember the last time I heard talk about the latest study locating the “gay gene.”

And yet, science and politics have turned their gaze towards specific subsets of the LGBTQ population.  Transgender rights (a notable recent gain in my home state) are still ignored or reduced to bathroom conversations and debates about the poor parenting of those who don’t make their children conform to Cisgender norms.  The status of LGBTQ youth of color as a priority population is met with grumbling.  Bisexuals are still considered in transition or confused, asexuals frigid or repressed.  Polyamory is confused with lack of commitment or neurotic ambivalence, and BDSM isn’t even recognized as worthy of any sort of advocacy.

And to a large extent, whenever one of these specific subcultures are targeted, the other factions of the LGBTQ community remain silent.  And in doing so, they become allied with the perpetrator.  As Judith Herman points out in her seminal work, Trauma And Recovery, “It is very tempting to take the side of the perpetrator. All the perpetrator asks is that the bystander do nothing.”  This is exactly what members of the LGBTQ community are doing when they cease to maintain the solidarity and mutual support that helped get homosexuality removed from the DSM-III.

And so the focus shifts from the general “gay people are bad/sick” to the more specific populations also under the LGBTQ umbrella, and rather than fighting for them we allow them to be omitted from civil rights.  A case in point was made by openly trans HRC member Donna Rose, when she resigned in protest to HRC supporting an Employment Non-Discrimination Act which included sexual orientation but didn’t include protections for transgender people.  A group may only be as strong as its weakest member, but solidarity often ends when the strongest members of an alliance get what they want.

The gaming community would do well to take a lesson here.  Recently video games have been getting increasing recognition as an art form, an educational tool, and possible solution to world problems ranging from poverty to AIDS.  As society moves to a more progressive stance on technology and video games, studies come under scrutiny for their sweeping and pathological generalizations of a complex and diverse group.

(The most pernicious example of this in my opinion is the concept of the “screen” and “screentime.”  Studies ask questions about how much time subjects spend in front of electronic devices, as if all activities were identical in experience and effect.  Watching television, playing video games, surfing on Facebook are all treated as similar neurological phenomenon, when they aren’t.  It’s much more complicated than that, and different physiological systems are affected in different ways.  Even the idea that all screen time dysregulates sleep the same way is being questioned recently, with televisions showing less repression of melatonin than iPads.  So what screen you’re doing things on makes a difference.  And then there’s what you are doing.

Watching television is a more passive and anergic activiy than playing video games in my experience.  No, I’m not going to cite a particular study here, because I want us to focus on thinking critically about the designs of studies not the data.  And as Paul Howard Jones points out in his video, learning itself activates different parts of the brain at different phases of the individual’s learning cycle of a particular activity.  So yes, video game users have different looking brains than those that aren’t using them, that doesn’t mean it is bad, but that they are using different parts of their brain function and learning different things.  Most people in the gaming community would have some solidarity here with other gamers, and balk at the idea that a screen is a screen is a screen.  And “screen time” is usually implying screens watching television, playing games or surfing the net, not screens compiling doctoral dissertation lit reviews, planning a vacation, doing your homework, or looking up a recipe.)

So gamers are solidly behind fighting these blanket generalizations.  That’s great.  But I find that where gamer solidarity is starting to fall apart is around the more specific attacks that are being levied in science and politics around FPS and violent games.  Studies says these desensitize children to violence, increase aggression and correlate to hostile personalities.  There are also studies that conflict these findings, but I want to ask a different, albeit more provocative question:

What’s wrong with being aggressive?

I think that child’s play has a long history of being aggressive:  Cops and Robbers, water pistols, football, wrestling, boxing, tag all encourage some element of aggression.  Most of us have played several of these in our lifetime with some regularity, have we become desensitized and aggressive as a result?  Am I sounding too hostile?  🙂

And we are sending children and adolescents a mixed message if we label aggression as all out bad.  Not everyone or every job requires the same amount of aggression.  Wanting to be #1 and competing, whether it be in a boxer or a president, requires some aggression.  Aggression is in fact a leadership quality.  It allows us to take risks, weigh the potential hazards, and go for something.  Feelings of aggression heighten our sense acumen, can speed up our assessment of a situation and help us stand up to bullies.  Whether we agree with this war or that, would we really want our soldiers to be in-country with no aggression to help them serve and defend?  Fortune, as the saying goes, favors the bold, not the timid.

FPS games have a place on the Gamestop shelf and a place in the gaming community.  They allow us to engage in virtual activities that have real-life benefits.  They are a focal point for millions of gamers, and I believe unlocking their DNA will go a long way to discovering how to improve work and learning environments.  Stop letting critics shoot them down, or don’t be surprised if you’re in the crossfires next.

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