I have to confess: I’m a user. 

Before my proper diagnosis and treatment, playing video games was one of the few activities I could count on to reliably reduce my OCD symptoms.  I’ve dealt with the consequences of this behavior since childhood: social ostracism, thousands of dollars spent on accessories such as link cables and extra controllers, cramped and gnarled fingers. 

For the most part, I’ve learned to limit my vice - to indulge myself a little when I really need it, but to restrain myself from full-blown addiction.   However, the fear of that addiction lingers – the fear that one day I’ll gaze into the glass and see a stranger’s face, an image with vacant eyes and bulbous nose and prominent moustache.  And he’ll speak to me and say, “It’s-a me, Mario.”  And I’ll nod and repeat  the phrase,  because no difference exists between us any more – I’m-a Mario too.

My relationship with video games is a conflicted one:  they’ve both offered relief from and aggravated my OCD.   Certainly, the focus and the gradual mastery that some video games demand have felt therapeutic.  During my months at the OCD Institute at McLean Hospital, I played the Playstation2 title God of War – a violent beat-em-up game that pits the player against figures from Greek mythology.  The gameplay was dull and the story was cheesy, but while I was struggling through painful Exposure Response Prevention Therapy, I found that taking an occasional break to decapitate virtual centaurs could be incredibly cathartic. 

In recent years, I’ve found the most challenging “hardcore” games to be rewarding in their own right. I’m thinking of some of my favorite cult titles, like Clover Studio’s God Hand or Treasure’s Astro Boy shooter for the Game Boy – games where an enemy’s stray bullet or a flailing punch mean instant death, games that demand a state of total focus and concentration.  Such games don’t offer the instant gratification of titles like God of War, but the process of working through frustration, of perfecting reflexes and tactics to overcome challenges, is uniquely rewarding.  I’ve recently taken up meditation to help cope with my disorder, and I’ve found that the states of intense concentration one experiences during meditation and while playing the most difficult video games aren’t as different as one might think.

But some games, such as many role-playing titles, emphasize gameplay complexity and storytelling over challenge. These are the games that I have the most difficult relationship with, the games that have both relieved and aggravated my OCD.  Many of these games don’t even feature real-time, reflex-based gameplay;  instead, they let players take turns trading blows with their enemies, like in a game of chess.  Such titles are fiendishly complicated: a player will have to decide what tools to give characters, which techniques to use in battle, which character traits to upgrade.  One can spend hours plotting strategy, optimizing equipment, tracking down and completing every last optional quest.  Some of these games take literally hundreds of hours to complete.

Games like this are the ultimate distraction from OCD.  They contain worlds so vast, with rules so complicated, that OCD is silenced – I become so engrossed that my obsessions can’t even begin to get my attention.  But while these games can shut out OCD, they kind of shut out everything else, too.  We’ve all heard horror stories of gamers wasting their life savings on virtual items, or playing marathon sessions until they suffer major health problems.  Games can offer relief, but they are also a way to hide from challenges that one might be better off confronting. And this doesn’t even begin to address games that prey on a player’s obsessive perfectionism – if I’ve collected 98 treasures out of 100, how can I stop playing until I’ve tracked down those last two?

It’s easy to blame video games for exacerbating the problems of the mentally ill – how often have games been accused of driving young people to violence, or of cutting them off from society?  But in my experience, the truth is much more complex.  Games can isolate or empower, they can create mania and addiction or peace of mind.  If you had told me, when I was a child, that I’d still be playing video games in my mid-twenties, I probably would have been horrified.  But I’ve found that, by using them carefully and thoughtfully, video games have been instrumental in maintaining my mental health.

Copyright, Fletcher Wortmann, 2013. 

Author of Triggered: A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press, 2012), named one of Booklist’s “Top 10 Science & Health Books of 2012”.

Visit my website:  http://www.fletcherwortmann.com/ 

Read my Psychology Today blog: http://www.psychologytoday.com/blog/triggered

Image:   ©iStockphoto.com/Gavh

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