I Recorded a Podcast on Asylums for The Ontological Geek

I was a guest on the Ontological Geek's second podcast, which is posted here. I had a really great time recording it with Oscar, Aaron and my fellow guest Rowan and I think we covered a lot of interesting ground. Especially the bit about Zuma's Revenge. The lead topic for the episode is the depiction of asylums in games - a topic I will be writing about in more detail myself sooner or later - and so should be of interest to readers of this blog. I would like to thank Aaron and Oscar for inviting me to join them and especially Oscar for doing all the hard work of editing and in Aaron's case staying up til four in the morning to talk to us Europeans.

One of the things that became really clear to me during the course of the discussion, or rather was reiterated for me, was how crucial it is to avoid one-size-fits-all thinking when it comes to mental health issues. Despite the fact that they are both covered under the aegis of psychiatry and neuroscience, and are both often defined with recourse to the DSM, I think that it is clear to say that mine and Rowan's conditions (for want of a better word) affect us and our lives in very different manners. As such our fears and expectations of, as well as our hopes and requirements from, the mental health system are necessarily different in many respects and negotiating and teasing apart these differences is vital if we are to ensure that people get the support, help and the respect that they need and are entitled to.

The idea of neurodiversity is a serious one and should be considered in the same way as physical diversity, i.e. as a way of conceptualising that people have a range of different needs, rather than as a buzzword signifying yet another binary division. I discussed an earlier draft of this post with him and Rowan was very clear that he is Aspie and that that is a disability (in that it is something that abled society uses to deny him agency) whereas I view my depression as something closer to a recurring illness, as well as a madness, and that these are both valid ways of approaching these conditions.

Madness as anything undesirable.

We also discussed briefly the sort of people-first language which I delineated in an earlier post and how that is not relevant in the context of autism-as-disability. I had never really intended to cover, or to have this blog as something that could be viewed to cover, autism because I don't think that it can necessarily be described as a mental illness, although even now I’m not sure about this distinction. However, I hadn't really thought of it as a position that needed to be made clear, mainly because my knowledge of autism and of disability is so limited. As such, I still stand by my previous post but with the caveat that I'm talking about one thing but that people may be reading it as about something different. The history of institutionalisation is one that amply illustrates the way in which disparate and discrete categories can become conflated in both the public and the bureaucratic mindset to no-one's advantage.

There is a long history of, as part of and alongside the labelling and diagnostic project of psychiatry, a move towards hierarchising those with mental health problems and setting them against one another. Experiments such as Milton Rokeach's on the 'Three Christs of Ypsilanti', where three men who all believed they were Christ were grouped together and essentially left to fight it out, have entered the folklore of mental illness. A trope which we briefly mentioned in the discussion was that of asylum inmates, who have been clearly coded as mad, who profess that they are sane whilst everyone around them is not. Whilst this is sometimes done in order to present the argument that 'maybe everyone is really insane' it just as often serves to promote a race amongst these fictional patients toward the heavily normalised (and clearly rewarded, most frequently with freedom) end-state of being sane; a race that it is explicitly suggested is codified as zero-sum: you win it by throwing your fellow competitors under a bus. As with all tropes these ideas bleed through into common parlance and knowledge and are reinforced by then being shown again and again, taking on a truth value quite divorced from the original observation that will have led to the first usage.

Participating in this discussion, and working through the points it raised up, has helped me to come to realise how important it is to resist that, often internalised, competition. (Marketplaces of internalised competition and the damage they do to unity is a key part of feminist theory and I'm somewhat disappointed with myself that I've only just applied it to this situation now.) It has also helped me to understand and contextualise my own reactions to this competition arising in and affecting my life. These include things as simple and hidden as the sense that being on or off drugs, or in or out of therapy are more or less desirable states for any external reason to a person’s own well-being, as well as the more obvious badges of ‘honour’ such as never having been hospitalised.

I want to mention briefly a specific piece of writing by Jordan Erica Webber, in issue 3 of Five out of Ten magazine. I reread it in preparation for the podcast but it has also been playing on my mind in a nagging fashion since I first read it a few months ago and I single it out not to attack the writer but because I think it illustrates perfectly what I have been talking about just now. Webber, who has Asperger's Syndrome, describes discovering something about an important character in Borderlands in what is for the game itself an apparently throwaway aside.

