janemcgonigal

Play, don’t replay! HELP PREVENT PTSD

In SuperBetter on March 27, 2014 at 4:57 pm

Please join our effort to help prevent post-traumatic stress disorder by learning and sharing this simple technique:

If you experience or witness a trauma, play a pattern-matching videogame such as Tetris or Candy Crush Saga as soon as possible, ideally within the first twenty-four hours after the event.

Play the game for at least 10 minutes. It may help to play the game again immediately before going to sleep that same night.

It sounds too simple to work, but this simple technique has been scientifically investigated — and the evidence suggests that it can indeed help.

fullscreen tetris

THE SCIENCE

Researchers at Oxford University tested a theory that playing the videogame Tetris as soon as possible after witnessing or experiencing a trauma could prevent flashbacks, one of the most painful and difficult-to-treat symptoms of PTSD.

How it works: Visual pattern-matching games like Tetris (and Candy Crush Saga, Bejeweled, etc) are so visually absorbing, they prevent your brain from concentrating on what you saw, and therefore block your brain from forming long-term visual memories of the trauma. You will still be able to recall all of the details of what happened, but you are less likely to suffer unwanted flashbacks.

ONLY visual pattern-matching games like Tetris are expected to help. Other types of games (such as racing games or first-person shooters) are not likely to help, and some games (such as trivia quizzes) may even increase flashbacks.

The researchers successfully tested their theory in a laboratory setting — twice, and then again more recently in a follow-up study. Tetris DID prevent flashbacks after witnessing traumatic imagery. Tetris players also reported less trauma overall on a traumatic experience survey. But it’s much more difficult to test with real trauma in real-world situations. It’s unknown exactly how helpful this technique will be in different kinds of traumatic situations. However, the research to date suggests strong potential for significant benefit — and, in its favor, this technique is free, widely accessible, has no known side effects, and does not interfere with other forms of treatment or support.

WHO CAN THIS TECHNIQUE HELP?

If you or someone you love experiences or witness a trauma such as a motor vehicle accident, a physical injury, a rape, a physical assault, a violent crime, the loss of a pet, a workplace accident, the death of a loved one, this technique could help prevent flashbacks and nightmares.

These are terrible things to imagine happening, but if they do, this simple cognitive vaccine could prevent months or even years of suffering.

To make it easier to remember during a crisis, just think: “PLAY, don’t REPLAY.” Play a game, to avoid replaying the trauma over and over again in your mind. “PLAY, don’t REPLAY” is the stop-drop-and-roll of preventing PTSD.

Tetris is free to play at http://www.freetetris.org/. Bejeweled is free to play at http://www.popcap.com/games/bejeweled2/online.

Although studies suggest this technique may help reduce the quantity and severity of flashbacks, you may still experience some flashbacks or other symptoms of PTSD. Please don’t hesitate to seek additional help. You can learn more about the symptoms of PTSD, and how to get help for yourself or others.

Here’s how you can help prevent PTSD today:

Please SPREAD THE WORD: Share this page with as many people as possible — via Twitter, Facebook, or email.

This technique only works if you know about it before you experience or witness a trauma. That’s why we need to teach as many people as we can now, in case they need it one day in the future.

To make it easier to remember during a crisis, just think: “PLAY, not REPLAY.” Play a game, to avoid replaying the trauma over and over again in your mind. “PLAY, not REPLAY” is the stop-drop-and-roll of preventing PTSD.

candycrush

Please remember: While there is evidence to suggest this technique can reduce the number and severity of flashbacks, this technique is NOT an alternative to other forms of support or treatment. Please continue to seek any and all medical, legal, psychological, and social support you may need.

How you can help prevent PTSD in the FUTURE:

SHARE YOUR EXPERIENCE: If you or a loved one ever has the need to use this technique, please send an email to playnotreplay@gmail.com letting us know. We would love to ask you a few simple questions (such as what game you played, how soon after the trauma, and whether you experienced flashbacks or nightmares) so we can start to learn more about whether this technique works, and how much it helps, in real-world situations.

Questions we might be able to answer: How can this videogame “cognitive vaccine” be incorporated into first-response to traumas, in hospitals, schools, or police settings? Is it even possible for someone to focus attention on a videogame immediately after a traumatic event, or are some events so traumatic that concentrating on anything at all is nearly impossible? Does this technique help more with those who witness, but are not directly impacted by the trauma?

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For more information, reach out to Jane McGonigal, PhD @avantgame on Twitter.

For more information about the Tetris “cognitive vaccine” technique, you can read coverage in Time Magazine, Discover Magazine, and Psychology Today — or read the original scientific paper on this technique, as well as its larger follow-up study.

Here is a helpful review of research on the ethics of researching trauma, and the impacts on participants of trauma research. “Trauma researchers are often those who are facilitating the telling of a story to a supportive audience for the first time. Finding a way to tell these stories well, to examine their meaning, and to promote the understanding necessary to prevent the further occurrence of trauma, is one purpose of trauma research. Implicit in this goal is the duty to perform the research with integrity and respect.”

This project is not associated with Oxford University, or their researchers. It is an independent effort. It is not affiliated with or supported by the makers of Tetris, or any other videogame company for that matter!

  1. Is there any research on using similar games when you’re working with people whose trauma is older? I work with a lot of sexual and other assault victims, and they almost never come forward or get into therapy that quickly.

