- Mike Amory is a social worker in New York.
- He says gaming often comes up in his sessions.
As a young social worker, I wasn't prepared for how often video games — and the way my patients interacted with them — would come up in sessions.
From a nonclinical lens, this shouldn't be surprising. The Entertainment Software Association, a trade association, estimated that in 2022, 215 million Americans played video games. That's the majority. If anything is that common, you should expect it to come up in a therapy session.
But when I was in graduate school and working under various supervisors, the topic of video games never came up. I think it's the generational divide between therapist and client, the former skewing older, with an average age of 50, the US Census Bureau's American Community Survey found. In my private practice, I'm seeing people in their late 20s and early 30s. This means gaming isn't talked about in sessions as often as it appears in our daily life.
When I examined a patient's relationship with video games more closely, I learned how gaming could be a window into the soul showing the need for validation that some aren't getting in the real world.
Video games took center stage with one of my clients
My client Matthew, whom I will refer to by a fake name because of my profession's legal and ethical standards, came to therapy because he was struggling with work and relationship issues, but it was only through a discussion of video games that we discovered a more subconscious issue: He lacked a feeling of accomplishment in his life.
Matthew said he was concerned about the increase in his video-game usage over the past few months, specifically on games focused on accumulating better gear that helps a character survive longer and hit enemies harder. Usually, these games have no "end state" and can theoretically go on forever. There is no final boss, just the next piece of slightly better gear to chase.
It made sense that Matthew would find himself spending more and more time on a game that, by design, rewards you constantly with real — if superficial — feelings of accomplishment and validation. That is exactly what he was lacking in his day-to-day, so, of course, he would seek out a facsimile of the feeling in a video game. It was the closest and easiest option available to him.
I conducted a test with my patient to see whether he was using gaming as a way to feel accomplished
If this connection was true, that he was using gaming as a crutch, then Matthew should feel less compelled to play video games the more accomplishment he got in other areas of his life.
Over the next few weeks, my client started cooking meals on a daily basis and visiting a local shooting range. He reported back that his desire to play video games had gone down. There seemed to be a base level of accomplishment Matthew needed in his day-to-day life, and if he wasn't able to get that, he was going to turn to the closest approximation, which was gaming.
Research on the relationship between video games and mental health is limited
Studies looking at the connection between mental health and video games are still in their infancy.
But there are some takeaways from existing research.
One questionnaire of over 2,000 people found that the reason a person played video games mattered. For example, those playing games as a means of distraction were more likely to have negative psychological symptoms, such as lower self-esteem and poor coping skills, compared with those who played to connect with others.
I feel that like any activity or hobby, video games do not operate in a vacuum and our mental state can influence how we engage with gaming.
This isn't to say video games are a net negative
For example, Matthew tends to play multiplayer games and thus has built a community of friends that he connects with through games — an obvious benefit to his life.
Plus, that diet version of accomplishment or validation discussed earlier isn't an inherently bad thing. Sometimes we all need the cheap pick-me-up of the not-quite-real-thing to rebound from a tough day at work or an argument with a loved one. The issue is of frequency, not use.
Building a sense of accomplishment on the basis of video games is shaky because they are not tangible. I found they could be wiped away by a server reset or a newer version.
Matthew's case is an example of how shifting video games from a primary to a secondary source of accomplishment can put people in their proper spot.