"... we’re using our headsets to abuse the characters rather than each other. In this case, we’re undertaking missions for Patricia Tannis, whom we hate because her mental instability caused her to betray us in the previous game. She deals out our next task with a typically psychotic comment, and the mission description itself – which doesn’t come from her – reads:

How did an insane introvert with Asperger’s manage to survive in Sanctuary?

My body reacts like I’ve seen a horrible accident too far away to intervene."

What is interesting to me is that the exact same feeling of sickness that Webber goes on to describe is what I myself felt reading the article. It feels as if, whilst invoking the psychiatric system she has been a part of since childhood, Webber separates her own condition from a morass of conditions that can be described without much reflection as insanity and which are presented as valid reasons to hate or devalue the experience of a character. It is only when the specific diagnosis is given that she seems to make the leap toward association and wants to elevate the character from stigma and stereotype, ending the article with the note that Tannis is ‘partly unlikable, partly insane, and partly a bit like me.’

I spoke to Webber and she was dismayed to discover that this was what I took away from the piece. On the subject of having a ‘valid reason to hate’ Tannis she remarked that it was the betrayal that she had been referring to and that the the reason for the betrayal is being presented as a valueless aside for imparting extra information relevant to the thrust of the argument. However, I could only read the sentence quoted above as implying the ‘mental instability’ to be a causal factor in the betrayal that heightens rather than lessens the sting of it. In other words, I read it as saying that to be betrayed because of an illness is worse than being betrayed for the sound and logical reasons of the betrayer being a nasty piece of work. This stung because there is a long history of representation of mental illness as a moral failing or as being synonymous with evil or malice that the text, here, seems to me to be uninterested in countering.

Webber was clear that the article was about her internalised feelings of negativity about her own mental illness rather than any attempt to place herself above or to compete with other sufferers and I accept and am happy to stress that. I must also stress that I did enjoy and do recommend the article and its exploration of ambivalence to and acceptance of characters that are imperfect or offensive representations of the labels that have been used to define you. I also think, however, that this is an illustration of the internalised, and therefore often invisible, nature of the competition that I attempted to tease out above - an imposition of hierarchy which I myself have been, and no doubt am still, guilty of. Even the fact that I reacted like that, believing that Webber was until that point putting herself above ‘the typically psychotic’ Tannis is evidence of that.

As is Webber's eventual relationship to Borderlands, my relationship to her article is now ultimately fraught with contradiction. We are both glad for the opportunity to relate and for representation to be at least somewhat advanced, but reminded of the hold that the structures that seek to erase or delegitimise our experience still have. I am glad also that Webber took the time to speak to me about my concerns and to clear up the intention behind the words. Maybe the goal, the escape from the asylum as it is constructed both physically and metaphorically, should not be sanity as such; a badge and with it a special dispensation to join the outside world. Instead we need a meaningful engagement with and discussion of what either madness or neurodiversity, in all of their multifarious forms, might actually be.

Terminology

The absolute key here is that, when you are talking about real people, especially in reportage or descriptive prose, you talk about the person first. These guidelines for journalists and other media workers from Time to Change are a good resource, especially the Mind Your Language page, but if you take one thing away from this post it should be this: a person who suffers from an illness is not defined by that illness and you have no right to so define them when you refer to them. If an illness or condition or whatever is essential to an article or to a point that is being made then, with their consent, you should describe someone using a formula along the lines of '[person] with [diagnosis]', otherwise, there's just no need to mention it.

Of course, it gets more complicated than that, so I'm going to delineate a little bit my own position and some of the issues around it. But, if you are in any doubt remember that you're talking about people so your default position should be one of respect and compassion. (That goes for all issues of representation and terminology, actually, not just when talking about health issues.)

If you follow me on twitter you may have noticed that in my profile I call myself a 'depressed games blogger', in stark contravention of my advice above. This is partly because it's my space and I can do what I want within it. Part of what I use my twitter account for is to talk about my depression and my games blogging about being depressed so it is a relevant introduction to what you might find in my feed. Bios like that are always invented personalities, highlighting what the (auto)biographer considers relevant and informing the reader as to the implied author for a given body of work. The definition-first convention that has appeared in many social media  profiles is also, I think, part of that process of negotiating the constructed nature of people's online personalities. This is not to say that these constructs are false or artificial either, just that they are in effect an edited highlights package for a particular (implied) audience. By bullet-pointing self-definitions you can unobtrusively set out what sort of person you intend to be within a given online space, in lieu of the visual and social cues that might be available to you in an offline space.

