There have been many great players throughout history in basketball, football, or even chess. Brilliant, disciplined, intelligent — these are a few words one might first think of when describing the famous chess grandmaster Magnus Carlsen, but “addict” would be quite far down the list. Often there’s a focus on gaming being an addictive substance, but that same criticism is typically withheld from popular disciplines such as traditional sports or even chess. Does that change if someone pours countless hours into training for a video game? Does the justification change based on if it's a career or a hobby? Certain activities and pursuits are given a pass when it comes to obsession, whether that be someone that is a workaholic, or a person that is meticulous about their diet and exercise. Modern conceptions of addiction are rapidly changing, but gaming in particular seems to quickly get labeled as an addiction because of the many techniques and facets implemented to get players hooked. Esports Heaven went on a journey to ReSTART–a gaming addiction treatment center with their headquarters located in Bellevue Washington–to discover if gaming addiction was a real problem. Armed with a healthy dose of skepticism given our background in gaming, but a willingness to be open-minded, we hoped to understand the difference between gaming addiction and any other addiction. We also wanted to get some answers about gaming industry practices and the possible ways companies push to get users addicted. Founded in 2009 with facilities in the cities of Monroe, Fall City, and Carnation, ReSTART claims to be the first internet gaming addiction center in the United States. We approached ReSTART with the simple but fundamental question: what is gaming addiction? Dr. Hilarie Cash — co-founder of ReSTART and author of several books and cited by thousands of research papers — responded with, “gaming addiction means that the gamer has lost control over their gaming. They have been making gaming a priority over everything else and as a result of that, there are negative consequences but in spite of the negative consequences because they’ve lost control, they keep gaming”.

(ReSTART Serenity Mountain Campus)

B.F Skinner, the famous psychologist whose research is world renown in progressing the field of psychology and behavioral science noted that he could get rats to do specific behaviors (research paper) such as tapping a specific part of a box apparatus to receive food. He observed that the behavior of the rat changes in accordance with how that behavior successfully produces a reward. This is known as operant conditioning. He also made the discovery that randomizing rewards is better than guaranteeing a reward through a given action. Little did Skinner know that companies would use this same discovery to help their products become more addictive; in no shock to anyone, gaming companies are using these same discoveries to enthrall their audience via random number generators (RNG) and reward mechanisms. League of Legends (LoL)–the popular Multiplayer Online Battle Arena by Riot Games–introduced Hextech Crafting in 2016. This feature allows players to gain components for crafting loot boxes via playing the game and accomplishing missions or milestones. The player can also opt to shortcut this system by paying a monetary sum to purchase loot boxes and keys to unlock these boxes. There have been several studies on loot boxes and the addictive gambling nature they pose, using psychological techniques such as the sunken cost fallacy. This fallacy takes into consideration that the user has a certain amount of time or money invested in a situation, so therefore should invest more because otherwise the entirety of time or money invested would be deemed a waste. In LoL users will often find they have more loot boxes than keys (or vice versa), with the boxes containing rare skin cosmetics for your characters This instills a fear of missing out (FOMO), so the player purchases more of the missing items needed to unlock extra features. Hextech Crafting has prompted large concerns, with even the Chinese government forcing Riot Games to disclose their loot box odds. Additionally, in December of 2022 Epic Games (the creators of Fortnite) agreed to pay $520 million with pressure from the US government’s Federal Trade Commission for violating the Children’s Online Privacy Protection Act, in which Epic Games collected personal information from children under 13 years of age. “Loot boxes are gambling. There’s absolutely no question about it because the mechanics of it are, you’ve paid for the chance to open the loot box. You’re paying something of value on the chance you will acquire something of even greater value. That’s gambling” says Dr. Hilarie Cash in response to the prevalence of loot boxes in video games. Current games often now have several gambling elements in them, and for most players it’s not a problem, but for some it’s life-ruining.

(ReSTART Bellevue Campus)

We spoke with one patient at ReSTART, age 25, who chose to remain anonymous, and he discussed with us his gaming addiction and where it led him. “I was basically stuck with constant negativity and depression and I was using games and YouTube to escape. It got so bad to the point that I was living in my car because I couldn’t pay rent”. When asked how much he spent on gaming his response was, “I would consider myself a whale, especially with mobile games and loot boxes. I spent an exorbitant amount of money, like over $45,000”. Although he is still on the path to recovery, he did find it hard to connect with friends that are still entrenched in gaming. The function of gaming could be thought of as a conduit for people connecting and developing friendships, which may lead to greater fulfillment in life overall, but there is a concern when it becomes a necessary vector to maintain friendships. We spoke with another patient who chose to remain anonymous saying, “the only connection I had with my friends was through video games. Anytime we would talk it would be about video games. I think that’s kind of sad, that the only reason why some people have friendships is because it’s being held together by a video game”. In an article published by The American Survey Center in June of 2021, they found that 12% of Americans reported they had no close friends, compared to only 3% in 1990. There is a large crisis of loneliness in America and around the western world, and it may very well be that gaming and social media are here to help replace meaningful friendships. Whether it be through a lack of meaningful friendships, or a struggle to start them, according to Dr. Cash, there is a stark difference in substance addiction versus gaming addiction inhibiting social development.

