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Federico Alvarez Igarzábal and Emmanuel Guardiola, "Video Games and Mental Health: Perspectives of Psychology and Game Design" (Transcript Publishing, 2024)
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- [00:02]
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Federico
Welcome to the New Books Network.
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Rudolf Inderst
Hi everyone and welcome back to New Books and Game Studies, a podcast channel on the New Books Network. On this channel we explore new scholarship that unpacks what games mean, how they are designed, how they are played, and how they resonate far beyond the screen. I'm your host Rudolf I Professor for Game Studies at the University of Applied Sciences, Neue Ulm, Germany. Before we get started though, if you enjoy the show, what does it even mean? If you enjoy the show, please consider leaving us a five star review on Apple Podcasts or whichever platform you prefer. It really helps others discover us. And of course please feel free to share this episode or all the others with your community of gaming groups. And now let's dive into today's conversation. I'm very pleased to welcome Emmanuel and Federico who join us to talk about the edited volume Video Games and Mental Perspectives on Psychology and Game Design published by TransKript. Emmanuel Federico, welcome to the show.
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Emmanuel
Yeah, thank you for the invitation.
- [02:43]
Federico
Thanks for having us.
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Rudolf Inderst
To start us off, could you briefly introduce yourself and your background as a co editor or co editors of this volume? What motivated you to bring together psychology and game design to address the topic of mental health at this particular moment in time?
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Emmanuel
So I am professor doctor at the Apply Science University of Cologne in an institute named Cologne Game Lab that maybe some of your listener know. And before that I was in the industry game designer for 15 years and released many, many games. So about the interests nowadays, I think we are not anymore in the dark age of criticism of video game. Even if it's still criticized by people or some people, it is not as it was in the past. Personally, I born in 71 and that was the date, the year of the release of the first Akan machine. And from Atari it was Pong. And after that, when I get older, I got my first CVS VSC Atari console, the first with cartridge at the time and then a PC and then I play, I mean for 50 years to all the possible console. And during all this journey into video game we had strong, strong criticism from the beginning. But no, it's more, it's mature. I mean, even if, yes, we are studying some aspects of negative aspect of game and mental health, but there is also some kind of mature discussion about it. So really I consider as very important to have to unlike in particular the positive effect of the connection between mental health and video games.
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Federico
Yeah, from my end, I think, as Emmanuel said, video games have been almost for a long time at the center of moral panics. And for the last 10, 15 years, maybe, maybe a bit longer. But more or less we've been seeing a change in the zeitgeist, where people, scientists, but also the general public and designers as well, have been more interested in the positive effects of games. And we wanted to look more into this perspective. And I think especially Covid was a big turning point. The pandemic, of course I'm talking about which we all live through. And it seems like it seems so real to think about it now. But back then, even the World Health Organization WHO has their gaming disorder and has been publicly somewhat critical about video games because of the alleged addiction that they produce. That's a debate that's still ongoing. But they even encouraged people to play more video games during lockdown, to stay in touch with people. And I think it helped a lot of us to keep calm, to deal with our anxieties at the time and the uncertainties of this very strange thing we were living through. And that even made, I think, this question about the connection between games and mental health even more important, urgent. It was like a catalyzer. So I think that sparked also our interest a bit more and fed into our motivation to. To publish this book. Before that, I was also working at a project of virtual times where we were looking at the possibilities to treat and diagnose psychopathologies like depression and schizophrenia through the malipinization of time perception through virtual environments and video games. So I already was developing this interest through this. It was a postdoctoral position back then in fiber with Mark Twittmann, part of this EU funded project. So that combined with COVID and this changing Zeitgeist I think led us to want to explore this in more depth and produce this anthology.
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Rudolf Inderst
Right. So mental health has become a central concern, as you Jeff has said, across the gaming industry as well in recent years in your book. And I was talking about to one of our colleagues, Arno Gergen, actually I think one or two weeks ago. And you make this important distinction between applied games drawing on diagnostics therapy and digital medicine and entertainment games that approach mental health from more personal auto driven perspectives. So I wonder why was it important to you to examine both of these domains side by side?
