Interview: Dr. Hilarie Cash continued

Mike Schramm
M. Schramm|09.09.09

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I don't want to take up too much of your time, but I did want to talk a little bit about what we've reported so far. We've reported on a lot of the media portrayals of addiction as well. One of the thing we continually see whenever the media talks about Internet addiction and how this all works is this tendency to say it's the game's fault. There's the news piece where the mom is crying, and she's like "oh, the kid won't get off the computer." And we all know, because we all play the game, that someone's paying the subscription, someone bought the computer, someone has it plugged in. We know that all of this stuff is going on in the background, and the media is saying that this game is extremely addictive and people play it for hours a day. How do you characterize that? It seems tough to blame the game, and you said it a little bit before, too. Blizzard is the company that makes this game, and they're known for making games that are very addictive in terms of how fun they are and how they give you rewards. How do you, coming from the other perspective, put those two together? How do you see that portrayal?

This is a really fascinating question. How much responsibility, where does responsibility lie. When I give lectures, for instance I go to Digipen and give lectures, or I go to one of the colleges around here to a class that one of my friends teaches and all of the students in that class are wannabe game designers. And so I talk to them about this problem with game addiction and Internet addiction, and they always ask, so what do we do? We don't want to create addicts, but we want to make successful games that will earn us money, so how do we balance that, what do we do? And I don't presume to have the answer to that. Obviously you're right that parents have responsibility with their kids to limit effectively how much time, or even if kids play World of Warcraft, right? That's a parent's responsibility, I thoroughly believe that. On the other hand, is it the game designer's responsibility to find ways to help moderate this? On cigarette boxes, there are at least those warnings, on alcohol there are at least warnings. Do the makers of these games need to at least, at the very least put warnings? And I'd love to see game designers trying to come up with games that are successful and fun, but that don't just go on and on and on. Which is of course what World of Warcraft does.

In Blizzard's defense, since they're not here I'll speak for them, in their defense, they have done things like, there's a feature called rested experience, where if you stop playing the game for a while, you get a bonus when you come back. And they've also done things like, instead of an ongoing game, where you just play play play, they've done things like daily quests, where you come back once a day, and you do a 5 minute, 10 minute quest and that's the only thing you have to do that day, so if you only have a little bit of time to play, you have things to do.

That's good, so they're trying to address it.

And I don't think that they've necessarily done it in terms of keeping addicts out, they've done it because people don't always have tons of time to play. And so they're kind of focusing on that type of audience. The other question I wanted to ask you about this is if you knew of any parallels to this. Gambling is probably the closest thing, and it sounds like, from what you've said about the DSM, that gambling is much farther along in terms of the research, and much farther along in terms of being recognized as a problem. Do you know of any situations where a casino had a game going and someone said, "you can't play this game, it's too addictive, you can't put this sound in the slot machine, it's too addictive."

No, none that I've ever heard of. It's a free-for-all. The parallel is apt.

Is that a bad thing? It doesn't seem like, in terms of gambling, anyone has ever held the casinos responsible.

I think you're right. I don't know much about that, so I don't know, but I think you're right, they don't hold the casinos responsible, what communities do is maybe try to keep casinos out, like not let casinos in somewhere close by, that's one of the ways they respond, and they can't do that with the Internet. You can't keep World of Warcraft or any of the other games out of your community. And I think it's one of the great frustrations that parents have is that the Internet is so intrusive and so ubiquitous it is very hard to keep it of your own home.

I guess the question is do you want that? As we report, there are 12 million players of this game around the world, and as you probably know, it's very hard to tell exactly how many people are "addicted" or in the situation where they need to stop playing. But I would have to imagine that in terms of a percentage, it seems much smaller, so much so that it's difficult to say, you have to do this to the game that so many people are enjoying healthily, even though there's a few people that aren't.

I totally understand your question and where you're coming from, and I think the way that it will turn out is that people are going to not require the game companies to create those limits. In China, when I was there, I was there in November, and went to Beijing and toured the Internet addiction facility that they have in Beijing, and got an opportunity to talk with the Chinese about some of the ways that they're trying to manage this there. Well because the government is so worried about this whole thing, the government has -- obviously a completely different kind of government, and a different kind of culture and society than we have, but because the government's worried, and because, the way I understand it, the game developers in China don't want to get in trouble with the government, they've created things like if you keep playing beyond a certain point you start losing points, and things like that. There are sort of built-in disincentives for people who overgame. Are you familiar with that?

