World of Warcraft

Heroes

November 1, 2015 by langloimsw Leave a Comment

This post is more personal than some, but then at some time in many of our lives cancer gets personal. As many of you know, I have a companion and co-therapist named Boo. For the past 12 years Miss Boo has worked with me to help in therapy. We have worked with hundreds of children, adolescents and adults in settings ranging from special needs classrooms, alternative schools and outpatient settings. And for the past decade we have been working together in my private practice.

This past Spring Boo developed a form of cancer known as osteosarcoma, which is a form of cancer where the tumor grows in the bone. In her case, Boo began limping and we discovered that she had it in her front right leg. What followed was a series of scary tests and decisions. The recommended treatment for this in dogs is amputation of the limb and a course of chemo. I was worried about this on so many levels: I didn’t want to lose my friend, I didn’t want her to be in pain, and how was I doing to explain this to my patients? You can’t just have a dog show up one week with one less leg and be all blank screen about it. Some people suggested I retire her, but so many people come to me with ruptures in attachment, people who just walked out on them or were taken from them, that that didn’t make sense either. Nope, we were going to do this honestly and mindfully. If Boo could show up for such a challenging treatment, I could show up for her and we could show up for our patients.

Over the next few weeks I let people know what was going on if they wanted to know, to the extent they wanted to know. While she was recovering from surgery I let people know that as well. And when Boo came back to work, well that was a powerful week. Cancer changes your body, but the self persists. Boo had a visible change, there was a scar. Some people approached petting her, some didn’t. Boo accepted all of them. Some people were reluctant to talk at first, imagining their problems were nothing compared to cancer or losing a leg, but we explored and put those concerns in perspective. We all had work to do, and we did it.

Time passed, and chemo ended. This is the result:

Each year, I take part in Extra Life, a worldwide celebration of the social impact of gamers of all kinds from video games to board games and tabletop RPG’s! Since 2010, Extra Life has raised more than $14 million to help children’s hospitals provide critical treatments and healthcare services, pediatric medical equipment, research and charitible care. Your donation is tax-deductible and ALL PROCEEDS go to help kids nationwide and locally at my awesome colleagues at Boston Children’s Hospital.

This year, on November 7th, I’ll be playing World of Warcraft with a special avatar in honor of Boo. (Of course I’ll be taking breaks every 45 minutes to keep my health ans stamina in good shape.) If you want to join our team, Miss Boo’s Battalion, you can do that too!* You don’t have to play WoW, you can play Minecraft, Dark Souls, Candy Crush, my colleague Jane McGonigal’s Superbetter, Zombies Run!, anything. You can play Tabletop games like D&D or Pathfinder. You don’t have to go 24 hours straight, any amount of time, anything you raise, helps. Sharing the post helps too–you never know who might decide to donate or get their game on.

Miss Boo is my hero, and if you are living with cancer in your life you are my hero too. Whether you are battling it yourself, defeating it, thriving after it, supporting someone who is, celebrating a win or grieving a loss, you are a hero. On Saturday, November 7th, why not be a hero too?

*Past and present patients are asked to refrain to protect their privacy, but can always get involved with Extra Life on their own here.

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Filed Under: Gamer Therapy Tagged With: activism, adolescents, behavior change, cancer, digital literacy, education, extra-life, gaming, mindfulness, private practice, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft

Using Gaming & Gamification in Clinical Practice

June 25, 2014 by langloimsw 4 Comments

What does “gamification” mean, and what is its relevance to mental health practice? In this video of a conversation I had at University at Buffalo with Charles Syms, I take a stab at answering those questions. This is just a start, and hopefully by the end of the video you can begin to see how applying principles of game design could be therapeutic for people dealing with issues ranging from trauma to executive functioning challenges to substance abuse and beyond.

Find this video interesting? I can speak in person too: Check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: activism, addiction, adolescents, behavior change, call of duty, children, dark souls, education, game theory, gamers, games, gamification, gaming, mindfulness, minecraft, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft, wow

Gamer-Affirmative Practice: Today’s Play Therapy

June 13, 2014 by langloimsw 1 Comment

The importance of play is universal, and in many ways the nature of play is timeless. That said, there is a lot to learn about video games as 21st-century play, especially if you are a play therapist. Adding 21st-century forms of play to your repertoire can be daunting. With so many naysayers in the mental health profession, avoidance of learning the new takes the form of contempt prior to investigation. With video games being low-hanging fruit for political arguments ranging from gun control to teen bullying, many social workers, psychologists and counselors give in to the media hype and spend far more time demonizing or ignoring this form of play than they do understanding it.

Recently my colleagues at the University at Buffalo made it a point to take a gamer-affirmative stance and offer a beginning piece of continuing education on integrating video games as play therapy in the form of a podcast. In it my friend, colleague, and yes, fellow video game player Anthony Guzman and I have a beginning conversation about just that. Have a listen:

inSocialWork® Episode 144 – Michael Langlois: Gamer-Affirmative Practice: Today’s Play Therapy

Find this podcast interesting? I can speak in person too: Check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, call of duty, children, dark souls, digital literacy, education, game theory, gamers, games, gaming, mindfulness, minecraft, play, play therapy, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, technology, therapy, video games, Web 2.0, World of Warcraft, wow

Bringing Emerging Technology into the Clinical Process: Implications for Engagement and Treatment

June 2, 2014 by langloimsw 1 Comment

If you have ever wondered how to begin attending to, listening for, and asking questions about a patient’s use of technology, this video might give you some ideas. In it my colleague Lesa Fichte, LMSW, University at Buffalo School of Social Work, and I, discuss the role of technology, people’s relationship with technology, and how to integrate it into the treatment process by listening, inquiring, and learning.

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, digital literacy, education, facebook, gamers, games, gaming, LGBT, mental health parity, mindfulness, minecraft, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, twitter, video games, Web 2.0, World of Warcraft

Evocation and Mindfulness: Or, How to Think Better

October 16, 2013 by langloimsw 2 Comments

Like other art forms, video games can be both a mirror and a candle held up to our culture, at times reflecting it and at times revealing things about it. Normally I direct my posts primarily at people: therapists, gamers, educators, parents. But today I want to include the company that produces World of Warcraft as well. We have a crisis regarding thinking, and although I don’t think WoW created it at all, it has reflected it in a recent game mechanic change.

I am referring to a change mages that happened recently, where the spell Evocation was replaced by Rune of Power. For people not familiar with the game, here’s a simple explanation. Mages cast spells, but spells require an energy called mana, which gets used up gradually as you cast spells. How much mana you start with depends on your character’s intellect, and once you have used up your mana, you can’t cast any more spells until it is replenished. To replenish it you can either wait and it will gradually return (not the greatest idea in combat,) or eat and drink (not possible while you are in combat.) Or you could in the older days cast Evocation, which meant you stood in place as the spell was going, gain 15% of your total mana instantly and another 45% of your total mana over 6 sec. Move or get attacked, and the spell broke.

This recently was replaced with Rune of Power, which places a rune on the ground, which lasts for 1 min. While standing within 5 yds of it, your mana regeneration is increased by 75% and your spell damage is increased by 15%. You have to keep remembering to replace it every minute, but that’s not the problem. It may even be an easier game mechanic, but that’s not the problem either. My problem with it is how it reflects our dysfunctional attitude about thinking, and specifically our tendency to think of thinking as separate from doing something.

We live in a culture where people frequently worry about things, and in fact have ruminations that are intrusive. Many people report feeling hijacked by their minds with worrying or intrusive thoughts. And yet at the same time, few of us seem to mark our time and set it aside specifically for thinking. We schedule appointments to do things, but thinking isn’t one of them. We treat thinking, which is intangible, as if it can occur in the same space as doing other activities that are more observable and tangible. And then we are surprised when our minds rebel and hijack our thinking with thoughts and feelings that come unbidden, when all along we have been failing to cultivate the practice of intentional, mindful thinking about things.

This is where I think Blizzard and Wow initially had it right with Evocation. It was acknowledging an important truth, that Thinking IS doing something, and when done intentionally it occupies time and has benefits. Sure you weren’t able to do other things while casting Evocation, but isn’t that the point? In the real world, when you want to think deeply and seriously about something, you really do need to be intentional about it, and make a space in your day to do it. Rune of power definitely embraces the multitasking model, which encourages you to set up a rune and then go about your other business while keeping half an eye on it to know when to refresh. Multitasking is not inherently a bad thing, but there are times and places that intentional thinking may be more appropriate and less anxiety-provoking.

Part of helping patients learn to manage worrying is often to help them set up a specific time for worrying about things. This “worry time” can be a placeholder in the day or week which the patient uses when an intrusive worry enters into their thinking: They can dismiss it by deciding to put that on the agenda for the scheduled worry time. This is a way of training your mind to be intentional about what you choose to think about and when. But implicit in this is the idea that training your mind to think about things intentionally is a learned skill.

You can apply this to many different aspects of your life and work. If you are growing your private practice, when was the last time you set aside an hour to think deeply about your business plan or clinical focus. I’m not talking about daydreaming here, I’m talking about sustained intentional thought. Clinically, do you set aside supervision time to think deeply about patients? As students do you take 15 minutes after each article to think specifically about the reading? As parents, when was the last time you said to your co-parent, let’s make a time to think together about how our child is doing in life at home and school. Classroom teachers, when was the last time you asked students to take 5 minutes and think quietly about the classroom topic?

Another challenge here is the confusion of tongues around the concept of thinking. Self-help gurus often exhort us to stop thinking about things and JUST DO IT. But I don’t think they are talking about intentional thinking, I think they are talking about reactive or intrusive thinking. Procrastination is reactive thinking, worrying can be intrusive thinking. Those are often roadblocks to success, but the form of thinking I have been referring to is perhaps better described as a form of concentration meditation. Concentration meditation has come to be seen by many of us as concentrating on an image, or a candle, or chanting, or a revered object, but that is not necessarily the case, and in fact it is limiting.

What if your idea is the revered object? What if your thought process about your work, child, patient, class is worthy of your undivided attention? What if you were to schedule a specific time to think about a certain project?

If you are one of those detractors who say, “I just don’t have time to think,” I don’t buy it. Thinking time is not a luxury item, although it may be a learned discipline to set aside a few minutes at a time to do it. So please take a second and schedule a time on your calendar to think about an idea that is important to you. Schedule a time to hold your random worries and thoughts and show up at that appointed time to seriously consider them. I suspect this will free up more mental space and time than you may imagine.

And please Blizzard, bring back Evocation. I miss it, and the important life lesson in mindfulness it has to teach us.

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Filed Under: Gamer Therapy Tagged With: behavior change, building your business, digital literacy, education, game theory, gamers, games, gaming, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, ROI, stress, video games, World of Warcraft, wow

Innovation is Dangerous & Gaming Causes Asperger’s

August 31, 2013 by langloimsw Leave a Comment

GamerTherapist blog is on vacation and will return with new posts after Labor Day. In the meantime, here is a reader favorite:

At its heart, diagnosis is about exerting control. Clinicians want to get some sense of control in understanding a problem. We link diagnosis to prognosis to control our expectations of how likely and how much we will see a change in the patient’s condition. Insurance companies want to get a handle on how much to spend on who. Schools want to control access to resources and organize their student body. And with the current healthcare situation, the government is sure to use diagnosis as a major part of the criteria in determining who gets what kind of care.

Therapists and Educators do not like to think of ourselves as controlling people. But we often inadvertently attempt to exert control over our patients and entire segments of the population, by defining something as a problem and then locating it squarely in the individual we are “helping.”

This week has been one of those weeks where I have heard from several different colleagues about workshops they are attending where the presenters are linking Asperger’s with Gaming Addiction: Not in the sense of “Many people on the Autism Spectrum find success and motivation through the use of video games,” but rather in the sense of “excessive gaming is prevalent in the autistic spectrum community.”

This has always frustrated me, for several reasons, and I decided its time to elaborate on them again:

1. Correlation does not imply Causation. Although this is basic statistics 101 stuff, therapists and educators continue to make this mistake over and over. Lots of people with Asperger’s play video games, this is true. This should not surprise us, because lots of people play video games! 97% of all adolescent boys and 94% of adolescent girls, according to the Pew Research Center. But we love to make connections, and we love the idea that we are “in the know.” I can’t tell you how many times when I worked in education and clinics I heard talk of people were “suspected” of having Asperger’s because they liked computers and did not make eye contact. Really. If a kiddo didn’t look at the teacher, and liked to spend time on the computer, a suggested diagnosis of Autism couldn’t be far behind. We like to see patterns in life, even oversimplified ones.

2. Causation often DOES imply bias. Have you ever stopped to wonder what causes “neurotypical” behavior? Or what causes heterosexuality for that matter. Probably not. We usually try to look for the causation of things we are busily pathologizing in people. We want everyone to fit within the realm of what the unspoken majority has determined as normal. Our education system is still prone to be designed like a little factory. We want to have our desks in rows, our seats assigned, and our tests standardized. So if your sensory input is a little different, or your neurology atypical, you get “helped.” Your behavior is labeled as inappropriate if it diverges, and you are taught that you do not have and need to learn social skills.

Educators, parents, therapists and partners of folks on the Austism Spectrum, please repeat this mantra 3 times:

It is not good social skills to tell someone they do not have good social skills.

By the same token, technology, and video games, are not bad or abnormal either. Don’t you see that it is this consensual attitude that there is something “off” about kids with differences or gamers or geeks that silently telegraphs to school bullies that certain kids are targets? Yet, when an adolescent has no friends and is bullied it is often considered understandable because they have “poor social skills and spend too much time on the computer.” Of course, many of the same kids are successfully socializing online through these games, and are active members of guilds where the stuff they hear daily in school is not tolerated on guild chat.

Let’s do a little experiment: How about I forbid you to go to your book discussion group, poker night, or psychoanalytic institute. Instead, you need to spend all of your time with the people at work who annoy you, gossip about you and make your life miserable. Sorry, but it is for your own good. You need to learn to get along with them, because they are a part of your real life. You can’t hide in rooms with other weirdos who like talking about things that never happened or happened a long time ago; or hide in rooms with other people that like to spend hours holding little colored pieces of cardboard, sort them, and exchange them with each other for money; or hide in rooms where people interpret dreams and talk about “the family romance.”

I’m sure you get my point. We have forgotten how little personal power human beings have before they turn 18. So even if playing video games was a sign of Asperger’s, we need to reconsider our idea that there is something “wrong” with neuro-atypical behaviors. There isn’t.

A lot of the work I have done with adults on the spectrum has been to help them debrief the trauma of the first 20 years of their lives. I’ve had several conversations where we’ve realized that they are afraid to ask me or anyone questions about how to do things, because they worried that asking the question was inappropriate or showed poor social skills. Is that really what you want our children to learn in school and in treatment? That it is not ok to ask questions? What a recipe for a life of loneliness and fear!

If you aren’t convinced, please check out this list of famous people with ASD. They include Actors (Daryl Hannah,) bankers, composers, rock stars, a royal prince and the creator of Pokemon. Not really surprising when you think about innovation.

3. Innovation is Dangerous. Innovation, like art, requires you to want things to be different than the way they are. Those are the kids that don’t like to do math “that way,” or are seen as weird. These are the “oversensitive” ones. These are the ones who spend a lot of time in fantasy, imagining a world that is different. These are the people I want to have over for hot chocolate and talk to, frankly.

But in our world, innovation is dangerous. There are unspoken social contracts that support normalcy and bureaucracy (have you been following Congress lately?) And there are hundreds of our colleagues who are “experts” in trying to get us all marching in lockstep, even if that means killing a different drummer. When people try to innovate, they are mocked, fired from their jobs, beaten up, put down and ignored. It takes a great deal of courage to innovate. The status quo is not neutral, it actively tries to grind those who are different down.

People who are fans of technology, nowadays that means internet and computing, have always been suspect, and treated as different or out of touch with reality. They spend “too much time on the computer,” we think, until they discover the next cool thing, or crack a code that will help fight HIV. Only after society sees the value of what they did do they get any slack.

Stop counting the hours your kid is playing video games and start asking them what they are playing and what they like about it. Stop focusing exclusively on the “poor social skills” of the vulnerable kids and start paying attention to bullies, whether they be playground bullies or experts. Stop worrying about what causes autism and start worrying about how to make the world a better place for people with it.

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Filed Under: Gamer Therapy Tagged With: activism, adolescents, behavior change, call of duty, children, dark souls, digital literacy, education, gamers, gaming, mindfulness, minecraft, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft

Dopey About Dopamine: Video Games, Drugs, & Addiction

August 25, 2013 by langloimsw 4 Comments

Last week I was speaking to a colleague whose partner is a gamer. She was telling me about their visit to his mother. During the visit my colleague was speaking to his mother about how much he still enjoys playing video games. His mother expressed how concerned she had been about his playing when he was young. “It could have been worse though,” she’d said, “at least he wasn’t into drugs.”

This comparison is reminiscent of the homophobic one where the tolerant person says, “I don’t mind if you’re gay, as long as you don’t come home with a goat.” The “distinction” made actually implies that the two things are comparable. But in fact they are not.

Our culture uses the word addiction pretty frequently and casually. And gamers and opponents of gaming alike use it in reference to playing video games. Frequently we hear the comments “gaming is like a drug,” or “video games are addictive,” or “I’m addicted to Halo 3.” What muddies the waters further are the dozens of articles that talk about “proof” that video games are addictive, that they cause real changes in the brain, changes just like drugs.

We live in a positivistic age, where something is “real” if it can be shown to be biological in nature. I could argue that biology is only one way of looking at the world, but for a change I thought I’d encourage us to take a look at the idea of gaming as addictive from the point of view of biology, specifically dopamine levels in the brain.

Dopamine levels are associated with the reward center of the brain, and the heightened sense of pleasure that characterizes rewarding experiences. When we experience something pleasurable, our dopamine levels increase. It’s nature’s way of reinforcing behaviors that are often necessary for survival.

One of the frequent pieces of evidence to support video game addiction is studies like this one by Koepp et al, which was done in 1998. It monitored changes in dopamine levels from subjects who were playing a video game. The study noted that dopamine levels increased during game play “at least twofold.” Since then literature reviews and articles with an anti-gaming bias frequently and rightly state that video games can cause dopamine levels to “double” or significantly increase.

They’re absolutely right, video games have been shown to increase dopamine levels by 100% (aka doubling.)

Just like studies have shown that food and sex increase dopamine levels:

This graph shows that eating food often doubles the level of dopamine in the brain, ranging from a spike of 50% to a spike of 100% an hour after eating. Sex is even more noticeable, in that it increases dopamine levels in the brain by 200%.

So, yes, playing video games increases dopamine levels in your brain, just like eating and having sex do, albeit less. But just because something changes your dopamine levels doesn’t mean it is addictive. In fact, we’d be in big trouble if we never had increases in our dopamine levels. Why eat or reproduce when it is just as pleasurable to lie on the rock and bask in the sun?

But here’s the other thing that gets lost in the spin. Not all dopamine level increases are created equal. Let’s take a look at another chart, from the Meth Inside-Out Public Media Service Kit:

This is a case where a picture is worth a thousand words. When we read that something “doubles” it certainly sounds intense, or severe. But an increase of 100% seems rather paltry compare to 350% (cocaine) or 1200% (Meth)!

One last chart for you, again from the NIDA. This one shows the dopamine increases (the pink line) in amphetamine, cocaine, nicotine and morphine:

Of all of these, the drug morphine comes closest to a relatively “low” increase of 100%.

So my point here is twofold:

1. Lots of things, not all or most of them drugs, increase the levels of dopamine.

2. Drugs have a much more marked, sudden, and intense increase in dopamine level increase compared to video games.

Does this mean that people can’t have problem usage of video games? No. But what it does mean, in my opinion, is that we have to stop treating behaviors as if they were controlled substances. Playing video games, watching television, eating, and having sex are behaviors that can all be problematic in certain times and certain contexts. But they are not the same as ingesting drugs, they don’t cause the same level of chemical change in the brain.

And we need to acknowledge that there is a confusion of tongues where the word addiction is involved. Using it in a clinical sense is different than in a lay sense– saying “I’m hooked on meth” is not the same as saying “I’m hooked on phonics.” Therapists and gamers alike need to be more mindful of what they are saying and meaning when they say they are addicted to video games. Do they mean it is a psychological illness, a medical phenomenon? Do they mean they can’t get enough of them, or that they like them a whole lot? Do they mean it is a problem in their life, or are they parroting what someone else has said to them?

I don’t want to oversimplify addiction by reducing it to dopamine level increase. Even in the above discussion I have oversimplified these pieces of “data.” There are several factors, such as time after drug, that we didn’t compare. And there are several other changes in brain chemistry that contribute to rewarding behavior and where it goes awry. I just want to show an example of how research can be cited and misused to distort things. The study we started out with simply found that we can measure changes in brain chemistry which occur when we do certain activities. It was not designed or intended to be proof that video games are dangerous or addictive.