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Emmanuel
Yes, for sure. And I mean mental health in video game was evoked starting the end of the 70s, but mainly for criticism again. And I invite you to look for a video that is hilarious. It was made by Saturday night life like comedian at the time. And it's about the parody of our children addicted to arcade video games. Really I think it's Alen if I find again it's Alan the video game junkie. You can find it everywhere. It's really, really hilarious. So already at that time there was a distance between the reality of addiction and what the mainstream maybe press say about it. But I mean since 2005, 2010 that there was a big change and it's due mainly to a technical aspect. It's the moment the engine, the game engine became free. So you were able to use and develop your thing by yourself. So at that time you have a lot of more people and in particular in the balance autor who wanted to make games who were free to to talk about many topics including the one that are related to fragile person or person character with mental illness. And on the other side you also have researchers who were able to use in a more easy way the tool of video game to investigate how they can have an impact on mental health. And now you can see crossover with data even it progress in the two directions. They inspire each other. And I mean we have the example here on the project that is Izeda about managing victim of domestic violence. And the inspiration we have for the gameplay in it comes from L A Noir and from Life is Strange. And then it became a natural game to manage the emotional state of victims. So, yeah, I mean, it happens now. There is this connection constantly. And that was one of the, I think, key aspect of the book we worked on.
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Rudolf Inderst
So one of the strengths of the book is for sure its interdisciplinary scope. So from your perspective as an editor, and this is one of my favorite questions actually, because I find myself often in this position as well. So what were some of your key challenges and perhaps also the rewards of bringing together contributors from psychology, game design and game studies into a shared conversation? Because I have the feeling that these kind of work, these volumes and anthologies, they're often belittled and overlooked in what they actually mean and how much work you put into it.
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Federico
Yeah, they are quite a bit of work and over a long period of time and you become this sort of middle person between authors and the publisher. And I think, yeah, one, I myself sometimes forget how much work this is every time embarking one of these projects. But it's always rewarding as well. And so let's focus first on the rewards because, of course, yeah, since we have these two angles, like the applied games and games that come more already with a perspective from science and academia, and then this more under tendency of indie games that are looking at these subjects from a more personal, perhaps subjective perspective, but are still being informed, or these developers are trying to inform themselves as well as they can about these things that they're presenting. We thought it was important to combine these voices in one volume. And I think this was one of the rewarding things as well, to read while you're editing the same thing, the same object texts that come from such different perspectives and at the same time be informing yourself from the point of view of a scientist who. Who is trying to understand this medium and looking at it from an outsider's perspective with their tools of science, the research tools and theories, and in the larger context, perhaps of society. And then this other perspective then from the game developer, game designer, perhaps from a more intuitive point of view, working through their own struggles oftentimes. We have two chapters, for example, of game designers that worked on games that are very autobiographical. One is more allegorical, the other one is very openly autobiographical. But they're both dealing with their own mental health struggles and processing them through the language of the video game. I think that's fascinating and maybe you lack the academic rigorous, but you have this other view from inside of video gaming and video game development, which is very rich and interesting. And one of the challenges was while starting to edit this book was, well, what do we. When we're editing books as academics and just editing the voices and the texts of scholars. Right? And how do we deal with this disparity in voices and in points of view? Right. And we just decided we will just let it be. This is the idea of dialogue like this, that these texts coexist and allow them to be different, allow them to have different perspectives, different points of view on the same topic or on similar topics, and that the readers can explore these points of view in the different chapters. And even that may cause some contrast perhaps to the reader. I think there's a value also in this mixed perspective content that we've collected here in this, in this book. Precisely this idea of the more intuitive personal search and exploration and the more perhaps academically rigorous but colder and outsider's view of game developer from academics. They both have immense value and I think it's interesting to have them both sort of coexist in one volume.
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Emmanuel
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Rudolf Inderst
Yeah, I absolutely agree. So this actually builds the perfect bridge to my next question then, because.
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Federico
This.
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Rudolf Inderst
Volume also, it doesn't only take a look at the current practices, but also at future perspectives. So based on the contributions, what trends do you see emerging in how games are being used to address, represent or support mental health, whether in clinical contexts, self help or mainstream entertainment?
- [15:57]
Federico
Yeah, there's a lot to unpack there, of course, and talk about. It's always difficult and I'm hesitant to talk about future trends, but one can talk about current trends and of course speculate up where this may be going. But I think starting with representation, which was one of the matters that you touched upon there in your question there, I think we're releasing from the side of designers. This is of course one of the sides where designers have a lot to offer in sense of, well, listen to how they dealt with this matter. So when we're designing a game and one of our protagonists or characters is supposed to have some mental health, what was this disorder issue? Psychopathology. How do we represent it fairly and without stigmatizing it? I feel like there's an interest in game designers to depart from this idea of the person with the mental health issue is the villain or the bad guy or whatever, and explore this from more of a perspective of empathic perspective, where often these characters are the protagonists and we're supposed to sympathize with them, to experience a little bit. And I'm talking about now neurotypical people like us, right, that we play something like Hellblade and then we kind of get a glimpse into what it may be to have psychosis.