And like I said, I think there are things in the game that do that sort of thing now, not in response to addiction, but in response to, people don't have the time to play a game nonstop forever. So I think maybe that's the solution is that the companies will respond to their customers not wanting to play all the time, as opposed to looking at the addicts and saying we're not supporting them, we're doing things to keep them out of the game.

So how it's all going to work itself out, really in the end, I don't have a clue. But I think they're very interesting questions to think about.

And the last question I had was about another disconnect. And this is why I was so excited to talk to you, because a lot of the stuff that we cover in terms of addiction is the media, and so we're going through that venue, which is not a great way to do it. So I wanted to ask you directly -- a lot of the time when we hear from psychologists about these games, there seems to be a disconnect with the psychologists talking about the games and the gamers themselves. Psychologists say things like, "games keep you from having productive relationships," when in reality, we're players of the game who have productive relationships with people ingame. I just got back from a convention for the game, and I met so many people that I knew ingame that I had met through the community, and it was a great time with fun and healthy people. The other thing that's said by psychologists in the media is that thing where "if you play for 14 hours a day, that means you're addicted," when sometimes, you've been working for weeks, and you want to take the day off and run heroics all day. There's a disconnect between the actual gaming experience and a lot of what the psychologists say. What do you think of all that?

Sure, I have some things to say to that. For instance, the 14 hours a day, well of course if you've been working hard and you want to play for 14 hours a day, that's quite different from playing consistently 14 hours every day, and you're much more likely to be addicted if you're playing 14 hours every day than if you're playing 14 hours once in a while. The way we have to define addiction depends on the signs and symptoms of addiction. We don't have a set amount of time that we can say "if you play this much time, you're going to be addicted." What we can say is if you let yourself play too much, you're much more likely to get addicted. It's going to be correlated with starting that whole trend with your body developing tolerance to the neurochemicals, and you start experiencing withdrawal if you don't get your fix, and then you become compulsive in your Internet or gaming behavior and then over time you truly are addicted and your life is falling apart. That's why we can't talk strictly in terms of hours played, but we can say, obviously the more hours you play per day, the more likely you are to get addicted.

Yeah. And I think again part of that is going through the media filter as well. The sound bite is playing 14 hours a day, and that's not everything that goes into the diagnosis. But from the other perspective, though, even you said, "Ben will go back and do things in the real world," and I think a lot of players feel like this as well, psychologists will say, "it's not productive to play these games, there's no way to have interesting relationships, you have to interact with the real world as well." Obviously I'm not saying you have to escape from the real world completely -- too much of anything isn't healthy. But it's definitely possible to have relationships in these games that can grow into real life relationships, or real life relationships that are then continued in the real world.

This is something I think a lot about, and I think it is again one of those really fascinating questions that over time, we'll do a much better job of having answers to. There's this thing called limbic resonance, and it refers to what happens in my brain and your brain if we have a caring, close relationship. It can stimulate this thing called limbic resonance, and limbic resonance is something which, when that part of the brain is simulated, it helps us be regulated, both physiologically and emotionally. We have this need for limbic resonance because we are social animals -- we're not meant to be isolated, we are social animals. That's part of why people marry, they don't marry just because they want sex, they want to be in a close, intimate relationship that's safe and loving, there are social needs for that intimacy and that limbic resonance, that's why we have good friends, because we're social animals. And people who are too isolated suffer from loneliness and from this lack of intimacy. So the question is, does the Internet provide an adequate substitute for the real thing and the real world. And I do firmly believe, based on my experience with the folks I've worked with over the years, that it is not an adequate substitute. I think that we are animals, who need, in order for this limbic resonance need to really be satisfied, I think we get that satisfaction from face-to-face, body-to-body encounters, where we can see and hear and touch and smell each other. And so when people withdraw too much from the real-world face-to-face social experience because they are spending so much time online, I do believe they are not getting their social needs adequately met. That's the important point. I think it's very possible to find a balance, so that you're somebody who has relationships in the real world that are very satisfying to you and you go online and you play with your buddies and you have a grand old time.

