Living Free from Games
by Andrew P. Doan, MPH, MD, PhD
Video games are an enormous part of our society, and they are here to stay. The gaming industry generated over $180 billion dollars in revenue in 2021, which nearly exceeds the revenues from books, movies, and music combined. Cloud gaming services like Microsoft’s Xbox Game Pass, Nvidia’s GeForce Now, and Google’s Stadia, provide hundreds of games that can be played on smart televisions, computers, consoles, and phones. Similar to online streaming services for movies, such as Netflix, cloud gaming allows playing video games without a console and has increased accessibility to video games significantly. In 2019, the State of Online Gaming concluded smart phones are the primary devices used for gaming. The majority (96%) of 18-25-year-olds own a smart phone and have access to gaming on demand. A few phone-based games generate over $1 billion in annual revenues each.
The problem is that video games are not completely benign. Video games can act on the mind and body like pharmaceuticals that are ingested orally. The pleasure and excitement associated with the online experience such as in-game achievements, immersive environments enhanced with built-in-music, and interactions with other players, stimulate hormonal systems in the body.,, Physiologically, this causes increased heart rate, blood pressure, sympathetic tone, plasma norepinephrine, and food consumption.
To be honest, there are many benefits to gaming. For example, the physiological arousal associated with gaming can be utilized for clinical and emotional benefit. In the medical field, doctors utilize gaming-induced physiological stimulation to reduce burn pain, assist women during childbirth, and treat mental health disorders. The father of toxicology, Dr. Paracelsus, stated that “All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison.” Therefore, it’s the amount of exposure to gaming that can become toxic, and not just the gaming itself. Similar to desserts like chocolate cake, when eaten in moderation can provide joy and pleasure. However, when cake is eaten in excess, obesity and diabetes can devastate the human body. Video games can be healthy when played with balance and self-control. However, when abused, gaming can be associated with severe consequences to the body and mind.
People seek to escape and deal with stress by engaging in things and activities that make the body feel good. People tend to overuse and over-engage when the brain receives positive feedback from activities that are engaging, stimulating, and fun. During my 20 years in clinical medicine, I have yet to discover an individual addicted to broccoli or cauliflower. In contrast, people will overeat foods that stimulate the taste buds with bursts of pleasurable flavors. Video games are “digital sugars”, and work-related software programs are the “digital veggies” of the 21st Century. Due to the ease of access to the $180-billion-dollar video game industry, 1 in 11 gamers exhibit full-blown clinical addiction with a significant number of individuals exhibiting problematic play. Problematic play is when an individual exhibits gaming-related issues in their life, for instance failing school, but do not have additional life problems to be considered “clinically addicted”. The World Health Organization has classified internet gaming disorder as a clinical problem, and individuals who are addicts exhibit five or six gaming-related impairments in personal, family, social, educational, occupational, or other important areas of functioning for at least 12 months.
As a physician, I see few gamers being addicts and a significant number of gamers engaged in problematic play. As a Christian, I am observing a significant population of the church drunk on digital sugars. In the Bible, we’re instructed to be not drunk on wine but instead be filled with the Holy Spirit (Ephesians 5:18). During the first century, wine was the socially acceptable substance to soothe the soul and assist in escape from daily stressors. In the 21st Century, digital sugars in the form of gaming, social media, movies, and pornography are the modern equivalents of alcohol.
In 2013, I received this email from Julia, and she gave me permission to share her story that illustrates the growing problem with gaming in the church.
My girlfriend just sent me the YouTube link from your lecture with the City of Temecula, and I just had to send you a note to thank you for your work and to encourage you and your ministry and share my own story with you. A few years ago, my husband of seven years left me. We met at a Christian College, and we spent the first year of our marriage as missionaries in China. We got married the same day we graduated from college and went straight from the dorms into our first apartment, so I had no clue he had a video game addiction. I knew he liked games and was a computer programmer (which seem to go hand in hand), but was completely naive to this whole other gaming world and culture. All I knew was every Tuesday his buddies would bring their computers into one dorm room and play Halo all day. But when he brought his Xbox on our honeymoon, I started to realize this hobby wasn’t “normal.” He wanted to get into the video game industry and so many of the symptoms of this addiction I dismissed or tried to excuse because it was for his career.
He struggled with some social anxiety issues, and would get extremely angry if I would complain about his video game use. The video game world was his way to relax and unwind. He would say, “at least you know where I am every night… some husbands are out at bars and strip clubs and I am home.” Of course, the games he played were role-playing games with no pause button, so there was no way to interrupt him without ensuing wrath. Countless nights he would stay up playing World of Warcraft, family vacations he would not come on because the new Final Fantasy game was released, night after night going to bed alone.
I just cannot express in words how painful and lonely those years were. He would go to work and come home and immediately sit in front of the TV or computer where he would eat alone, and that was his whole life. He took on no household responsibilities (when he left he had to YouTube how to turn on a washing machine because I guess he paid friends to do his laundry in college for him), I would have to beg him to even get him to occasionally come with me to church, let alone any kind of social events. He would drive separately to family functions like Thanksgiving or Christmas so he could leave as soon as possible to go home and play games.