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Emmanuel
Right.
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Federico
And to perhaps when we encounter someone with a psychopathology like this, we have a better idea what they're going through, what they're suffering, but also not be just afraid of it because of not knowing what it is like. I think these things can help educate the general public, but also make people feel heard and Represented, I think that also has value. Mental health issues can be very isolating, which is I think oftentimes a side effect of having a mental illness that people can't understand. You, it's something when you're physically hurt, people can see where you're hurt, right. Your wound, whatever. I can understand why you have to be in bed, right? Because your leg is broken or something. But when there's something inside of you that brings you to stay in bed, people perhaps are more prone to say, like, just, just wake up, just stand up and do something, you know, and it's much harder to understand. So I think having this, this perspective, having games put us in more of a first person perspective. Of course they'll never be able to put us fully in there, but a little bit closer to that, you know, helps us understand this, this sort of struggle and to better empathize with it and to better help those who need help. That's one thing that I think is changing in gaming and that's important and that I hope a friend that continues. We also have in this regard, these chapters that I talked about about designers who talk about their own struggle. And I think it's incredible that they. Because it's a very vulnerable position that are putting themselves into by doing this. And very admirable to, to expose yourself like that and saying, here's my struggle with. And I'll put it into a game. Here's my struggle with grief because my wife passed away. Right. And actually one of our texts is from Sebastien Jeanbeault is about a game that he designed after his wife took her own life. And he deals with that also and what it's like having a son in this context as well.
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Emmanuel
Right.
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Federico
It's a heartbreaking game, but it's also great that they put it out there so others in similar situations can feel heard and can maybe find a voice they can relate to in these very isolating hard moments. Right. And then we also see, on the side of academia and science, I think we also see a lot of interest in exploring beyond this stigmatizing and negative effects of games that have usually been in the focus of attention, like addiction, violence, et cetera. We see researchers trying to see, well, what are maybe the positive side effects. And we see people like, I don't know, I think of Andrew Szyzbylski, for example, in Oxford, who's doing a lot of work now cooperating, working together with Nintendo and other companies and showing through his research that there are positive side effects on mood and, well, being from playing video games like Animal Crossing. And we have a lot of researchers, psychologists, psychiatrists, neuroscientists working on applied games to treat psychopathologies. And we have an FDA approved game recently for a few years ago the Food and Drug administration in the U.S. approved a game like Endeavor XR for the treatment of adhd. I'm sorry. Yeah, so that's I think also an incredible trend that we're seeing and I really hope that that continues that we see more games that are also design already informed by clinicians, psychiatrists, neuroscientists to really be applied in therapy as means to treat and diagnose psychopathology. There's a lot of potential there. I was lucky enough to be part of one of these projects, Virtual Times that I already mentioned that we it was an EU project that where we were exploring. These are similar things as well. And we have a few chapters on this as well. Like a chapter by Nick Bauman, for example, and colleagues explores the positive effects of nostalgia in gaming and retro gaming. In well being, Marco Rout, who's looking into how serious games can impact our behavior in positive ways so that we have healthier behaviors and more environmentally friendly behaviors through serious gaming, or that we adopt behaviors that allow us to stop smoking or prevent smoking or eat healthier. And he goes through a lot of the evidence showing that games can have this impact. So there's a bunch of chapters as well in our book that explore these trends. Also from science, we're looking at this potential of serious gaming in improving our mental health. So I think these are some of the of the trends that we observe that I think are very positive and I hope that they continue right before we continue.
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Rudolf Inderst
A quick note to our listeners. If you are involved in running an academic program in game design development or game studies, this podcast might be the perfect place to share your vision. Our listeners include engaged scholars, educators, students and professionals across the field. Consider placing a short promotional segment to connect with this thoughtful international audience passionate about games and research, just like us. So a recurring concern in discussions about games and mental health is the risk of simplification or even instrumentalization. So reducing complex psychological experiences to mechanics or even metrics. So how does your book address these ethical and design related tensions?
