The worst thing about obsessive-compulsive disorder is that it lies to you. For something called a "disorder," it convinces you that you're doing things over and over again to create order, rather than chaos—to stave off a lack of control in your life. Terrifying lacks of control, like becoming unwell and having your body rebel against you, or having your house burgled. Turning that light switch off and on again 30 times before you leave for work just feels... right. It makes sense to you, because you lack the life-saving objectivity of a third party.
I've had severe OCD since I was a child, and was only formally diagnosed and treated for it as an adult. Six months of high-intensity cognitive behavioral therapy (CBT) helped me get to a point where I had a series of coping strategies to prevent me from becoming Mr. Lightswitch. But what was interesting was the way in which I noticed my interaction with video games starting to change—areas of my life in which I had far more control than normal, where I could be found building rockets, planning cities, saving soldiers, and finding treasure. In a land where I could live as a god, my behavior was starting to veer away from the benefits of omnipotence.
For someone like me, a game like Kerbal Space Program is a minefield of Things That I Have to Control or Everything Goes Wrong. The thing about OCD is that it's a disorder that forces you to avoid ever looking at the forest, crushing your face into the bark of a single tree so hard you can't hear your own common sense. Kerbal Space Program functions similarly, as a space agency simulator in which you build intricate rockets, planes, and other aerospace tech and pilot it using a variety of incredibly intricate controls. A single tap of a button can cause a crash. A badly placed release mechanism can kill three brave astronauts.
The parallel here, for me, is leaving the house. I lock the door. I check the windows. I lock the door again. I check the door. I realize people might be staring at me if they've noticed, but I keep checking the door. I start to panic, and tears start to make their way out of my ducts. I become a shaking, nervous mess, and it's because I'm trying to make sure we don't get robbed and nobody dies—even though I know I locked the door.
I didn't check the ship. I didn't alter the design. I launched, I watched it crash, and I kept going. I forced the guilt down and I did it over and over again.
CBT taught me that actually, an unlocked front door is not the sole cause of burglaries, and over time, I stopped checking the front door as much. I started walking away and living my life. When it came to launching rockets in Kerbal Space Program, I realized that, realistically, my desire to see what happens when I hit the launch button was so great, my desire to live, to experience things, that I was willing to take the risk. I didn't check the ship. I didn't alter the design. I launched, I watched it crash, and I kept going. I forced the guilt down and I did it over and over again.
When it comes to environments that we can design, those with OCD, you'll find, tend to organize things slightly differently. Not noticeably, but they will set themselves up in a way that minimizes their anxieties. Creating areas in games in god sims and real-time strategy titles has long been the same for me. Obsessive behavior relating to symmetry and counting often led to me wasting time, resources and doing worse in games. Everything had to fit. Nothing could feel out of place. It was frustrating, and difficult to work through.
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Playing Cities: Skylines has helped me face up to this problem and push past it. Sure, I still like pretty, organized cities, and at first, I was carefully planning things out before realizing that as a city expands, it needs to change, rewrite itself—buildings must come down in favor of highways, and houses must make way for apartments. It forces you to accept change or fail—its consequences, rare for a video game, can feel as severe as those in real life, in that sense, for those with this kind of anxiety.
But it also teaches you a similar lesson to the one you'll learn as you slowly start to cope and deal with your OCD—to let go and see what happens. Kerbal Space Program is similar, with both titles encouraging you to just hit the button, and let your greatest adventure become the simple act of finding out what will be. The most important lesson I've learned when dealing with my disorder is that I cannot always control what happens, but I can control how I react to it.
Video games become therapy of a sort, enabling you to put yourself in anxiety-causing situations and push through them as a training simulator for the risks, trials, and tribulations of reality.
Jamie Madigan, psychology and games design theorist and author of Getting Gamers: The Psychology of Video Games and Their Impact on the People Who Play Them, tells me that games can be a good environment in which we can learn to take greater risks and explore without the danger. "We can not only set our own goals, but take whatever paths we want to get to them. What city planner in the real world could simply bulldoze a high-income suburb simply to make room for a football stadium? Real life is full of compromises and restrictions, and for good reasons. Video games are much more less so by design and let you experiment and experience more meaningful choices."
This is the important thing about video games for people with a lifelong fear of risk. By constantly showing you that taking considerable risks can lead to great rewards, it encourages you to start pushing yourself that little bit more in real life. In that sense, video games become therapy of a sort, enabling you to put yourself in anxiety-causing situations and push through them as a training simulator for the risks, trials, and tribulations of reality.
I ask Jamie what he thinks of taking risks in games, and why we do it, when real-life risk is scary enough to put the fear in us even when we realize these fears in the media we engage with. "Because they let us," he replies. "Consequences are generally less severe and often don't involve complicated things like reputation or opportunity costs. And they pay off quickly—minutes or hours instead of months and years." This constant, accelerated feedback format can be helpful—we're seeing the long-term benefits in games and it can help us to perceive them in real life.
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It's possible to push the concept of irreversible risk even further, by playing games that remove your option for manual saves and enforce permanent choice. XCOM: Enemy Unknown is a great example of this, with its Ironman mode making every soldier's death permanent, and refusing to allow you to undo your mistakes, but allowing you to continue forward and learn from them. It's a good life lesson in general, but when you're trying to physically force yourself to use the same hand for your wallet that you used to hold onto the escalator handrail, lest you look like you're reaching for a gun in a train station, it's a vital one.
We're used to using games as something to alleviate depression, but when it comes to disorders like OCD, it's easy to think of them as too complex to address with a bunch of bullets and space aliens. But using video games to train those with OCD that risks can be adventure, and that you can't control everything save for how you react, is important. We're allowing people to find their own healthy way of using media to treat problems, and for me, launching rockets and building suburbs has allowed me to explore ongoing issues I still face and treat them with little experiments in pushing my fear of risk. I am not my illness—just an aerospace engineer working on his nerves, and a city planner deliberately placing something asymmetrically and gritting his teeth.
If you feel that you are experiencing mental health problems, there are many organizations and charities that you can turn to for advice. For US readers, visit the Mental Health America website.
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