Saying that something changes your brain chemistry shouldn’t become the new morality. Lots of things change your brain chemistry. But as Loretta Laroche says, “a wet towel on the bed is not the same as a mugging.” We need to keep it complicated and not throw words around like “addiction” and “drug” because we want people to take us seriously or agree with us. That isn’t scientific inquiry. That’s hysteria.

Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, call of duty, children, dark souls, dopamine, education, Freud, game theory, games, gaming, mindfulness, minecraft, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft

Bad Object Rising: How We Learn to Hate Our Educated Selves

June 30, 2013 by langloimsw 1 Comment

Recently I had the opportunity to work with a great set of educators in a daylong seminar. One of the things I do with teachers when I present is have them play Minecraft. In this case I started off by giving a general presentation that ended with a story of auto-didactism in an Ethiopian village, where 20 children who had never seen the printed word were given tablets and taught themselves to read. I did this in part to frame the pedagogy for what came next: I had them turn on Minecraft and spend 30 minutes exploring the game without any instruction other than getting them networked.

The responses were as varied as the instructors, but one response fascinated me in particular. Midway into the 30 minutes, one teacher stopped playing the game and started checking her email. Later, when we returned to our group to have a discussion about the thoughts and feelings that came up around game play, this same teacher spoke up. We were discussing the idea of playfulness in learning when she said , “you know, I hear a lot about games and learning, and making learning fun; but sometimes learning isn’t fun and you have to do it anyway. Sometimes you just have to suck it up and do the work.”

“I’m not saying that I disagree with you entirely,” I said. “But then how do we account for your giving up on Minecraft and starting to check your email?”

She looked a little surprised, and after a moment’s reflection said, “fair enough.”

I use this example because these are educators who are extremely dedicated to teaching their students, and very academically educated themselves. Academia has this way, though, of seeping into your mind and convincing you that academics and education are one and the same. They’re not.

I worked in the field of Special Education for more than a decade from the inside of it, and one of the things I came to believe is that there are no unteachable students. That is the good news and the bad news. Bad news because if a student was truly unteachable, they wouldn’t learn from us that they are dumb or bad if they don’t demonstrate the academic achievement we expect. I remember the youth I worked with calling each other “SPED monkeys” as an insult; clearly they learned that from somewhere and someone. They had learned to hate themselves as a bad object, in object relations terms, or to project that badness onto other students. They learned this from the adults around them, from the microaggressions of hatred they experienced every day: By hate I’ll go with Merriam as close enough, “intense hostility and aversion usually deriving from fear, anger, or sense of injury.”

We tend to mistakenly equate hatred with rage and physical violence, but I suggest that this is because we want to set hatred itself up as hated by and other from ourselves; surely we never behave that way. But hatred is not always garbed in extremis. Hatred appears every day to students who don’t fit the academic mold. Hatred yells “speak English!” to the 6 year olds getting off the bus chatting in Spanish. Hatred shakes its head barely (but nevertheless) perceptibly before moving on to the next student when the first has fallen silent in their struggle. Hatred identifies the problem student in the class and bears down on her, saying proudly, “I don’t coddle my students.” And Hatred shrugs his shoulders when the student has been absent for 3 weeks, and waits for them to be dropped from the rolls.

I’m not sure how I came to see this, because I was one of the privileged academically. I got straight A’s, achieved academic awards and scholarships that lifted me into an upperclass world and peer group. I wrote papers seemingly without effort, read for pleasure, and was excited to get 3 more years of graduate school. And I have had the opportunity to become an educator and an academic myself, having taught college and graduate students. I could have stayed quiet and siloed in my area of expertise, but work with differently-abled learners taught me something different. It taught me that people learn to dislike education, shortly after academia learns to dislike them.

Perhaps one of the best literary portrayals of adult hatred of divergent thinkers comes from the movie Matilda:

“Listen, you little wise acre. I’m smart, you’re dumb; I’m big, you’re little; I’m right, you’re wrong. And there’s nothing you can do about it.”

Nowadays I teach in a much different way than I did early on, before I flipped my classrooms and facilitated guided learning experiences rather than encourage people to memorize me and ideas that I had memorized from others. And I struggle with this new approach, because I enjoy it so much I feel guilty. You see, I have internalized the bad object too. Even with my good grades I internalized it. And any time I start to depart from the traditional mold of the educated self, I experience a moment of blindness, then a stony silence that seems to say, “you’re being lazy, you should make them a powerpoint and prepare a lecture.” Yet, if my evaluations on the whole and student and colleague testimonies have truth to them, I am a “good” educator. So let’s say I am a “good” educator, and if I as a good educator struggle with this, we shouldn’t assume that people that struggle with these issues are “bad” educators.

In fact, when it comes to emerging technologies like social media and video games, educators often try to avoid them, if not because they are fun and suspect, then because educators risk experiencing themselves as the bad object: Who wants to experience themselves as hopelessly dumb, clumsy or lazy when they can experience themselves as the bountiful and perfectly cited fount of all wisdom? Truth is, both are distorted images of the educated self.

Don’t forget that educators themselves experience tons of societal hatred. For them it often comes in the guise of curriculum requirements or linking their performance to outcomes on standardized testing. Hatred comes in the low salaries and the perception that people doing intellectual or emotional labor aren’t really working. All of this helps educators to internalize a bad object which feels shaming and awful; is it any wonder that we sometimes unconsciously try to get that bad object away from ourselves and locate it in the student?

The good news as I said before is that we are all teachable. We can learn to make conscious and make sense of the internalized bad object representations. We can see that thinking of people in terms of smart or dumb is a form of splitting.

And yes, there’s a lot we can do about it.

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: ADHD, adolescents, Asperger's, behavior change, children, digital literacy, education, gamers, games, gaming, minecraft, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, special education, stress, technology, therapy, video games, Web 2.0, World of Warcraft

Empathy (Re)Training

June 8, 2013 by langloimsw 2 Comments

Last night I was mining Gold Omber in the asteroid belt near Erindur VI, and I can’t begin to tell you what an accomplishment that was. (This post is not just about spaceships, but about pacifists, Ethiopia and education, so non-gaming educators and therapists keep reading.) OK, let me tell you why it was an accomplishment. I am talking about playing the MMO EVE Online, which involves piloting spaceships across vast amounts of space in order to mine, trade, build or pirate among other things. In essence, your spaceship is your character, with the ship’s parts being the equivalent of your armor and weapons in games like World of Warcraft. But you can only build or use these parts as your pilot acquires skills, ranging from engineering to planetology to cybernetics, so in that way the player’s pilot is the character in the game. But at the start of the game you’re told that the pilot is actually a clone (this becomes important later on) and as someone was explaining to me last night the whole cloning thing has its own complications once you start using implants to modify individual clones, which you can only do after you’ve trained the skill of Cybernetics. And why all that is important is because once you use implants you can learn skills more quickly.

If you think that is confusing, try learning how to use the sprawling user interface or UI, which one of my friends says “was made by demons who hate people, hate their hopes and dreams. Know that you are playing with toys made by demons for their amusement and tread lightly.” Another way of putting it is that you have keep trying to remember what window you opened in the game to do what, and often have multiple windows open simultaneously in order to figure out what you’re doing or buying or training. There is a robot tutorial program in the game that helps somewhat, but the whole thing is very frustrating and intriguing for the first several hours of game play. During this time I was ganked repeatedly, lost lots of loot and ore I had mined, as well as a nice spaceship or two. So to get to the point where I had learned enough skills to be able to warp halfway across the galaxy, lock onto an asteroid, orbit and mine it while defending myself from marauders was extremely exciting. I was only able to do this because my above-mentioned friend had given me a much bigger and safer ship than I had started out with, as well as lots of instructions on how to do things; and because I was chatting with people in the game who offered great tips. Of course one of those people then clicked on my profile in chat to then locate me and gank me again (bye-bye nice ship,) but the knowledge is mine to keep.

By now you may be asking “what has any of this got to do with psychotherapy, social work or education?” so I’ll explain. I had tried EVE months ago, and given up after about a week of on and off attempts, but this past month I have begun teaching an online course for college educators and MSWs about integrating technology into psychotherapy and education. One of the required exercises in the course is for the students to get a trial account of World of Warcraft and level a character to 20. There has been a lot of good-natured reluctance and resistance to doing this, in this class and others: I have been asked to justify this course material in a way I have never had to justify other learning materials to students. This included several objecting to playing the game because of violent content prior to playing it much or at all. It’s as if people were not initially able to perceive the course material of World of Warcraft as being in the same oeuvre as required readings or videos. It is one thing to bring up in your English literature class that you found the violence in “Ivanhoe” or the sex in “The Monk” objectionable after reading it, but I’ve not heard of cases where students have refused to read these books for class based on those objections. So I was curious, what made video games so different in people’s minds?

Things became easier for several folks after I set up times to meet them in the game world, and help them learn and play through the first few quests. As I chatted with them and tried to explain the basic game mechanics I realized that I had learned to take for granted certain knowledge and skills, such as running, jumping, and clicking on characters to speak with them. I started to suspect that the resistance to playing these games was perhaps connected to the tremendous amount of learning that was having to go on in order to even begin to play the game. In literacy education circles we would call this learning pre-readiness skills. Being thrown into a learning environment in front of peers and your instructor was unsettling, immediate, and potentially embarrassing. And I think being educators may have actually made this even harder. Education in the dominant paradigm of the 20th and 21st century seeks to create literary critics and professors as the ultimate outcome of education, according to Ken Robinson. So here are a group of people who have excelled at reading and writing suddenly being asked to learn and develop an entirely new and different skill set within the framework of a college course: Of course they were frustrated.

So I started playing EVE again not just to have fun, but to have a little refresher course in empathy. I have leveled to 90 in WoW, so I know how to do things there, and had begun to forget how frustrating and bewildering learning new games can be. In EVE I have been clueless and failing repeatedly, and getting in touch with how frustrating that learning curve can be. I have also been re-experiencing how thrilling it is the first time I make a connection between too concepts or actions in the game: When I realized that there was a difference between my “Assets” and my “Inventory” I wanted to shout it from the rooftops. I have begun to see and help my students reflect on similar “learning rushes” when they get them as well. They are now , in short, rocking the house in Azeroth.

We forget how thrilling and confusing it can be to learn sometimes, especially to the large population on the planet that doesn’t necessarily want to be a college professor or psychotherapist. We forget that our patients and students are asked to master these frustrations and resistances every day with little notice or credit.

There is a village in Ethiopia, where 20 children were given Xoom tablet computers last year. The researchers/founders of One Laptop Per Child dropped them off in boxes to these children, who had never learned to read or write. They were offered no instruction and the only restriction placed on the tablet was to disable the camera. Within minutes the children had opened the box and learned how to turn the computers on; within weeks they were learning their ABCs and writing; and within months they had learned how to hack into the tablet and turn the camera back on, all without teachers. This story inspires and terrifies many. It is inspiring in that it tells the story of what children can learn if they are allowed to be experimental and playful. It is terrifying because if all this was done without a teacher to lecture or a therapist to raise self-esteem, it raises the question “do we still need them?”

Having played EVE, and taught academics in World of Warcraft, let me assure you that the world still needs teachers and therapists. But the world needs us to begin to learn how to teach and help in a different way. If EVE had nothing but online tutorials I would have probably struggled more and given up. I needed to remain social and related to ask for help, listen to tips, and get the occasional leg up. We need to retrain ourselves in empathic attunement by going to the places that scare or frustrate us, even if those places are video games. The relationship is still important; to inspire, encourage and enjoy when learning happens in its myriad forms. But we need to remember that there are many literacies and that not all human beings aspire to teach an infinitely recurring scholasticism to others. We need to remember how embarrassing it can be to “not get it,” and how the people we work with every day are heroic that they can continue to show up to live and be educated in a system that humiliates them.

What’s exciting and promising, though, is this simple fact: Learning is happening everywhere, all the time! Whether it’s a village in Ethiopia, Elwynn Forest in Azeroth, or in orbit around Erindur VI; learning is happening. Across worlds real and imagined, rich and poor, learning IS happening.

And we get to keep all the knowledge we find.

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Filed Under: Gamer Therapy Tagged With: adolescents, avatar, behavior change, children, digital literacy, education, EVE, game theory, gamers, games, gaming, mindfulness, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft, wow

Want To Help Stop Youth Cyberbullying? Let Your Kids Raid More.

May 23, 2013 by langloimsw 7 Comments

The above title is misleading. In fact it is as misleading as the term cyberbullying, which is an umbrella term used from experiences which range drastically. “Cyberbullying” has been used to describe the humiliation of LGBT youth via video; the racial hatred of Sikhs on Reddit, the systematic harassment and suicide of a teenage girl by a neighboring peer’s mother; a hoax wherein a Facebooker pretended to be a woman’s missing (for 31 years); and the bad Yelp reviews of a restauranteur in AZ.

Wait, huh?

My point, exactly: All of the things described above are different in scope, intentionality, form of media used, duration, and impact. We need to keep this complicated. This is not to take away from the horrific acts that people have perpetuated with social media, or excuse them. Rather I think we need to help kids and their parents find more nuanced ways to make sense of the way newer technologies are impacting us.

Social media amplifies ideas, feelings, and conflicts. It often dysregulates family systems. Growing up, many family members didn’t need to learn the level of digital literacy that today’s world requires. Parents may be tempted to put their children in a lengthy or permanent internet lockdown. I hear the threats, or read them, all the time: No screens. You’re unplugged. She’s grounded from Facebook.

Please don’t do that.

I’ve worked with a number of young adults who have had the experiences of being on the receiving end of hatred, stalking, harassment and intrusion delivered via the internet. And thank goodness that their parents didn’t unplug them as kids. Because they stayed online they got to:

learn how to ignore haters
see/hear others stand up for them in a social media setting
come to the defense of a peer themselves
increase their ability to meet verbal aggression with cognition
make the hundreds of microdecisions about whether to “fight this battle”
seek out support from other peers
form strong online communities and followings that helped them cope with and marginalize the aggressors

More and more, online technologies are becoming a prevalent form of communication, and to take away access is to remove the hearing and voice of youth. To do this is disempowerment, not protection.

I’ve said before that parents need to take an engaged approach with kids in order to be there to help kids understand and process the conflicts that are communicated through and amplified by social media. But this time I want to go further, and suggest that one way to help kids achieve digital literacy in terms of social skills is to let them play more multiplayer video games.

Many of you probably saw that coming, but for those of you who didn’t, let me explain. 21st century video games are themselves a powerful form of social media. Multiplayer games allow individuals to band together as guilds, raids, platoons and other groups to achieve higher endgame goals. Collaboration is built into them as part of the fun and as necessary to meet the challenges.

There are exceptions to this, but it has been my experience that people don’t begin systematic personal attacks on each other when they are in the middle of downing Onyxia. They are too busy joining forces to win. I am convinced that much hatred we see in the developed world is there in large part because of boredom and apathy. Games provide an alternative form of engagement to hatin’

Look, I’m not saying that people playing games never say sexist things, swear, or utter homophobic comments. But I can say that I have heard more people, adults and children, stand up to hatred in World of Warcraft than I ever have in the 2 decades I worked in public school settings. I’ve seen racism confronted numerous times in guild chat, seen rules for civility created and enforced over and over, always citing a variation of the same reason: “We’re all here to have fun, so please keep the climate conducive to that.”

Video games provide powerful interactive arenas for diverse groups of people to collaborate or compete strategically. They capture our interest with a different sort of drama than the sort that we see our youth struggle with in other settings. In fact, for many individuals video games provide a welcome respite from the drama that occurs in those other settings.

Social media does indeed amplify nastiness, harassment and hatred. It also amplifies kindness, hope, generosity and cooperation. If we don’t lean into social media with our kids, they’ll never know how to use it to amplify goodness in the world. Worse yet, if we cut them off from connecting with the world online we’ll deprive them of the necessary opportunities to recognize and choose between good and evil.

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, buddhism, children, cyberbullying, digital literacy, education, facebook, game theory, gamers, games, gaming, LGBT, mindfulness, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, twitter, video games, Web 2.0, World of Warcraft

Continuing Education From Pax East

March 24, 2013 by langloimsw Leave a Comment

For those of you who may not know, Pax East is a yearly convention here in Boston celebrating all things video game. This year I was so fortunate to have the opportunity to present there on “Rethinking Gaming Addiction.” If you are interested in seeing what the presentation was about, you can view the Prezi here:

For those with the stamina, you can find a video of the presentation here:

And if you want to just listen to it in MP3 form, you can do so here:

Like this post? I can speak in person too, check out the Press Kit for Public Speaking info. And, for only $4.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, children, digital literacy, education, game theory, gamers, games, gaming, LGBT, mindfulness, minecraft, Pax east, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, public speaking, social media, therapy, twitter, video games, Web 2.0, World of Warcraft, youtube

Live At The Cooney Center: “Improving Our Aim: A Psychotherapist’s Take On Video Games & Violence”

February 20, 2013 by langloimsw Leave a Comment

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Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, children, cooney center, digital literacy, education, game theory, gamers, games, gaming, mindfulness, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, sesame, social media, technology, video games, violence, Web 2.0, World of Warcraft

Learn More About Rethinking Video Games & Addiction Here!

February 17, 2013 by langloimsw 1 Comment

In the midst of several projects, including the upcoming 2013 SXSW presentation, but wanted to give you a post in the meantime. Here is the presentation on rethinking gaming addiction I did there last year.

[gigya ]

This can give you an idea of:

The power of Prezi, even in its’ most stripped down version
The visuals that accompanied the presentation you can listen to if you go here
What my approach to technology and psychology is
What my style is as a public speaker

Enjoy, and I will be posting again with bigger news soon!

Like this post? I can rant in person too, check out the Press Kit for Public Speaking info? And, for only $2.99 you can buy my book. You can also Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, digital literacy, education, game theory, gamers, games, gaming, mindfulness, play, prezi, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, sxsw, technology, therapy, video games, Web 2.0, World of Warcraft, wow

4 Tips For Dealing With Video Game Violence For Parents

February 2, 2013 by langloimsw 2 Comments

Whenever there is an upsurge in moral panic around violence in the media, the focus becomes more polarizing than pragmatic. Despite the overwhelming research (such as these articles) that shows weak if any links between video games and violence, media pundits whip up mental health providers and the parents they work with into a frenzy. Feelings such as a passionate urge to protect children and adolescents are often to intense to be suspended to look at data. In the midst of all this, moderate and practical ways to address the graphic content of some video games are overlooked in favor of heated philosophical debates. So for those of you who are parents and/or work with them, here are a few tips and links on how to handle violence in video games:

1. Set console parental controls. You can set your game consoles to only play games of a certain rating. If you haven’t done so and are complaining about violence in video games, take some action here. Here are the how-tos:

XBox Parental Controls

Playstation Parental Controls (Video from CNET

Wii Parental Controls

These are password-protected, and will allow you to set the ratings limits, which brings us to:

2. Know your ratings. Although I have mixed feelings about the Entertainment Software Rating Board, it’s what we’ve got. But the ESRB is only as useful if you familiarize yourself with it. This means not only looking at what each rating means, but using the other resources they have, including mobile tools, setting controls, family discussion guides and other tips for safety. The message here is that there is more to understanding and moderating access to your child’s gameplay than a rating system, including discussion of in-game content.

3. Make use of graphical content filters. Many parents, educators and therapists don’t know that a growing number of games have options that can be set to filter out violent graphics, profanity, and alter the experience of game content to a more family-friendly level. If your child wants a video game, have searching online to see if the game has a GCF be part of the process. Not only will you be teaching them about consumer choice, but digital literacy as well. Here are some popular games that have GCFs:

Call of Duty Black Ops 2

Gears of War 3

World of Warcraft

4. MOST IMPORTANT TIP: Parenting has no “settings.” Parents and educators often want some expert to rely on–don’t try to “park it” that way. Most games can be rented before you buy them from services like GameFly so you can test drive them. That’s right, I’m suggesting you play the games yourself so you can make a personally informed decision. At the very least you should be watching your child play them some of the time, not to be nosy, but because part of your role as a parent is to take an interest in their world. If you can spend 2 hours going to their Little League game, you can spend an hour watching (if not playing) Borderlands 2.

If you’re an educator or therapist, you’re not off the hook either. 🙂 If you are going to offer opinions on video games and their content, make sure you are playing them. Chances are you don’t say things like “reading Dickens is dangerous for young minds” if you have never read any of his work. If you did, you’d probably be out at a book burning rather than reading this blog. By the same token, don’t presume to opine about video games if you have done nothing to educate yourselves about them. And please note that asking children about them is a place to start, but by no means sufficient for educating yourself. If you are a play therapist, please start including 21st century play materials like video games in your repertoire. And be sure to provide parents with the resources they need to help them make sense of this stuff, such as the resources this post gives you.

