Mad Games

Actual Sunlight and the value of games on mental illness

Back when I watched commercial television, it seemed during every ad break there would be at least one commercial for an antidepressant or antidepressant adjunct. Usually there is a cartoon woman under a rain cloud, or in a hole, until her doctor prescribes her one of the many psychopharmacological drugs used to treat and manage depression. The rain cloud lifts, she gets out of the pit she has been in, and gets back to enjoying time with her family. It’s a simple portrayal of depression and its treatment, expected of commercials, but the depiction of the experience of depression as being under that perpetual raincloud due to low serotonin levels which can be treated and managed through the use of SSRIs is a common one, perhaps the most common one. While it would be foolish to argue that brain functions are not involved in the experience of depression and other forms of mental distress; brain functions are involved in everything we do, including your reading this right now. But what is missing from this biomedical model of mental illness (i.e. mental illness as the result of an imbalance in brain chemistry) is the context in which these mental states exist in people’s lives. If the biomedical model of mental illness fails to take into account the context in which mental illness exists and presents and the meaning symptoms have for people, first-person accounts of madness offer a much needed counterpoint.

When exploring first-person accounts of madness, it is common to find the authors moving between addressing the biomedical model and more experiential writing. These different modes of writing have been called “writing to power” (i.e. writing to the dominant discourse) and “writing to experience” (or what Kofman calls “writing without power”). One of the key features of writing to experience is playing with and undermining or subversion of language and traditional narrative structures. In first-person accounts of madness, it is not uncommon to find the chronology to be non-linear, for time to feel inconsistent, to jump between experiences and states. This playing with structure often lends the text a sense of immediacy and can evoke for the reader the experience of madness far better than any psychology textbook description.

Because first-person accounts of madness frequently play with form in order to better convey the experience of madness, it is likely that first-person narrative games on mental illness will similarly play with and subvert narrative and game form. For example, in Depression Quest, which I have argued speaks more often to power than to experience, plays with the structure of games by limiting options. Using the choose-your-own-adventure style formatting, Depression Quest plays with our expectation to be able to choose, narrowing options and denying the player agency in an attempt to evoke the loss experienced by those with depression. Yet even Depression Quest, which employs many traditional game elements—status bars, multiple endings—is questioned about its legitimacy as a game. The element of the game in which it is most experiential—the removal of choice—is precisely the thing which often results in these not-a-game accusations.

Actual Sunlight, a first-person narrative created in RPG-maker, early on makes the claim that it is not a game, but a portrait. It is as if the creator, Will O’Neill, anticipated the response of formalists to the ways he plays with narrative and game form in order to convey his experience. O’Neill’s writing jumps between the narrator’s present experience and snippets of poetry, fantasies of late-night talk show appearances with cloying laugh tracks, and patient-doctor transcripts. The pull between these various pieces of writing is at times jarring and confusing. The text is frequently uncomfortable as we witness the character’s misanthropic view of the world. As players we may not want to continue to spend time with this character, but then neither does the character. The aversion created through O’Neill’s text creates a shared experience between us and the character—neither of us want to stay with these thoughts for long.

Similar to Depression Quest, the element of choice is limited in Actual Sunlight. In one scene, we find ourselves at a store looking at video games. The character’s thoughts express that purchasing the video games will not help him, and we are then given the option to buy a game or leave the store with the game still on the shelf. However, if we choose to leave without a purchase we are told as soon as we reach the door that we are ultimately not going to be able to resist the compulsion to buy the game and are forced back to make the inevitably regretted purchase. O’Neill uses the lack of choice in much of Actual Sunlight to convey the tension between the desire to make different choices and the compulsion to make the ones the character does. O’Neill uses his knowledge of behavioral tendencies in games in order to convey the experience of knowing there are better, healthier options, but finding oneself unable to actually choose them. The lack of choice in these games is not only reflective of the experience they seek to portray, but is a not uncommon feature of games which are based on personal experience. As players we are invited into the creator’s world for a moment, but if given too many choices, the potential for the story to cease to resemble their own would increase. There is a tension in these games between providing and limiting player choice. Because this tension is reflective of aspects of the experience portrayed in games like Actual Sunlight, it can serve the narrative by eliciting in the player some of the feelings experienced by the author.

