Friday, September 23, 2011

MMO's and anxiety

It’s been a while since we last spoke about the psychology of gaming, which only makes the link I found two days ago all the more relevant.

The link in question is found at the official World of Warcraft forums (a constructive thread in there? Shocking!) and you can read it here:

The TLDR-version: The OP’er addresses the forums because he needs helps with his newest project. He wants to become a tank. A class-type currently in severe minority in the WoW community, which is hardly surprising given the amount of responsibility and shit they have to put up with.
However, he is currently blocked from achieving his goal by the fact that he tends to get extremely nervous, often quitting before even getting started. It’s obvious that this anxiety is a serious problem and that he wants help getting rid of it. And this got me thinking.

Why should we think of mental challenges in gaming?
Those of you who know me well are aware that I’m a clinical psychologist in real life that specializes in anxiety related disorders. I’ve listened to, written about and even treated a good amount of patients in this regard. Anxiety is more or less becoming one of the more common psychiatric problems of the modern world, along with (often comorbid) depression. It is therefore not a surprise that we should start considering this effect in regards to the online community. After all the internet is not safe haven, although it is certainly tempting to think of it that way.

My personal experience with anxiety in online games somehow resembles the one described by the aspiring tank, albeit mine was on the healing-side. Some of you might have followed my elaborations on ‘The Healer’s Journey’ in which I sat out to literally conquer my deepest fear. I was scared shitless by the very thought of healing, especially since I’ve been a sworn DPS’er in WoW since 2005. I’ve spent lots of time shouting at healers and tanks alike, but ask me to walk a mile in their shoes and I turn yellow.

In this way I represent a group, the size of which we might never be able to pinpoint, that has great ambitions for a game offering a myriad of possibilities. And yet we are limited by very unpleasant factors that we keep struggling with, whenever our aspirations surface for a short moment. For many, including me and the original poster, this can be a severe problem. Mind you that I am in no way saying that every person who’s nervous to play a certain class in WoW should be compared to clinical patient. But the associated distress and personal disappointment might be closer related than we think. I therefore argue that we should at least consider how we can best address these issues for this group of the MMO-community.

Allow me to elaborate for a short while.

What is anxiety?
Much knowledge is publically available today about anxiety, and yet there are some who have difficulties grasping its true nature.
Most people can relate to the physiological component of anxiety which usually consist of any variety of nausea, dizziness, (cold) sweating, trembling, abdomen and/or chest pain, and accelerated heartbeats and breathing. On the behavioural side there is often a very strong urge to escape the anxiety provoking situation or simply avoid it entirely in the first place. Although fleeing will usually bring immediate relief feelings of depression and personal disappointment can quickly follow up.
Many people struggling with anxiety tend to ‘give in’ after some bad experiences and stick to avoidance of the problems. Whereas the client with social anxiety will never go to a party in order to avoid her anxiety, the WoW player will likely roll another class, take a break or quit the game all together.

An example of MMO-anxiety
I will provide you with a personal example from back when I first started healing.
I rolled up a paladin because I like paladins. Simple as that. This was in Wrath so getting some good gear wasn’t really a biggie. He was an old character of mine already levelled to 80 so I did jump right into it, signed up for a VoA-pug and stormed in, holy lights blazing.

Before getting this far I remember spending about an hour staring at the trade chat. Whenever someone looked for a healer (which happens a lot, really) my heart would immediately start pounding, my chest would hurt and I’d start feeling chilly. In a way I was actually frozen, even though part of me really wanted to whisper “Sure, invite ahead!”. I’d always make up excuses for not writing, such as checking my Facebook and such. Once the raid was full I felt better for half a minute and then I felt bad why I was such a wuss.
I was, of course, afraid whether I could perform well in a role I never tried out before. Afraid that I’d wipe the raid, that I’d be kicked and foulmouthed along the way.

