Rebecca: Alright, I am back now with Alok and Kruti Kanojia, who are the co-founders of Healthy Gamer. We have been talking about the importance of relationship, we’ve been talking about technology, we’ve been talking about gaming and today we’re going to talk about when is it a problem. And so, on your Healthy Gamer website, you have some of these aspects. I just wanted to throw them out just for a conversation: physical health, emotional stability, social growth, real-world outcomes and mental health. And kind of the question that I’ve been sitting with is, “Is technology the problem or is it a symptom?”
Dr. K: So oddly enough I’d say that technology is actually in some ways the solution.
Rebecca: Ah nice oh tell me more.
Dr. K: I think that technology does things for us that are important. Right? So, if we think about why a video game is fun, there have been studies that show that video game addiction is different from other addictions because most addictions are about receiving a reward. If you use something like, let’s say you’re addicted to opiates. When you use an opiate like heroin, you get high and video games are actually different for one really important reason. What they found is that video games are more addictive based on the denial of the reward. If you think about what makes the game fun, it’s that it’s hard and you win in the end. If a game is too easy, then no one wants to play it. So, what’s addictive about video games or what can really engrossed people is that it’s a challenge, right, and we’re all wired to like want challenges to overcome things. As a society, we value accomplishment. And our brain sometimes can’t tell the difference between accomplishing something in a video game and accomplishing something in real life.
Rebecca: Because our dopamine — can you say that again.
Dr. K: Yeah, so because our dopamine circuitry can’t tell the difference between a real world reward and a video game a virtual reward. There are other parts.
Rebecca: So, dopamine, so just for the people who don’t know can you talk about dopamine really quick.
Dr. K: Sure, so dopamine is our pleasure like neurotransmitters. So, when it gets released, we tend to feel good and there are other parts of us, for example, like our identity, we can tell the difference, like the part of our brain that has a sense of identity. We can tell the difference between accomplishing something in the real world and accomplishing something in the virtual world, but our primitive reinforcement circuitry. So, the things that reinforce behaviors and make us feel good can’t tell the difference and that’s why games are fun because we have fun and anytime you’re having fun, that releases dopamine. When I win first prize in a contest, I get a huge rush of dopamine and when I beat a video game, I get a huge rush of dopamine. And so, what we’re beginning to see is that that video games fulfill basic drives that our brain wants, like they fulfill basic human drives. Video games now give us a sense of community, right? You have friends online, you meet them every week, you guys play together, you know, they give us a sense of accomplishment, they give us a sense of challenge, they give us a sense of exploration and curiosity. And so, the real thing to understand about video games is that for your child, they’re probably a solution to a lot of things. And when we think about how does it become a problem, it’s when that becomes their exclusive solution. And that solution starts to impact other parts of their life. When they’re so close with their online friends that they start to develop social anxiety because they don’t know how to interact with other people in the real world. You know and so those different dimensions that we cover on our website are talking about the different problems that video games can cause. And for me it’s a really simple sort of diagnosis because if it causes a problem, it is a problem. If you’re playing four hours a day and your kid is active and athletics has an active social life fulfills his responsibilities and does good in school. I used the masculine pronoun because most of the gamers that I work with are men, probably 80% of them. But if your child does all of those things and they play video games for a couple hours a day, I don’t know if that’s a problem.
You could also say that you know they’re not pursuing other things like they could be learning: how to play an instrument, or they could be spending more time outdoors or whatever. But at the end of the day, if it causes an impact, if their grades suffer, if their job suffers, if they’re unable to find a job because they’re playing too many video games. If their weight is a problem or if they have physical health problems, if they’re not able to like run a mile or three miles or whatever. If it affects them mentally- if it causes problems in terms of depression or anxiety or social anxiety, we see a lot of that. And so if it causes any of those problems, if it causes problems within your family, then it’s a problem. If it impacts your relationships in terms of not being able to have them so a lot of gamers that I work with want to be able to find a boyfriend or girlfriend and they just can’t. They don’t feel comfortable, they feel ashamed. If it impacts relationships with family members. If I can just share an anecdote. So, I got a call from someone in Iran actually and they were saying, “We don’t know what to do. Our child plays so much PlayStation.” They locked up. So, what they decided to start doing is when they go to bed at night, they unplug they take the power cord out of the back of the PlayStation and they lock it. And one day the kids older sister came downstairs in the middle of the night and found him playing at like 4:00 in the morning and that’s when they realized that what the child had learned how to do is pick locks. He would go downstairs at 11 pm, pick the lock, plug in the PlayStation, play until about 4 or 5, would unplug it, lock it back and would go to sleep.
