Prickly denial is the wrong response to WHO's "gaming disorder"

The proposed definition is careful and cautious; more research is needed and the industry should be cooperating, not stonewalling

By Rob Fahey.Published Friday 22nd June 2018, 9:00am GMT

The World Health Organisation is to adopt a definition of a "gaming disorder" in its new set of diagnostic standards, ICD-11 - prompting a set of reactions from both sides of the aisle that are as predictable as they are unconstructive. Elements of the mass media, having recently been inspired by the success of Fortnite to dust down their decades-old Greatest Hits album of scare stories about video games, have trotted out wildly inaccurate hyperbole about game addiction. Meanwhile, industry bodies around the world have formed an impromptu Greek chorus of denial, straight-up stonewalling the very notion that such a disorder might exist.

Of course, there's no point being annoyed by the lack of nuance industry bodies display in these situations; they basically exist to trot out the 'everything is fine' line in response to any criticism of the business. The one-note chorus of denial over this issue in particular, however, may be doing more harm than good. There are many reasonable criticisms of the disorder's inclusion - and the reaction from the mass media definitely deserves a drubbing - but those aspects are actually undermined by the blunt insistence that gaming has no negative externalities.

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Worst of all is the public image damage done by presenting the industry as being stubbornly set on butting heads with the WHO, based on arguments that stem from what feels like a rather wilful ignorance of the clarity and precision of the disorder's definition. Having your industry's negative externalities pointed out by a high profile international health body may sting, but setting yourself up in the public eye as an uncooperative enemy of that body is like responding to the sting by amputating a limb.

"The one-note chorus of denial over this issue in particular, however, may be doing more harm than good"

Let me go back for a moment to brass tacks - the actual definition we're talking about. The WHO's definition of gaming disorder is extremely careful and precise; the science behind it may not be settled (which is one of the very reasonable criticisms of the definition) but the organisation is not swinging at fences here. Several major diagnostic criteria are laid out, describing an individual who has lost control of their own ability to regulate their use of games, has suffered major consequences in their social, professional or personal life as a consequence but has continued or even escalated their usage, and who has continued in this destructive pattern of behaviour for at least 12 months.

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In other words, the WHO isn't talking about playing games being a disorder, or even playing games extensively being a disorder. It's not saying that a teenager who slams a door because his mum told him to stop playing Fortnite has a disorder. It's very clearly and carefully talking about playing games to the extent that they impair normal daily life being a disorder. It's not talking about me bailing on someone's house party last week to finish God of War; it's talking about people who lose their jobs, drop out of school, destroy their relationships and even mess with their physical health through playing games.

If you're thinking, "well that's a tiny, tiny fraction of people who play games" - yes, that's rather the point. I'm sympathetic to the argument that we shouldn't pathologise our daily lives, and claiming something is an "addiction" - a word the WHO is careful not to use at any point - is a regular go-to for turning normal bad or anti-social behaviour into a diagnosable condition (plus it's a great way for cheating middle-aged men to claim that they're really the victims of a terrible and formerly undiagnosed sex addiction). However, someone developing an obsession or immersing themselves in a game to the extent that it has massive, sustained and clearly uncontrolled negative consequences for their ability to function as a human being - well, that's not daily life, is it? That's absolutely something we should be pathologizing and trying to find ways to help with.

"Authors and film makers don't have conferences multiple times a year where talks focus on building compulsion loops and snaring 'whales'"

Isn't that kind of obsessive, self-destructive behaviour just a symptom of a deeper problem, though? That's entirely possible. In response to the news of the disorder's inclusion, many people have been sharing stories of different things they became obsessed with at low points in their lives and pointing out that these things were just coping mechanisms, not the root of the issue. I get the point; hand on heart, last time I suffered from a serious bout of depression I binge-watched the entirety of Stargate SG-1 and Stargate Atlantis while barely leaving my apartment. Now, that's a fairly specific and exquisite form of self-harm, but the point is I don't see the WHO adding a Stargate Disorder to ICD-11, or even a (perhaps more sensible) DVD box-set or Netflix Binge Disorder.