Look anyone can have an opinion on video games and violence, but we need practical processes to help people be informed consumers. This is one parenting issue that has practical, doable options, and is rated “O” for “Ongoing…”

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Filed Under: Gamer Therapy Tagged With: adolescents, call of duty, children, digital literacy, education, ESRB, gamers, games, gaming, Gears of War, parenting, play, Playstation, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, violence, wii, World of Warcraft, wow, Xbox

Avatars & The Curated Self

November 25, 2012 by langloimsw 2 Comments

If I ever meet James Cameron, I hope I will remember to ask him if it was a coincidence that he chose to the make the aliens blue. His movie, Avatar, garnered 3 Academy Awards for it’s epic tale of humanity’s encounter with the Na’Vi, largely through the creation of avatars, body forms that humans beam their consciousness into so they can mingle and fraternize with the locals.

The concept of the avatar comes originally from Hinduism, and refers to the concept of a God or Supreme Being deliberately descending to earth in a manifest form. One of the most popular gods for doing this is Vishnu, also blue. The concept of avatar in Hinduism is more complicated than this, but the piece of it that pertains to this post is the general concept of the attempt of a supreme being to incarnate part of itself to enter the world. There is an inherent diminution or derivative quality to it.

If you are more familiar with video games than Hinduism, you are probably more familiar with the concept of an avatar meaning the graphical representation of the player’s character in the game. When we play Pac-Man, our avatar manifests in the video game as a little yellow circle with a mouth that races around gobbling dots. Over the decades games and graphics have become capable of more sophisticated avatars ranging from the Viking-like Nords of Skyrim to the soldiers of Call Of Duty. As these video game worlds proliferate, players descend into them with avatars of many shapes, sizes and species. Some games, like Eve Online, allow you to customize the features of your avatar extensively; others allow you to pick from a limited number. We are always diminished by the process of taking on an avatar. Even if the powers an avatar has in the video game world are immense, it is derivative of the complexity of being human.

What is interesting is that most of us use avatars every day online, we just never realize it. Video games are just one form of social media, and avatars abound in all of them. The graphic may be as simple as our picture next to a blog post or comment, or a video on Youtube. But in the 21st century most of us are digital citizens and use one form of avatar or another. Some people in the world will only ever know us through our avatar in a video game or Second Life. And yet we know something of each other.

I think more and more of us are becoming aware of the connection between the avatar and the curated self, the aspects of our psychological self we choose to represent online. The curated self is the part of ourselves we have some ability to shape, by what we disclose, what graphics we choose, and how we respond to others. Like an avatar, the curated self at its best is deliberate. I say at its best, because although the curated self is in our care, we can also be careless with it.

Recently I posted a video of myself on my YouTube channel entitled “Should Therapists & Social Workers Post Videos Of Themselves On YouTube?” In making the video I chose to wear a bike helmet, and by the end of the post was using the bike helmet as an example of the risks we take when we opt to attempt innovation of our curated self. The video was designed to inspire critical discussion and thinking, and it did just that. In some groups where it appeared people described the video and points it was illustrating as “brilliant.” Other groups interpreted it as an instructional video on how to advertise your therapy practice and lambasted it. There was a myriad of responses, and I’m sure even more from people who opted not to comment on it. I received a number of likes of it, and a number of dislikes.

What I think is important and instructional here was how people began to comment through their avatars as if they were addressing the whole person I am rather than an avatar. And they made incorrect assumptions ranging from my age to my motives. The bike helmet and my posture on the video became the target for some incredible nastiness disguised as constructive criticism. From the safety of their own avatars they hurled some invectives at who they thought I was and what they thought I was doing in front of an audience of other avatars who alternately joined in, were silent, emailed me privately to offer words of support, or publicly commented on what they saw. The irony to me was that people began to demonstrate all of the roles we encounter in “cyberbullying,” which was part of what the video also touched on. In a perhaps not surpising parallel process, we got to see and play out the sorts of dynamics that our patients and children experience all the time.

We need to remember that every avatar is a derivative of the person. It is connected enough that we have attachments and responses to it. We can feel proud or ashamed, hurt or healed through our avatars. In fact, research from Nick Yee on “The Proteus Effect” has shown that playing a game with a powerful avatar for 90 seconds can give the player increased self-confidence that persists for up to 6 hours. It stands to reason that if someone experiences their avatar as weak or socially unacceptable for a brief time there may be lasting effects as well. Behind the guy in a bike helmet is someone else. He may be a faculty member at Harvard, a sensitive fellow, a father, a student, a man who just lost his partner, a person with a criminal record, or any, all or none of these. But he is always more than the derivative of his avatar. We need to practice being mindful of this and model it as we train others to be digital citizens. It is counterproductive to sound off on cyberbullying to our children or grandchildren, when they can Google us online and see us doing it ourselves.

We also need to help our patients, their families, and colleagues understand the active role we need to take in curating ourselves online. We need to understand what may happen when we put certain things out there. For therapists this includes the dilemma of putting out a curated self that resembles what kind of work you would do, while not disclosing or conveying more than you want the world to know. The example I always use with students and consultees is how I talk about my family but never who they are in particular. This is deliberate, because it is no big disclosure that I have a family, everyone on the planet has one of sorts with the possible exception of Dolly the cloned sheep. But beyond that I curate a private self, and let folks project what they may. If we put out comments describing patients or coleagues as “screwed up,” we are also curating ourself, I suggest poorly. We need to be mindful that most groups we participate online in are open and searchable. Many of my colleagues became therapists at least in part because they didn’t want to be known and thought the best defense was a good offense (“We’re here to talk about you, not me.”) They’re used to sharing the gallows humor with the team, and think the same applies to online. I’m with Rilke on this one: “for here there is no place/that does not see you. You must change your life.”

To paraphrase Wittgenstein, “our self is everything that is the case,” not just one avatar, blog, string of emails or video; not even the composite of all of them. Nor is our curated self everything that is the case. We’re more than our Facebook likes or our Twitter following. Human beings are so much more, much more wondrous and tragic than the curated self. We descend into the Internet and are diminished, but do bring some deliberate part of ourselves along. We will only ever know hints and glimmers of ourselves and each other online. As for the rest:

“Whereof one cannot speak, thereof one must be silent.” –Wittgenstein

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Filed Under: Gamer Therapy Tagged With: adolescents, avatar, behavior change, building your business, call of duty, curated self, digital citizenship, digital literacy, education, Eve Online, gamers, gaming, mindfulness, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, rilke, second life, self-promotion, Skyrim, video games, Web 2.0, wittgenstein, World of Warcraft

On The Importance Of Feeling Useless

November 7, 2012 by langloimsw 1 Comment

Recently I was being trounced in a game of Call Of Duty 3: Modern Warfare 3. Not only was I having a difficult time understanding the lingo and mechanics of the game, the controls for this first person shooter were bewildering to me. I found myself staring down at the controller more than at the screen. Why couldn’t I remember what the A button did? Over the course of the week, I was also informed that Halo 4, Assassin’s Creed, and Paper Mario: Sticker Star are also here or on the horizon.

I wasn’t sure when I was going to find the time to try all of these. I was already behind. Skyrim had new DLC, Minecraft had different updates for both PC and the XBox 360 versions, and the Secret World and Guild Wars 2 had both been preempted by the latest World of Warcraft : Mists of Pandaria expansion. And what about Salem? I had gotten a beta key for that, didn’t that make me obligated to try a little more? And I won’t even go into the iPad and iPhone games, but Baldur’s Gate was just 3 weeks away…

I write all this because I have found that readers and colleagues often assume that because gaming is an area of clinical practice and focus of mine, that I am up on all of the latest games. If you have been imagining that I always know what every MMO gamer is talking about, or can jive with adolescents about the finer points of COD: MW3 (Call of Duty: Modern Warfare 3) and how it differs from Max Payne, you are in for a rude awakening.

I can relate to every therapist who has sat with a patient and said no repeatedly to “Do you know about” questions involving video games. I can relate to every colleague with thumbs of lead who plays with (against) their patients on XBox. I too struggle against the countertransference urge to display my “hipness.” And boy am I tempted sometimes to throw up my hands and say I am so over the latest thing.

But I don’t throw up my hands because I recognize that it is a defense against feeling useless. Who wants to feel slow, clumsy, behind the times? Feeling useless coincides with feeling powerless, devoid of meaning or hope, and isolation. For me, that feeling of uselessness is touching the water’s bottom: It’s where I kick off. Uselessness is almost always the feeling that precedes determination for me and the moment when I am closest to getting going again. Here are just a few reasons why feeling useless can be important:

1. Feeling useless reminds me of how my patients often feel. Regardless of age, gender or walk of life, I have sat with people who experience feelings of utter uselessness. Most kids feel useless in school at one point or another. Adults tend to embrace amnesia when it comes to remembering how dumb education can make you feel before you feel smart. They have forgotten what it was like to be called last for the kickball team, or draw and erase and draw until your paper ripped. And the population of Baby Boomers can feel useless as they sense the impatiences of their younger colleagues in the workplace: You talk too slow, drive too slow, and why don’t you just retire? Meanwhile, younger adults send out resume after resume and spend more hours in sweatpants as they feel that they and their education are both useless. Parents send their children off to college and experience the empty nest, or send them off to war and experience a more terrifying version of uselessness. We need to remember how it feels to be useless if we are going to stay empathically attuned to our patients.

2. To recognize that you are feeling useless is to begin to wake up. At least it can be, because the sense of being useless is completely irrational. There is nobody, not one person on the planet who has nothing to give of themselves. There is no such thing as a useless person, it is a cognitive distortion. And the minute we recognize that distortion we can begin to use our observing ego to ask ourselves “who is this who is telling me I am useless?” Whoever it is, the media, a parent, an old tape running in our head, or all of the above, it is just wrong. And that’s ok, because we’ve been wrong before, and now that we know it we can begin to gently guide our thinking back to a more rational place. If this sounds like meditation, that’s probably because it is.

3. To feel useless is only a feeling. Sure feelings are important, and a powerful part of human experience. But they are only one part of human experience. Thinking and behavior are two other parts. We can use feeling useless to motivate ourselves. We can use it as a barometer for our overall mental health. We can also use it as a defense to stay stuck, or to attempt to elicit pity from others. There are all sorts of ways we can use a feeling, and they aren’t all necessarily, well, useful. Or we can just sit still for a bit, because being just a feeling, feeling useless will float by and be replaced by another feeling, and another and another…

So if you are a therapist, and you notice yourself feeling useless, you are one step closer to coming to your senses. You can become more mindful of how unpleasant the feeling is, and mindful of how your patient may feel when they experience it. You can remember it is only a feeling, and become curious about it and why it is coming up. And you can consciously decide how to use it or cope with it, rather than unconsciously act out in response to it.

To return to my video game example, here’s how I used it. I noticed the feeling and said to myself, “That’s how my patients experience themselves sometimes.” From there I went on to think, “That’s how the therapists I consult with about technology experience themselves sometimes.” Interesting information, and it helped me pause a moment more. And when I sat with it more it occurred to me that there was some symbolic content that had come up in a session recently that I’d overlooked. And then it occurred to me to write this blog, and as I wrote the first paragraph I remembered how video games are a form of social media, and how my friend Susan Giurleo often reminds me that we don’t need to be on every single platform of it to be technically savvy. From that stream of consciousness, and more importantly, from my feeling of uselessness, came this post. And I have no doubt that at least a few of my colleagues will find it useful, which totally debunks the useless Mike theory.

What about you? What has elicited a feeling of uselessness for you lately? What is that feeling about, and what are you going to do with it?

Filed Under: Gamer Therapy Tagged With: adolescents, Assassin's Creed, behavior change, buddhism, call of duty, children, education, gamers, games, gaming, Halo, mindfulness, minecraft, Pandaria, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, technology, video games, World of Warcraft

Taking An Interest

October 14, 2012 by langloimsw 2 Comments

This week I was at the dentist, and the appointment probably took twice as long as it was supposed to. This was because as I was waiting in the dentist chair, I was playing Denki Blocks on my iPhone when the assstant came in. She found the game interesting, and confessed to me that she didn’t know how to download games on her new iPhone. And as I was explaining how to do that, the dentist came in and he talked about how his children weren’t allowed to play games on the iPhone because they discouraged socializing. So then of course I explained that there was research that suggested very differently. He listened quietly and I said, “maybe I shouldn’t be arguing with someone who is about to put a drill in my mouth.”

“No, no,” he said. “It’s just that I’m thinking about what you said, and I haven’t thought about it that way before.” All three of us had an ongoing conversation between all the stages of filling a cavitiy, about smartphones, digital literacy, gaming. And at the end of it I noted how clearly this is a topic for our times if all of us can be talking and listening intently about it for such a long period of time.

In college, one of my creative writing teachers once said, “What interests you is interesting.” I think there is a lot of truth in this in general, and specifically when it comes to psychotherapy and running a business. I feel extremely fortunate to be in a portfolio career that allows me to pursue my interests and take an interest in the psyche and society. Not everybody has an easy or clear path to this in our society. Some self-help gurus make it sound like all you need is a burning interest to become the happy and successful, which is absolutely not true. There are millions of talented people out there that start off with less privilege and opportunity, and more stressors due to race, gender, poverty, or living in an ableist culture. But what I do think my professor was on to was the idea that often what interests you can be a strong motivator to yourself and exciting to others.

A supervisee and I recently were discussing the possible meanings and messages that could be conveyed in leaving a voicemail for a patient. After discussing this for 30 minutes, I interjected by saying, “Can I just take a step back and point out what a weird profession we’re in that we can spend so much time talking about this?” We both laughed at this, and it was true, but the time had gone by so fast because we were mutually interested in the subject.

Enthusiasm, in its original meaning, was taken from the Greek enthousiasmos, which came from enthousiazein, to be possessed from within by a spirit or god. That sense of a powerful force from within that can fill one with energy and ideas and lose track of time is at work in all of the stories above. It is not the only ingredient to having a successful business, but I believe it is an essential one. We need to be able to geek out about what we do, to go on at length about it. Hopefully we can do so in an engaging way, but we need to be able to lose a bit of self-consciousness to be able to focus properly on our patients, our work, and our business.

Frequently I consult with therapists who come to me because they want to grow their practice. A few of them say that, but what they really mean is that they want to make more money and work less. That is not in itself a bad thing, but for some it is an attempt at compromise. For they have grown tired or disinterested in what they are doing. They feel trapped in their work, not interested in it. They are afraid that they are too old to change, or don’t have anything else they can do. Some dream about a time they’ll retire and write a novel. But for now they are consigned to sit silently and voicelessly in their office. They grow bored and resentful of their patients, who if they are lucky, escape. This vicious cycle can go on for years.

The same holds for supervision. I have heard from a lot of supervisees about supervisions where it’s all about the paperwork, or the liability, or the billable hours. I’ve heard supervisors lament how they don’t have time to focus on talking about the dynamics of therapies, as if that was “extra” stuff! My experience is that these comments are voiced midway or at the end of a progression towards burnout. First the supervisor feels overwhelmed by the “musts” of paperwork and filing 51As, and then the supervision shifts to only being about those. Next, the supervision gets defined as merely being about that, so that the supervisee sees the supervisor rushing down the hall or on the phone, pausing to ask, “Anything we need to talk about?” If there is no crisis the student feels pressured and becomes trained to say no, there isn’t. And now that supervision is only about crises and paperwork, it becomes something everyone wants to avoid because it is boring, lifeless. There is no enthusiasm.

I would suggest this is ultimately a setup for malpractice. Supervisees trust supervisors who seem interested in them. Over and over I have heard that supervisees have a hard time connecting or trusting supervisors who are “just business,” or cheerleaders. Yes, supervisees don’t want a supervisor who lets them talk for an hour and then says, “sounds like you handled that well.” This bears saying, because sometimes we unconsciously or consciously try to substitute affirmation for engagement and interest. If you’re a supervisor, don’t do it, because your supervisees can smell it a mile away. If you’re vacant, they know it. If you are filled with the spirit of interest, they know that as well.

I’ve had colleagues tell me how clever I am to have found the niche I have, which drives me crazy frankly. I didn’t choose to focus on technology, gaming and social media in therapy because I saw a vacuum. I was just lucky that there was one. I chose these areas of specialty because I am a total geek about them. I could play or talk about video games for hours. I can’t talk about Twitter or Google+ without getting animated. I see their influence everywhere, read vociferously about them on my “free” time. I wrote a book about it which I charge $2.99 for. When asked to teach a class on clinical practice I declined, and said, “No, but I’ll write a syllabus and teach a class for social work and technology.” Any of you who have taught at the graduate level know that teaching from a pre-existing syllabus is easier and less time-consuming than writing and proposing a pilot course. But I was enthusiastic about the topic, which fueled my work ethic. And this has set up a virtuous cycle, where I get more recommendations for reading or TED Talks than I can handle, and referrals to work with those patients.

I’d be lying if I said I didn’t hope someday to become famous or rich, but it is more likely that I will make a decent living and have a modest reputation. Because as I said there are thousands, no millions of people out there who have talents and interests to share with the world. I’m just grateful I got lucky enough to be one of the ones who got the chance to do it.

Filed Under: Gamer Therapy Tagged With: building your business, education, gamers, games, gaming, interest, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, supervision, technology, therapy, twitter, video games, Web 2.0, World of Warcraft

Bio Breaks

September 17, 2012 by langloimsw 1 Comment

If you’re a therapist looking to join a group of innovative colleagues for supervision, you may want to take advantage of this. Like this post? There’s more where that came from, for only $2.99 you can buy my book. I can rant in person too, check out the Press Kit for Public Speaking info. Subscribe to the Epic Newsletter!

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, bio break, children, education, gamers, games, gaming, mental health parity, private practice, psychodynamic, psychology, psychotherapy, stress, technology, therapy, video games, World of Warcraft, wow

What Back to School Could Mean

September 8, 2012 by langloimsw 2 Comments

This past week, over 70 million students from Pre-K to PhD went back to school in the United States. Of those, an estimated 1 million students are homeless, an all-time high. And this past week, many of us went back to school ourselves to teach these folks. Maybe you have a adjunct position, or maybe you are supervising an intern, or maybe you are a school counselor or work at a university health service.

It has never seemed more urgent to me then now that we help people get the educations they desire and work toward. Our country has been struggling immensely over the past several years with fiscal crashes, growing gaps between the upper, middle and working classes, and the sense of hopelessness and pessimism that accompany them. When 1 million children are homeless in one of the 10 richest countries in the world, there is a lot of change needed.

Education should be fueled by optimism even though it always begins in failure. By that I mean that we start off by not knowing stuff, and hoping to change that. If we all knew how to read, write and think critically innately, we’d never need to go to school. We begin not-knowing, but, and this is what is amazing, hard-wired to learn things. We are wired to attach to caregivers, acquire language, and make meaning of the world. And we all have the ability to have ideas.

Recently there has been a lot of useful commentary on how we need to get better at failing, in order to be able to innovate. That is true, and it is only half the story. To be able to innovate, we need to be willing to risk and tolerate failure, true. But just as importantly, we need to allow for the possibility that we could contribute something important and transformative to the world as well.

Recently I was talking with a group of my graduate students, and I asked them to be honest with me and raise their hand if they thought they could get an A in my class. I was heartened to see that 3/4 of class raised their hands. Then I said, “Now raise your hand if you believe that you could have an idea in this class that could change the world.”

One student raised their hand. It was a poignant moment for me, and I suspect many of them.

What has happened to our educational system and values that we teach people to expect they can get an A, but not come up with an idea that can change the world?

I do not fault the students at ALL for this, because I think they have been taught this pessimism by our system. SATs and standardized tests are the ways we grant access to more educational privilege in the U.S., but numbers don’t allow for the reality that everyone has the ability to ideate, to come up with a new thought that could change the world in small and large ways. And students are given or not given financial support based on numbers, which at best only indicate potential, the potential in many ways to know what has already been known, rather than the ability to discover the unknown. These numbers become a driving concern to parents and children, to teachers and students 0f all ages.

Many of the students you are working with are starting the year feeling defeated already. I remember a talk I gave a while back to students on academic probation at a community college, in the last chance class they had to pass in order to continue. Every one of them played and enjoyed some sort of video game, and I asked them why they were willing to try and fail repeatedly with video games when they were having such reluctance to try and fail at school?

One student raised his hand and answered, “because with a video game, I might win.”

What a damning indictment of the educational environment we are shaping people’s hearts and minds in. And yet, by the end of that class every one of the students had spoken, had put forth an idea of their own which brought us as a group further.

Recently, I have been playing a new MMO called Guild Wars 2 and I am finding it very timely for the back to school season. Although I have played WoW for years and have leveled characters up to 85 there, suddenly I find myself thrown into a new world. There is a completely unexplored map, a new economy to master, the game mechanics and character classes just different enough to make my keyboard skills rusty. I didn’t have a clue what was going on until I hit level 5 or 6, when suddenly I began to “get it.” The big question I have for you is, what kept me going to level 5?

I suspect the answer is that video games like GW2 create an optimistic world, where the possibility of success and creating something new is a distinct one. I kept trying in places where I got stuck because I knew both that failure was a possibility but so was success. I also had the opportunity to play the beta version, where we were always being asked by the game designers for our impressions and ideas. Many of these ideas have been incorporated into the later iterations of games like GW2, WoW, and Minecraft. These ideas have literally changed the worlds of these games.