In the end I signed up, likely before my brain could get started. And I got invited.
Long story short, all my fears were confirmed. The raid wiped, my blessings were wrong and I got kicked immediately afterwards with some harsh words. It was then it all came crashing down.
I frankly looked forward to try something new in Wrath, but this night ruined everything for me. In a way I tried to be happy since it was now confirmed once and for all that healing was not for me. But from thereon I couldn’t bother. I forgot all about the expansion and my anxiety was cemented.

A lot of people out there might recognise something along this pattern, and I am willing to make an educated guess saying that the majority of you are either tanks or healers. Those of you might recognise how demoralising this process can be, especially if your mind was truly set on it.

How it usually starts and how it usually ends
Whether we’re talking WoW or that ‘real life’ thing the problem with anxiety is often that the victims start out with some great ideas and intentions and end up forsaking them, provided they don’t get the support they need. Sticking with the most important aspect (the MMO) I’ve spoken to a lot of people who’ve grown tired with their former role and now want to try out something new.

As mentioned I’ve been DPS since 2005, and it’s fun to see how the majority of these cases are in fact former DPS’ers who now wish to experience another aspect of the game. In technical terms it’s not surprising that the initial change can make something of an impact for these people. Whereas DPS should (in an ideal world) be just as much on their toes as a healer they can more easily get away with making mistakes. Which means less pressure and certainly less expectations.
Take me for an example (again); I’ve always wanted to be a warrior tank. I tried the healing role and made it almost through. But I’m thrilled by the idea of tanking, ever since I saw my former raid leader in action. I was truly inspired by what that man could pull off.
However, the idea instantly hit the shelf. The amount of tanking I’ve done is so minor and the expectations I feel everyone has really puts me off right from the start.
It’s pretty safe to say that my situation resembles the guy in the original link. Except I placed my ambition on the shelf permanently. In this way I basically resembles the social anxiety struck client that has given up and accepted that she’ll likely never attend anymore parties in her life.

And that is a problem.

Why do some people experience such distress over an MMO?
From previous statement it is tempting to assume that I put MMO-anxiety on equal severity with a clinical disorder. Again I must stress that I am not intending to differentiate nor compare the two, except from the sole point of their consequences. Whether we talk about parties in real life or instancing as a tank, anxiety has the power to cause great distress once we’re limited by its influence.

Why some people are more anxiety than others hasn’t been determined exactly but there is a myriad of biological, social and psychological factors that play in. I recommend doing some reading up on your national welfare homepage or other community, as this blog is more about handling it in an MMO-milieu.

The origin of anxiety can be specific due to an isolated episode associated with great distress (such as my adventure in VoA). Alternatively some people (me included) are simply more attuned to experience anxiety or nervousness than others, which can again be due to biological or social reasons. MMO-wise most people are actually quite good at identifying when it all began and work with it from there.

What can we do about MMO-anxiety? – The cognitive aspect
Luckily there are evidence-based methods in modern psychiatry that are able to reduce and handle anxiety in a more optimal way. Whereas some of these are specifically designed for long therapeutic sessions running for months I do believe there are a few pointers we could provide for people with MMO-anxiety.

One of the major approaches within the psychiatry is the cognitive behavioural treatment (CBT), which has proven capable of addressing many cases of anxiety. In these modern times quite a few people have heard of it (and if you haven’t there is PLENTY of reading out there) but to describe it in a simplified nutshell:

The basic premise of CBT is that our thoughts and how we think about ourselves and the world heavily influences how we feel about it. Thus it starts with a situation, moves on to what we think about it which then turns into a feeling and then into behaviour. We’ll talk more about the behavioural aspect later.
Let’s stay with WoW.

When you wipe on your first trashpack you might think the fault is yours alone for not interrupting or doing enough damage, which will likely lead you to feel guilty, sad or even angry. If you on the other hand speculate that it could be due to inexperience on the part of the other DPS’ers, the tank or the healer you might shrug it off as something bad that merely happens and move on. Again, notice the difference in the result.