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Emmanuel
Maybe some author address it as part of their paper, but this is not like a core topic in the book. But yes, we face simplification for sure, but it doesn't mean that simplification is bad. Like for instance, simplify character in an antitheband viewer game to make them more Understandable. So in video game and game design, we need simplification and game that simulate mental health needs this model. Any simulation is a simplification of reality and that's fine. Any artist doing it, it's okay. It's touchy. When the purpose is to have an impact like sensibilized to certain mental health issue. Like it's interesting because as a reasoning of example, sooner we have a team who work on a game for professors to understand. Certain students suffer from severe social anxiety. For instance, typically the one that would never talk to a professor. And we have a group of students working on that game with the department of Disabled to help people with disabilities at thcon. So when you are doing so, you have to back it seriously with expert, we're not talking into a simple simulation. It has to be a more precise simulation. So game designer of Titan packed game have to establish also very clear outcome. Because you cannot solve everything, you cannot represent everything you have to say. We are attached to the representation or the simplification or the modelization of this particular and most model. Most psychological models, including psychological models are made of number. You certainly already heard about the Ocean personality evaluation. That is one of the best personality models ever. But the content was made by experts. And these five key criteria of the personality is measured by number. When you're answering questions and we can say yeah, you are an extraverted person, blah blah blah. But the problem is when number are talking to number like pure statistical model, like okay, you are doing that, then you have X percentage to like this thing, etc. So now it's a number that are talking to number. So I believe that in particular in the mental health domain we still need strong expert model. It's not we cannot be be relate on the LLM model or things like that that are pure statistics. We need people know the topic and build with you a strong simulation as efficient as possible for your purpose.
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Rudolf Inderst
So finally, for psychologists, designers and scholars listening, what do you hope readers will take away from your book Video Games and Mental Health? How might this volume inform future collaborations between research and practice?
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Emmanuel
So when it comes to mental health as designer we are free to do and show anything. And because we want the player to experience something and so we can go deep, we can even make mistakes because the purpose even try to make the audience being uncomfortable and to find a way and also to find a way to create safe environment when you are experiencing very dark psychological aspect erdenstrong disabilities. And one of the trends that we try to have here and I think we will strength in the future is the involvement of the two parties in both type of game like a scientific and entertainment game developer together in each other's discipline. An example or two examples one that is a serious game the one to teach police officer how to manage victim of domestic violence. The source of this project were video games as I said and we also had for that project very strong professional working with us. We need this professional to do the. And also sorry, I want to say this project, we need game designer to make it properly interesting for the police officer.
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Federico
That.
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Emmanuel
That's what I mean. But you also have a project like entertainment project like the senior Sacrifice here. It's the contrary. We have experts in psychology who are helping game designers to create an entertainment game so. But even if it still start to be here, there is a room for improvement in this connection between the two world and we try to show it a little in the book but we have to. We lack so much about the mandal health's well being and psychological mechanic at play when we play. That's a big topic and I think it's at the meeting of these two trends that we will progress.
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Rudolf Inderst
So Emmanuel Federico, thank you so much for joining me today and for sharing insights into this timely and important volume. In my opinion, video games and mental health makes a valuable contribution. No ongoing conversation at the intersection of games design and well being. Now one more thing here. I usually ask what's your favorite game but Federico, the old Fox as we say in German, the Alte Fuchs. He told me okay, he was already here so we need to change the very question and this time I'm going to ask what's the game you've enjoyed the most in the past year.
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Emmanuel
So for myself it's Baldur's Gate 3. I think it's the game I play the most follow up by Solasta and Humankind, but that's the main one, Baldur's Gate three.
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Federico
Well, I have to say probably the game I'm playing right now, which is Ghost of Yotei. Yeah. And I wasn't sure what I was to answer but I've been playing it more and more in the intervening days and I'm blown away by that game. It's so good, so much fun. So I can recommend it to everyone especially if they played Ghost of Tsushima. So the previous one and they've liked it. You should go for it. Yeah.
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Rudolf Inderst
So thank you again for being.
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Emmanuel
Oh, I may have a little thing to add. Rodolphe. It's if you are interested, buy the book. Don't go on website where the book is sell. Go directly at Transcript on transcript website. Because it's an open science book, you can download the PDF for free and use it so you don't have to buy a cover version of it.
- [29:58]
Rudolf Inderst
Thank you very much. Thanks for being with us today. Thank you again for your time. Thanks for your effort and thanks for your really grand book. Thank you very much.
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Emmanuel
Thank you. Bye bye.
- [30:08]
Rudolf Inderst
Dear listeners, I hope you enjoyed this episode. If you're an author or editor working game studies or research and would like to discuss your latest work, please feel free to reach out@rudolf.inderstooglemail.com you can also find me on LinkedIn under Rudolf Indust. And of course Blue sky under AME Studies. What you're doing on X. Leave there. Leave immediately. And one last reminder, if you want to support the show, head over to gamestudiesmerch.de and check out our Game Studies hoodie. Until next time and always keep it playful. Goodbye. Good night. Bye bye.