Dr. K: Crazy, just so extreme, and it impacts their relationship. So, if it’s causing problems like that, impacting their sleep, if they’re not able to sleep, or staying up too late, then I think it’s a problem.
Rebecca: And so I need to ask what happened with that family?
Dr. K: Unfortunately, I don’t know. I wish I could say that there was a happy ending, but the family reached out to me and said, “Can you help?” and I said sure, you know, I’m happy to talk to him. So just give him my information and then you know he didn’t follow up or they couldn’t convince him and then I circled back with them and I said, “Hey, so I do things that are kind of gamer friendly. So, I run support groups on something called Discord which is like a gamer chat kind of program. And so, I said, “Hey, I run groups on Discord.” Maybe he’ll be more amenable to that and I’m going to actually circle back with them one more time and tell him because I think he’s hesitant to engage. And then I’ll tell them, “Hey, you know we actually I started streaming on Twitch where I’ll kind of just answer questions gamers, will come on stream and they’ll just ask whatever and then you know because then he can completely passively, he doesn’t have to admit he has a problem.” Doesn’t have to engage he can just watch and hopefully he’ll get help that way.
Rebecca: Yeah, yeah wow and there’s lots of ways but I also hear you’re really encouraging him to get the help.
Dr. K: Yeah, I’m trying to meet him where he is.
Rebecca: Yeah, so what would you say to the parents if parents have a child who’s doing things like that who’s getting up in the middle of the night and not sleeping and where do you begin?
Dr. K: That’s a great question. I think that’s where we really think a little bit about professional help. I think someone needs to talk to that kid who understands him and can really dig into why he’s doing that. What does that child think is going to happen over the next five years? Where does he see himself? And chances are that that kid is terrified because that kid is smart enough to know. So, I think he was like a high schooler, so I think he knows that his grades aren’t good and that things aren’t going to go well, but there’s so much shame. And the really kind of bizarre thing is that sometimes it can be really hard as a parent because your child wants your respect and so the things that are the most shaming to them they will fight tooth and nail to let you see. Like they just don’t want you to see it and so I think in that kind of case, if you really so I do think trying to have a conversation with your child is a great place to start. You can just talk to them about why you are doing this, what do you think is going to happen, instead of just punishing them for it. Start by asking, “Where do you think this is going?” And then chances are the child will say, “Oh it’ll be fine, it’s not going to be a big deal.” They’ll downplay it, they’ll engage in some denial and that’s tough. Because how do you as a parent then I think it’s really delicate and this is why I think a third party is helpful. And the third party can kind of be a neutral party right and they can say well let’s actually explore that.
“So, when do you think it’s going to change? How are your grades now? Do you think you’ll go to college? How many places are you going to apply?” And instead of being judgmental, play the tape through to the end. Accept their assumptions. “Okay, you say everything’s going to be fine. How is that going to happen? Walk me through it. And I’d also advocate that parents, you know this is something that’s really tricky that you share your feelings without making judgments.
So, you can say, “I’m having trouble being confident in knowing that this path is going to have you okay because I think the trajectory that I see you on I just don’t see that happening.” This is where they say therefore it’s not going to happen and something needs to change and so what I would actually advocate for parents to do is stop and say, “You show me why I’m wrong you convinced me. I’m open-minded. So, if you say that everything’s going to be okay, fine walk me through it because I don’t see how that’s going to happen,” and then the cool thing is that you know it’s not going to be okay. I think the parent knows that the child knows that right, but you got to let them come to that realization and in the process of trying to convince you, you know they may get more and more frustrated and deny more and they’ll you know if you can’t really pin them down. They don’t give you a plan, then you comment on that. They’re like, “Oh no, it’s going to be fine, I’ll figure things out, I’ll be fine,” and then then comment on that. You can say, “Well, you keep on saying that you’re going to be fine, but I’m asking you to convince me and you’re not able to actually like give me anything concrete. You need some time to think about it right what’s going on here.”
Rebecca: Yeah, yeah but I really I like how what I hear you saying is you’re having them connect with their child, they’re connecting and the judgmental piece is the thing that gets in the way of the relationship. Because especially with older kids, we need to give them space to think through it without us saying you’re going to flunk out. You know this: you’re not doing your homework, you’re not sleeping at night, you’re afraid to go out, and then they have tuned us out, it’s over.
Dr. K: You go on attack and they go on defense and then you guys are you’re not allies, you’re enemies.
Rebecca: That’s right, that’s right so being able to say that and then giving them the opportunity, yeah, go ahead Kruti.
