My Teenage Video Game Obsession Wasn't 'Gaming Disorder'
I was a gay teen in the 1980s, hiding from a terrifying world in an arcade. The WHO's push to uniquely pathologize gaming won't help people like me.
Back in my teen years, I spent hours nearly every single afternoon hovering around the game machines at a local strip mall arcade within walking distance of my home down in Sanford, Florida. If I had nothing else to do, that's where I spent my time. If I had things to do, well, sometimes I played video games instead of doing those things. Virtually all my free time was absorbed in video games (oh, and Dungeons & Dragons as well).
I was also a deeply depressed, closeted gay teen at the darkest, cruelest point of the AIDS crisis, terrified that if anybody found out I'd get the crap beaten out of me, and if I ever acted on my urges I'd get sick and die.
It's not difficult to imagine why I might have wanted to distract myself in a candy-colored world of maze-dwelling Pac-people, bug-shaped invading space aliens, and pixelated spy games. I'm not sure if I would have survived my 1980s puberty without video games as an omnipresent distraction.
Under new draft guidelines by the World Health Organization (WHO), I would be classified as having a "gaming disorder," which they are attempting to present as a standalone psychological addiction. There has been debate for years, decades even, among psychologists and pundits as to whether video game addiction is a real thing. On Monday, WHO took the next step to declare that it is.
This is a tremendously bad idea, designed to scapegoat technology and divert resources. People who have experience with video games—as well as those who understand the complex reasons why people's lives become consumed with them—should resist the push to separate game addiction into its own special category.
WHO is careful not to define the "disorder" as simply spending a ton of time playing video games. But its definition is still vague and bounded by a desire to fit the diagnosis into a substance abuse template. Here's their proposed definition, to be published next year, from a Q&A:
Gaming disorder is defined in the draft 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior ("digital-gaming" or "video-gaming") characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.
For gaming disorder to be diagnosed, the behaviour pattern must be of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning and would normally have been evident for at least 12 months.
That was definitely me throughout most of high school. One time, furious at me due to my tendency to prioritize video games over everything else, my dad actually destroyed a home gaming system (an Atari 2600) in front of me with a hammer. It didn't stop my gaming. Of course it didn't. The "addiction" wasn't caused by the existence of the technology. It was caused my desperate need for activities that took up enough mental real estate that I did not spend that time thinking about horrible I felt almost every waking hour of the day.
And that's one of the reasons many psychology experts have been reluctant to call video game addiction a separate disorder. From The New York Times reporting of WHO's new designation:
But some mental health professionals insist that gaming disorder is not a stand-alone medical condition. Rather, they see it as a symptom or a side effect of more familiar conditions, such as depression or anxiety.
"We don't know how to treat gaming disorder," said Nancy Petry, a psychology professor and addiction expert with the University of Connecticut. "It's such a new condition and phenomenon."
But is it really new? One person who founded an online support group for people trying to reduce their own gaming habits says there's "a massive tsunami coming that we're not prepared for."
To this recovered gaming addict, this all sounds exactly the same as it always does. The entirety of the nearly 40-year history of video game culture media coverage is full of this story repeating over and over and over again. People were saying the exact same thing about arcades. Then about home consoles. About online gaming. About every single development in video game entertainment. We should be drowning under this alleged "tsunami" by this point. But we're not.
Imagine if every time a new television show were a runaway hit, there were fearful news stories that we're increasingly addicted to television. This is what video game news coverage is like. The latest target is Fortnite, an online battle arena that has taken off massively over the past few months. Yes, people play the game for hours at a time. They used to play League of Legends for hours at a time. And before that, there was World of Warcraft. And before that, there was EverQuest. And you can follow that path all the way back to Space Invaders if you have a mind to. There's this constant myth that video games were some fringe little hobby that blew up as the internet blew up. The reality is that ever since video games were introduced as a consumer product in America, they've been enormously popular. The top video games make more millions more in revenue than the top movies.
The nature of video game panic cycles is eerily similar to the freakout about every single new drug trend that's going to destroy us all. Every single Halloween now there are fearmongering stories on the local news fretting that somebody's going to hand out marijuana edible candies to trick-or-treating tots, as though they didn't run the exact same story the previous year, and nothing of the sort happened.
The new twist on this story now is the money to be made from flogging video game addiction as its own thing. If this "gaming disorder" remains in this manual when it's published next year, public health agencies in many countries will be encouraged to recognize it. That's the point. WHO notes in its Q&A that its manual "is used by medical practitioners around the world to diagnose conditions and by researchers to categorize conditions." There are potential consequences of WHO formally classifying gaming disorder as a separate diagnosis.
One quote in the Times writeup gives away the game: A classification by WHO can be used as justification for redirecting spending. "Experts" on the condition often have a financial stake in having problem gaming formally recognized. They want health insurance companies to be required to cover treatment. They want money for more research.
"It's going to untie our hands in terms of treatment, in that we'll be able to treat patients and get reimbursed," said Dr. Petros Levounis, the chairman of the psychiatry department at Rutgers New Jersey Medical School. "We won't have to go dancing around the issue, calling it depression or anxiety or some other consequence of the issue but not the issue itself."
I'm telling the story of my own past because I think it's profoundly dangerous to look at the kind of behavior I exhibited as a teen this way. I certainly would not have been well served by therapist who believed I was in thrall to some kind of uniquely powerful or dangerous technology, or who thought addressing the underlying questions of why the addiction was happening counted as "dancing around the issue."
I'm still a hard-core gamer (I'm currently a closed beta tester for Magic: The Gathering Arena), but I don't suffer from "gaming disorder." I actually haven't played any games at all for the last few days—something that would have been unthinkable to me as a teen. What changed? The world changed. My life changed. I don't have to be afraid of being gay. I don't to have to live in fear of AIDS. I don't feel powerless about the world around me. I have control over my own life.
There was nothing about my relationship with games that needed to change. It was my relationship with everything else that needed fixing. There's an unhelpful bias in the way WHO describes gaming addiction in the assumption that "personal, family, social, educational, occupational or other important areas of functioning" are inherently more rewarding than playing video games, and if they're not, than the problem lies within the gamer. That's not always the case, particularly for people who feel depressed, alone, and powerless, and that's exactly why it's really important to consider that gaming addiction is a symptom, not the cause. If people are turning to video games to "escape reality" as "experts" warn, isn't the actual most logical step to simply ask, "Is there something about our reality that needs fixing?"
Bonus link: Peter Suderman explained in Reason magazine in 2017 why we shouldn't panic about young men dropping out of the employment market to find personal fulfillment in playing video games.