What if we looked at our classrooms and studies more like a beta test? What if we allowed for the possibility that each of us, any of us, could have an idea that changes the world? What kind of learning and character building would that environment produce?

I highly doubt that if aliens were to visit our planet thousands of years from now that they would be impressed with anyone’s GPA. I doubt that they’d sift through the ashes of a civilization to see its test results. They might note the high levels of anxiety and rhetoric in the 21st century speeches on education reform though.

If you are a student reading this I hope you will take this to heart: I believe that you are capable of coming up with an idea that could change the world. If you are a teacher I hope you’ll fight to keep your classroom a laboratory of innovation or a beta test rather than crank out widgets of standardized educational achievement. If you are a therapist I hope you will help support your patients and their families to maintain a sense of their capability and optimism. If you are a parent I hope you will remember that your children’s willingness to take risks and find interests in the world may not always match your own or the status quo and that that is a good thing.

Someone, many someones, somewhere, many somewheres out there, a world-changing idea is about to happen. Let’s not miss it.

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, education, gamers, games, gaming, guild wars 2, gw2, mindfulness, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social justice, social media, technology, therapy, video games, Web 2.0, World of Warcraft, wow

21st Century (Psycho)education

July 8, 2012 by langloimsw 2 Comments

Whether you’re a psychotherapist, an educator or a parent, sooner or later you will be involved in the facilitation of growth through learning. The bad news is that most of us were educated in the 20th century, when education was largely modeled on the 19th century. The view of literacy then was narrower, standardized and often monolithic. The good news is that technology today can help us invigorate learning as never before, often by using the mechanics or design of video games and social media.

Before we press on, it is time to choose your own adventure! I encourage you to ask yourself and answer this question: Is education inevitably like a daily spoonful of cod liver oil? That is, do I believe that it is something that is routine, unavoidably unpleasant the people need to just suck it up and deal with?

If you answered yes, click here to stop reading this post and go to Mordor, where you can play a free MUD with other denizens of gloom and doom.

If you answered no, read on to find some examples of how simple game mechanics can revolutionize a curriculum.

1. Game Patches

Game patches are supplementary, downloadable game content that patches into existing games to either fix bugs or introduce new content into existing games. One example was the famous Burning Crusade from World of Warcraft, which added another world of play, new races to create characters as, flying, and many new quests to challenge players. More recently, Minecraft added patches to include jungles (1.2,) fixed multiple crashes (1.2.4,) and made cats more impatient and eager to sit on things (1.2.5.) Much of the patch content comes from user experience comments, and players often know and eagerly await for patches for weeks in advance of their arrival.

Introducing content into classroom settings can benefit from this approach. First off, polling students during subject matter about what aspects of what they are learning would they like to know more about? What ways can learning or behavioral problems be debugged? For example, elementary school teachers can hype up the class before rolling out Grade 3.5, at the halfway mark of the year, and include in this patch a total restructure of seating plans, allowing new class configurations and addressing problems in a way that starts to be both expected and exciting.

In terms of curriculum, from kindergarten to college, most educators have some lesson plan, and previewing content of upcoming lessons can generate interest and engagement. This can range from creating a funny trailer on YouTube with teasers for the next lesson, to releasing hints about upcoming problems and subject matter. This can include contests to name upcoming characters, for example the characters involved in mathematical word problems, or residents of new areas about to be unlocked and explored in geography.

In school-based and outpatient therapy groups, where is often a psychoeducation component, group leaders can initiate a countdown before patching new content or welcoming new group members into the group. For process-oriented groups, members can be invited to debug and modify the design of the group to deal with challenges or conflicts in the group. I remember a really interesting version of this that a colleague of mine went through in her internship. We were at an outpatient mental health clinic, and although it was not languaged as a patch, her co-leader had her join the group for the first several weeks as a participant-observer. She attended the first 4 groups without speaking, and as week five approached there was much discussion and projection from other members about what she would say when she finally spoke. She was in essence the new content “patched” into the existing group, which introduced change, and new transference while maintaining some group stability and continuity.

2. Talent Trees

If we can just get beyond the tendency towards and linear thinking in curriculum, I am convinced that this intervention could be extremely effective. First, for those of you who are unfamiliar with the idea of a talent tree, here’s an example:

In many games, players have some choices about how to specialize in the area of talents. As they progress through levels, they acquire talent points to spend on unlocking different talents. So if an educator can be flexible in the order of learning certain topics, students can choose to specialize in learning something first or second. Let’s take Literature, would you like to be an Arcane Satirist, Epic Voyager, or specialize in Bloodmagic Murder. If you want to progress through the first talent tree, you will need to read and complete assignments involving Gulliver’s Travels, the second, The Odyssey, and the third MacBeth.

If you are doing psychotherapy we already have a version of this, it’s called DBT. In it people focus on unlocking talent points in the trees of mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. Which does the patient feel that they would benefit from working on first? Which do you recommend? For adolescents especially, this can make the difference between engaging in treatment and just another boring worksheet.

Other ways to use talent trees effectively can include: Helping gamer couples unlock skills to better communicate or improve their sex lives; helping parents focus on and prioritize specific behaviors to work on with their children; a template for an emergent adult’s first career search; and systematic desensitization of a phobia.

These are just two ways that we can use both the technology and concepts behind it effect change therapeutically and educationally. Can you think of others?

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Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, children, dbt, education, gamers, gaming, play, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, stress, technology, therapy, video games, Web 2.0, World of Warcraft

Unplanned Obsolescence: Rethinking Play Therapy

June 10, 2012 by langloimsw 13 Comments

Recently I ordered a copy of Call Of Duty: Modern Warfare 3, which I plan to try this week. As I have mentioned in a previous post, I am not easily interested by first-person shooters, but as a gamer-affirmative therapist I can’t let my low interest get in the way of educating myself.

I once calculated that by a conservative estimate I had played approximately 27,000 games of Uno in my decade working in a public school as a clinical social worker. I drove around with a ton of board games and a sand tray as well. I had learned the value of play therapy at the first placement I ever had as an intern, from Winnicott’s squiggle game to the infamous Talking, Feeling, Doing Game. This is all a roundabout way of establishing my “street cred” for valuing play therapy.

Back then, I would go home from work, and many times play Legend of Zelda: Majora’s Mask on the Nintendo 64. My roommate at the time liked to hang out with me while I played and we chatted about life, education (he was a teacher) and politics. He also liked to imitate the fairy guide in the game, and would often cry out, “Listen!” and offer a couple of tips.

In all those years, it never occurred to me that I could have played those games at school if I’d had an office (and some years I did) or that there was a disconnect between what I was doing with the students (card playing) and what they were talking about (Nintendo, XBox, Playstation.) I could hold a conversation with them about these things because I played them in my spare time, but the idea of playing them with my students didn’t register as, well, therapeutic.

I am not alone in this. Many if not most play therapists are not inclined to play video games with their patients, and it is time to rethink this. When 97% of the boys and 94% of the girls we work with play video games, it is no longer an outlier. But there are a few fallacies which I think get in the way of play therapists integrating play therapy into the 21st century.

One I hear frequently is that video games don’t require imagination, or offer projections to explore. But I think this is contempt prior to investigation for the most part. The proliferation of video games is itself the best evidence that there is imagination going into each generation of games, which are produced by imaginative people who must have been able to develop their imagination in part through video games. And we don’t start each session making our children build their own dolls and dollhouse from scratch. We use available tools that do to an extent always structure and limit the imagination. For example, why does the dollhouse have a pointy roof and two floors? This is limiting, and in fact didn’t represent 90% of the urban population I worked with at all. And few play therapists would avoid using Elmo puppets on the grounds that it limits the imagination of the child, even though Elmo is clearly an icon of popular culture.

In fact, play has often had its inception in the popular culture of the time. We may take chess for granted now, but when it came into being it was a reflection of a medieval monarchy, with kings, queens, and bishops. Yet play therapists often fall prey to nostalgia, if not luddism, and maintain that there are certain games and play that are relational and therapeutic, and others, usually the modern ones, are not.

This brings me to what I suspect is another reason we resist using video games in play therapy, which is the therapist’s fear of being incompetent or failing at the unfamiliar. Years of training in a traditional educational model have taught us to silo down in our area of “expertise” as soon as we can. We “major” in psychology or social work, go to graduate school for advanced specialization, and basically get to a point where we can work in a routine and structured environment. For years we get in the habit of certain forms of play therapy: Candy Land, Chutes and Ladders, cards, chess, dollhouses and telephones. These are easy and portable, but more importantly perhaps, we know how to play them, so we can not be “distracted” by the game, or lose by design if we want to build the kids self-esteem, and otherwise feel in control of the play situation.

It’s time we work through this resistance. People can and do have conversations while they play video games, and video games are in themselves social media. There are plenty of metaphors to explore in and after video gameplay. Angry Birds is rife with themes of anger, different abilities, and protecting the innocent and defenseless. Call of Duty can give rise to expression of competition, drives, and the hunger for destruction or cooperation. And a recent (to me) favorite, Demon Souls, is a tone poem on isolation, yearning to connect, and persistence in the face of despair.

I’m sure I’ll get comments arguing that video games are inherently violent as well. To which I would respond, just like Battleship and the card game War are inherently violent. We have become insulated to the violence in them, and it may not have the graphic sophistication of video games. But the next time you play Battleship ask yourself what you think happened to all the people on the battleships that sunk? The game doesn’t come with little lifeboats, you’re drowning people. Play therapy does not avoid violence in its expression.

Virginia Axline, one of the founders of modern play therapy, had 8 guiding principles for play therapists:

The therapist must develop a warm, friendly relationship with the child, in which good rapport is established as soon as possible.
The therapist accepts the child exactly as he is.
The therapist establishes a feeling of permissiveness in the relationship so that the child feels free to express his feelings completely.
The therapist is alert to recognise the feelings the child is expressing and reflects those feelings back to him in such a manner that he gains insight into his behaviour.
The therapist maintains a deep respect for the child’s ability to resolve his own problems if given an opportunity to do so. The responsibility to make choices and to institute changes is the child’s.
The therapist does not attempt to direct the child’s actions or conversation in any manner. The child leads the way; the therapist follows.
The therapist does not attempt to hurry the therapy along. It is a gradual process and is recognised as such by the therapist.
The therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the child aware of his responsibility in the relationship.

Nowhere in there does it say, the therapist sticks with the tried and true games s/he grew up with. To my colleagues who are ready to decry the death of the imagination and lesser play of video games, I think Axline said it best: “The child leads the way: the therapist follows.”

Following in the 21st century means having Gameboys and Playstations in our repertoire. If we don’t keep learning and using technology in our play therapy, we may find ourselves in a state of unplanned obsolesence. Am I saying we should stop playing Jenga and Uno? No. But if our patients are looking for video games amongst the chess sets and dollhouses, perhaps they are telling us something we need to pay attention to. Just because we don’t know how to play a game doesn’t exempt us from learning it. And what a gift it can be for an adolescent to experience themselves as more competent and talented by an adult! So many of them come to us having been labeled as “failed learners,” and we have the potential to help them experience themselves as successful teachers, of us.

Those of us working in agencies and schools need to resist the temptation whenever possible to use the excuse of needing to be mobile or budgetary constraints. Video games are now as portable as a Nintendo DS PSVita or Smartphone. And the price of a video game system is not so prohibitive as to be a given. The real reason we often don’t advocate for video games at the agency or school is our own bias that they are somehow less valuable as therapeutic play media.

I anticipate that this will meet with resounding criticisms from the “play-is-going-to-hell-in-a-hand-basket” crowd, but I’m really interested in hearing from colleagues who have managed to successfully integrate video games into their play therapy. What are your success stories? What have been some challenges you’ve had to overcome? Do you schedule online play sessions? How do you manage the noise in an office suite? I’m really interested in your experiences.

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Filed Under: Gamer Therapy Tagged With: adolescents, angry birds, call of duty, children, dark souls, demon's souls, education, gamers, gaming, play, private practice, psychotherapy, technology, video games, virginia axline, Web 2.0, World of Warcraft

Digital Citizenship and the Forward Edge Transference

April 28, 2012 by langloimsw 11 Comments

Recently I had an opportunity to visit a school for a daylong workshop, where I got to meet with the kids during the day, and their parents at night. I love it when this happens because I can then ask the children what they struggle most about with their parents regarding technology. So during the course of the morning I asked over 425 5th, 6th, and 7th graders what I should help their parent understand about technology. I got lots of great answers from them all, and my favorite one came when one 7th grader raised his hand and said, “can you please explain to my parents that multiplayer video games have no save?”

There are several reasons why that request is actually brilliant, but the one I want to focus on is how this statement, and a person’s frustration at being asked to log off in the midst of a multiplayer video game may be a forward edge transference.

The term “forward edge transference” comes from Marian Elson’s work in self-psychology. She has described the forward edge transference as being akin to what Kohut was talking with his interns about when he described leading edge transference. Forward edge transferences, according to Tolpin, are tendrils of psychological growth in the patient, often hard to see, if not completely overlooked, by the therapist because they don’t look like growth. Often we consider “psychological growth” as in the eye of the beholder, whether it be therapist, parent, teacher or someone else other than the patient. One of the example’s Tolpin uses is that of a patient who cuts to be able to “feel,” and to bleed. The forward edge transference there in Tolpin’s estimation, is the self’s still healthy yearning for kinship, to “bleed like everyone else.”

I use this example because it very powerfully demonstrates how even an easily pathologized concern such as cutting, could indicate a tendril of healthy growth, easily overlooked. The behavior forward edge transference travels concealed within is glaringly “obvious” to us, and because of that forward edge transferences may be misunderstood, and the striving for psychological health get stymied.

So what does this have to do with Massively Multiplayer Online Games?

As I mention in my book MMOs are a form of social media, and collaborative play, where the player is often cooperating with a group of others in a raid or guild to achieve something that could not be accomplished individually. Whether it be downing a dragon in World of Warcraft, unlocking guild achievements, or building a city overnight in Minecraft, the player is part of a larger group. They matter to the larger group.

Embedded in the comment “multiplayer has no save” is the forward transference for a sense of kinship, and more specifically the dawning of a concept of being a digital citizen. Here is an adolescent saying that they understand their behavior has an impact on others, that they want to collaborate online, and that they feel responsible to the larger group. Saying in fact what all the adults around them have been trumpeting for over a decade of their lives in most cases.

A digital citizen is defined in Wikipedia as “a person utilizing information technology (IT) in order to engage in society, politics, and government participation.” To be a digital citizen requires “extensive skills, knowledge, and access of using the internet through computers, mobile phones, and web-ready devices to interact…” And the elements of digital citizenship per digitalcitizenship.net include:

Digital Access:full electronic participation in society.
Digital Commerce:electronic buying and selling of goods.
Digital Communication: electronic exchange of information.
Digital Literacy:process of teaching and learning about technology and the use of technology.
Digital Etiquette: electronic standards of conduct or procedure.
Digital Law:electronic responsibility for actions and deeds
Digital Rights & Responsibilities: those freedoms extended to everyone in a digital world.
Digital Health & Wellness:physical and psychological well-being in a digital technology world.
Digital Security (self-protection):electronic precautions to guarantee safety.

Here’s the rub: If you look at those elements, many of the adults charged with caring for and educating the young aren’t necessarily competent digital citizens themselves. I can tell you for a fact that I have participated over the past decade with professionals and peers on listservs and bulletin boards, and have seen appalling standards for conduct and procedure. It rivals anything I’ve seen adolescents do to each other.

We live in interesting times, when we are entrusted to educate youth about a technology when we often don’t know how to use socially and effectively ourselves. We tell them not to interrupt, then answer our cell-phones in the middle of them telling us about their day. We tell them to pay attention to us even as we’re checking our emails on the Blackberry. We stalk them on Facebook to censor them in one browser window, and post embarrasing pictures and comments of them in another. And we pull the plug on them while they’re playing an MMO even as we tell them that they’ve been inconsiderate of their younger sibling who wants a “turn.”

Part of the problem here is our neophyte digital citizenship. People from older generations tend to think of video games as this:

when they’re actually more like this:

When was the last time you showed up at your daughter’s basketball game in the 3rd quarter and told her, “you’ve been on the court long enough, you’re coming home?” And yet, we do this to kids online all the time, and foil their attempts to be team players and group contributors.

There’s a lot at stake here: Multiplayer has no save. 10-30 people, often from all over the world have come together to try to overcome an obstacle. When you pull the plug, you’re pulling it on all of them. It is great that our kids know this and care about it!

Most of us have wanted to be a part of something bigger than ourselves, to create something together, even if it is just one moment or memory with others. We need to look at video games without the Pong Goggles, and see it as a form of society and an opportunity for digital citizenship.

To recognize the forward edge of a transference is never an easy thing. It is small, fragile, the newest shoot of growth. In a sense, all of us on this planet are in the midst of such a tendril of growth when it comes to technology. But the time when digital literacy was optional has passed, and we need to do a better job with the next generation of digital citizens than we are doing.

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Filed Under: Gamer Therapy Tagged With: adolescents, adultism, children, digital citizenship, digital literacy, education, forward edge transference, gamers, games, gaming, Kohut, mmos, play, psychoanalysis, psychodynamic, psychology, psychotherapy, self psychology, social justice, tolpin, video games, Web 2.0, World of Warcraft

Worth a Thousand Words?: Infographics on Video Games

April 1, 2012 by langloimsw 4 Comments

For those of you who haven’t heard, Pinterest is a pinboard style of social media which emphasizes visuals. Recently I was trying to learn more about it and how it might apply to the psychotherapy/psychology field. So far I can see possibilities:

DBT- Using Pinterest to create worksheet boards, or better yet boards of images which provide self-soothing for distress tolerance.

Behavior Charts which are visual and available instantly from home instead of going home in a book bag and being forgotten.

Virtual Comic Books to help adolescents learn and practice sequencing and pragmatic speech.

Screenshots of video games that can be shared by gaming patients with gamer-affirmative therapists.

Psychoeducation Tools for a variety of issues, including the above example. Click on the image to see my board on Infographics for video games and gaming. They are not intended as professionally vetted research, and you’ll not the heading encourages viewers to check out the research.

There are obviously things to be concerned about, such as privacy and how best to bring Pinterest into the therapeutic session, office and process. Pinterest is not HIPAA-compliant, for example, so would a link sent via hushmail be secure enough for some uses? How might we make sure our patients could use this powerful visual tool in a way that did not disclose what health information described what they were using it for.

What do you think? How might we use this powerful visual medium to enhance our treatment with patients in an best-practice way?

Like this post? There’s more where that came from, for only $2.99 you can buy my book. I can rant in person too, check out the Press Kit for Public Speaking info.

Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, chris brogan, dbt, education, gaming, mental health parity, minecraft, pinterest, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, social media, video games, Web 2.0, World of Warcraft, wow

The Kids Are All Right

February 4, 2012 by langloimsw 4 Comments

image courtesy of gamerfit.com

Last week some family friends came over to our house for dinner. The children, we’ll call them Larry, Curly and Moesha, were ages 12, 4, and 8 respectively. As you may imagine, children enjoy coming over to the Gamer Therapist house, which has 3 gaming consoles and a dedicated big-screen TV. After a quick tour of the gaming room, Larry and Moesha sorted through my games and located Portal 2, and within minutes had set themselves up to play cooperative mode. Curly was content to sit between them, and the adults retired to the first floor to hang out and prepare dinner.

Throughout the evening we could hear the sounds of the happy gamers and the game, while my friend Rebecca talked frankly about her ambivalence about their gameplay. The ambivalence sprang primarily from a well-meaning friend who had criticized her parenting style. Another set of parents had told them that their children wouldn’t be able to play with them anymore because they thought that the children were picking up bad messages from video games.

This conversation was interrupted by the children twice, both by Moesha. The first time she came down to inform us that Larry had succeeded in unlocking a very difficult achievement. The second time she came down to ask me if I could join them and help them solve a puzzle in the game they had been struggling with. I went up, and within a few minutes a fresh perspective and Larry having some patience as I familiarized myself with the controls had advanced them to the next level. A polite thank you let me know that I was no longer required, and I returned to our conversation.

A discussion about education and video games was in full swing, and a debate about how much screen time is too much. At this juncture I pointed out how hard it is for us to catch children when they are doing things right. I observed that for the past 2 hours children, siblings, spanning an age difference of 8 years had been engaged in cooperative learning. What’s more they had voluntarily engaged with the adults on two occasions. The first was for one child to express pride in the achievement of her sibling. The second was to request adult assistance with some problem solving. And all along our parental ears had heard not one whit of conflict or argument. Yet all of this would have been easy to miss, or worse, dismiss as “parking the children in front of a screen.”