  2. Or, just don’t sleep. Sleep takes visual memory from the temporary memory storage area of your brain and puts it into the permanent storage area. While playing Tetris just before sleep should help if you are going to sleep, not sleeping is also a good method – and honestly, who is able to sleep after a trauma?

  3. Reblogged this on This is what I think today and commented:
    fantastic. Tetris saves sanity.

  4. Reblogged this on 2 BE JAMMED and commented:
    Hi Judith/Ha Judith,

    Sometimes an other persons’ Blogpost says it all. In this case it does. A blogpost from Jane who is on a quest in delivering this message to 100k+ people. It’s a blog on trauma and an opportunity to prevent PTSD if you play Tetris or Candy Crush within 6 hours after the trauma event. Crazy or Science (or Both)? At least enough to make me Curious! So here’s her Blog on it. Enjoy.

    Soms zegt een blogpost van iemand anders genoeg en hoef je daar zelfs niets anders van te maken. Dit is zo’n voorbeeld. Natuurlijk van Jane, die schrijft over dat als je een trauma hebt evaren dat je dan PTSD meer kan voorkomen als je Tetris of Candy Crush speelt binnen 6 uur na het trauma. Gek of Wetenschappelijk (of beide?) In ieder geval ben ik er nieuwsgierig door geworden en wil ik haar graag helpen om 100.000+ bezoekers te krijgen!

  5. Jane, what precautions are in place within this project to support traumatised people for whom this activity does not work? Is this designed as further research into the efficacy of Tetris for the type of psych treatment, and if so how are you mitigating bias in your responses? What research has been done into the mid- to long-term effects of this approach on PTSD patients and other trauma victims?

    It concerns me that you are recommending an approach on minimal evidence, without consideration for patient safety, in a way that would never be taken for a physical illness, and would never be accepted if it were an experimental drug treatment you were promoting rather than a game.

    • Hi Mary. To answer your questions: The primary purpose of this project is to share this technique as widely as possible so that individuals who may need it one day will know about it. This technique is not recommended for individuals who are already suffering from PTSD. It is recommended as a one-time “cognitive vaccine”, 10 minutes of gameplay on one occasion. There is no reason to believe that one 10-minute period of gameplay on one occasion would interfere with other treatments or ways of processing the trauma. As someone who has suffered frequent flashbacks and nightmares from an accident that led to a traumatic brain injury, I am personally very interested in providing this simple resource to as many people as possible. There is no evidence to suggest harms from a single, 10-minute gameplay session, and multiple studies suggest benefit. Given that this technique is free, is not dangerous, does not exclude or interfere with other treatment, and can be easily tried by virtually anyone with a phone or computer — AND can potentially prevent weeks, months or even years of suffering — I find on the whole the potential benefits VASTLY exceed any reason for concern. I do not take the prevention of PTSD lightly, but nor do I want to stand by and do nothing when this promising technique has been studied but is not yet widely known.

      • Thanks Jane, that’s helpful context. I’m genuinely interested in knowing about other studies suggesting benefit for this specific intervention, especially those conducted in real-life situations, as the only ones I’ve been able to track down have been in lab settings. I’m all for the use of games as therapeutic tools but I’m also aware of the potential of unwanted effects of various types of treatment, including psychological ones, as well as the importance of that time period in the development of PTSD, and I’m keen to know whether those things have been studied here. It’s the same level of skepticism as I’d show to someone suggesting that games can cause violent behaviour.

  6. Oh, and one more small, but important point:

    “The researchers successfully tested their theory in a laboratory setting — Tetris DID prevent flashbacks.”

    That’s a fairly loose reading of their work and results. They use a trauma film type scenario, and test the extent to which Tetris playing reduced the degree of detail to which subjects could recall specifics from the trauma film. The viewing of the film is not precisely a personal experience of trauma, and their diminished recall of its details is not precisely the prevention of flashbacks.

    They use their research design to demonstrate the validity of their model, namely that the mechanism by which seeing trauma and forming the memory of it can be disrupted by overloading the resources required to generate mental images via video game play. They then reason by analogy to suggest that this same approach could be exploited outside a laboratory setting, and may be applicable to reducing flashback experiences in PTSD-sufferers.

    It would be perhaps more fair to write that “(t)he researchers successfully tested their theory in a laboratory setting — Tetris DID inhibit traumatic memory formation, and could potentially prevent flashbacks in PTSD-sufferers.”

    Their reasoning is sound (imho) and it suggests the potential here, but success in the laboratory analog is not proof of effectiveness for the real deal.

    • Thanks for raising these questions, xnbomb, but I think you’ve misread the studies. The Tetris technique absolutely DID reduce flashbacks — it was NOT a matter of memory inhibition. Both studies show that memory formation was NOT inhibited. Tetris players remembered as many details, correctly, about the traumatic images they witnessed. This is one reason why this method, rather than pharmaceutical memory suppression, is considered potentially viable and helpful. Individuals who used this technique would have complete recall if they needed to testify in court, for example, about what they experienced or saw. Both studies also show that Tetris DID reduce flashbacks both DURING the initial gameplay period (an average reduction of 70% fewer flashbacks) and for a week after (an average reduction of 50% fewer flashbacks.) Also crucial to these studies was measuring their level of traumatic response using validated surveys. People who watched the images without the Tetris intervention reported much higher scores for traumatization, suggesting that 1) this is a valid method of studying trauma (as hundreds of other peer-reviewed studies have) and 2) that it not only reduced flashbacks but also traumatization. I wanted to add this clarification for you because I know you’ve given this a lot of attention and thought which I greatly appreciate.

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