Perhaps games are being unfairly picked on compared to other media, then. Or perhaps games have developed into a massive medium with some branches that are particularly enticing and potentially damaging for people in those vulnerable situations. Again, the research isn't terribly conclusive in this field, which is precisely why the WHO is being cautious; it wants to highlight a potential problem for practitioners to be aware of, while hopefully encouraging more and better research around the issue. But stonewalling about the existence of this kind of disorder is a losing strategy in the public sphere regardless of the status of the research, simply because rather a lot of people have a sense that they've actually seen it in action.

Of course it's a tiny minority of gamers who are subject to this sort of disorder, and tens of millions of people play games very extensively without the slightest issue. But how many people of our generation can really say they don't know anyone who's managed to lose a job, fail a year of school, or mess up an important human relationship because they couldn't get their obsession with a game under control? How much worse is this in the next generation down the line, I wonder, now that so many games are deliberately designed not just to be fun for 50 or 100 hours, but to engage players for years on end - and often to keep them financially engaged for the long term, too?

"This isn't the tobacco industry and we shouldn't act like it; the games industry is not and should not be in the business of harming its players"

That's rather the point with regard to the question of whether games are being singled out unfairly. This is an issue on which the industry wants to have its cake and eat it. Comparisons with other kinds of media and talking about the value of escapism is a rather slippery attempt to avoid the core point; book authors and film makers don't have conferences multiple times a year where talks focus on building compulsion loops, snaring "whales" and using psychological tactics to encourage consumers to stay engaged for years. Some of those tactics are fine (some of them aren't, mind you), but you can't openly and proudly discuss that stuff for years on end and then scream blue murder when a health body points out that, for a small minority of vulnerable people, those strategies may be working far too well altogether.

Moreover, for all the hand-wringing about how defining a gaming disorder might obscure diagnosis of underlying issues, that's simply not how diagnosis works. Talk to professionals who actually work with addicts and similar cases, and you'll find that an accurate diagnosis of a non-physical addiction (e.g. gambling addiction) is often a very helpful step in identifying deeper problems. Sure, the mass media is going to have a field day and some unscrupulous authors are undoubtedly going to write some books squarely targeted at parents convinced their teenager would be a sweet angel if it weren't for the demon PlayStation, but for those people (a tiny minority but still likely a large number in itself) whose obsessive and self-destructive engagement with games is a signpost to a deeper issue, the ability to have that effectively diagnosed could be an important step on the path to recovery.

I keep emphasising that we're talking about a tiny minority, because that's an important point. Nobody is trying to pathologise an ordinary gaming habit, even a pretty hardcore one. Saying this is a small minority, however, doesn't actually detract from the WHO's decision in any way.

Most people who drink alcohol don't get addicted or mess up their lives, red wine is good for you in moderation, whiskey's great for a cold, and hardly anyone would ever start a new relationship without a bit of Dutch courage, but none of that changes the fact that alcoholism exists and can be utterly devastating. The whole point of the WHO's definition is that playing a game to the extent that you lose your job and your friends, forget to feed yourself right and collect bottles of piss under your desk is not actually daily life, and needs to be treated as abnormal - researched, understood and, hopefully, cured.

That's precisely why the industry's response is all wrong. It should be presenting itself as cooperative and willing to assist, not as stubborn and prickly. If the research is unsatisfactory (which it is), then get involved; open up data and access to medical and social researchers (not just your hand-picked tame ones, either) and let them really get to the bottom of this. If there's no harm being done and games truly are just incidental to a set of other issues some people face, great; games are off the hook and that's important information for the professionals working with those cases. If there is harm being done to a minority of players, however, that's also an important finding for the industry, and one it should welcome knowing about.

This isn't the tobacco industry and we shouldn't act like it; the games industry is not and should not be in the business of harming its players, inadvertently or otherwise, and presented with evidence that this may be happening, it should welcome the chance to help right that situation. Pointing out that games can have strong positive social impacts and even therapeutic value is right and true, but that's all meaningless if valid suggestions of harm are met with stonewalling and stubbornness. Engagement and openness, not denial and derailing, would be the responses of a properly mature and responsible industry.

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