Every day, parents like Rebecca are bombarded with much-hyped exposes on how dangerous video games are to children. Horror stories like the one my colleague at BC psychologist Peter Gray blogs about are touted, in which a South Korean young man plays for 50 hours straight and dies after going into cardiac arrest. Gray goes on to put this tragedy in perspective: There are 7 billion people on the planet, and this incident represents 0.000000014% of the population. It is by contrast far more difficult to catch the number of children and adult gamers doing things like learning physics, researching a vaccine for HIV, or gaming to raise money for hospitals.

And although studies linking the dangerous connection video games have to childhood obesity, the media somehow never manages to pickup ones like this that showed that children who had electronic devices in their room were more likely to engage in outdoor play. Perhaps the Obama administration did read this study though, as they are moving to a more gamer-friendly position with the appointment of Constance Steinkhueler to study the civic potential of playing games (Thanks to my colleague Uriah Gilford for calling my attention to this.) The video game danger is overhyped.

Parents are playing a game far more dangerous than any video game, and that is the “Who Is Parenting Best” game. Over and over I hear conversations about what the best school district is, how to set privacy settings and enrichment activities. This despite, as Rob Evans EdD. points out in his book Family Matters that by age 18 children and adolescents will have only spent about 10% of their total lives in school. Setting privacy settings is the first and most minimal step to helping children navigate the 21st century community that relies on the internet. And enrichment activities are unfortunately often activities that appeal to what a parent wants quality time to look like, rather than what a child enjoys.

In discussing school districts, privacy settings and quality time, parents are often missing the point. Worse, they are confusing worry with effort.

We need to stop “phoning it in” with our kids, finding the “right” school, program or setting to park them on so we don’t need to worry. It is human nature to want to get to a safe spot to relax and stop changing: We need to fight it.

Often when I speak with parents who complain about the amount of time their offspring are spending playing I ask them if they have ever played the game with their child. The answer is invariably that they haven’t, even though a recent study showed that girls who gamed with their fathers reported lower levels of depression. Quality time always has to be some Puritanical ideal: a bracing hike, the symphony, or a museum. I love doing all of those things, which is why I do them. That doesn’t mean that a child or adolescent will have them as a preferred activity.

I know, I’m criticizing your parenting, please bear with me. Because you can take it, and your children need you to stop playing the Who Is Parenting Best Game. They need you to try playing Portal 2 with them if that is what they’re into. If you fumble with the controller, all the better, because we adults have forgotten how clumsy and awkward learning makes children feel. Education has gone taught us to find a safe spot and stop learning about anything that is outside that comfort zone.

We have long known that one of the strongest protective factors for children is an involved parent, but somewhere along the line we have gotten the mistaken idea that that means control. To be clear, parental control does not equal parental involvement. At best it is one element of involvement, at worst it is phoning it in.

Does this mean schools have no responsibility? Absolutely not. But I would like to suggest we return to Larry, Curly, and Moesha for a different example, namely a curatorial model. That means setting up a place for them to explore and negotiate things on their own for the most part, while we are constantly available for engagement. Yes that is a tall order, and one that requires that we think beyond the nuclear family and school as factory models.

I am fortunate to belong to massivelyminecraft.org a server where children and adults from the UK, US, Australia and other places play the sandbox game Minecraft together. It is not segregated by age, but vetted by the server moderators, who require parental permission for children to join. Within the game world, you can see adults and children learning and playing together at any hour of the day or night. They are voluntarily learning about geometry, math, physics, animal husbandry, chemistry, geology, economy, social skills, communication and a host of other things, in a way that is curatorial rather than proscriptive. Adults are there and occasionally on chat or via Skype will step in to mediate a conflict between two children, or if help with a task is requested.

Why can’t 21st century education be like this? Imagine a virtual classroom where parents and teachers can privately chat while both observing unobtrusively a child’s progress. Imagine homework at the table replaced by building a virtual pyramid together. Imagine virtual trips to Paris in Second Life, where no one is too poor to come along. Imagine time on learning that is maximizing the child’s engagement and minimizing unnecessary supervision. Imagine adolescents finally having educational settings that run synchronously with their biological clocks. Imagine a collaborative effort that doesn’t segregate human beings by rigid grades, parent/teacher roles or socioeconomic status. Imagine recess that can happen year-round, sometimes in a field, sometimes on the Wii Fit or Kinnect.

I believe the research is showing more and more that these things are possible. And I believe that our children are counting on us taking a leadership role in technology and education rather than a fear-based ones.

I leave you with this image. As he was leaving my house, Larry looked at me and declared that I “wasn’t entirely horrible” for an adult. What parent wouldn’t love to hear such high praise from their tween?

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Filed Under: Gamer Therapy Tagged With: addiction, adolescents, behavior change, children, education, gamers, games, minecraft, parenting, play, psychology, psychotherapy, social media, video games, Web 2.0, World of Warcraft

The Uses of Disenchantment

January 12, 2012 by langloimsw 6 Comments

Magic fulfills the wish that we could have powers to be beyond who we sadly suspect we are. As children, magic explains the inexplicable nature of external forces (i.e. parents, teachers, death) and internal ones (unconscious drives, nameless attachments, inconsolable sorrows and consuming rages.)

Anyone who plays WoW, Elder Scrolls, or Dungeons & Dragons, knows that enchanted weapons and armor are valuable items to be gotten. They raise our stats, make us stronger, more intelligent agile, or resistant to harm. They fulfill the wish that we could be more than we are.

That being the case, the profession of Enchanting is a very valuable one to master. To do so is to be able to craft our own items for use or to sell. And to master the skill requires not only enchanting practice, but also the act of disenchantment.

Disenchantment is the breaking down of an enchanted item into its component reagents. In Skyrim this consists of taking the enchanted item and destroying it, which allows you to discover the enchantment. So, for example, if you come across an Iron Battleaxe of Scorching, you have a choice. You can enjoy your new battleaxe which will add fire damage to the physical damage you do using it. Or you can disenchant it, and learn how to imbue any weapon with the ability to do fire damage.

In World of Warcraft disenchanting items is necessary to provide you with the reagents, or raw materials, to do other enchantments. Learning the enchantment is done separately, by training or reading a recipe, but disenchantment is still necessary to break down enchanted items into components you can use for other enchantments. Enchantment operates in the domain of creation and destruction, attachment and loss. I can remember feeling many the hesitation as I was about to take an Epic staff I’d used for months and dissolve into Abyss Crystals. Even though I knew that I was going to get a new weapon with a strong enchantment out of it, disenchantment required sacrafice.

Many patients labor under the illusion that the purpose of therapy is to make you feel good. I have always maintained that that is not true. Therapy is not about making you feel good, but rather about learning how to not to feel good. It’s about learning how to experience and tolerate those unpleasant feelings in a different way than we’ve learned to previously. People abuse substances, food, sex, and yes, occasionally video games because they cannot tolerate feelings that don’t feel “good.” Who wants to feel inconsolable sorrow, thwarted passion, grief, terror, or hopelessness?

And so people come to us wanting symptom reduction, not character building; relief, not the raising of unmentionable wishes and fears to consciousness. At first, we often provide those other things to be sure. A compassionate ear to listen, a calming influence, a holding environment. But in the end, therapists are alchemists and enchanters: Nothing new can be created by our patients without something being destroyed. Something must be given up to create something else.

Consider this: Neurosis is like an enchanted armor that we can no longer use. Maybe we have outgrown it. Maybe it never really fit well but it was the best compromise we could come up with. Maybe it buffed up our strength stats when we really needed more intelligence to play our class effectively. For whatever reason, it is no longer helping us, in fact it has created distress.

Symptom reduction alone won’t solve this problem. It may alleviate our distress for the moment, relieve pain enough to create the “space” between feeling and behavior so that we can begin to do the longer-term work.

That’s where disenchantment comes in. We need to take the item, the neurotic conflict, and break it down into the components that create it. What is the wish and the worry? What causes the guilt? Just what are we so afraid of that we can’t look at it directly?

This doesn’t always have to be painful, and therapists shouldn’t use this as a justification for brutality. But to think that the process of therapy is not going to be uncomfortable and difficult; is not going to take some time and hard work is pretty much delusional. If our enchantments could have gotten us any farther we wouldn’t have given them up. Most addicts and alcoholics would have used longer if they could have. If they could have enjoyed one more binge, party or high, they would have.

Insurance companies love to focus on symptom reduction, and a narrow view of what evidence-based treatment really is. Symptoms are problems to be solved, rather than signposts pointing towards underlying issues. And although this is short-sighted, it is understandable: 10 sessions costs a lot less than weekly sessions. And yet, the most recent research I’ve read indicates that psychodynamic therapy is as effective as CBT and other therapies, and in fact more effective in sustaining longterm change.

Bruno Bettelheim, a psychoanalytic thinker, is perhaps best known for his book The Uses of Enchantment. In it he discusses how the themes of fairy tales often symbolize the real emotional and psychological struggles that children go through. Through the projections of stories, children are able to work through their fears in remote and tolerable ways. In a similar way, Klein speaks of the paranoid-schizoid position where the parent is split into good and bad objects, the fairy godmothers and evil witches of fairy tales.

Disenchantment, from a Kleinian lens, leads to the depressive position. It is where we hopefully get to, despite the depressing name, that point when we realize that people are not either all-good, or all-bad, but both good and bad, nurturing and depriving, gratifying and frustrating. In other words, human. The world seems less magical in some ways, and that is experienced as a loss. Sounds depressing, eh? So what is gained?

There is a practice in Tibetan Buddhism called tonglen. In this form of meditation, you begin by touching the tender spot of whatever is sorrowing or distressing to you. Say you’ve lost your loved one. Allow yourself to feel that grief for a moment, really feel it. What an awful wrenching feeling that is. You may reflect that nobody should have to feel what you’re feeling right now. And yet, all over the world, there are those who have felt that, may be feeling it even as you are right now. So you breathe in, and imagine breathing in all of that grief as if for that moment you could take it into your heart so that nobody else would have to feel it. And then you imagine yourself breathing out comfort and security and everything that is the opposite of grief and suffering to the world and to all those in it who need it. You reverse the cycle of trying to avoid pain and grasp pleasure, and in doing so generate compassion.

That is the use of disenchantment; breaking down our fantasies that we can avoid pain and transmuting it into compassion for others. Imagine if you were to really accept that everyone is human and fallible and mortal. If you were able to walk around tomorrow and remain conscious that everyone you meet is dying, would you treat them in the same way as you did today?

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Filed Under: Gamer Therapy Tagged With: addiction, bettelheim, buddhism, children, disenchantment, enchantment, gamers, gaming, klein, managed care, psychoanalysis, psychodynamic, psychology, psychotherapy, Skyrim, therapy, tonglen, World of Warcraft

Not All Failure Is Epic

December 4, 2011 by langloimsw 5 Comments

In gaming there is a concept known as the “Epic Fail.” Roughly translated this means, a failure so colossal, so unbelievable in its nature, that it will go down in history as epic. Epic failure can be extremely frustrating in the moment, but is almost always funny in retrospect.

Recently I was playing Dark Souls, and I was trying to down two bosses known as the Belltower Gargoyles. Just as you get one down to half health, the other, who likes to breathe fire on you, shows up. Oy. I kept getting killed, which sent me back to a save point, running back up the belltower, and trying again. What kept me going up there was that each time I was surviving a few seconds longer, and each time I was getting the gargoyle’s health down a little more. At one point I started to consistently kill the first gargoyle before the second one finished me off. Finally, through an unbelievable feat of mashing all the buttons, luck, and strategy, I beat them both.

The failure that kept happening was not what I would call Epic Failure. It was certainly what Jane McGonigal et al call fun failure though. It was failure with just enough progress mixed in that I’d say, “Oooh, you’re going to get it,” to the gargoyles and try again. And again. Fun failures in video games are designed to work that way. The game can’t be so hard that the person gives up, but can’t be so easy that you don’t feel challenged. Because if you don’t feel challenged then there is little or no sense of accomplishment.

Heinz Kohut, one of my favorite psychoanalytic thinkers, would probably have a lot to say about video games if he were alive today. Kohut knew that failure was a part of life and human development. In fact, he thought that therapy was full of failure. He talked about empathic failure, when the therapist fails to respond empathically to the patient in some way. Maybe we don’t pay attention enough to a story, or don’t remember something, or start 5 minutes late. These are all parts of the therapist being human, and therefore being unable to stay absolutely in empathic attunement with the patient. This kind of failure is inevitable.

Kohut goes on to say that it is not necessary to deliberately make mistakes and empathically fail our patients, because we are going to do so naturally in the course of our work with them. In fact, to deliberately fail our patients is rather sadistic. But usually we aren’t being sadistic when we forget something, or run late a few minutes, even though the patient may experience it that way.

So first a note to therapists here. In the course of your work with patients you are going to fail a lot. But not all failures are epic. That is not to say that your patients won’t experience it that way. That vacation you’re going on may be an epic failure on your part, as far as they are concerned. Does that mean you cancel your flight plans? Of course not. Our job is initially to help the patient by understanding by empathy the epic nature of our failure from their point of view. We try to imagine ourselves into that moment they are having.

But that doesn’t mean that we stay there. We need to maintain some perspective, have some sense of fun failure, to keep doing our work. By that I don’t mean have fun at our patient’s expense, but rather be able to be lighthearted enough in our introspection to say “Oops, I missed that one,” or “there I go again.” If we can do that we are able to then refocus on the patient. If we instead get sucked into the idea that this is an Epic Fail we will lose all perspective, and actually start focussing on ourselves rather than the patient.

Do you ever say to yourself, “I’m such a bad therapist?” I don’t. Of course, I also don’t say, “I’m such a perfect therapist” either. I do frequently think, “I was not at my best today,” or, “oooh, how come I keep missing that with patients!” This helps me keep perspective so that I can get back in the game as soon as possible.

Whether you are a therapist, a gamer or someone else who is still breathing, chances are that you are failing sometimes. In fact, this time of year with all its’ hype and expectations about being joyful and loving families can make you feel even more like a failure. Some examples of Epic Fail statements that we think consciously or unconsciously include:

I’m a terrible parent.
I’m a terrible daughter/son.
I’m a terrible sex partner.
I’m a terrible worker.
I’m a terrible cook.
I’m a terrible student.

and the list could go on.

If any of those sounds like you, take a moment to reflect. Is this really an Epic Fail? Or are you distorting things? Chances are you are not a perfect parent, child, worker, sex partner, student or anything else. But if you really identify this as an Epic Fail, chances are you are solidifying a form of self-identity rather than accurately appraising yourself.

Why would we do that? Well, one reason is that we learned those messages of Epic Failure as a child. You probably still remember a few failures that can make your stomach churn if you think of them. But as often, I think we grasp on to solid identities, even negative ones, so we can stop working on ourselves. I’m just X, I’m the kind of person who can’t Y, Nobody ever thinks Z about me: These all kill our curiousity about ourselves and help us stay stuck.

Mindfulness is about fun failure. It is about being able to look at ourselves and reflect on ourselves without going to extremes. Mindfulness is about being able to be curious rather than judgmental, having roominess in our minds and souls rather than rigidity. This perspective leads to “Ooooh, I’m going to get that boss down this time.” The other leads to hopelessness.

So try to remember this as the days are getting shorter and tensions may be rising: Not all Failure is Epic. And if we can be right-sized about our failures we can learn from them. We can take an interest in our thoughts, feelings and behaviors rather than judge ourselves. If we catch ourselves saying “what kind of monster I must be to hate Aunt Myrtle,” we can perhaps think, “oops, there I go again. Isn’t it odd/interesting that I feel hatred towards Aunt Myrtle, what’s THAT about?”

Eighty-five percent of the time gamers are failing. And yes some of those are Epic, but the gamer attitude is to view those Epic Failures as moments of camaraderie and learning. In life outside the game, do you treat the Epic Fail that way? Do you seek out others and try to learn from the experience, or do you isolate? There is always some observing ego in the game Epic Fail that is often lacking in our non-game life. And in some ways that is understandable, you can’t always reset in life outside video games.

But consider this: Where there is life there is hope. If this was a true Epic Fail in your life you can still learn from it in time. Failures are inevitable, but with time and perspective they can be instructive as well. In the end I’d say that whether you think you’ve had an Epic Failure or not what matters most is how you move on from it. Who knows, maybe the only real Epic Fail is the one where you give up..

Note: No real Aunt Myrtles were hated in the writing of this post.

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Filed Under: Gamer Therapy Tagged With: behavior change, buddhism, dark souls, education, Kohut, narcissism, private practice, psychoanalysis, psychodynamic, psychology, psychotherapy, video games, World of Warcraft

Dopey About Dopamine: Video Games, Drugs, & Addiction

November 8, 2011 by langloimsw 23 Comments

They’re absolutely right, video games have been shown to increase dopamine levels by 100% (aka doubling.)

Just like studies have shown that food and sex increase dopamine levels:

But here’s the other thing that gets lost in the spin. Not all dopamine level increases are created equal. Let’s take a look at another chart, from the Meth Inside-Out Public Media Service Kit:

One last chart for you, again from the NIDA. This one shows the dopamine increases (the pink line) in amphetamine, cocaine, nicotine and morphine:

Of all of these, the drug morphine comes closest to a relatively “low” increase of 100%.

So my point here is twofold:

1. Lots of things, not all or most of them drugs, increase the levels of dopamine.

2. Drugs have a much more marked, sudden, and intense increase in dopamine level increase compared to video games.

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Filed Under: Gamer Therapy Tagged With: brain, dopamine, education, gamers, gaming, neurology, private practice, psychology, psychotherapy, video games, World of Warcraft

A Follow Up to Dings & Grats

October 18, 2011 by langloimsw 12 Comments

My last post, “Dings & Grats,” generated quite a lot of commentary from both therapists and gamers alike. I was surprised at many of the comments, which tended to fall into one of several groups. I’ll summarize and paraphrase them below, following with my response.

1. “I haven’t seen any research that shows video games can increase self-confidence, but I have seen research that shows they cause violent behavior.”

Fair enough, not everyone keeps up to date on research in this area, and the media certainly hypes the research that indicates “dire” consequences. So let me direct you to a study here which shows that using video games can increase your self-confidence. And here is a study from which debunks the mythology of video games causing violence.

2. “I find gamers to be generally lacking in confidence, introverted, reactive and aggressive, lacking in social skills, etc.”

These responses amazed me. Gamers are part of a culture, and I doubt that many of my colleagues would say such overarching generalizations about other groups, at least in public. Would you post “I find women to be generally lacking in confidence,” or “I find obese people introverted,” or “I find African American people lacking in social skills?” And yet the open way many mental health professionals denigrated gamers without any sense of observing ego was stunning. I was actually grateful that most of these comments were on therapist discussion groups, so that gamers didn’t have to read them. This is cultural insensitivity and I hope that if my colleagues aren’t interested in becoming culturally competent around gaming they will refer those patients out.

3. “Real relationships with real people are more valuable than online relationships.”

This judgment confused me. Who do we think is behind the screen playing video games online, Munchkins? Those are real people, and they are having real relationships, which are just as varied as relationships which aren’t mediated by technology. Sure some relationships online are superficial, and others are intense; just like in your life as a whole some of your relationships are superficial and others are intense and many between the two. I’ve heard from gamers who met online playing and ended up married. And if you don’t think relationships online are real, stop responding to your boss’s emails because you don’t consider them real, see what happens.

4. “Video Games prevent people from enjoying nature.”

I am not sure where the all or nothing thinking here comes from, but I was certainly not staying that people should play video games 24 hours a day instead of running, hiking, going to a petting zoo, or kayaking. I know I certainly get outside on a daily basis. But even supposing that people never came up for air when playing video games, I don’t think that would be worse than doing anything else for 24 hours a day. I enjoy running, but if I did it 24/7 that would be as damaging as video games. What I think these arguments were really saying is, “we know what is the best way to spend time, and it is not playing video games.” I really don’t think it is our business as therapists to determine a hierarchy of leisure activities for our patients, and if they don’t want to go outside as much as we think they ought to, that’s our trip.

5. “I’m a gamer, and I can tell you I have seen horrible behavior online.”

Me too, and I have seen horrible behavior offline as well. Yes, some people feel emboldened by anonymity, but we also tend to generalize a few rotten apples rather than the 12 million + people who play WoW for example. Many are friendly or neutral in their behavior. And there is actually research that shows although a large number of teens (63%) encounter aggressive behavior in online games, 73% of those reported that they have witnessed others step in to intervene and put a stop to it. In an era where teachers turn a blind eye in”real” life to students who are bullied or harassed, I think video games are doing a better, not worse job on the whole addressing verbally abusive behavior. Personally, I hate when people use the phrase “got raped by a dungeon boss,” and I hope that people stop using it. But I have heard language like that at football games and even unprofessional comments at business meetings. I don’t think we should hold gamers to a higher standard than anyone else. Look, we’ve all seen jerks in WoW or Second Life, but we’ve seen jerks in First Life as well. Bad behavior is everywhere.