There are for example a number of other mini-bios for myself floating around out there and in the majority of those I don't mention depression because it isn't relevant to what I use those spaces to talk about. Which leads into another important point about self-definition in distributed and discrete spaces; just because you see someone use a term (or allow a term to be used) to describe themselves in one context it doesn't automatically make the term relevant in all contexts.

Mental Health terminology should not be used pejoratively. That really ought to go without saying, but unfortunately it still needs repeating. Terms like 'psycho' and 'schizo' are stigmatising and inaccurate, while even the correct terms, for example schizophrenic, need to be handled with care. This is especially important considering the tendency for people to use those terms within a moral framework; i.e. when discussing criminality and evil or unpleasant acts. Having a mental illness is not a reliable explanation for these acts and as such mental illness diagnoses should not be used as synonyms for them. Similarly, saying someone did something that you dislike because they are 'insane' is damaging because it suggests that the insane are inherently dislikable, whilst simultaneously normalising your own preferences under the banner of 'sanity'.

On the other hand, I'm not sure I agree with the (extreme) position in mental health advocacy and discourse that would like to excise words like 'mad' and 'crazy' from the language completely. That should be at least partly clear from the title of this blog, as well as from the way I talk about those concepts. There are two main reasons for my view on this. The first is that I think the concept of, especially, madness is one that goes beyond the concept of mental health and that to lose it would be to inescapably fall into the diagnostic trap I have talked about elsewhere in this blog. It's not that the diagnosis and categorisation of mental states is a bad way of talking about these concepts, on the contrary, it is just that it should not be the only way. The second reason is more personal, in that I like the explanatory power of the terms; I am sometimes crazy, and I have had days that, objectively, have felt insane.

There is a fine line between stigma and description here, but I think that in this particular case it is a place for negotiation rather than proscription, but I cannot speak for everyone.Recently, Zoya Street asked the following question on twitter:

Is "sociopath" an ableist slur?
— Zoyə Street (@rupazero) December 10, 2013

I think that the responses that he got are instructive and it is worth clicking through to the tweet to see the entire discussion. You can see as well how my gut response changed as the nature of the context in which the word was being used came out. I also think that the term sociopath, similar to the term psychopath which I discussed in a previous post, is a slightly different case to the diagnostic labels I mentioned a few paragraphs ago anyway. As I understand it it is, even more so than most psychiatric labels, a cultural construction for talking about certain types of behaviour and is less likely to be used in a clinical setting than popular culture would have you believe. I still don't think it's healthy to label someone a sociopath just because you don't agree with them or they don't care about you, but it can be useful when you need to talk about emotional response, and there remains a useful fictive power in the idea.

Given that this is my position, I'm not always going to get things right, although I do think carefully about my usage of various terms in my writing. As this is a space where I write both descriptively and polemically I sometimes use constructions that cut close to the bone for emotional or political effect rather than comfort. Provided that the space is one where that sort of use can be reasonably expected, and the clear intent is to challenge rather than uphold stigmatising or offensive power structures then I would argue that this kind of use is legitimate. Again, however, it should not be considered a licence to throw around insults in any given situation or to describe real people in ways that they would not want to be described.

Except, in a blog that deals with fictions and artworks a lot of the time we are not going to be discussing real people, and that again changes the outlook somewhat. For a creator of fictional people the advice remains the same: they should be a person before they are a diagnosis. But when dealing with pre-existing characters, although you may try your best to view them as a person, sometimes they are clearly written only as a diagnosis. In this case, especially if you are focusing on the textual aspects of the character then you may find that you have no choice but to engage with them as the diagnosis. This is, in my opinion, fine as long as you remain aware that you are dealing with a fictional character and that if they are written that one-dimensionally then what they might be able to tell you about real people with the same condition is almost certainly very limited. And if you love that character and want them to be more than they are then my advice: kill that author, get metatextual and start writing fanfiction, even if it's just in your head.