When you engage in negative thinking in this way, it is usually termed negative automatic thoughts (NATs). NATs are swift judgements we pass on ourselves and surroundings, either in the form of statements or pictures. For the majority they are so fast (and automatic) that we barely notice them until we start paying attention.

A significant part of battling your MMO-anxiety is becoming aware of your own NATs, your own expectations of yourself and how you evaluate your performance. I will go over each and how to best handle them in turn.

Before going, measuring your expetancies
In the light of former example, whether you expect everything will go horribly wrong or really great will heavily influence your level of anxiety.
You’ve got your shiny heirlooms and open the dungeon queue, ready to sign up for that healing or tanking. But wait a minute; what do you actually expect? Of the run and especially of yourself?

The latter being the most important point for the player new at his trade. How much perfection can you honestly require from yourself, and is it even realistic? Do you expect perfectly smooth runs with no deaths at all? Is it okay for you to see some people die because you couldn’t save them? Do you expect to perform so well that nobody will quit? Do you expect people to write “good job!” specifically before you’re satisfied?

Try taking some time jotting it down beforehand, if you’re feeling anxious. Leave some space next to each expectancy where you can evaluate the realism of your expectation and perhaps room to set a more realistic goal for yourself.

For example, expecting to go through a dungeon without anyone dying is certainly a noble goal but not especially realistic once you consider it. There are several factors outside your control, such as the skills of other players, whether they insist on standing in the fire or you having a limited experience with your role. In this way you’re fighting against windmills, if you can’t set a more realistic goal for yourself. A better goal could initially be ‘It’s okay if people die or we wipe, the most important thing is that we complete the instance’. As you get better you can set higher standards (still within the limits of realism of course) and suddenly you’re progressing.

A lot of people have certain expectancies about the run of things. There is an old saying that everyone should blame the healer whenever something goes wrong, which is tempting to bring inside the instance. The danger in doing so is that this can become the automatic conclusion, so that when/if you wipe, you might automatically think complaining from other party members is addressed at you.
If you’ve had some bad experiences before with your role, try and write them down as well, and what they make you expect for the upcoming run. Make sure to include the “What’s the worst possible outcome you could imagine?” This is the catastrophe thought. Then think hard, and realistically, about counterarguments. Remember that you’re likely biased by your anxiety and negative thoughts so it’s important to try and be objective. Maybe ask someone you trust about their input.

When I started healing again as a druid, I still remembered my paladin fiasco and made a list like this:

Negative expectancies:
“I did terrible at VoA. So terrible that they kicked me and this will happen again”
“Whenever something goes wrong they will automatically blame me”
“I will have shit thrown at me for not doing a good job”
“They will expect me to be able to save them from all situations”
“Maybe it will all go to shit, crash and burn and everyone be angry and blame me entirely!” (Catastrophe thought)

Counter arguments:
“My first healing was in a raid with a class I never tried before. Perhaps I just started out too big. This is a dungeon, it’s something entirely different’”
“If something goes wrong it could be my fault, yes, but chances are good that the other players will fuck up as well. If something was my fault I can instead learn from it, like all the experienced healers have!”
“If they throw shit at me it frankly shows more about them having a problem than me.”
“No class is able to save everyone from everything. They’ve got to learn as well, and if they do something stupid that gets them killed it’s likely their fault in the first place. Not mine. I don’t have a Heal: Stupidity spell. Yet.”
“And so what? This is a game, I will likely never see the people in this pug again. Besides, look at the great healers in the big guilds. They’ve been beginners too. Everyone got to start somewhere and take their downfalls.” (Catastrophe counterargument)
“Maybe this will actually go smooth? Maybe I will perform so well at times that I did turn an otherwise impossible situation into a victory?” (Catastrophe countersituation)

Write a long list initially and notice what works especially well for you. I advice to hang it somewhere within sight so you can easily access it and remember it every time you feel anxious. The most important thing is that it works for you.