6. “Based on my extensive observations of my 2 children and their 3 best friends, it seems clear to me that…”

Ok, this one does drive me nuts. If you are basing your assertions on your own children, not only do you have a statistically insignificant N of 2 or so, but you are a biased observer. I know it is human nature to generalize based on what we know, but to cite it as actually valid data is ludicrous.

7. “I think face to face contact is the gold standard of human contact.”

Ok, that’s your opinion, and I’m not going to argue with it. But research shows that it is not either/or, and the majority of teens are playing games with people they also see in their offline life. And let’s not confuse opinion with fact. You can think that video game playing encourages people to be asocial, but that is not what the research I’ve seen shows. In fact, I doubt it could ever show that, because as we know from Research 101 “correlation is not causation.”

By now, if you’re still with me, I have probably hit a nerve or too. And I’ve probably blown any chance that you’ll get my book, which is much more elaborate and articulate at this post. But I felt compelled to sound off a little, because it seemed that a lot of generalizations, unkind ones, were coming out and masquerading as clinical facts. Twenty-First Century gaming is a form of social media, and gamers are social. What’s more they are people, with unique and holisitic presences in the world. I wasn’t around to speak up in the 50s, 60s and 70s when therapists were saying that research showed all gays had distant fathers and smothering mothers. I wasn’t around when mothers were called schizophrenogenic and cited as the cause of schizophrenia. And I wasn’t around when the Moynihan Report came out to provide “evidence” that the Black family was pathological. But I am around to push back when digital natives in general and gamers in particular are derided in the guise of clinical language.

To those who would argue that technology today is causing the social fabric to unravel, I would cite a quote by my elder, Andy Rooney, who once said, “It’s just amazing how long this country has been going to hell without ever having got there.”

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Filed Under: Gamer Therapy Tagged With: activism, adolescents, gamers, gaming, LGBT, private practice, psychoanalysis, psychotherapy, social justice, social media, therapy, Web 2.0, World of Warcraft

Dings & Grats

October 15, 2011 by langloimsw 1 Comment

I am convinced that if more people played video games, in particular massively-multiplayer online games, the human race would become kinder and self-confident. Here’s one reason why:

In MMOs like Warcraft, you have a social chat text window that is in the lower corner of your screen, constantly streaming messages. These messages are color coated so you can identify those you want to be reading, and screen out or hide those you don’t. For example, I usually have my guild chat “on” so I can talk and listen to guildies, but I rarely have the world “Trade” chat on, because I’m not a big shopper.

As you progress through the game, you level up. And when you level up, that’s an accomplishment. So you type into guild chat: “Ding!”

Ding, reminscent of the bell on a game show, is a way of calling attention to the fact that you have accomplished something. It’s tooting your own horn. But in gaming, dinging is socially acceptable! So when you announce over chat, “Ding!” You usually get a stream of “Grats!”

Grats, you may have guessed, is short for “Congratulations!” It is the public acknowledgement in gamer culture of your achievements. And if you are in a big guild and there are a lot of people online, you will sometimes get a stream of 50 or more “Grats.” This also means that if you are logging on or only half-paying attention you will catch on that somebody just achieved something.

Since everyone goes through the same levels, everyone recalls what a sense of accomplishment they often had when they dinged, and they pay it back or forward because they know how great it felt to get those grats. What emerges is a culture where achievements are announced and mirrored, which makes for a heightened sense of community and self-esteem.

When gamer patients announce they’ve hit level 85, or downed a major boss, or rolled and won on a piece of Epic loot, I am often quick to Grats them. I also encourage some coaching clients to get better at dinging when they have hit an achievement. “I finally rented my own office, Ding!” “I have 10 new patients, Ding!” Each of these is worthy of a quick energetic announcement of accomplishment.

By now some of the naysayers are probably thinking, “How corny.” And who has time to congratulate someone for every little achievement? We’ll just end up raising a generation of narcisists who overstate every accomplishment.

Obviously I disagree. First off, you don’t have to Ding on world chat, so to speak. Who is your guild? What group of people form your supportive circle that want to know when you’ve accomplished something. Second, there is always some self-regulation when Dinging. I don’t ding every time I mine some ore or pick an herb in WoW, but when I hit level 85 you bet I Dinged.

Third, when did we get so miserly with compliments? Is it some sort of holdover from the Pilgrims and the dour work ethic? It takes a second to Ding and the same to Grats. What is lost in that second pales in comparison to the affective shift in our psyche and the change in our neurochemistry. Think about any day you went into a job you hated, and the number of decision moves you made to do it even though you didn’t want to. If that didn’t deserve a Ding as you passed a co-worker’s cubicle, I don’t know what does.

Lately I have been trying to increase my Grats as well. Whenever a colleague posts on Twitter that they published a book, or finished a course, or got their license, I try to retweet with a big “Grats!” I try to amplify their achievement, not ignore it or dismiss it. One of the great powers of social media is how it can amplify things. And one thing many of us need practice with is unlearning a depressive stance, where we only see the negative. Now I am not a positive thinker, in fact positive thinkers make me feel uncomfortable, because I think they’re a bit deluded. But that doesn’t mean that I can’t get better at noticing and acknowledging the achievements and positive contributions others make.

I’m sure you can begin to see how this is applicable to therapy. Help your couples patients practice dinging and gratsing. Work with school staff to set up a Ding and Grats system in their classroom. Can you imagine how amazing it would have felt in middle school to finish your presentation with a “Ding!” instead of “The End,” and hearing 25 voices say “Grats!”

Dinging and Gratsing are expressions of enthusiasm, and sometimes it seems to me that there is some silent war being waged on enthusiasm. We’re supposed to play it cool, be “laid back,” and never indicate we care that strongly about anything. Is that really the apathetic and guarded culture we want to pass on? Let’s get off Plymouth Rock for goodness sake, and start calling out with some enthusiasm!

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Filed Under: Gamer Therapy Tagged With: achievement, adolescents, behavior change, building your business, children, coaching, ding, education, gamers, gaming, grats, level, private practice, psychodynamic, psychotherapy, video games, Web 2.0, World of Warcraft

Innovation is Dangerous & Gaming Causes Asperger’s

October 1, 2011 by langloimsw 18 Comments

This has always frustrated me, for several reasons, and I decided its time to elaborate on them again:

Educators, parents, therapists and partners of folks on the Austism Spectrum, please repeat this mantra 3 times:

It is not good social skills to tell someone they do not have good social skills.

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Filed Under: Gamer Therapy Tagged With: adolescents, ASD, Asperger's, autism, children, education, gamers, gaming, private practice, psychodynamic, psychotherapy, social justice, video games, World of Warcraft

Defeating the Boss: Overcoming Your “Big Bad”

September 18, 2011 by langloimsw 4 Comments

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Filed Under: Gamer Therapy Tagged With: adolescents, behavior change, boss, building your business, coaching, consultant, gamers, gaming, private practice, psychotherapy, video games, Web 2.0, World of Warcraft

Gaming, Slacking, & Stigma

August 17, 2011 by langloimsw 7 Comments

Any group that is stigmatized usually finds that they are the object of more than one stereotype. In fact, the stereotypes are often completely opposite in nature. Women are weak enough to be the “frail sex,” yet strong enough to be a “battle ax.” Blacks were considered lazy enough to require slavery to motivate them, yet motivated enough to steal away white women. Gays are either acting like “sissies” or always at the gym working out. The abstract contortions made to bind all these stereotypes into a web that seems to hang together contains many tensions of opposites. In short, stigma creates a lose/lose situation for whatever population is targeted.

I have recently tried to explain the connection between technology and class, a connection that has endured as far back as Greece in 400 BC. And I have often decried the pathologization of gaming as an addiction and gamers as “addicts.” The portrait I often see sketched is that of gamers as monomaniacal, sacrificing work, friends and their health because they can’t stop playing video games. These addicted personalities, the stereotype asserts, are online for hours playing without any regard for real life. Worse, I often hear gamers refer to themselves as “addicted” to video games, which is often a shorthand for and identification with the negativism they have picked up from popular culture and popular psychology. Even therapists who feign neutrality often convey this stereotype: When was the last time you asked someone how many hours they did something that you didn’t think was a problem.

But forever Scylla there’s a Charybdis, and gamer stereotypes are no exception. For people who are so obsessive and driven by addiction, gamers are also referred to as slackers. They’re never working hard enough at what really matters, rarely bathe, are morbidly obese and locked in a perpetual state of early adolescents. As slackers, gamers are purported to be lazy, unkempt, and always slouched over their keyboards. They have no interest in “real life,” which is the term we use to refer to anything we think is interesting. This stereotype presents the gamer as apathetic and avoidant of any work or investment. And one thing we know about stereotypes is that they can be internalized and lead to self-fulfilling negativism, and I’ve come to hear gamers refer to themselves as lazy slackers.

Here’s why I know this isn’t true.

It’s not just the survey PopCap did which showed 35% of executives surveyed played video games at work. Nor is it the fact that gamers have compiled the second largest compendium of online knowledge, WoWwiki, the first being Wikipedia. I know the reason why Gamers aren’t slackers is because as Nicole Lazzaro points out gamers are failing 80% of the time they are playing the game. That’s right, 80% of the time a gamer plays a video game they try, and fail, and try again. That is not the characteristic of a slacker. If anything, that’s a perfectionist.

Video games create experiences that can be challenging and frustrating, but engaging nevertheless. This hard fun would not be possible if gamers were truly lazy or apathetic. And the level of detail that many gamers pay attention to is staggering, whether it be leveling a profession to 525 in WoW, unlocking every achievement in Halo 3, or mapping out every detail of the EVE universe. This is not apathy, this is meticulousness.

One of the most ironic things about the slacker stereotype is that it has its roots in the US History of WWI when the word slacker was used to avoid the draft and avoid serving in the military. One hundred year later, video games have been embraced by the military, with research that shows gaming to be the 2nd most efficacious coping mechanism for psychosocial stressors during service in Afghanistan. Apparently if that’s slacking, it keeps you saner. The US Army has not bought into the slacker stereotype at least since 2008, when it invested $50 million to create and fund a video game unit for 5 years to help prepare soldiers for combat.

Working with gamers as a therapist requires its own cultural competency, and we need to be cautious about using the oversimplification that stereotyping allows. Just because someone is interested in something we aren’t doesn’t mean they are delusional. In fact we may be the ones slacking off if we aren’t trying to understand a video game beyond hours played.

And gamers have their own responsibility in this. We need to stop bandying about terms like addiction and slacker. And perhaps more importantly, gamers cannot and should not resign themselves to being misunderstood in treatment. If your therapist seems unable to discuss video games beyond hours played, encourage them to read Jane McGonigal’s work. Print out some of my posts for them. Let them know that games are an important part of your life and world and that they need to try to understand them in order to understand you. And if they refuse to do that, consider finding a gamer-affirmative therapist.

It wasn’t many years ago that therapists didn’t think they had any gay, lesbian, transgendered or bisexual patients because they never asked their patients if they were gay, lesbian, transgendered or bisexual. And worse, because therapists assumed they weren’t. This vicious cycle made learning how to best treat LGBT patients take much longer than it should have. This can only change through therapist education.

We need to stop trivializing video games in life and in treatment. We need to stop rushing to peg gamers as addicts or slackers, and try to listen to them. Because I am convinced that it is within the content of the video game’s meaning that we may best understand the gamer, and how they play the game may hold the key to how they can resolve their difficulties elsewhere.

Filed Under: Gamer Therapy Tagged With: gamers, gaming, psychodynamic, psychology, psychotherapy, social justice, stereotyping, stigma, video games, World of Warcraft

Technology, Video Games & Class

August 6, 2011 by langloimsw 5 Comments

Some 500 years after the Greeks began using the alphabet they’d adopted from the Phoenicians, Socrates expressed his concern and disdain for the new technology of writing:

“for this discovery of yours will create forgetfulness in the learners’ souls, because they will not use their memories; they will trust to the external written characters and not remember of themselves… they will be hearers of many things and will have learned nothing; they will appear to be omniscient and will generally know nothing; they will be tiresome company, having the show of wisdom without the reality.” –Socrates in Phaedrus

Fortunately for us, Plato disagreed with Socrates, at least to the point where he wrote down the dialogues which have endured to the present.

Aristotle, who was probably a teenager when Phaedrus was written, describes in his Nicomachean Ethics several different concepts of thought including episteme, techne, and phronesis. Episteme referred to knowledge that is rational, eternal and certain. Phronesis is ethical thought. And techne is usually translated as “craft” or “craftsmanship.” Techne was considered the realm of the Mechanical Arts by the ancient Greeks, as opposed to the Liberal Arts. As such it was the realm of the common worker of the lower classes, while episteme was the pursuit of the free man of the upper class. This perhaps is why Socrates was so concerned about writing: The common worker would not have the time to engage in dialogues with learned teachers, and his understanding of philosophy could go awry. The Liberal Arts clearly involved having free time to talk and listen to teachers.

I elaborated on all this to help make the point that technology has always been about class.

Anything kinesthetic, or hands on, was associated with techne, and the lower class occupations of masonry, carpentry, and back in ancient Greece, medicine. Working with ones hands was not then, or is it now, considered one of the characteristics of the upper class. Gentleman don’t work with their hands.

This attitude persists, albeit more subtly to this day. We see it in our educational system: Students who don’t score high on IQ tests are often tracked to vocational tech schools. Students are often discouraged from using the technology of calculators because they need to “learn” how to solve the problem. What distinguishes us as adults in math is our ability to count in our heads, not with our hands. We see it in work in the difference between blue and white collar jobs. And we see it in our attitude of technology.

Therapists often view technology in general, and video games in particular with a thinly veiled disdain. Technology has been accused of ruining relationships, causing addictions, destroying our neurology, and fostering escapism. We pathologize people playing video games in a way that is reminiscent of the novel in the 19th century, when solitary reading was considered a dangerous pastime for women, leading to languishment and insanity. The gamer has become the hysteric of the 21st century: out of touch with reality, immature, lazy and troubled.

Anything that smacks of being technological and kinesthetic is also seen as at best a necessary evil in therapy. Using the phone to call insurance companies, filling out paperwork are examples of the work we therapists often feel takes away from our time to do “what matters.” Emails, Facebook and Twitter are unnecessary and probably a liability issue. In fact the majority of our workshops on technology aren’t actually about techne but Phronesis, i.e., the “ethical” use of technology. And when our patients try to talk with us about technology, they are often rebuffed or pathologized (“How many hours are you spending on the internet, anyway?”)

With our adolescent patients, the assumptions are even more dire: It’s less than face to face contact. It’s too complicated to understand. It’s too boring to listen to teens about. It gets in the way of “real” relationships. It distracts teens from therapy, and listening to adults in general. Its for kids with Aspergers Syndrome / who have poor social skills. And heaven forbid they meet people they talk to online, they’ll be killed.

It is a dangerous assumption to leave unexamined, the linking of different forms of thought to class. We have seen how it has played out in race, gender, and sexual orientation. And it is being played out today in our disdain and suspicion of all things technical and the people who use those things. Just listen at your local office or agency to the way people talk about the “IT guy” and you’ll hear it.

Although class issues remain in play, techne and technology inevitably become integrated into our society. Imagine for example that you go to the local Apple store, only 600 years ago:

Skeptical customer: “I’ve begun seeing more and more of these “pencils” around, but they don’t seem very useful to me.”

Pencil salesman: “Oh not true, they are very useful indeed. Combined with this “paper” they become a powerful storage system. You can write your ideas down on the paper, and it will store it for later use. And you can expand your paper and store even more ideas.”

Skeptical: “But isn’t that a privacy risk? If I write something with this pencil, can’t it be lost and read by others?”

Pencil Salesman: “Well, yes, but you can always store the paper securely..”

Skeptical: “But even so, what if I write down something on paper and want to unwrite it later.”

Pencil Salesman: “Our developers have anticipated that! See down here, this part of the pencil is an “eraser.” Just swipe the eraser across the markings and they’ll disappear.”

Skeptical: “I dunno, I don’t have a lot of writing to do.”

Pencil Salesman: “Well, everyone has different needs, that’s why this pencil comes with several Applications. You can use the pencil to draw pictures. You can use it to do mathematics. Or you can compose poetry. Or you can play games with it alone or with your children. Whatever you want to do, there’s an App for that.”

Nobody would seriously imagine that they need to be convinced of the usefulness of the technology of the pencil. Nor would they suggest that if you write a threatening note to someone that it was because the pencil was bad. But today we seem to be at an earlier phase of development with computers, smartphones and tablets. And much of this fear and suspicion, I would suggest, involves class.

Technology has become more complex through time, but our attitudes about it are still generally simplistic. And right in the middle of this terrain we have the video game. It’s one thing to have to use technology for our work, but to actually enjoy using it? That’s strange and suspect. And so people talk about how much time others are “wasting” on Facebook, or playing World of Warcraft, downloading music to their iPod, or surfing the net. I know people who are actually ashamed that they spend time trying to figure out a new technology like Google+, and we have a word for these people, geeks. Although the term geek has begun to be reclaimed by many, it’s important to remember that the word comes from the English and German dialects to mean fool or freak.

We need to be open to learning about our patients, and with gamers especially, about their technology. To do this we need to understand how gamers, and geeks, are part of a marginalized population. To practice gamer-affirmative therapy one needs to be culturally competent, and I believe that part of this competence is understanding the stigmatizing connection between technology and class.

To be gamer-affirmative, I believe therapists need to get technical, that is, “hands on.” Every time I do a consult or a workshop I tell therapists that there are dozens of free trials of the different games their patients play, and encourage them to spend some time playing them. I consistently get resistance on this, usually a version of the comment “I don’t have time to play video games.” Really? Over half of all adults play video games, and 4 out of 5 young adults do. If they can find the time to play while holding down a job and having meaningful relationships, so can you.When email first came out, many people decried it saying that it was going to be impossible to use it because there wasn’t enough time in the day. And yet, we’ve managed somehow to make time. “I don’t have time to play video games” is usually a gussied-up version of “I have better things to do with my time than play video games.”

But too often people have bought into the stereotype of gamers as unemployed, unmarried, and unfit. This is the same form of projection and splitting that our society has used to “other” people in terms of race (lazy Mexicans,) gender (weaker sex,) sexual orientation (promiscuous bisexuals,) and class (poor white trash.)

Very often I hear therapists protest that they like technology, that it has “its place” in our lives. This sense of having and knowing one’s place is inextricably bound to issues of class and status. Technology doesn’t have its place, technology is everywhere. It is a vital part of human being, ever evolving, responding to us, shaping and being shaped by us. In therapy, we need to unlearn our privileging of one group over another if we are to truly understand our patients. When we demure and say, “oh I don’t know anything about video games or Facebook,” we are being more haughty than contrite. The fact that we act as though using or talking about technology is unnecessary is our class bias at work in our profession.

Filed Under: Gamer Therapy Tagged With: adolescents, aristotle, class, gamer, gaming, philosophy, play, social justice, social media, socrates, technology, therapy, video games, Web 2.0, World of Warcraft

How To Learn About Video Games & Why You Ought To

July 29, 2011 by langloimsw 1 Comment

http://www.youtube.com/watch?&v=JY8h-U7rE6Y

Filed Under: Gamer Therapy, Games Tagged With: adolescents, building your business, gamers, gaming, LGBT, play, psychodynamic, psychology, psychotherapy, ROI, social media, Web 2.0, Wizard 101, World of Warcraft, wow

Being A Noob

June 11, 2011 by langloimsw 1 Comment

Over the past few months I have taken some time off from playing World of Warcraft to try a new MMO called Rift. Rift takes place in a different world from WoW, the world of Telara. It has a different storyline and although the user interface is pretty much a duplicate of WoW’s, there are many many other differences as well. I have been playing WoW for several years, and had progressed my character to level 85, the highest you can get as of now. In those several years I have been a member of three guilds, leveled 6 professions, and spent countless hours researching the internet on strategies, spell rotations, and boss strategies. I’ve traveled the length and breadth of Azeroth and Outland, and completed hundreds of quests and achievements.

And now I’m a noob again.

In Telara I’m just out of the training zone, and level 13. I have no idea where I am, and most of the map is still an undiscovered blank screen. I don’t have more then 20 points in any profession and I’m not in a guild. I’m reading new material and trying to figure out what sort of place Telara is, why the sky is constantly ripping apart as rifts from some other dimension open up and rain down monsters on me and any other players in the area at the time. I keep running the wrong way into mobs of villains many levels higher than me and dying. Lots and lots of dying. And lots and lots of running back from graveyards as a ghost trying to find my body.

Good times.

For those of you who don’t know this, being a “noob” is a term for being a newbie, a newcomer unfamiliar with game mechanics and the lay of the land. It can be a very frustrating experience. The first time I was a noob, in WoW, I had no idea how much I was learning as I was learning it. There was such a steady progression that I didn’t realize how much experience and skill I had amassed with the game until I switched over to a new game. Now it is like I have lost all of that experience and skill, and I can feel overwhelmed. I am nowhere near Rift’s “endgame,” and everything is new and weird. So why not just go back to playing WoW?