Insufficent Memory

I have an essay in the latest issue of gaming and history e-zine Memory Insufficient. This month's theme is the history of ecology in games and there are two other essays, both really strong and interesting pieces, alongside mine which look at the flaws in the concept of natural balance and at visions of post-apocalyptic futures and how they relate to climate disaster. I've written a quite post-modern piece about the Gaia hypothesis (sort of), which is in a very different register to most of what I write for this blog. If you have an interest in games and like how I write then hopefully you will also like that piece so please do check it out.

On the other hand, if you read my piece in Memory Insufficient and ended up here via the bio then hello, nice to see you, and please note that this blog is nowhere near as post-modern or structurally complex as that essay. You can find out more in the links above, but the short version is that I write about representations of mental health issues in gaming and talk about my own experiences of depression and how they relate to my experiences playing games. I did write a somewhat post-modern blog for a while called Things I Failed to Do which is generally quite bad but has a few nice entries in it.

Also, if you like post-modern, heavily structurally significant essays on pop culture though I would recommend reading Philip Sandifer's blog, or for specifically game related work his long-abandoned Nintendo Project. Sandifer has definitely been an influence for me; not only do I really enjoy his writing I am indebted to it for demonstrating how to do the encoding-meaning-in-structure technique well and for generally getting me keyed in to the idea of blogging to a structure as a way of keeping writing as I was coming to the natural end of my small press comics phase.

What Makes a Psychopath?

I came across an interesting paper via Mind Hacks recently on portrayals of psychopaths in cinema. It is something of a given that mental health is portrayed overwhelmingly negatively and inaccurately in the media, and that is something that I've talked about before on this blog. In this paper however, Leistedt and Linkowski were interested in looking at that depiction in a closer and more methodical fashion, analysing 126 film psychopaths against current criteria. Unfortunately the paper is locked as it has a wonderfully dry humour accentuated by the constraints academic language but the key points are summarised nicely in that Mind Hacks post.

It did get me to thinking about doing a similar exercise with games, although I have neither the time, resources nor the expertise to do a review of that scope. Again, as with most media, games have a real problem of labelling individuals as psychopathic when they actually aren't and so a great many members of our subject pool would be automatically disqualified. Even then there should be enough to make a survey, although I imagine that they would come mainly from the less-narratively heavy end of the spectrum than most people would expect.

Psychopathy is a funny old disorder in that it is beloved of melodrama and yet the more lurid the invocation the less likely it is to be accurate. Writers like the concept as an explanation for evil acts and yet by definition it has no moralistic explanatory power. In some ways it's fine if you want a villain to commit random violent acts to establish them as a psychopath (although it isn't really) as in many ways the term psychopath is one we use to get an intellectual handle on people who commit random violent acts (although this has been expanded). The problem arises when that label becomes established as a synonym for a certain kind of villain and then writers seeking greater sophistication but lacking the psychological awareness attempt to get into the mind of the character. I am absolutely all for better-rounded villains, but essentially as you provide (emotional) motivation you degrade the integrity of your original diagnosis: as one of the key aspects of psychopathy is invulnerability you cannot retain the right to call your villain a psychopath even as you make them vulnerable.

I'm talking a lot about villains here, but I'm doing so because Leistedt and Linkowski do so too. It is almost a given in their paper that it is always the villains who display psychopathic behaviour. Partly I think this is to do with the general sense in which  psychopathy has become a moralistic concept; its essential amorality being consistently read as immorality, and partly it is as they say that psychopathy lends villains danger and intrigue. I also think it is a function of genre expectations, in that when for instance an action film protagonist acts in ways that might in other contexts be considered as psychopathic we don't consider it to be so because they are acting in-genre and we recognise that and so parse their behaviour accordingly. In many of his films James Bond is almost certainly a psychopath, for example, and although this is sometimes made explicit and sometime lampshaded it is usually excused in a way that the psychopathy of the villains he meets is not. Meanwhile numerous films and heroes are based on the Bond model without even that complexity and with the assumption instead that their heroes are just acting heroically.

What does this mean for video games though? It would be easy to shrug and to say that a great many video game protagonists are psychopathic and that by extension they engage players in episodes of psychopathy; and a great many people do say this. It’s all there: the violence, the lack of empathy, the erratic and impulsive behaviour and the emotional invulnerability; I never once saw Mario shed a tear over the first goomba let alone the thousandth. These particular extracts from Liestedt and Linkowski particularly struck a cord with me, especially if you consider the perfect no-deaths playthrough of any particular game to be the canonical version of the events depicted.