Out there in the field, I fight for my heals
Analyzing thoughts is all well and good but a vital part is confronting your fears. A lot of people tell that doing what they feel most anxious about is also the most effective initiative, which was certainly true for me.

Although you might be able to tell yourself that everything will work out fine, you need to see it happen before actually believing wholeheartedly. As a lot of friendly posters tell our aspiring tanks in the original thread, the best way is simply to dive and take it. Be aware that PUGS can be ruthlessly unforgiving in this regard, which can be a blessing or a curse. Although the lower level dungeons aren’t that much of challenge anymore, sustaining some players certainly is. They will give you hell. On the other hand nothing prepares you better for those ‘Oh shit!’ situations than a pack of random morons derping around in the fire as if they were paid for it. As my old healing mentor said (God bless you, Watagai) PUGs are a pain. But the trick is learning how to work through pain. And you will be all the stronger for the job.

Returning to anxiety there are plenty of opportunities for this to kick in during the heat of battle. Luckily our brains tend to work better once the adrenalin starts pumping through our veins and there is a certain irony to it, since a lot of people have told me they were more efficient when they stopped thinking and just fucking did it. I will have to agree in this regard, since some of my greatest achievements were done once my automatic response kicked in. When we double pulled in Hellfire Ramparts and I managed to heal the group through it everyone was in awe. I was spammed with comments about how great my healing was and once asked how I could throw so much of it out, I frankly couldn’t say so. I’d healed all my way through the vanilla instances. By now it was just something I did from the top of my head.

It’s when things start to panic out there (and they will) the anxiety will usually kick in, since it starts confirming your original exaggerated fears. If this sets in, it’s a good idea to be prepared with some memorized counterarguments. Sure, you’ve wiped, that doesn’t prove you suck. Instead, ask yourself what could be wrong. Be analytical. It could’ve been a retarded DPS ninjapulling. Someone might not understand the mechanics. Always, when NATs show up, instantly switch to analytical mode, no matter what shit people throw at you. Be prepared to admit when you err, though. That’s human. Don’t let anyone tell you otherwise.

A great idea some people prefer is to tell the group upon arrival that you’re new. Some will react harshly others be polite. Good groups can calm your anxiety from the start if they’re understanding, even try and recommend you once you do well. In razorfen craul I told the group that I was new but would do my best to keep them going and they turned out to be really friendly, even telling me not to be nervous since my healing was quite good.

As you try out your new role it’s important to notice your victories, even write them down. This goes without saying, you might say, but we humans are a funny lot. In many cases we have an uncanny knack for remembering and focusing on our fiascos rather than our achievements. We can become obsessed with that which doesn’t work. In this way we easily risk committing cognitive dissonance, meaning we will look back at only our downfalls and devalue the meaning of victory.

An example in WoW is my old list:
- Ragefire Chasm: Healed a paladin-tank without shield and wearing mostly leather, for me being the first time healing in a long time.
- Razorfen craul: Recommended by DPS that my healing was way better than anyone he’d played with in a long time.
- Scholomance: Tank pulled three packs, couldn’t control them and left with a dps’er. Healed the remaining three of us through the carnage.
- Hellfire Ramparts: Received great praise for healing us through double trashpack.
- Mana tombs: Healed us through double trash pull followed by ninjapull around the middle.

And so on. Don’t count on people providing you with this praise though. WoW players aren’t always good at praising each other.

If everything comes crashing down, consider asking for a breather to gather your thoughts. If you’re a tank or a healer, your party will likely be fine (or have to put up with) you going afk for a couple of minutes. Then consider doing the following.