But that was just the beginning… in the matter of five years, his addiction broadened to include prescription drugs and alcohol, what he called “emotional affairs” with other women, a completely new group of friends who would spend all night at techno clubs, and ultimately a total renouncing of any relationship with God and the values he had previously held. He divorced me claiming he never loved me and just wanted to wake up happy and took his games and left.
His mother was a very young single mom with no money trying to finish school. She would rent or buy a video game and leave him home alone because she couldn’t afford child care and knew he wouldn’t move from the TV while she was gone if he was playing a game. So these patterns started from kindergarten age onward and that was in the 80s! I can’t imagine this generation of future husbands being brought up in this technology soaked culture.
God was my rock and my refuge and my strength. By the grace of God I am happily remarried to a wonderful man who is thankfully completely disinterested in video games. But my heart aches because I know my story is not that uncommon. There are so many lonely wives out there with selfish, unloving husbands who care more about feeding this addiction than anything else in the world. These husbands need to repent of this idolatry and find their security and significance not in their ranking on a game, but in Christ. And we need God honoring men to step up to their role as heads in their homes with the self-control to deny the fleshly temptation to waste their days and nights away on their own pleasure and to seek after raising up children in the nurture and admonition of the Lord.
That is why I am just so thankful you are working to educate people about this!!! I will be praying for your ministry, and if there is anything else I can do, please let me know.
In Him,
Julia
From a Christian perspective, Julia stated the solutions clearly: God is our rock (Psalm 18:2), turn away from idols (1 Corinthians 10:14), exhibit self-control (Galatians 5:22-23), and seek Christ for our security and peace (Matthew 11:28-30). As parents, we can guide our children by establishing healthy boundaries with gaming and media to allow them the time and opportunities to develop their own relationships with the Lord. In a collaboration with Dr. Hilarie Cash and Cris Rowan, we considered research from the American Academy of Pediatrics and the Canadian Pediatric Society to develop these guidelines for families.
For gamers, how do you monitor your self-control with gaming? First, be honest with yourself. I’ve modified the CAGE questions used for alcohol abuse that gamers can utilize to monitor themselves.
C – cut back. Do you feel or others feel that you should cut back on your gaming?
A – agitation. Are you agitated when others mention that you should cut back on your gaming?
G – guilt. Do you feel guilty when you are gaming because you’re ignoring other real-life activities, tasks, or deadlines?
E – eye opener. Is gaming the first thing you do or think about in the morning?
If gamers answer yes to any of the questions above, then there may be problems with gaming. Healthy boundaries should be established with digital media in the home. Christie Walsh, my wife Julie, and I created the following infographic for Real Battle Ministries. The infographic provides guidelines for families to consider when managing digital media and gaming in their homes.
For additional information, please refer to my book, “Hooked on Games” (https://www.amazon.com/Hooked-Games-Video-Internet-Addiction/dp/193557602X/) and workbook “Digital Vortex Survival Guide: Behaviors, Digital Media, & the Brain” (https://www.amazon.com/Digital-Vortex-Survival-Guide-Behaviors/dp/1935576054/)
Our primary objective as parents is to raise God-honoring children. As Christians, it is our mission to serve the Lord, make disciples, and share the Gospel to all nations (Matthew 28:19). Living a balanced, healthy life is essential to keeping focused on God and loving Him and others well.
References:
Palumbo, Alessio. Gaming Industry to Mark Another Revenue Record ($180.3B) This Year. https://wccftech.com/gaming-industry-to-mark-another-revenue-record-180-3b-this-year/ Published Dec. 22, 2021. Accessed March 2, 2022.
Limelight Networks. Market research: The State of Online Gaming – 2019. Market Research: The State of Online Gaming – 2019. https://www.limelight.com/resources/white-paper/state-of-online-gaming-2019/. Published March 15, 2019. Accessed September 26, 2021.
O'Dea S. US mobile phone ownership by age group 2019. Statista. https://www.statista.com/statistics/194992/percentage-of-us-smartphone-owners-by-age-group/. Published March 12, 2021. Accessed March 2, 2022.
Chaput JP, Visby T, Nyby S, et al: Video game playing increases food intake in adolescents: a randomized crossover study. Am J Clin Nutr 2011; 93: 1196–203.
Phan-Hug F, Thurneysen E, Theintz G, Ruffieux C, Grouzmann E: Impact of videogame playing on glucose metabolism in children with type 1 diabetes. Pediatr Diabetes 2011; 12: 713–7.
Hebert S, Beland R, Dionne-Fournelle O, Crete M, Lupien SJ: Physiological stress response to video-game playing: the contribution of built-in music. Life Sci 2005; 76: 2371-80.
Gentile DA, Choo H, Liau A, Sim T, Li D, Fung D, & Khoo A. Pathological video game use among youths: a two-year longitudinal study. Pediatrics 2011; 127(2), e319–e329.
WHO. Addictive Behaviors: gaming disorder. World Health Organization. https://www.who.int/news-room/questions-and-answers/item/addictive-behaviours-gaming-disorder. Published October 22, 2020. Accessed March 2, 2022.