"In these slasher films, psychopathic characters are generally unrealistic, accumulating many traits and characteristics, such as sadism, intelligence, and the ability to predict the plan that the future victims will use to escape."

"Psychopaths in films generally possess a number of standard characteristics that are not necessarily as common among real-life psychopaths, ... The traditional “Hollywood psychopath,” generally found before 2000, is likely to exhibit some or all of the following traits ... (ii) a somewhat vain, stylish, almost “cat-like” demeanor; ... (iv) a calm, calculating and always-in-control attitude; and (v) unrealistic, exceptional skill at killing people, especially with blades or household objects (sometimes overpowering multiple assailants with superior armament). These traits, especially in combination, are generally not present in real psychopaths."

So yes, we could say that video games make us inhabit the lives and minds of psychopaths and blunt our capacity to feel in the process but I think that that would be both grossly unfair, to players, game characters and psychopaths alike. the key sentence in those extracts is the last. As I mentioned a few paragraphs ago this is more a question of genre; these characters are not psychopaths within the rules of the world that they live in. To say 'why aren't video game characters more like real humans?' is to miss the point that they fundamentally aren't real humans but are artistic representations of humans instead. The reason I don't feel it as jarringly out of character for Lara Croft to kill hundreds of grunts but feel sad about her dead mate is the same reason I don't feel it is jarringly out of character for Arnie to kill hundreds of grunts in Commando but feel sad about his dead mate. The art, unless you're in a movement like Dogme 95 where verisimilitude is paramount, is in negotiating between abstractions and representations to create something that feels true rather than merely is true. And sometimes that involves building a jigsaw puzzle of different registers and genre tropes to create a bigger and more vibrant picture that maybe has to gloss over some of the details.

The other problem I have with that analysis is that it is particularly teenage in it’s level of insight, especially as it usually comes alongside an assumption that most players are passive consumers in this situation allowing their minds to be dangerously warped by desensitising media. I say teenage because it's sort of this idea that you are the only one who can see the truth and who was affected a certain way by a certain piece of work. It ignores the internal life of others who may not have the inclination or the vocabulary to express themselves, assuming that if feelings or responses are not being talked about then they must not exist.

Video games are getting technically more competent and so are looking at broadening the emotional register of their characters in-game, but to assume that that is happening in parallel with a broadening of emotional register in players is demonstrably false because human emotional evolution is not tied to graphical processing capabilities; I was having emotional responses to games, and questioning the thoughtlessly violent nature of their protagonists, 20 years ago and I am no-one special. I don't mean to say that there aren't plenty of people wilfully missing the point or interacting with a given work purely on the surface level at any given time, myself included. But, my default position is to assume that the way any given person feels about a work of art is much more complicated than the way that they talk about it.

Psychology and in particular anthropology have historically suffered from a version of this fallacy which has left a legacy of popular belief in the emotional simplicity of both sub-cultures within and external cultures to the western education system from which they draw their explanatory framework. Which actually, neatly, brings us full circle to the initial problem with labelling people psychopaths: which is that it can easily fall prey to the same instinct to ignore internal lives and pathologise solely on the basis of external actions. Which is not to say that the concept of the psychopath is without use or validity, but that it's usage in media is certainly fraught with problems.

Liestedt and Linkowski (2013) Psychopathy and the Cinema: Fact or Fiction? Link

Getting Shot At In All My Guises

I'm used to being shot at in games. I'm intimate with it, with the experience of viewing myself through the sights of a gun, with depressing a trigger that brings release and relief from being and wholeness for both the bullet and the me the bullet interrupts. Being subject and object holds no fear for me, as whichever is destroyed I know that I will continue. I remember my sister complaining that her boyfriend sat around in front of her just playing games where he shot Germans without realising that it might upset her but I knew the problem was deeper than that. We're always killing someone in games, it's just something I learned to be down with because I like playing them. Killing myself, or at least my great grand parents, on a regular basis just made things a whole lot more honest. It humanised everything else I've ever killed.

