Computer Gaming--When Virtual Violence Becomes Real

Virtual games, such as World of Warcraft, The Sims, and Second Life, are played by thousands every day, allowing people, worldwide, to connect and share information. In fact, the virtual "worlds" that can be created in these games are now being used to make money (through buying and selling virtual objects), to form partnerships and friendships, and even to conduct business; it is easy to see how many become engrossed in this alternative life.

But what happens if such a person's computer is taken away or its use is severely restricted? According to psychiatrist Jerald J. Block, MD, the sudden restriction of computer use may cause adverse reactions—and may have been a trigger in the Columbine High School shootings in 1998.

In an article published in the American Journal of Forensic Psychiatry¹ and subsequently reported on in the Denver Post,² Block details the possible motivations behind Columbine shooters Dylan Klebold and Eric Harris's attacks. He explores many possible motivations behind the shootings, which killed 15 and injured 24, including traumatic childhoods, bad parenting, psychosis, bullying, copycat killing, and peer pressure. As he told Psychiatric Times, "There were several things that made Harris and Klebold change from bright children to terrorists. A childhood medical ailment, bullying, the copycatting of prior school shootings, mental illness, and alcohol(Drug information on alcohol) abuse were all important factors."

However, the one factor Block feels has been neglected by investigators is the youths' computer restrictions preceding the shootings. Block found evidence while looking through documents, including the boys' personal writings, that their use of computers was restricted at home (in Harris's case, this was at the recommendation of his therapist) and at school, with each restriction leading to more violent threats and behavior from the adolescents.

Klebold and Harris were known to be avid players of a computer game, Doom. They often made references to the game in their writings and created levels and characters to share with others on the Internet. The amount of time spent playing could have led to confusion between the virtual world and reality, Block notes. He cites dreams that Harris wrote of in class papers. "Harris wrote of a dream in which he and a friend were attacked by Doom-like 'shadows that seemed to have evil, demented inhabitants' that made an 'evil growling.'"¹

Yet, Block does not believe that the boys necessarily acted out because of the violence they viewed through the computer screen. "The computer acts like a heat sink for aggressive, depressed, angry, and sexual emotions," he told Psychiatric Times. He noted that restricting computer use in a person who uses the computer as an outlet for his or her emotions may be "profoundly upsetting." As a result, the gamer may feel attacked, underestimated, and misunderstood. Without their computers to turn to, Harris and Klebold may have focused their aggression on the real world.

In fact, Block cautions readers against drawing an automatic link between video and computer game use and violent behavior, a relationship that has been proposed frequently in the media. "It is debatable whether the actual content of the violent games was important [in the Columbine shootings]... I argue the near-total immersion into an idealized virtual world and the subsequent annihilation of that alternative world is what was dangerous."

Lawrence Kutner, codirector of the Center for Mental Health and Media at Massachusetts General Hospital in Boston, was a coauthor of a recent study, "Factors Correlated With Violent Video Game Use by Adolescent Boys and Girls," published in the Journal of Adolescent Health.³ The study found that most adolescent boys and many adolescent girls play M-rated games regularly; however, this does not necessarily mean that the kids go on to commit violent acts. Kutner explained to Psychiatric Times, "There have been some studies that attempt to look at [the relationship between violence in the media and violent behaviors]. The problems with many of them include unrealistic levels of exposure (eg, 20 minutes of play of a new game), questionable measures of aggressive behavior (eg, timing of blasts of a horn), and other problems with links to the real world. Also . . . definitions of violent media are constantly changing. When many of the television violence studies were done, they considered Road Runner cartoons and Starsky and Hutch to be violent programming."

Dr Block notes that it is not always easy for a clinician to recognize when a person presents with pathological computer use. He cited a case in which "a patient presented complaining of loneliness, isolation, and depression. Several of her friends insisted she see me. It took me, an expert on this, nearly half the session to figure out [that] her friends were all from the virtual realm—the games she plays in—and that she actually had no real friends."

Research on the topic is emerging, according to Block, with much of it coming from Asia; there are about 50 treatment centers for pathological computer use in South Korea.

Block urges researchers to further examine the effects of computer use on people's lives, both positive and negative. "Why does a shooter [Virginia Tech's Seung-Hui Cho] kill 2 people and, then, take the time to delete his e-mail and Web page, and dismantle/destroy his computer's hard drive and cell phone [only to] go on to kill another 30 people and himself? Why did the killer [Jeff Weise] at Red Lake High School post highly graphic computer-generated Flash videos to the Web, forecasting his school killings? ... These high-profile cases are yelling at us to start paying attention to the intersection of psychiatry and our patients' use of computers."

Since total restriction of computer use may very well have negative effects, Dr Block suggests that therapist and patient work together to come up with the best option, possibly negotiating appropriate limits.