When I completed my Master’s dissertation on gaming addiction, I noted that a majority of research on the topic focused on defining it is as a disorder, assessing the aetiology or causes of gaming addiction, assessing how prevalent it might be, and identifying the problems that arise from gaming addiction. Daria Kuss and Mark Griffiths, two UK-based researchers noted the same thing in 2011 when they stated that “It appears that the current scientific knowledge of Internet gaming addiction can be categorised into aetiology, pathology, and associated ramifications”. While these topics are often the focus of research, in the media the most common questions about gaming and gaming addiction seem to be:
2. Do violent games lead to violent behaviour?
3. Are games addictive?, and
To save anyone curious about these questions time, and to get on to my main point, I’ll answer those questions briefly:
1. It depends, and it’s less about the amount of time and more about the way in which the games are used.
3. Games are not inherently addictive (and neither is anything else). Addiction is a psychological process fixated on a particular behaviour or substance.
4. No, and everyone involved in asking this question should feel bad
While there is still meaningful work to be done in terms of understanding predisposition to gaming addiction, identifying how prevalent it actually is, and identifying psychological motivations for gaming I think we’re well and truly at the point where far more interesting questions can be asked about the topic. Many if not most therapists will by now have encountered clients with some form of gaming addiction, and so there must be a significant body of clinical knowledge and wisdom about the topic. Yet, I rarely see these other questions named or discussed.
I would like to pose some questions to clinicians based on my own experience both with experiencing and treating gaming addiction, and would invite anyone who has thoughts on these topics to share their own perspectives.
What are the implications of the lack of natural limitations in gaming addiction?
With other addictions, there are generally automatic limiting factors. With drugs and alcohol, you reach a point where you can no longer consume more. With gambling, you run out of money. This tends to lead to shorter binge/craving cycles. With gaming addiction, other than the need for sleep there are no self-limiting factors and some gaming addicts can play for up to 16 hours, sleep and repeat the process. What are the clinical implications of this difference?
What are the implications of gaming addiction’s lack of visibility?
Other addictions are more well recognised and acknowledged than gaming addiction, and therefore more visible. At the same time, other addictions tend to more quickly lead to awareness of the addiction from others – gambling addicts often end up in debt to fund their addiction, and drug and alcohol addiction often leads to behaviours which are publicly visible, or at least visible to friends and family. By contrast, gaming addiction has less immediate impact on others and can therefore remain invisible for much longer. How might this affect gaming addicts’ likelihood of seeking treatment, and their engagement in treatment when they do?
What are the implications of gaming’s omnipresence?
With gaming having moved to mobile platforms, and therefore being available through the devices that many of us require in day-to-day life to stay connected or to perform our jobs, how does gaming addiction differ from other addictions? While we might be able to avoid the alcohol aisle in the supermarket or take a different route to avoid driving past our favourite gambling venue, few of us can put aside our computers or smartphones.
Are particular personality structures more likely to be drawn to gaming addiction due to its interaction with particular psychological defences?
Like all addictions, gaming can serve a defensive function, and like all addictions can particularly facilitate defences of withdrawal and isolation. Does gaming addiction particularly complement certain psychological defences more so than other addictions? For example, does the competitive and black-and-white world of most video games, the ‘us vs them’ mentality that many games entail lend itself to the use of idealisation/devaluation defences or splitting? To what extent do players use identification with their online character/persona in a defensive way, and to what extent are displacement and sublimation taking place through interactions in-game?
Can a person’s behaviour and way of engaging in-game provide us a deeper understanding of internal conflicts and sense of self?
If a person behaves very differently in-game from how they are in the rest of their life, what does this tell us about internal conflicts and splitting, and their sense of self? If a client is passive and compliant in therapy, but is dominant and aggressive to other players in-game, what can we make of this contrast, and how can we work with it clinically? If a player prefers to play supportive roles in a team game compared to being a ‘carry’ (someone who can carry their team to victory if they perform well), does this tell us anything about a client’s needs and ways of functioning in the world?
Does historical stigma around gaming create barriers to seeking treatment?
With gaming historically (and to some extent still presently) being seen as a ‘nerdy’ or ‘geeky’ hobby, are gamers less likely to seek treatment than people experiencing other addictions? If they do seek treatment, are they more likely to seek it through alternate channels (e.g. online support groups, Skype/tele-therapy) over seeking a therapist in person?
There are a lot more questions I am curious about, and a lot more I would like to ask but this seems like enough as a starting point. There are many clinicians working with gaming addiction, many of whom likely have a huge amount of insight and understanding about working with these clients. During my training, I learned that evidence-based medicine meant integrating the best available research evidence with clinical experience. In this case, the research evidence is, I suspect, lagging far behind what many clinicians are already aware of. It is my hope that we can begin a conversation about these topics and develop a much deeper and richer understanding of working with gaming addiction than what we currently seem to have.