Of course, we don't really kill Germans in our computer games any more, if we ever did. As the atrocities fade into history, the stock Nazi villains that populated early shooters have developed an armour of camp and irrelevance. Too many other players have caught up with me and can see themselves, or someone like them, in the ordinary soldiers. Duty now calls upon you to kill brown people instead, for the most part, (the rhetoric of culpability remains, shorn of any shred of the justificatory logic it might have held) so I've been dodging that particular bullet for a number of years. Except that they aren't people at all, they're Terrorists, who are like Nazis but without the sexy uniforms. They're an ideology wrapped up in flesh for you to try to wipe out: you can't shoot an idea, but maybe if you can trap it in a fragile mind you have a chance of deleting it once and for all. Every repeated instance.

(But ideologies don't work like that anyway. They are external to the minds that they touch upon and change, like the protagonist in Geist they are unaffected by the death of the host. Execution and war become punishment; punishment for every German's culpability in the holocaust whether they were a Nazi or not. It's a ritual, but one that's hidden from the player - referencing the one reason the war was worth prosecuting would fundamentally spoil the fun of prosecuting it again and again and again. My favourite, personalised, example of the disinterest displayed in the true horror of Nazism is Call of Duty's General Heinrich Amsel. In a game that slavishly recreates the weapons that mechanised death no-one researched the names of the villains. Heinrich Amsel would never have fought for the Nazis, he would have been obliterated by them, because Amsel is a German-Jewish surname. So it goes.)

This is all a preamble to what was to be my main point but maybe isn't any more: why I don't feel that there's anything wrong when I gun down the mentally ill in games. I mean, I do think that there's something wrong, something massively wrong, it's just that I'm used to it. I can't always feel the disgust that I know I probably should. I'm far too used to it.

The mentally ill make for good villains, across all media in fact. You see, we just don't stop, we don't know how. We can't listen to reason, so the question of the appropriateness of force is taken away from you, the protagonist. We make things easy as well, because ultimately, we want to die. Not the clean, pure death urge of the hero either, who stakes his life on the promise of a better world; we just want to be put out of our misery.

It's bullshit, of course. Stigmatising bullshit at that, coming from the same root formulation of moral innateness that allows us to bomb civilians because they look like our enemies and fuelled by a desire to have new villains as uncontroversially evil as the Nazis until recently have been able to be. But I've seen it again and again. Its in the cutscene where a defeated enemy attacks again, justifying the final blow. It's on the choice tree that pops up when an antagonist's eyes clear, reason returns and he begs for an end; and I've provided it. In horror games where the horror is that your mind may not be your own so you obliterate any evidence of what you may become. The mad are both cause and victim of the evil that threatens you.

Even cures are worthless, the popular anti-psych message about medication is that it turns you into a zombie: unfeeling and unaffected; effectively unable to contribute in a meaningful way any more. And, well, the good thing about zombies is how fun they are to kill, how many you can wade through without any feeling of remorse. They are better off dead; both the victim and the cause of the evil that threatens you.

It should stop, though. We need to be able to tell the difference between madness and malice. We need to be able to show the difference between madness and malice, because ideologies spread in a way that madness doesn't. But the secret I know is that we'll always need enemies to populate our fantasies of opposition, and my complicity in this narrative power structure is as unavoidable as my complicity in global inequality. But then, if there's one thing I've learnt from my ancestry it's that an awareness and acceptance of your past is vital for the work of doing things better in the future.

A Little bit of Housekeeping

First up, I'd like to point out the tabs at the top of the page. Yesterday I set up a new one to go alongside the Further Reading page as a resource listing Games that feature madness either mechanically or thematically. I intend to keep adding to both these lists and will gladly take suggestions for titles I've missed. The games page doesn't have links because primarily because choosing a definitive resource on each title seems somewhat too subjective, but again I'd be willing to put something in if enough people shout.

Secondly, it's in the further reading tab, but if you found my take on Depression Quest interesting then you might also like this take by The Orts. I don't agree with everything it says, especially the slight anti-psychiatry stance that seems to push the, in my mind false, dichotomy between treating mental distress as illness and treating it as a part of your inviolable self. But it does say a lot of stuff that I agree with, and that I would say myself, and it does so more eloquently and more academically than I'm capable of.