Take a deep breath. If anxiety is bad, try doing an exercise such as counting all the white things in the room (do it more than once).
Look over your list of counterarguments. Often the anxiety is related to your original NATs and going over the details once more can really help.
Try to find your curiosity and ask yourself what could be done differently either by your or the party. Analyze and consider as this provides you with some amount of control.
Go through with it. One of the bad things you can actually do is giving up, as this will only reinforce your anxiety and negative thoughts. Unless you’re truly on the verge of a breakdown, going on till you either complete it or get kicked will be more profitable, at least for the experience.

Once the silence settles once more
The instance is over, the battle is done. Time to evaluate.
Maybe you completed the dungeon with no problems. Maybe it was a bumpy ride. Maybe you got kicked and everything went to hell. Either way, fetch your original list of fears and compare the actual run with what you dreaded the most.
Notice and similarities and differences and write them down. What fears were (partly) confirmed and what weren’t confirmed at all?

As always remaining objective is alpha and omega in this regard. Stick to an analyzing, objective perspective and go over the bad experiences one by one. A good start is to jot down three episodes in which things went bad and think about what you could realistically have done otherwise. Perhaps you wiped on a trash pull, but was it really due to you stinking as a healer? Did the DPS refuse to move out of the AoE? Was the tank well geared? Or, if you were the tank, was it an aspiring healer? Did DPS break the crowd controls? Did you?
No always are the answers written in stone. In some cases giving yourself the benefit of the doubt is much more viable than simply concluding that you did a poor performance. Switch your gaze and look outside. A solid part of instancing is the teamwork, after all.

There is a certain trend involving players verbally abusing their group before they leave, either due to a completed instance or simply ragequit. A vital part of battling your anxiety is the ability to ignore unconstructive criticism from other players, especially when it involves profane language. It can initially be easy to take this to heart, but eventually you should be able to see through it.
If and when it happens, it’s a great time to keep your accomplishments in mind. Remember, for you it’s a simple run to forget about. For them it’s probably like that in every single instance.

Just as making notes for your expectations, writing down your conclusions as you go along can be great fun. I did so for my healer, described in my “Healer’s Journey” blog. Looking back at this later is not only great fun, but also a good way to see how much you’ve learned since you started out. It’s also a subtle pat on the back for your great progress. An alternative is to rate your level on anxiety (on a scale from 1 to 10) before entering an instance. Looking back after some time, noticing your progress, perhaps even visualizing it by a diagram, can be really rewarding.

Finally, remember to stay updated on your trade. There are several ways in which you can improve and reflect upon your praxis, such as reading guides and scouring the AH for upgrades. Working on getting some more heirlooms or crafting better gear can be a nice reprieve and make you better for the job. On the other end of the continuum is the notion that you shouldn’t be an idiot. There is a fine difference between the newb and the noob. As a tank, don’t go into dungeons wearing INT-gear, for example.

Sparring with friends and other people who have more experience with the class than you can be a really great idea too. Most of them are happy (and proud) to share their knowledge and give input on certain situations.

So, am I cured then?
A word of caution should be given. The presented approach has obvious advantages in combating anxiety but also has a few pitfalls. First and foremost it’s pretty established that you have to keep up a continuous effort, especially in the area of exposure. If too much time passes in between you risk forgetting some of the lessons and conclusions you made, meaning you might experience more anxiety than you previously did. Luckily, you should easily be able to catch up.

Fighting anxiety is a process just as demanding as losing weight. It takes effort. Additionally, some people will spend very little time making significant progress. For others this is a battle uphill, perhaps only for a moderate gain. The only way to find out how much potential you’re in for is to do it. Some people might require other methods or ‘deeper’ cognitive methods.

The conclusion: Don’t go in with a defeatist attitude. Don’t expect miracles either.
There is great potential in these methods, and trying them out will help some people immensely. Fighting anxiety is rarely a feat easily accomplished, but I will say from experience; it’s doable. You shouldn’t be limited or unable to reach your ambitions because of it. Not when there is indeed hope for everyone, if they at least give it a go.

Still with me here?

Then go hit that dungeon finder. And I’ll wish you the best of luck.


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