First off, I have a little faith. As I stumble through being a noob in Rift, I can remember feeling similarly clueless at the beginning of my time playing WoW. I know that I am learning a great deal, more than I can even tell, and that this sense of being overwhelmed will pass. Also, I am enjoying the heightened sense of discovery, stumbling into the city of Meridian for the first time, having chats with other noobs as we form public groups and down elites.

The last time I was on, my mage was teamed with a warlock and a warrior, and we took on an elite without a healer. We gave it all we got, and then the warrior was down and the warlock was getting attacked. As the warlock fell, and the boss approached me with only 5% of its health left I kept spamming shadow bolts at it until it got to me. Just as it killed me I set off one more bolt that killed it. We closed the Rift, resurrected ourselves, collected the loot, and I felt the same level of thrill and achievement as when I first started playing WoW.

Every gamer was once a noob. Every gamer you see in your therapy practice was once thrown into a strange unfamiliar world knowing no one, with only the clothes on her or his back and a few silver in their satchel. Those men and women in your office who have been deemed failures at school or work by parents or coworkers has tried and failed and tried again hundreds of times. They have wandered around lost in a dangerous world knowing no one, and struck up conversations with other wanderers. They’ve banded together with others to defeat powerful adversaries, worked diligently to perfect professions and skills, and you’ve known nothing about it, because you didn’t ask. Instead therapists often focus on how many hours a person plays, pathologizes gaming as an addiction, or dismisses it as a silly hobby with no clinical or real-life value.

(How many of us approach our patients’ dreams that way? How many of us ask, “how many hours a night do you dream?” or consider them to have a dreaming addiction? When was the last time you dismissed dreaming as a valueless, silly hobby.)

Being a noob takes courage, and stamina. We therapists know this deep down. Most of us gravitated to our profession because we wanted to help the vulnerable, the bewildered and the confused grow into the strong, wise and whole people our patients become. We help them map out their inner world, strengthen their coping skills through trial and error and retrial. We encourage them as they level their professions at work or school, build guilds of peers and loved ones to raid life with, and face whatever monsters they have to to heal from trauma. Let’s recognize the game mechanics in what we do, and learn from the game mechanics in what they do.

Last but not least, let’s talk business.

In the 21st century, many therapists are seeing a game change in our profession. The way we practice therapy and help our patients is changing in many ways. We can use Google to help them find the closest AA meeting, Skype with them when they are away on business in Hong Kong, email them DBT worksheets or set up mindfulness reminders for our groups on Twitter. Even if we avoid using these technologies with our patients, they are trying to talk to us about bullying via Facebook, sexting on their iPhones, or falling in love in Second Life or World of Warcraft. In the 21st century, technology is no longer negotiable, it is embedded in virtually all treatment issues one way or another. And so therapists are noobs once more. This doesn’t mean that we can’t still practice psychotherapy the way we always have. But do you think that that should be our prime goal, to do things the way we always have?

When I first advertised on Google, I paid .10 a click. Nowadays colleagues in my area are paying upwards of 6$ a click to be visible. Having a Google ad or website is now pretty common. Between changes in social media and healthcare, many of my colleagues and the therapists I consult with are finding that the game has changed again, and they feel frustrated and bewildered like they haven’t in years. They’ve become noobs again.

Being a noob isn’t bad, although it can be uncomfortable. But what I’ve learned from fellow gamers is that being a noob can be fun as well. The key is to keep your sense of humor, and not take having to learn new things as an insult. I sometimes hear colleagues express outrage at having to do things differently to grow their business, and heaven forbid they spend money on coaching or business planning or consulting with someone who has more expertise than they do! The subtext is “How dare I be treated this way?!”

Change isn’t meant to single out and insult you, lighten up. Of course you should be learning new things, and leveling up. Have a little faith that you are learning even though it feels clumsy. We keep trying to get to this “secure” place where we’ll never need to stretch or do something different, and it just doesn’t exist. We need to cultivate what my colleague Chris Willard refers to in his book of the same title as our “Child’s Mind.”

In other words, we need to embrace being a noob.

Filed Under: Gamer Therapy Tagged With: building your business, chris willard, gamers, gaming, marketing, noob, private practice, psychotherapy, rift, therapy, video games, Web 2.0, World of Warcraft, wow

Do Your Dailies

March 28, 2011 by langloimsw 10 Comments

UVN4UFFHFPND

Epic Therapists do their dailies. And if you’re not a therapist, but a gamer or someone else who wants to have a better life, this post may be useful to you also.

At a recent workshop, I began by showing a slide with our “Epic Agenda.” And the first question I got from a therapist was a great one, one that staggered me:

“What does Epic mean?”

Gamers among you may be chuckling now, but try to answer that question, and try to remember back to a time when you didn’t know the difference between green and purple gear. Back then you didn’t know what Epic meant either. So let me offer us a working definition of Epic:

Epic means “the most super amazing over the top of all time.” An Epic Win would be the most super amazing over the top win of all time. An Epic Fail would be the most super amazing over the top fail of all time. Epic is big, Epic is superlative, the most super dooper in history.

We don’t talk about ourselves in epic language much. We tend to think of it as arrogant, unrealistic, and asking to be taken down a peg. The idea of being Epic anything makes us self-conscious, with a lower-case s. And yet, I think it is time we change that.

All over the world you people are being Epic. Right now in Japan, every one of those people is Epic. The people surviving a disaster of multiple phases and historic proportions are Epic. I doubt that any of my readers would argue that. Every person helping those survivors is Epic. Even as we speak the people of Japan are pulling off what will be seen in years to come as one of the biggest Epic Wins in their history. (By the way, if you want to support their Epic Win, go to the Red Cross and take 5 mins to donate. There’s also a great definition of psychosocial support there for you therapist types.)

But you don’t have to be at the epicenter of a disaster to be Epic. Gamers know that there are several ways to get that Epic gear. Sure, one of the ways to do that is to down that boss on heroic mode. But there is another way to get that gear and become Epic: Do your dailies.

Dailies, in WoW, are daily quests that you do to gain XP, gold, or points towards buying Epic gear. And it takes a long time to earn those points. But each day, the game server resets, and you get to run these daily quests again. One of the first things an experienced gamer will tell a “noob” who wants to get better gear is, “Do your dailies.”

Back to you therapists: Epic therapists do their dailies. The most successful therapists I know show up for those mundane tasks every day. They return phone calls every day, respond to emails every day, step back to consider the state of their practice every day. Epic therapists read about their craft regularly. Epic therapists learn about what their patients are talking about regularly. Epic therapists reach out and connect with their colleagues regularly, and Epic therapists take risks to make their business visible regularly.

Last Friday I met a dozen Epic therapists who came to my workshop. They spent time and money to learn about online gaming and gamers. I can’t tell you how moved I was to see these colleagues spend 3.5 hours with me learning how to better understand gamers. They were willing to step beyond the model of addiction and see gaming as a culture they needed to become more competent with. They decided not to dismiss video games as trivial or uninteresting and as a result will be able to meet their patients “where they’re at” more than ever. Less than 50 therapists across the world have ever spent 3.5 hours on a workshop to understand gaming, so these folks are truly Epic!

Am I suggesting you all enroll in my workshop to become Epic? Hardly. But I am suggesting that you do your dailies and when you’re feeling down about your practice, keep doing them. I have noticed that the people who tend to be naysayers in our profession tend to be people who don’t want to take risks or invest extra time on a daily basis. They are hoping for a quick fix or solution, one book or secret that will tell them how to succeed. I think there are a lot of books out there that may help, but I think the secret to becoming an Epic Therapist may just be to do your dailies.

And if you’re one of my gamer readers, this applies to you too. You can be Epic out of the game as well as in it. That same stamina it takes to do your Baradin Hold dailies can be applied to your life outside of Azeroth. Getting up a half hour earlier so that you can get to work without feeling anxious is doing your dailies. Doing every bit of your homework is doing your dailies. Listening to your parents and doing your chores are doing your dailies. Telling your partner that you love them is doing your dailies. Spending an hour in meditation, in therapy or at an AA meeting are examples of doing your dailies. Sometimes these dailies will seem easy and quick. Sometimes they will seem a grind. No matter.

Do your dailies.

UVN4UFFHFPND

Filed Under: Gamer Therapy Tagged With: adolescents, buddhism, building your business, dailies, gamers, mindfulness, private practice, psychotherapy, video games, World of Warcraft

Reputation, Grinding & You

March 18, 2011 by langloimsw 8 Comments

Filed Under: Gamer Therapy Tagged With: adolescents, autism, gamers, gaming, grinding, private practice, psychotherapy, relationships, rep, reputation, video games, Web 2.0, World of Warcraft

What I Learned at Pax East.

March 12, 2011 by langloimsw 4 Comments

For those of you who aren’t in the know, Pax East is a 3 day event founded by Penny Arcade a great website for online comics and other fun stuff. Pax East takes place in Boston, and this is it’s 2nd year. It is a huge convention which had approximately 70,000 video, tabletop and PC gamers. Last year I went to Pax East because I had finally decided I needed to take gaming and gamer-affirmative therapy seriously as part of my growing practice. I had always thought video games were fun, but it was only over the past 10 years that I had come to see that they could be life-changing.

I had discovered firsthand how World of Warcraft, Mario, and Zelda had helped me recover from a terrible job loss and re-evaluate what I wanted my work and life to be like. I had met dozens of gamers in-game and out who were recovering from various life struggles through gaming. I met soldiers stationed in Iraq who were gaming to keep their morale up or stay in touch with their families. I met LGBT people who had come out and found community for the first time in a Warcraft guild. I met people who had fought off isolation in other countries by raiding with loved ones at home. Still more had survived a divorce, discovered a way to rebuild confidence when they’d lost the ability to walk, or taken the first steps to socializing when their autism had stigmatized them and all seemed lost.

I also began to meet a growing number of young men and women who were refusing to be labeled as addicted or abnormal by virtue of their gaming experience. And I began to wonder what it would be like if as a therapist I came out as a gamer and helped people begin to take video games seriously.

At the same time I began to realize that I needed to take my career more seriously, because I had decided to start a full-time private practice. I had had a part-time practice for over a decade, but it always felt like a hobby. And so when I began to float the idea to family and colleagues I was amazed by their response.

They took me seriously.

Anyone who has launched a business can probably identify to some extent. You spend a lot of time wishing, and then daring, and when you finally decide to tell others you find that they have a far easier time taking you seriously than you do yourself. It was as if the company I’d helped built, my education and my CV were all fluff in my head.

If I had a hard time imagining myself as a independent businessman and a full-time private practice therapist, you can imagine how hard it was to imagine being a successful therapist who specialized in video games, virtual worlds and social media. Sure I could justify playing video games with children I worked with, but a gamer-affirmative therapist? This was a harder row to hoe. I had people thinking I meant online gambling and referred gamblers to me. I had colleagues who pretended Facebook didn’t exist and glazed over when I told them about the social media company I had helped develop. And most often I had this response.

“Oh, I don’t know anything about video games.”

This from colleagues who were throwing out the term gaming addiction willy-nilly. So I knew that I had a couple of choices, keep quiet or begin working with gamers and educating psychotherapists about what video games actually are, and what they can do for us. And I decided that if I was to really try to educate people on video games and doing therapy with gamers, I’d have to take myself seriously. And that is where Pax East and Blizzcon came in.

Where better to meet gamers than in those places? And what better form of continuing education for me than to see what is happening in the gaming world? This was part of the work I wanted to do, and the only thing holding me back from engaging in it seriously was that I felt guilty for having fun. From graduate school and continuing education I had learned that education was serious and not necessarily fun. But when I took the plunge I found that the money I spent on travel and the conferences was totally worthwhile, and the people I met were really interested in my work. This is something my colleague Susan Giurleo wrote about recently regarding another such convention that she is going to, SXSW.

I’ve learned a lot in the past two years. Last year at Pax East I didn’t have nearly as much fun as I did this year, because I felt like I needed to be there every minute and take everything seriously. This year I went Friday and picked a few things I wanted to do, like attend Jane McGonigal‘s keynote speech. And I took fun more seriously and learned more. I got a sneak peek and play of the Nintendo 3DS. I got to watch the amazing new XBox Kinect game Child of Eden. I walked around all day with a Plants Vs. Zombies traffic cone on my head. I participated in the largest massively multiplayer thumb-wrestling match in world history! And all around me I saw happy and energized people playing and socializing with strangers.

I was reminded of the things I tell my supervisees all the time, that if you aren’t enjoying yourself in your work something is wrong. Because enjoying yourself helps you achieve a state of believing that success is possible. And that the people who settle for less in their work get less. Such optimism is crucial, because running your own business takes a lot of time and effort. I have never worked as hard at a job in my life, and I have never loved what I do as much as I do now.

Filed Under: Gamer Therapy Tagged With: building your business, gamers, gaming, marketing, Pax, private practice, psychology, psychotherapy, video games, Web 2.0, World of Warcraft

(Un)Desperate Times, or Know Your Talent Trees

February 16, 2011 by langloimsw 12 Comments

Recently I was given a referral for an evaluation, and upon some reflection I declined it. This is not something I am often in the habit of doing, but in this case the evaluation would have involved a clinical situation that did not fit with my integrity. So it got me thinking about the relationship between building your business and professional integrity.

The referral would definitely have been lucrative, and within my scope of experience and skill. And most of us these days certainly cannot afford to turn away business.

Or can we?

If I had taken this evaluation on, I would have most likely have been called on to testify about something that I was not entirely behind. This would have compromised my ability to be an expert witness. As I weighed the pros and cons I was quickly aware of my feeling of “halfheartedness” about the whole thing. And that was what clinched it for me. No patient deserves anything less than a wholehearted therapist as far as I am concerned. And I believe that when we catch ourselves trying to make something “fit” with our practice, we should probably stop right there.

Most of us were trained in clinics or hospital settings where we did not choose our patients. We were there to help everyone, and the idea of a good clinical fit was something we were usually reluctant to give voice to. Social workers in particular are often encouraged to be little mental health Statues of Liberty, treating any of the huddled masses that get sent our way. But no one of us is supposed to treat everyone in my opinion. And believe it or not, there are therapists who want to work with every segment of the population. I have met therapists who love working with borderline personality disorder. Others feel invigorated by working with substance abusers. There are people who really enjoy working with schizophrenia, like me. So in the long run, I think it is important to notice who you like working with, especially if you want to be in private practice.

Being clear on this is hard enough when we are starting or growing our practice. Turning down a referral can be terrifying and guilt-inducing. Somebody needs our help, we need to earn money, and we’re going to decline a referral? Sometimes, yes. Sometimes we need to hold a space open in our practice for a bit. And always the patient deserves a therapist who is 100% committed to the therapeutic relationship. So if we are lucky and have a good coach or supervisor we brave our fears and hold open the space for a while.

But later on in the development of a private practice, you may encounter a slightly different issue, what can be called an “embarrassment of riches.” The phone starts ringing with calls from potential patients, requests for court or special education evaluations, or maybe your old employer wants you to come back and do a workshop for your old agency. It can be tempting to overextend yourself, but I would suggest the following when this happens: Don’t just do something, sit there. Give yourself time to evaluate whether this opportunity is the best opportunity for you after the initial shine or honor of being asked has worn off a little. Because only you know your business plan, and which of the opportunities presenting themselves to you is the best one for furthering your practice.

The picture at the beginning of the blog is what World of Warcraft veterans will recognize as a talent tree. Each character class has three talent trees they can choose from to put their talent points into. The more talents points you put into one tree, the more access you have to higher powers and abilities of a certain kind. At the same time, since you have a finite amount of talent points, putting talent points deep into one tree makes it impossible to put them deep into another. So for example, if I am a mage, I can choose to put my talents in Fire, Frost, or Arcane trees. If I put most of them in fire, I won’t be as powerful when I need to use frost spells.

Sometimes newbie gamers decide to spread their talents across all three trees. They divide up the points and suddenly notice that they are at a high level but aren’t doing that well in the game. At some point someone will notice their talent trees are a mess, and explain to them the importance of specifying their talents. Sometimes therapists do the same thing: We try to be everything to everyone and learn to do a little of this and a little of that. This is often where the diabolical word “eclectic” comes up. We’re not frost mages OR fire mages, instead we’re hurling bolts of lukewarm water, and who needs that really?

If you have been building your practice for a while, you have probably noticed that your phone is starting to ring more, or your website is getting more hits, and this can be so exciting and intoxicating you’ll lose sight of your business plan. This week I had a day like that, where I got 2 referrals for psychotherapy, an extended evaluation, and invited to teach 2 classes! You bet that feels good (and overwhelming!)

But I needed to spend my talent points wisely. If I load up on patients, I won’t have time to do my writing or workshops and ultimately develop passive revenue streams. What’s worse, the patients will get an overworked overtired therapist who is not wholehearted. If I teach two classes, I won’t have enough time to do something else, and if I take on an eval that has me interviewing, writing and expert witnessing, same thing. Time to refer back to my Tweaking 2011 plan. So everything went on hold for a day (remember, we’re running a private practice, not an ER: If something seems so emergent that it can’t wait a day, it may not be something to take on) and I ended up declining half of the embarrassment of riches, offered alternate referrals, and hopefully everyone will be the better for it.

Have you started to specify your talents yet? Have you chosen the talent tree you’ll put the majority of your points in? The secondary one that enhances the first? Does what type of work you accept clearly map to the business plan you’ve made for yourself? I’ve written before about being an Epic Therapist and this is one of the qualities that makes a therapist Epic: Epic therapists specify and hone their talents in one main area. And because they do that they can explain what kind of therapist they are at parties. And they can do solid work and reading in their area so the patient gets excellence. Excellence is what will keep your business afloat in the coming years, so spend your time and talents wisely!

Filed Under: Gamer Therapy Tagged With: building your business, gamers, gaming, private practice, psychotherapy, referrals, talent tree, therapy, Web 2.0, World of Warcraft

Children, Mental Illness & Video Games

January 25, 2011 by langloimsw 7 Comments

Photography by Mykl Roventine

I hesitated to use the above title, because I can imagine my gamer audience rolling their eyes already. Bear with me please, it’s not what you think.

A new study has come out reporting that children are using video games “pathologically,” and that this is a global problem. The study, summarized here, reported that out of a sample of 3,034 children, 9% of them could be considered “pathological” in their play, which the researchers found “some serious problems – including depression, anxiety, social phobias and lower school performance – seemed to be outcomes of their pathological play.” And so the media has already begun to hype this up as video games cause mental illness in children, as well as video game addiction is a problem.

So let’s think this through together.

First, there is the problem of cultural translation. The study was conducted in Singapore, and as one of the researchers acknowledges, “”In the US, we didn’t follow the kids across time, so we don’t know where that threshold is across each culture or if there is a certain amount that is too much.” And we also don’t know the cultural variables when we compare Singapore, a city-state, with other countries. Children in urban areas often play more video games due to the safety concerns of living in an urban area.

But more importantly, let me share with you some other statistics, more close to home. The National Institute for Mental Health as recently as last September released this information. Using a sample of over 10,000 teens ages 13-18, they found that over their lifetimes 20% of the children had “suffered from a mental disorder with symptoms severe enough to impair their daily lives.” An earlier study with over 3000 younger children found that 13% of the children met the criteria for one or more mental disorder. This figure, by the way is down from the Joint Commission on the Mental Health of Children, which in 1969 found that 13.6% of all children had “emotional disturbance.” So that’s long before Pong, people, and the statistics if anything have gone down with the advent of better treatment.

Let me share with you one more statistic, from the Pew Research Center which found in 2009 that 99% of boys and 94% of girls play video games. So yes, close to 100% of children in the U.S. play video games, and yes, somewhere between 13-20% of U.S. children have some mental health issue, but that’s because the statistic correlates to a pretty consistent percentage of the population over time predating video games entirely. And if the first study from Singapore were comparable, we could make the argument that kids in Singapore play more video games and have less mental health issues than kids in the U.S. So go Singapore!

If you think you game more than you’d like, feel free to change that, but don’t do it because someone in Singapore says you should.

But if I stopped my rant here, I think that would be doing a large percentage of the population a disservice, namely, those 26.2% of Americans who live with some form of mental illness. Haven’t we stigmatized these folks enough? The constant warcry of “video games are bad,” leans on the ableist stereotype that “mental illness is bad.” It’s not. Mental illness can be challenging, heartbreaking, costly and different from a societal norm, but it is not bad. It is a prevalent health condition, like other prevalent health conditions like, per the CDC statistics, p. 292, Diabetes (10.1%,)High Cholesterol (15.6%,) Hypertension (30.5%,) and Low Back Pain (25.6%.) Whether it be providing adequate health coverage and parity, or taking away the moral overtones, it’s time we stopped treating mental illness like it is something different than other health concerns.

Gamers and people with mental illness do have something in common: They are both marginalized and socially stigmatized by the larger population. So whether you play Super Mario or live with PTSD; whether you play WoW or keep challenging your Depression; whether you have ADHD, Asperger’s or a PS3, game on! There’s nothing bad about you all, any of you, no matter what the experts say.

