'The Gaming Mind' Review: Games Therapists Play

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Videogame fans were elated in April when developer Square Enix released its long-awaited remake of "Final Fantasy VII," considered by many to be one of the greatest games of all time. The original game, released in 1997 for Playstation, had everything: an expansive story across three playable discs; an engaging battle system replete with magic spells; and a cast of compelling characters, not least the game's iconic hero, the spiky-haired Cloud Strife (and his nemesis, Sephiroth). I have fond memories of playing FFVII in my youth. Having the chance this spring, stuck inside during the pandemic, to revisit an expanded and upgraded version of this childhood touchstone was greatly satisfying.

Alexander Kriss has also been enthralled by videogames. In "The Gaming Mind," Mr. Kriss, a clinical psychologist in New York, describes playing "Silent Hill 2" as a teenager. "I played its twelve-hour runtime back-to-back, probably a dozen times," he says. "I discussed it exhaustively on message boards behind the veil of online anonymity." For all its grim subject matter—the protagonist is a widower who visits a haunted town in search of his dead wife, doing battle with monsters along the way—the game proved a balm for Mr. Kriss, who had recently lost a friend to suicide. "My relationship with Silent Hill 2 reflected who I was and what I was going through, not only because of what I played but how I played it."

"Silent Hill 2" is one of a number of games that figure in Mr. Kriss's book, which brings a critical sensibility—his chapter headings have epigraphs from the likes of Ursula K. Le Guin and Saul Bellow—to videogames. The author is quite entertaining when holding forth on specific titles. He describes "Minecraft," in which players build structures out of blocks, as "a vast, virtual sandpit" where "everything has a pixelated, low-resolution quality, as if drawn from an earlier generation of videogames when technology was too limited to make things appear vivid and realistic."

"The Gaming Mind" seeks in part to dismantle the stigma that surrounds videogames and the archetypal "gamer kid," a term Mr. Kriss dislikes. Much of the book recounts the author's experience in therapy sessions, in which discussions of his patients' videogame habits provided a basis for a breakthrough. The book also works in some early history of the industry, delves into the debate over whether videogames cause real-world violence (Mr. Kriss thinks these claims are wildly exaggerated) and parses the differences between various types of games.

The centerpiece of "The Gaming Mind" is Mr. Kriss's work with a patient he calls Jack, an outburst-prone young man with a difficult family life. Jack at first proves a tough nut to crack. But a year into therapy, the author learns that Jack plays the game "Mass Effect"—which, as Mr. Kriss explains, puts the player in the role of Commander Shepard, a veteran soldier who, in the year 2183, is enlisted by a galactic council to hunt down a treasonous peace-keeping official.

Reality seemed more difficult for Jack than playing as Shepard in the virtual world of "Mass Effect." "In a very real way," Mr. Kriss writes, "he struggled to keep the basic elements of his life in coherent order from day to day, but the complex politics, histories, and geographies of the game coalesced seamlessly in his mind and he was able to convey them to me in a relatively cogent fashion." Mr. Kriss saw in "Mass Effect" a useful jumping-off point for appraising his patient's progress. Whereas some might counsel that excessive gaming would only worsen Jack's problems, Mr. Kriss thought improvement "hinged not on discouraging Jack's gaming behavior outright but on understanding his relationship with the game and with the version of himself he inhabited when playing." He says that Jack's willingness "to share his virtual self with me brought with it a genuine sense of progress."

Though many of the external stressors in Jack's life were still present, Mr. Kriss claims that, toward the end of their work together, Jack was "starting to see himself as capable of emotional self-regulation and logical decision-making. The fact that he already felt such competency when acting as Shepard proved to be . . . a source of evidence that healthful change was possible." Not all of Jack's problems were solved, but "the integration of virtual and physical brought a degree of clarity for Jack, a better sense of himself and his emotional life."

Though there's much of interest in Mr. Kriss's experience with Jack, "The Gaming Mind" isn't uniformly convincing. Some of the author's other patient-vignettes—which bring in such games as "Super Mario Odyssey" and "Candy Crush"—seem less insightful. And readers perhaps could have been spared Mr. Kriss's digressions about Freud's "Civilization and Its Discontents" or about the difference between internal and external validity in research studies.

Mr. Kriss, himself a gamer, may occasionally exaggerate videogames' therapeutic power, but his passion for the subject adds to the book's appeal. "At times when players . . . are struggling to find purpose elsewhere in their lives," he writes, "the potential of games—and the act of sharing them with others—can prove invaluable." Mr. Kriss is certainly right to highlight the emotional space that games occupy in the lives of those who play them and to take seriously the feelings that emerge there.

Mr. Shull is an assistant books editor at the Journal.