Experiential moments like these in first person accounts offer us an alternative to textbooks, the DSM, our webMD searches on mental illness. Linguist, Dariusz Galasiński (2008), writing about men’s experience of depression, notes that articles in the series Handbooks of Depression “do not take up the issue of the patient perspective or their experience” (p. 11). This is not unusual. Patient accounts of their experience are frequently framed in psychiatry as suspect, a diagnosis of mental illness often leading to the tautological dismissal of their views as mentally ill and thus without meaning (Hornstein, 2009). It is not uncommon in psychiatric work to specify the level of insight the patient has into their illness, with the definition of insight being associated with an alignment with the psychiatrist’s model for the illness. Description of their experience and world when it differs radically from the psychiatrist’s may not be considered particularly insightful. Yet if, as Galasiński (2008) and others posit, “the knowledge about depression [and other experiences of mental illness] is ultimately held by the people suffering it,” then first-person accounts should be lauded as an incredible resource to those who wish to gain understanding of these mental states (p. 12). Rather than offering a checklist of symptoms, first-person accounts provide us with information about the meaning behind these symptoms, perspectives on the contribution of outside forces to one’s suffering, and frequently alternatives to the biomedical model of recovery.

First-person narrative games on madness give us not only a sense of the experience—confusion and frustration, repeated unwanted thoughts, feelings of being compelled toward actions you do not want to take—but offer us a broader context for the experience than that of the biomedical model of mental illness. Actual Sunlight’s character’s depression cannot be separated from the context of his life—the pressures of his age, the internalized body shame, his understanding and resentment of heterosexual relationships and expectations, the ways masculinity and capitalism intersect, even our society’s construction of masculinity itself. While the character is decidedly unhopeful about the potential for change and improvement, the experiences described are rich with meaning. And while, at times, the thoughts and beliefs expressed may be uncomfortable or for some disagreeable, the author offers up the context which makes them possible.

People do not exist separate from the world around them and our experiences of madness and mental distress do not exist separate from our broader lives. In phenomenological psychology, it is often stated that to understand a person’s distress, you must seek to understand their world. Phenomenological psychologist, J. H. van den Berg (1972) writes, “to be ill…means, above all, to experience things in a different way, to be different yonder, to live in another, maybe hardly different, maybe completely different world” (p. 45). He advises psychotherapists to “take the side of the patient” by putting ourselves “in his [sic] world” (p. 47). When we step into the person’s world, the meaning of the experience of madness has the potential to become clearer, symptoms more understandable. As van den Berg argues, our descriptions of our world and the objects in them are also descriptions of ourselves. Through the use of game making tools, people like Will O’Neill, offer us a way into their world, and we leave with a different understanding.

Contrary to popular discourse, focusing on mental illness as a disease like any other does little in decreasing stigma and actually may lead to further isolation of the mentally ill. First person accounts like O’Neill’s bring us closer to the person who is suffering. Thus, game designers like O’Neill are offering us valuable tools in fighting stigma even as they worry about the personal consequences of that stigma. In an interview with Polygon, O’Neill spoke of his fear that Actual Sunlight would be used against him when seeking employment or upon entering relationships. It could be argued that compared with the risks of stigma it takes to write these stories, their need to be told must be significant enough to compel us to take them. For those of us reading and playing them, we are lucky that that is the case. We need this counterpoint to the dominant narrative in order to better understand the unique ways people experience mental illness. If the biomedical model offers us insight into the biological factors involved in mental illness, these first person accounts provide the needed insight into how mental illness is lived and understood by the people who experience it. Whether or not first person narrative games on mental illness are successful in what they offer in terms of gameplay, they offer a needed perspective beyond games.

References

Galasiński, D. (2008). Men’s discourses of depression. New York: Palgrave Macmillan.

Hornstein, G. (2009). Agnes’s jacket: A psychologist’s search for the meanings of madness. New York: Rodale Inc.

van den Berg, J. H. (1972). A different existence: Principles of phenomenological psychology. Pittsburg, PN: Duquesne University Press.