What are games, and how do they affect mental health?

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Play is an essential activity in all phases of human development, and games are an important part of play. Game-related behavior can reflect and facilitate normative development as well as provide important clues to disruptions in development.
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Games are mental and physical activities engaged in for learning, leisure, or other social reasons. They are a recognized type of play behavior, in that they are motivating by virtue of their pleasure. Play is a voluntary activity that is intrinsically motivating, suggesting that it is sustained for its meaning or pleasure. It is a normal part of human development that reflects that development, helps it advance, and provides a window into understanding any developing problems.

Play first evidences in childhood and continues throughout the life cycle. It serves many functions, including simple expression and expressions of individuality. It is also part of cognitive development, problem solving, and creative thinking and can be done with language and behavior or with thinking and imagery. It can be done in solitude or with others. As such, it may affect language, intellectual, social, emotional, motor, or other physical development. Furthermore, because play often has rules, it is related to moral development and can affect abilities to learn, recognize, respond to, obey, circumvent, or transcend rules.

Play and Games in Development and Healing

Play and games are influenced by culture, family patterns, and physical and mental capacities of individuals. First play experiences are typically with parents. Thus, the extent to which parents do or do not interact with their child or have play experiences to draw on affects what the child learns. Different cultures have different games based on their resources and history, a fact that affects the content and amount of play.

As infants progress to early childhood, they engage in symbolic play via activities involving imagined or substituted objects. Symbolic play may be done alone or with a group. As children age, they typically move from solitary to social play. In early social play, children may be in parallel or near to each other without necessarily engaging each other. As development advances, social engagement, such as playing together using imagination, occurs more frequently. For example, a little girl might first pretend to be talking on the phone by talking into a block of wood. Later, the girl and another girl may sit side by side doing the same thing but not talking to each other. Eventually, this will evolve into a conversation between the two through the make-believe phones.

As children age, they typically become involved in formal games such as sports, board games, puzzles, storytelling, and role-playing. Adults play games similar to those played by children but often with more complex rules. Also, games for adults often involve more adult content and behavior, such as use of money, as in gambling or card games, or complex roles, as in multiple role-player and sexual games.

Games as a form of play serve many purposes and shift in form and function to mirror the developmental level of individuals. However, despite these shifts, games and play behaviors continue to function as expressions of feelings, wishes, fears, and experiences and are the basis for forming and developing relationships with others. They also affect identity development, the process by which one comes to define and recognize oneself.

Thus, play and gaming are normative and healthy. They are activities that provide opportunities for learning, growth, stress reduction, social bonding, general well-being, and, therefore, good mental health. In fact, play and gaming are also useful as therapeutic strategies for mental health treatment. Play therapy, the use of play for treating mental health disorders in children, often helps children deal with traumatic events or other psychopathology. Similarly, role-playing, which entails acting out new behaviors, personae, or past or future experiences, is a helpful strategy for adolescents and adults to work on mental health problems.

Games are also used for educational purposes. Teachers use games as a way to engage different learning styles. Regular classroom teaching might involve writing on a chalkboard, reading, and taking notes. Games allow for social collaboration, competition, and tactile and kinesthetic involvement, each of which enhances learning because of the engagement of different learning styles. Teachers may also use games to help students learn rules and problem solving or to develop different ways of remembering information through the use of rhymes, songs, stories, or dances. Role-playing can also be used by teachers, even advanced professionals, to learn new skills. Finally, video and computer games can be valuable teaching aids for facilitating skills related to dexterity, hand-eye coordination, and strategy. In military applications, for example, the use of flight and war games helps in these ways and may mirror what trainees experienced earlier while playing games for different reasons.

Disorders Related to Games

Games involving violence and aggression are controversial and often a cause for concern. The risks of encouraging expression of aggressive feelings and behaviors—such as is found in some contemporary video games that feature reckless driving, weaponry, or hand-to-hand combat with virtual opponents—are balanced against any benefits in terms of stress relief, physical coordination, or strategic thought. While in a computer- or Internet-based game, one can hit a reset button, but in real life, expression of aggressive or destructive behavior can have dire consequences.

Even in competitive games, reckless competition can be dangerous and have impact. For instance, in virtual role-playing games, the reckless killing of a character whose identity and skills had been developed over many years can trigger a real-world emotional impact in the person who created the character. Because the individual’s personal identity development or psychological health was related to that character’s existence, the character’s termination may have a profound impact. Social combat between characters resulting in virtual death may also have social and psychological implications for the victor. In the worst case, such gaming behavior can lead to conditions such as depression and anxiety in losers and potential patterns of socially aggressive behavior in victors.

Extraordinary competition or excessive participation in gaming can become an obsession. Individuals may experience such problems with almost any game, including online or face-to-face gambling, multiple role-player games, board games, solitary- or social-play games that may involve cards or other props, and sexual play. For some individuals, high levels of involvement with a game may become all consuming, isolating the person from others and interfering with everyday roles and obligations in real life. For children, adolescents, and young adults, this can take the form of interfering with important social or emotional developmental tasks.

Personal resources also may become diverted to support the gaming activity. For instance, in the case of pathological gambling, individuals may spend such large amounts of money on gaming that they cannot pay their regular living expenses. In such cases, the gaming activity has become an addiction. The person may also feel inescapably compelled to participate in the behavior, as in a compulsion. People in such situations may feel depressed, anxious, and out of control or perceive actual damage done to their lives and be unable to meet basic living needs. Often, the losses related to the behavior may be hidden or concealed until the problem has escalated beyond repair. In addition to suffering feelings of isolation, the compulsive individual may later lose relationships and social support, leaving the victim alone and even more emotionally vulnerable to the gaming behavior. Furthermore, many individuals participate in gaming activities while also using substances and therefore may develop unhealthy habits of both behaviors. Different forms of excessive gaming are often tied to problems with alcohol, nicotine, sleep aids, painkillers, or other substances. In such cases, violence against others or the self, in the form of suicide, may be potential dangers as the situation deteriorates.

For some individuals, these other conditions may only follow the onset of pathological gaming. Conditions such as anxiety, depression, or social isolation may be risk factors that leave individuals vulnerable to the reinforcing nature of gaming activities, and treatment for such problems must take this into account. In general, gaming and play are developmental and healthy aspects of youth and adulthood. While these activities can create problems for some, for most they are vital to good mental health and development.


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