(Image credit: American Survey Center)

“If you’re a drug addict, or an alcoholic, and you’re a teenager, what do you have to do to go get your drugs? Your parents aren’t handing it to you, so you have to develop some street smarts, you have to develop some social skills to talk someone into buying the alcohol (or drugs) for you". Lindsey Hammerly, MA graduate of Bastyr University and mental health therapist at ReSTART spoke about how their female clients struggle to make romantic relationships with others, citing that, “especially with female clients, they’re saying they don’t know how to start relationships outside of tech. One of them was saying to me recently that it was weird to start a conversation, and it was normal to start a relationship by following each other on Instagram. I hear that a lot, that it’s the norm to build relationships online”.

(ReSTART Fall City Campus)

The overall statistics of gaming skew more towards males, especially when considering a hardcore demographic such as esports, and that may help us pinpoint why men so heavily turn towards gaming as a bonding apparatus. In a recent article from The Guardian by Max Dickens, he describes how men have a problem retaining friendships. Takeaways from the famous anthropologist Dr. Robin Dunbar was, “the contrasting male and female social style is often characterized as ‘face-to-face’ versus ‘side-by-side’. Women tend to socialize face-to-face with a strong preference for one-to-one interactions, based around talk and intense emotional disclosure. Men, however, tend to socialize side-by-side, preferring to hang out in groups, where intimacy is demonstrated by doing stuff together”. This may have been one of the reasons for the creation of Men’s Shed, a movement around the entire world where elderly men can get together and build things while also talking about their problems. When speaking with head of academics Chris Robinson of ReSTART, this looks to be one of the core principles he uses when trying to rehabilitate his clients. “We do a lot of talking, the boys are in groups about 3-5 times a day and there’s a lot of talking that goes on, but it’s coupled with doing [stuff]. It’s not unusual for one of the boys to meet with a therapist while they’re walking, shooting basketball, doing archery or in the swimming pool. This idea of ‘doing’ seems to aid in the thought process that these boys need to realize the things that are going on in their life”, Chris Robinson told us. While all of these situations point towards some gamers having a problem with controlling their habit, what happens when it’s their career? Esports players are often known to play for 10-12 hours a day, and when asking Dr. Cash the approximate hours it takes to be considered addicted, she said, “[If] they’re treating it as an 8 hour day job and the next 16 hours are going to be spent exercising, eating well, socializing, sleeping, then that’s fine. This is just hearsay but from what I’ve heard, that’s not my impression. My impression is that most esports players are not living well-rounded lives”. The idea that some jobs such as being a lawyer require long hours is not rebuked and often is a go-to challenge when comparing esports to regular jobs; how do you make the distinction between a demanding profession being healthy and an esports player having an addiction? Dr Cash responded, “I would say that this lawyer is not living a well-rounded and healthy balanced life! That lawyer is probably a workaholic”.

(ReSTART Bellevue Music Room)

It’s been no secret that having a healthy work-life balance isn’t easy, especially when considering hobbies such as gaming. With companies trying to make their products as addictive as possible, they have created rewards and goals which mimic gambling companies manufacturing near-miss situations for jackpots, to having endless quests and objectives which researchers revealed were effective in proxy by the Bottomless Bowl Study; but are consumers to blame because of a highly addictive substance? The fight against addiction is often a fight against both an inability to regulate one’s own compulsions, but also fighting against the conditioning of large conglomerates. These figures hold a great deal of power through the process of addictive and deceptive practices. When asked about how Dr. Cash felt about behavioral scientists and psychologists being employed at gaming companies to make their products more addictive, she responded with, “it is really unethical to be helping them design highly addictive content”. Many states require a license to open a practice as a psychologist, but a license is not required if it isn’t in relation to therapy. Many psychologists have urged the American Psychological Association to take action against those working for companies to make their products more addictive. Dr. Richard Freed, clinical psychologist with a postdoctoral fellowship at Harvard Medical School, “co-led a national campaign encouraging the APA to condemn the unethical practice of psychologists employing persuasive design in consumer technologies used by kids”. He received hundreds of signatures from psychologists around the US, yet the APA still didn’t address his concerns. The growing state of alarm for video game addiction is a never-ending crescendo from the public media. While Esports Heaven weren’t entirely convinced gaming addiction was an epidemic, the torment some players face when playing an intentionally addictive game was not lost on us. The shackles in which gaming companies have placed upon players looks to be obscured under the guise of the lack of self-control from the end user. Just as the renowned psychologist Bruce Alexander pointed out with his experiment named “Rat Park”, rats chose socialization as opposed to drinking heroin-laced water when offered the choice instead of being locked in a cage isolated from others. Maybe it’s not so much the player’s fault but rather it’s their environment.

---

Izento has been a writer in esports since 2017. Follow him on Twitter at @ggIzento for more esports content.