UVN4UFFHFPND

Filed Under: Gamer Therapy Tagged With: ableism, addiction, children, gamers, gaming, mental illness, psychotherapy, social justice, video games, Web 2.0, World of Warcraft

What Do Gamers & Social Workers Have In Common?

January 22, 2011 by langloimsw 16 Comments

The Dutch cultural theorist and early scholar of ludic studies Johan Huizinga took play very seriously. Gamers and Social Workers alike would have loved Johan–he spoke out against Nazism and German influence on Dutch Science in 1942 at a lecture he gave. This was not the first time he had done so. As early as 1935 he had grown alarmed at the rise of fascism and written, “We live in a demened world, and we know it.” By 1942, his speaking truth to power had finally gone too far in Nazi estimations, and he was imprisoned, then detained, by the Nazis in the village of De Steeg. He died there 3 years later.

It was during these final years of his life that he refined and wrote his book, Homo Ludens, which translates to “Man the Player.” In this book he explored the serious nature of play as a cultural phenomenon present in art, war, and politics.

Huizinga determined that play has 5 essential elements, to which I add examples as appropriate to gaming and/or social work:

Play is free, is in fact freedom. When we are playing, we are not doing it for any other reason than that we want to. Play to be play must be a voluntary activity that we initiate or accept the invitation to enter into ourselves. In that regard you could say that play is always an assertion of the self, and free will. We gamers choose to spend our time gaming, choose one game over the other. This is why gaming as play does not adhere to the slavish concept of addiction.
Play is not “ordinary” or “real” life. What makes play so much fun, and so important is specifically that is isn’t bounded by the realities of daily living. It is pretend, and extraordinary, and it allows us to escape real life. But this is exactly why gamers and other people who play aren’t psychotic. We may talk about the games we play to lengths that bore or disturb others, but we know that games are apart from real life. That’s what makes them fun! I may hurl arcane energy at a dragon in WoW, but I am aware (albeit sadly at times) that if I ever encounter a dragon in real life I will not be able to summon magic at my whim to destroy it. And that is why Second Life is not called First Life. For play to be play, we have to know we are taking ourselves out of the real world to participate in something else.
Play is distinct from “ordinary” life both as to locality and duration. When I get ready to play WoW, I sit down or stand at my computer; but when I play I am in Azeroth. Whether it is chess, poker or a video game, the play experience takes place in another time and space, and it has a beginning and an end. Even MMORPGs, which push the last quality in some ways, have an end for individual players, when we cease participating in the game world for the time being and resume the activities of daily living that await us in the real world.
Play creates order, is order. Play demands order absolute and supreme. By this Huizinga meant that for play to work it needs to have rules as well as time and space boundaries. We all know how to play Hide and Seek, the next time you play it try being the “Seeker” and go hide along with everyone else; or come out of hiding and start chasing the Seeker. Bizarre and funny, but the game won’t be Hide and Seek anymore–Tag, maybe, but then we’ll know that something has fundamentally changed. And in World of Warcraft everyone needs the same amount of experience points to get to level 80, and we expect the griffin flight paths to always stop in the same places. Wizards will never wear plate mail and hunters can’t teleport. That’s just the way things are, that’s the order of things.
Play is connected with no material interest, and no profit can be gained from it. Ask any gold farmer around the world, and they will tell you that there is a big difference between playing WoW and logging in to the game to make and then sell money. Gold selling can’t even happen entirely in-game, and Blizzard bans it for good reason. It’s cheating, not serious play. The loot items that I “get” in the game aren’t things I can profit from in the real world. I can’t take my Corp’rethar Ceremonial Crown with me when I leave the game, which is why I would be so useless if a dragon shows up in Harvard Square. And although Second Life has a different approach, allowing you to buy in-world “Lindens” for real-world monies, I’d suggest that the act of buying the Lindens occurs outside the play experience: Sigmund Steampunk isn’t buying Lindens, Mike is buying Lindens “out here” and sending them to Sigmund “in there.”

So what’s all this got to do with gamers and social workers? Lots! Both gamers and social workers value freedom a great deal for starters. And social workers (I am saying social workers, but this applies to all psychotherapists) understand that therapy, like gaming, is a form of play. We experience more freedom to explore and express our internal world in therapy. It happens at a given time and place, even as an online event. What happens inside the therapy, a la Winnicott’s “Transitional Phenomenon,” is both alike and different from the “real world.” And there is order in therapy, some firm rules and limits in terms of what can or should happen in it.

As for the money bit, I would suggest that if we lived in a culture where capitalism was not the norm, the same parts of therapy that are so powerful and rewarding, the play-elements, would still be as powerful. Another way of looking at this is to ask yourself if you conduct therapy any differently with patients who are on Medicaid than those who are private pay? I’m not talking about feeling annoyed that you aren’t getting paid well, but the game you play. Do you only think psychodynamically with your private patients? Do you change the boundaries when its Medicaid? Or do you try your best to do what’s best for each patient regardless of the payment?

And as social workers, don’t you advocate for others with the powers that be in ways that are not connected with your material interest? Take Civil Rights, for example. The years and years of advocating, protesting and legislating are not something that the social workers involved derived a profit from. In fact that is what makes our endurance in fighting for social justice so admirable.

This is why many gamers will make excellent social workers, by the way. Gamers are experts at endurance. That guy in your office that seems like a “slacker” actually has more in common with you than you think. He has spent hours trying to down the Lich King–trying and failing, and then trying again. He has spent hours researching strategies to work as part of a team and not given up. Jane McGonigal pointed out recently on NPR that majority of time gamers are online, they are failing to accomplish their tasks. That’s why it is so admirable that they keep at it. So yes the adolescent you’re sitting with may have grades that are plummeting in school, but don’t blame the games! Try instead to harness that discipline, focus and stamina by exploring how it shows up in-game, and then how it can be used to change his real life.

And the connection between gaming and social justice isn’t as far-fetched as you may think: A 2009 Pew presentation from Amanda Lenhart showed that 49% of teen gamers reported seeing people being “hateful, racist or sexist” while playing– which means that they can identify hate, sexism and racism. What’s more, three-quarters of these kids reported seeing other players regularly respond to such behavior to confront it. That’s a hell of a lot better than most high schools and college campuses are doing these days!

So gamers and social workers both understand the value and seriousness of play, as an imagined space in therapy or in Azeroth. Gamers and social workers both understand the value of psychic change and social activism. And gamers and social workers alike regularly demonstrate hard work and stamina in the face of dragons and fascism.

Johan Huizinga would be proud.

Filed Under: Gamer Therapy Tagged With: avatar, fascism, gamers, gaming, jane mcgonigal, johan huizinga, play, private practice, psychotherapy, social justice, therapy, Web 2.0, World of Warcraft

Virtual Worlds, Real Feelings

January 14, 2011 by langloimsw 14 Comments

When psychotherapists begin working with gamers and exploring their in-world experience, it can be a bit overwhelming. So much new language, trying to imagine virtual worlds that you’ve never seen. What’s a raid? Why would someone go on quests? And aren’t guilds something that artisans used in the Middle Ages to control the market? I’ve often encouraged therapists to take the time to use the free trial membership on WoW or other games in order to immerse yourself in the virtual world (and hopefully have fun!) for a little while.

But one thing that can get overlooked in the exploration of the technology is the exploration of feelings, and one reason that this gets overlooked is because therapists inadvertently trivialize the experience of feelings experienced in-game or in social media.

Let me give you a real-life, non-game example to start. I went to Connecticut College with my friend and colleague Susan Giurleo (she’d never say this, but Susan was definitely the more organized one in college 🙂 ) and we went on to live the next two decades with no real contact. And then Twitter stepped in, and we resumed contact. When I read her blogs and posts I was happy to discover that we had a lot of similar and overlapping interests. We made a time to meet for coffee via email, and I was excited and nervous to see her for the first time in a long while. Those feelings, of happiness, discovery, excitement and nervousness were all real feelings happening in real time to a real person via a virtual world. We’d reunited virtually and this has had a real and positive emotional impact on me.

You may still be inclined to dismiss the emotional impact of virtual worlds. “Sure, Mike, you had real feelings, but Susan was a real person that you have had real face-to-face contact with in the past.” So let me give you another example. I recently had the opportunity to email Chris Brogan, and in the course of that mentioned my knowing Susan. Shortly after that I “heard” them talking about me on Twitter:

from @susangiurleo @chrisbrogan So glad you met my friend, @MikeLICSW ! RT Gamers meet therapy – http://ow.ly/3DT0A

@ chrisbrogan @susangiurleo – yep, loved what he shared. That @MikeLICSW is a nice fellow.

Two lines of Twitter, and as I read them I noticed myself smiling, well actually beaming. That’s real pleasure I was feeling, from feeling recognized and introduced. And I’ve never laid eyes on Chris in the virtual world.

So virtual worlds create real feelings, and we need to remember that when working with gamers.

I’ve written before about the face behind the screen but it bears repeating. Gamers are people, and they have feelings. Even if the stereotypes were true (and they’re not) that gamers are autistic, people on the spectrum have feelings too. Gamers get excited when they down a boss, upset when someone says something racist in guild chat, and happy when someone whispers them that they did a good job or tells them a joke. There is a world of real feelings in those virtual worlds, and we need to pay attention to them.

So do you ask adolescents about their facebook friends as well as their classmates? Do you ask gamers about how they get along with their guildmates as well as their roomates or partners? Do you explore their relationship to their raid leaders as well as their parents and other authority figures? If not, you are missing a whole lot of significant information, and it is only an ask away. Gamers may be reluctant to talk about their in-world feelings and relationships because of past disinterested receptions, but don’t imagine they don’t have them.

The next time you are checking out Facebook and see an old friend, or read a political post, notice if you are feeling happiness, excitement or anger.

The ask yourself, can I tell the difference between this and a “real” feeling.

Filed Under: Gamer Therapy Tagged With: avatar, gamers, gaming, psychoanalysis, psychodynamic, psychotherapy, Web 2.0, World of Warcraft

Tanks, Trauma and Epic Loot

January 11, 2011 by langloimsw 10 Comments

Therapists working with gamers need to understand many concepts, including the concept of tanking. In group play like raids and dungeons, it takes a team of players made up of various characters. One very important role is that of the tank. The tank is the warrior, paladin, Xena or Conan type who runs up to the big boss and starts smacking it with their sword or axe. The object of this is not primarily to do damage, but to get the boss mad, or “get aggro,” so that the boss will focus on this player and keep attacking her or him while the rest of the group can hurl fireballs or arrows or what-have-you from a safe distance without having to worry about drawing the boss away. The tank, being the player that has to take the most damage, usually has plate mail or chain mail or some sort of body armor, which brings us to Epic Loot.

We have discussed loot before in passing, but let me give you more detail. Much of the loot or rewards you get from defeating bosses is armor or weapons. The harder the boss the better the loot that drops. The better the armor you loot, the better “geared” you are. The armor raises your combat abilities or stats, which gives you more power and allows you to take more damage. Here are two examples of armor, one low level:

Not a lot of extra points to help you be powerful or take a lot of damage, as compared to epic loot armor:

You don’t have to be a gamer to get the difference between going into battle with Armor with a value of 62 and going with armor with a value of 3817.

I’m explaining all this to you in this level of detail because I want you to be able to use it when you work with gamers who survived childhood trauma in their families.

You see, many trauma survivors as children were living with oversized, overpowered bosses, called abusive parents. They often had brothers and sisters who were younger and more vulnerable than they were. They didn’t have anyone to help them, and they didn’t want the abusive parent to hurt any of the other members of their family.

So they tanked.

They pulled the abusive parent first, before the parent could hurt one of their siblings, or their other parent. They got aggro. They tried to endure the physical or emotional abuse that the abuser heaped on them. They tried very hard to endure it, they really did.

But they were undergeared.

Children have 62 armor. They’re armor is very fragile and doesn’t protect them much. They haven’t had a chance to go through enough of life to earn more powerful armor. It just won’t sustain damage from a higher level parent hurling “Comments of Increasing Pain” at their psyches, or casting “Fingers of Dark Intrusion” on their bodies.

This is not necessarily a new metaphor, and although Alice Miller may never have heard of World of Warcraft, I am sure she would know EXACTLY what I am talking about when it comes to tanks, trauma and epic loot. In her book For Your Own Good she writes:

“An enormous amount can be done to a child in the first two years: he or she can be molded, dominated, taught good habits, scolded, and punished–without any repercussions for the person raising the child and without the child taking revenge. The child will only overcome the serious consequences of the injustice he has suffered only if he succeeds in defending himself…”

Alice Miller knew how devastating it was to be undergeared. In her Introduction to that same book she writes, “…Unlike children, we adults… can choose knowledge and awareness over compulsion and fear.”

This then is the goal of the psychotherapist: We help the patient acquire Epic Loot. We join them and venture forth into heroic dungeons, and we try, fail, try, fail and try again to face the bosses there. And through our curiousity and empathy and bearing witness there comes a time when we finally down the boss, and the patient gets better tools for future adventures. They get to choose knowledge and awareness over compulsion and fear.

And that is Epic Loot.

Filed Under: Gamer Therapy Tagged With: alice miller, child abuse, epic loot, family systems, gaming, psychoanalysis, psychotherapy, PTSD, Tank, tanking, trauma, World of Warcraft

Want to Change a Behavior AND Feel Heroic? There’s an App for That…

December 28, 2010 by langloimsw 7 Comments

Click to See Looty Goodness!

I must confess I am not a big one for New Year’s resolutions. I rationalize this by saying that one should change one’s behavior when insight hits, not wait for a specific date. The truth is, like many of you, I want to avoid change, even if I know it is good for me. But if there is one thing that can motivate me to do something, it is “epic loot.”

In gamer parlance, “loot” is the general term for specific prizes you win in-game by completing a quest or downing a boss. In World of Warcraft the loot is color coded. White labeled loot is “common;” “uncommon” loot is green; “rare loot” is blue; and “epic” loot is purple. Recently we all had to say goodbye to our Epic armor and weapons, because the Cataclysm expansion introduced a higher level and item level. But I digress.

Token economies and reinforcement are nothing new to the field of psychology and the practice of behavioral modification. But now, if you or someone you know is a gamer, there is a way to tap into this love of loot and leveling up in the out-of-game daily life. It is a new App for the iPhone (sorry Droid, you fail!) and it is called Epic Win. (Thanks to @DorleeM on Twitter for tweeting this to my attention– follow her, she knows stuff.) This fun little app can be programmed with your list of to-dos. You choose your starting avatar, such as a Dwarf, Warrior Princess, or Skeleton. Then you enter the tasks you want to do.

You assign each task with a amount of experience points, and when you complete it you see a graphic of your character and a sound effect as you gain the points. Enough points and you level up, which also brings you loot, and you can see yourself progressing across the map of a Middle-Earth-like world towards your next loot. Ominous music and drum beats remind you that you are on a quest of great importance. You can measure your progress in miles as well as points, and the graphics and humor in the App are quite compelling.

To start with I chose two tasks that I wanted help and encouragement with: blog entries and my weekly run around Fresh Pond. I picked these because they are also recurring events, and I programmed the App to have them recur weekly and monthly, and to sound a little alarm to remind me to do them. To see how this would work (and give me some credit to level up!) I backdated my running for this month. After accomplishing these “quests” I was able to advance to level 2, and I received my first piece of loot, a “Tatty Wooden Chalice.” Humble beginnings, but it had a funny caption to go with it: “Yes it leaks, yes you get the occasional lip splinter, but it’s still better than cupping your hands.” The humor, sound effects and getting a prize all make it easier for me to stay motivated.

You can name your own avatar or the App will assign you one. I liked the one my Skelly got, and so I am keeping “Calcium Facebone” for the time being. As I have written previously, we often form attachments to our avatars, and this combined with the achievement of measurable goals and the heroic sense of being on a quest add up to behavior modification with a chance of succeeding. Calcium and I have already traveled many miles together (140 to be exact,) and collected 190 gold. And after I post this blog entry, the 100 points I get will porbably bring me to my next piece of loot.

I can’t wait to see what it is.

Filed Under: Gamer Therapy Tagged With: avatar, behavior change, gaming, iPhone App, loot, mindfulness, World of Warcraft

Players and Characters: A Primer

December 5, 2010 by langloimsw 3 Comments

Understanding Clients’ Involvement with Role-Playing Games

November 30, 2010 by langloimsw 4 Comments

Today’s blog is a twofer, in a couple of ways. I wanted to be able to discuss what playing online games like World of Warcraft might mean to patients, and how to approach them clinically. And I wanted to take the day off.

So I am attaching a two-part article that appeared in the MA NASW Focus Newsletter this September and October. It is co-written by my colleague Bet MacArthur and myself. Bet is a very interesting and dynamic clinician, and you can find out more about her here. Special Thanks to Carol Trust and MA NASW for allowing the reprint and making it available to clinicians outside of the Massachusetts area! Check out the NASW MA website, even if you can’t go in the Members Only Section there is a lot of good stuff to peruse.

I hope you find these articles helpful, and let me know if you have any questions or thoughts on them.

Understanding Client’s Involvement in Online RPGs Part 1

Understanding Client’s Involvement in RPGs Part 2

Filed Under: Gamer Therapy Tagged With: gamers, gaming, MMORPG, NASW, psychoanalysis, psychodynamic, psychotherapy, World of Warcraft

What Does Gamer-Affirmative Therapy Mean?

November 20, 2010 by langloimsw 8 Comments

Filed Under: Gamer Therapy Tagged With: gamers, gaming, LGBT, psychotherapy, Web 2.0, World of Warcraft, wow

Following Your Blizz

October 22, 2010 by langloimsw 5 Comments

This weekend I am enjoying Blizzcon 2010 in Anaheim, CA. Blizzcon is the biggest convention for fans of the online games World of Warcraft, Diablo, and Starcraft. The fact that I am able to go to this as part of my work and recreation is to me a testament to why private practice is worth the work.

I have been playing World of Warcraft since 2006, and in the course of the past 4 years I have met many people in-world who have educated me about who plays, and why. I have been part of several guilds, and learned about how groups deal with leadership and cooperation. But most of all I have had tons of fun and stress relief, and found a recreational pastime that is flexible and creative.

Because of my interest in online gaming, I began to think, write and teach about online gaming and psychotherapy. I was able to do this because I had built a private practice based on creativity and diligence, not fear and rigidity. I was willing to hold open a space in my practice to work with people who game, and who feel that they want a gamer-affirmative therapist. I was able to see that for me, trying to wheedle with insurance companies for an extra session was a waste of my time and money. In the time I had previously spent arguing with insurance companies for 8 more sessions I could write a workshop syllabus that brought in more revenue. In the process I discovered my niche, psychotherapy and it’s interface with Web 2.0, so that I was able to focus my business and help people find me.

An old creative writing teacher once told me, “What interests you is interesting.” Too often the therapists I consult with approach finding their niche as a chore or a limitation. My experience has been otherwise, I have found that I still have a generalist practice, which I will always want as part of my business plan; but in addition I have managed to diversify what I do so that all parts of my work become more interesting. So don’t be afraid of finding your niche, it is ok to have interests and passions, and your entire practice and you will be the better for it.

The other reason that this trip is happening is because I get to be my own boss. I worked a few hours more over the past few weeks to make some room for the trip, and I have even managed to find ways to mix business with pleasure. Not only is the trip tax deductible, but I am getting to be on the forward edge of the gaming industry and gamer culture. And, some of the CA psychotherapists I met via social media over the past several years and I are finally going to get to meet in person, and eat dinner together overlooking the Pacific. Good times, good colleagues, and things that engage the mind and soul!

So don’t be afraid to follow your bliss, as Joseph Campbell says, but don’t be afraid to do the extra footwork it takes to follow it. The work is daunting, sometimes tedious, always time consuming: But the payoff is huge.

Filed Under: Gamer Therapy Tagged With: blizzcon, joseph campbell, private practice, psychotherapy, World of Warcraft

Evocation and Mindfulness: Or, How to Think Better

Avatars & The Curated Self

Bio Breaks

Unplanned Obsolescence: Rethinking Play Therapy

The Uses of Disenchantment

Not All Failure Is Epic

Dopey About Dopamine: Video Games, Drugs, & Addiction

Dings & Grats

Defeating the Boss: Overcoming Your “Big Bad”

Being A Noob

Do Your Dailies

Reputation, Grinding & You

What I Learned at Pax East.

(Un)Desperate Times, or Know Your Talent Trees

Virtual Worlds, Real Feelings

Tanks, Trauma and Epic Loot

Want to Change a Behavior AND Feel Heroic? There’s an App for That…

Players and Characters: A Primer

Understanding Clients’ Involvement with Role-Playing Games

What Does Gamer-Affirmative Therapy Mean?

Following Your Blizz

Mouse Over My Pic For A Secret Message..

Epic Tweets

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Mouse Over My Pic For A Secret Message..

Epic Tweets

Ye Olde Vault