Right. You say it's not a substitute and on that I agree -- you can't exist on the Internet entirely and not have the same relationships in the real world. But I would say "complement" is what it does -- you can have the real relationships in the real world, and it's not as good when you're playing online with your friends, but on the other hand, that's an experience that actually strengthens the relationship and can make it stronger, I think.

I think that's fine, so I like the word "complement," but the addicts that I have dealt with, it's not a complement, it's a substitute. And when it's a substitute, it leads to trouble, I think.

That definitely makes sense. The last question I have was just about your gameplay -- do you play games at all, you said your son is into them, have you ever picked up or tried to play games?

I have tried to play some of the games with him on his Playstation, for instance, and I am just completely incompetent. [Laughs]

Well I am, too, on many games, so don't be embarrassed by that.

Really, I am so incompetent, I don't get any reward from it.

In my experience, even people who say I don't play games, I'm not a gamer, do actually play games, they just don't recognize them as such. Do you play Solitaire?

Oh I don't play them online, I play tons of games in the real world -- we love to play games, tabletop games, I play games a lot, but I just don't play online games or computer games.

So I assume then, that you've never played World of Warcraft or an MMO?

I haven't. I have friends who do, and I've spent time with them watching them, seeing what they're doing. So I have a sense of the game, but no, I myself have never been interested in doing it.

Do you think that would help, though? When I mention the rested XP and the mechanics in the game that ask you to stop playing once in a while, wouldn't that help for you to have a sense of what is this game like and what does this feel like and what happens here?

I do think it would be a -- I think it's a wonderful idea. I just feel no motivation to do it, so I probably won't.

Not even a curiosity even? Professional curiosity? In terms of working with these people who have done this for hours and hours and hours, you don't have a curiosity to check it out?

I satisfied my curiosity by sitting with and watching, on quite a few occasions, other people playing the game, but for my own, for me to play it, no I'm sorry.

No, and I will say, and forgive me if this is presumptuous, I apologize in advance --

I know just what you're going to say, go ahead.

I will say it's a very different experience watching someone else play and actually playing yourself.

I'm sure that's true.

And I'm not saying it as a gamer and as a fanboy of these games, I'm saying it as someone who has introduced people to games. I have a friend who enjoys watching me play, and it's two different experiences, when she picks up the controller and then she's watching me play, it's an almost entirely different point of view.

I'm sure that's really true, but I'm just of a different generation, and my brain is not wired to do it, and I have a very busy and fulfilling life, so it's like, why would I do it except to understand you guys better. Which is a good reason.

But certainly there's room in a busy and fulfilling life for games like this, right? I feel like I have a busy and fulfilling life and I tend to play games quite a bit.

I honestly have no idea where I would fit it in, truly I don't have time for it. But if it were a priority, I would make time for it instead of doing some of the other things I give time to.

Ok. Well I apologize for being presumptuous, but --

You aren't presumptuous, I think it's a great thing to talk about, and honestly, I think it's one of my failings, and it limits me in terms of my credibility for sure, it limits me that I've not played those games, but I just can't get myself to find the time to do anything.

You've been working on it for 15 years, I'm surprised that in all that time of talking about this with people and discussing this with people and all of these people coming in front of you and talking about what it's like... It takes me 30 seconds to hear about a game and I'm like oh, I want to check that out. I don't necessarily want to spend a ton of time playing it, but I want to at least get in and check that out, so maybe it's just the difference between us.

Clearly it is.

Well thank you very much for chatting with me, and like I said, this is a first for us, because we've talked a lot about media and this type of thing, but I don't know that we've ever talked with someone dealing with it, so I appreciate it.

And can I suggest to you and you can suggest to your audience a couple of really interesting books that I think might be of interest. One that talks about limbic resonance is a book called "A General Theory of Love." It's a marvelous book, it's poetically written, it's a pleasure to read, and it's very informative. So that's one I want to recommend to you, and the other is a book called "Distracted." And it's written by a woman named Maggie Jackson, and it's a very fascinating look at the culture of distraction that we are evolving as our lives are taken over more and more by all of our gadgets, and it's a really very fascinating book, so I can recommend both of those books to you.

All right, I'll check them out. Thanks again very much.
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