Kruti: I think one of the things that gets in parents heads a little bit is time because you feel like you know the grades are coming out soon or you need to start studying for the SATs or you guys it’s time to apply for colleges with these older kids. And so when time gets in your head, that’s when parents start to panic and start to kind of go into that attack mode because they’re under pressure too. And I think one of we talked a little bit about kind of the pros and cons of traditional therapy. I think there’s a way to say, “What do you think?” Is there a way for parents to kind of guide the therapy a little bit more to kind of go quicker?
Dr. K: I think that the problem is that most therapists actually aren’t going to know how to handle this right and while there’s definitely value to that, I think at the end of the day, the parent is the most important part.
Kruti: Right and so one of the things we do is we call it our action plan for that situation. Where you think you need professional help and you either would need to expedite it or you’re not 100% sure that therapist really gets it. It’s a little bit more directive and because time is the enemy here for this particular age and the goal is to condense that time frame from like having to be in therapy for 16, 20 weeks before you see a lot of progress and kind of accelerate that to be within four to eight weeks. And you know when time gets in your head, it can be so panicky for everyone right. Because that kid is like I don’t know I get one more shot to take the SATs and that and that that’s it or like you know.
Dr. K: Well just to be a little bit more concrete about what Kruti is saying… I think the scenario that kind of pushed us in that direction is you have a child, let’s say they’re a starting their sophomore year of high school. If you look for a therapist, wait times can be anywhere from like two to six months and then it takes like weeks if not months if you’re lucky to sort of make a change and before you know it you’re going into junior year with like bad grades and you can’t undo a GPA like you just there’s nothing you know you can do better in your junior year. I applied to medical school with a 2.5 GPA and that’s because I had less than a 2.0 GPA for two years of college and despite three years of decent grades like you just can never undo that.
Yes so I think there is a very real sense of urgency that you know your GPA is something that once you have your GPA you know you can never undo it and so what parents really feel is that like this is a problem now that’s going to create consequences that are going to really shape the trajectory of your child’s future and they’re right, it’s scary. And sometimes the mental health profession the field just can’t respond to the needs quick enough right and so that’s what really drove us to kind of you know you’re kind of asking what would you tell the parents to do or say and that’s really what we try to do. We try to educate parents and really like specifically like literally sample dialogues that carry some of the essence of trying to build a therapeutic alliance of trying to form a connection. This is how you say it judgmentally, this is how you say it non-judgmentally. Because that’s really what they need to do because their children are scared like many times, there’s fear, there’s shame and in order to create a productive connection you first have to really like disarm that because if that’s working against you, they’re just not going to open up and if you try to punish them for it that’s just going to reinforce their sense that something is going wrong.
Rebecca: Right and so what I’m really hearing is that the most important thing is the relationship with the parents. Yes, there are times where we might need some extra support information, but it’s that relationship with the parent that matters the most.
Dr. K: Absolutely Rebecca, because even if you find a therapist, the therapist is going to be with the kid for one hour a week. The parent is going to be with the kid for four hours a day and even everything else is going to be structured by the parent, too. Like what time they wake up, what time they go to bed, so the parents are really the ones that are on the front lines and that means that they have to do most of the heavy lifting. As a therapist, I can just tell you having supportive parents who are like compassionate and thoughtful is like night and day. You know one of them feels like I’m going downstream and one of them feels like I’m going upstream.
Kruti: So we’ve been talking a lot about grades, but I think a lot of parents will see you too like you and Bob have been friends for eight years, why aren’t you all hanging out anymore and parents will see these things you invest in your kid, you invest in cultivating these relationships and then you see them fall apart because the kid is playing video games or doing something else. And so it might not always be the grades that is the worrying factor. It can be this like social isolation that you might see for better or worse. Not all friendships are forever and that’s fine, but I think parents can kind of trust their intuition a little bit, too.
Where they can kind of see like something is wrong and that’s why we kind of look at emotional health, social health, physical health, mental health, and real-world outcomes, grades. It’s kind of one of five things that you would want to look at.
Rebecca: That’s right, that’s right yeah and I really appreciate what you just said about parents trusting their intuition. You know your child best, you know your family, you know when something isn’t working and trust yourself. And if it is working, trust yourself.
Kruti: If everyone around you is saying you should be worried because your kids are playing too much, you know what’s too much, you know there’s no reason to give in to panic. On the same side of that coin, trust yourself and if you’re at a loss for words if you are at a loss for like exactly how you would think about this, we have some frameworks that can help with that. But for the most part I think parents they know what’s going on.
Rebecca: Yeah, that’s right. So we’ve been talking with Aluk and Kruti Kanojia, co-founders of Healthy Gamer and we will be back tomorrow with setting goals as a family and supporting the gamer.