Thirdly, the latest issue of the as-always excellent Memory Insufficient is on Disability and Games History. Of the three essays two are primarily focused on issues of mental health, while the third encompasses it in its overview of disability as a concept, and so the issue will be of particular interest to anyone who reads this blog. A couple of confessions: editor Zoya Street's article on sanity rules in D&D does reference this blog, and I did intend to write a piece for this issue but couldn't get an angle I was happy with sorted out in time for the deadline.

(I was planning on taking a look at how the merit and flaw system popularised in the World of Darkness games deals with disability by both quantifying it but also systematically compensating for it by allowing players to buy unrelated bonuses but I didn't get much father than 'that's really quite reductive' which is pretty un-interesting really, because roleplaying rules literally are attempts to reduce complex realities into a system.)

I have a few brief responses to the articles in the issue which I'll lay out here. I though it was interesting that in general all the essays worked within a conceptual framework in which the DSM and psychiatry are essentially synonymous. This is a common position and a useful shorthand, especially for some of the points being made about medicalization and normativity but, as I discussed here, I think things are more complicated than that and I sometimes worry that this shorthand can become a self-limiting axiom. I don't think this impacts on what the articles have to say in any significant sense, and I may also be reading it in wrongly, but I think as a critical position it might be worth bearing in mind.

I have to admit that I've never played with the rules from Unearthed Arcana, so as far as I was aware the only sanity system in D&D was that developed for Ravenloft. I will have to read into it some more. In some ways that just goes to show how large D&D is as an entity, as well as the scope of its ambition as a system. (Are there any sanity rules for the explicitly universal systems like GURPS or Rifts/Palladium? There must be, although I've only ever read the core rulebooks for either of those.)

Zoya Street's take on D&D is probably harsher than mine, I was quite pleased to be described as 'even-handed' as I sometimes worry I get too polemical, but I suppose my problem is that I've always thought D&D to be self-evidently a terrible system. That's not to say I don't enjoy it as a game, just that in some ways that enjoyment was hard won and involved a lot of ignoring the really stupid bits. The article also reminded me of the tribalism in RPG circles, where people are wedded not only to systems, but to the primacy of those systems' representational models.

D&D, and AD&D especially, is never going to describe anything realistically, or allow you to play or explore any concepts in a realistic manner, because as a project it is about imposing the D&D mathematical model onto those concepts and not the other way around. While this is not to say that it shouldn't be called out for doing so, which is something Street does very well, I suppose my position is that it can only be understood in the light of this dynamic. One day James Wallis will finally publish FRUP and I'll be able to point at it and go 'look, this is what you have done - this is the world your slavish rules-lawyering has implied.' Until then you'll just have to take my word for it.

And finally, I recently wrote a piece for The Ontological Geek about horror in roleplaying games. I looked at where horror is located and how game systems, including sanity systems, can mediate and generate that horror. It isn't strictly about mental illness but I hope that my rule-happy readers will find it interesting. The Ontological Geek is running a horror month at the minute and I heartily recommend having a look at what is coming out of that.

Depression Quest and the Physicality of Mental Illness

Trigger warning, this is about depression in quite a visceral sense.

I know what it feels like to be depressed from my own past experience. As much as anything that means I have an understanding of the physiological effects as well as the mental, which can be important because, as a mental illness, it is often discussed in purely mental terms. 

But those physical effects can be horrible, almost indescribably so. It isn't just the lethargy and the headaches, in some manner similar to the experience of a bad cold, but the curious fear that accompanies them. Colds come and then they go, following a familiar and understandable self-limiting pattern. They are grim and they can vary in severity but they make sense and have an end that can be anticipated while the physical symptoms of depression merely persist. And the longer they persist the more the anxiety over that persistence becomes a physical thing in itself; a gnawing in the gut that feels like maybe you ate something wrong and oh god what if you might get sick for real and...

I imagine that this is similar to many other chronic illnesses, which I am aware have the capacity to feedback into mental illness. I also am certain that other mental illnesses have their own set of physical symptoms which I have never felt and will probably never know. It is interesting that I am better able to imagine the mental state of someone with mania than I am the physical feeling of it and it fascinates me, in part because the physicality of my own depression is a huge part of the way I understand it.

I said I know what it feels like to be depressed because what I realise is that I don't know what it feels like to become depressed. I can imagine that it must be terrifying on that purely physical level because there's no frame of reference for why your body suddenly feels the way that it does - it can be terrifying for me and I know that it's coming and that it will, eventually, pass.

Those games which do model mental illness seem for the most part to be focused on its onset - on the shift-point between sanity and madness. Once the illnesses are contracted, and they are contracted, imposed into the sanctity of a character's  mental cradle by the agencies in the external world, they become modifiers on play rather than lived and vital experiences. Or worse, they signify the end of playability.

But mental illnesses are progressive, not binary. Those acquired later in life do not snap into being, fully-formed in the sufferer's mind, but are wrought out of experience and predisposition. Of course, to make a secret list of the illnesses your character might develop would be a curious exercise, and to roll your winnings on the genetic lottery on a random table at the point of phenotype expression is functionally, if not teleologically, the same action as rolling at birth.

It makes me wonder what a game would have to do to actually embody the experience of being mad - to genuinely get at at the phsysicality of it without resorting to glitch or distortion, to showing things which aren't there when it's already in a world that isn't there and anyway can't we just get over the idea that hallucination is the be-all and end-all of being mad?

One game which makes a stab at this is Depression Quest. It's a good stab, and I like the core idea of having, in a choose-your-own-adventure, greyed-out choices. It says that the core of being depressed is knowing that there are things you could do, but nevertheless being unable to do them. Unfortunately the rest of it lets it down.

Really, it's doomed from the name onwards. The idea that depression is a quest already suggests that it has a win-condition, that no matter how many times the authors tell you that it is something you must learn to live with fundamentally they view it as something that can be beaten. And that it can be beaten by the sufferer. For some people that may be the case, but unfortunately the game clearly isn't talking about an isolated episode of depression as experienced by an otherwise healthy person, it's talking about the chronic kind. The kind I've got. The kind that isn't a game.

It's odd for me to say that because, perhaps unsurprisingly, I've gamified my own depression. When I was sixteen, and heavily self-harming, I sat in a park at night somewhere near Three Bridges and I made a deal with myself that if I was to commit suicide then I would have lost the game I was playing. I didn't know what the win condition was back then, I still don't, but that was a clear loss. It helped. It gave me a point of power and control and it's kept me going. But some of the worst mistakes I've made have been to, even unconsciously, project that system onto other suffering people, because it has seriously fucked up my relationship with them.

That's the problem with systems. Unlike events, for which you can disclaim universality, systems imply their applicability to all situations. Depression Quest allows that it doesn't describe every depressed person's experience, but it implies that it models it. Ignoring the use of static and glitch as signifiers, they may be tired but they are at least uncontroversially deployed, the first thing you notice when you load up the game, especially if you are used to playing games, are the three gauges at the bottom of the screen. Again, suddenly, there's a win condition, and it's when those gauges say the right things.

It almost doesn't matter that those gauges represent a hopelessly proscriptive view of what depression is and how it should be managed. The fact that they are there at all is enough to imply that failure in this game of coping is the fault of the player, the very thinking the game aims to subvert with it's greyed-out choices. It isn't the case that you can't try these options because you are unwell, it's because you rejected meds and meds always help. If you'd gone to the therapist you'd get to have sex with your girlfriend and enjoy it, but you didn't, so fuck you. You're just not thinking about your illness in the right way, because if you were you'd know how to fix it.

I should be clear, I think medication is wonderful if you get the right stuff, but because we don't know exactly how these illnesses work it is always a compromise. I think therapy can be an incredibly useful tool, but it can also become a very expensive sideshow, even more addictive than the supposed addictiveness of the drugs, and again it depends on so many factors I can't even begin to explain them here.

I stated earlier that I wondered what a game that truly embodied the experience of being mad was like but I'm not sure I actually want to know. I was imagining things like haptic feedback on controllers that flooded your limbs with dull current. Characters that controlled sluggishly, like you were pushing them through treacle. All those similes we employ, writ large on the screen. The thing is, I'm not sure I want to know, really. I wanted to love Depression Quest's core mechanic, but I ended up hating the execution. 

I still think that the best expressions of what it is to be depressed come through in Douglas Adams' adventure games. It's in the loneliness of Starship Titanic or the sheer bloody-minded hostility of the world in Hitch-hiker, but the systems of those games are not the vehicle for that expression. I want someone to show me a system that works as well as that, and I admire that people are trying, but I can't not point it out when those noble failures look like propagating further harm.