[Writer and researcher Neils Clark has previously covered the state of addiction in games for Gamasutra in a number of key articles, and returns to look at whether design can influence healthy play, and what his MMO analysis has to say on the phenomenon.]

Here we go again -- "the A-bomb". To just come out and say it, this article didn't go as planned. Originally, it was going to be a showcase of some different game developers speaking candidly about addiction -- most especially the subtleties that get missed by the popular press. Some devs bit, but not many.

This got the gears turning. Are we in an environment where anything you say can and will be used against you in a court of public opinion? Games have, after all, weathered a long history of emotional and anecdotal attacks.

This article looks at serious questions: where should game makers sit in discussions over game addictions, can design influence healthy play, and is silence still golden in 2008?

Word on the Street

"I'm not a crack dealer in real life," says Michael Wilson, CEO of There.com.

This is a sentiment that most game developers start with. It's the most obvious. So much artwork, sound design, programming and game design goes into the process that it doesn't add up for most developers when that gets equated to mixing chemicals in the basement.

It's a sentiment mirrored by Ernest Adams, who wrote an article for this site way back in 2002 on the topic -- "Stop Calling Games Addictive!" His article is still one of the most recognizable developer-written soapboxes on what's still being called addiction. By and large he stands alone as one of the few developers to offer an opinion, at the very least warning that a word used in the wrong context helps the industry dig its own hole.

The public opinions among developers run the gamut. Some talk about unleashed gamers with a tinge of jealousy in their voice -- "The biggest problem in your life is that you get to play games all day? Poor you." Others view it with an air of caution, saying that addiction is, "Bad for business, and the industry knows it."

Last year's GDC sponsored two roundtable events to discuss gaming addiction, with results that were anything but conclusive. Early on, game addiction was compared to excessive book reading. Some developers raised the time-honored D&D defense; that attacks against gaming hearken back to the days when Dungeons & Dragons was pelted with accuasations.

We'll get back to that. The most interesting voice in the roundtable was a programmer from Blizzard Entertainment, who discussed some of the company's design discussions prior to the Burning Crusade expansion for World of Warcraft.

He said that they wanted to distinguish between gameplay elements that might encourage all players to go overboard, versus those that caused problems for a select few. The idea was to keep the pieces that make the game enjoyable for everybody, but make sure that everyone's enjoyment wasn't punctuated by a design that required too much maintenance.

They didn't want to go overboard with changes, for obvious reasons, but the issue was on their radar. Other developers could do worse than to emulate Blizzard. The roundtable talk was cut off at the hour-long time limit, which was a shame because everyone in the room was rapt.

These are the kinds of exchanges that are seen all too rarely. While some onlookers might characterize silent developers as callous, too many subtleties get missed by the popular press and your average non-gamer.

Wilson brought up the TV show Friends, though any TV, book or radio show would work for this example. We form relationships with the people in these different reveries; we get excited for our favorite characters, disgusted when they make nice with our least favorite characters and shocked when any kind of tragedy befalls them.

In wholly new ways, games open up the playing field for these fictitious relationships. Beyond the gameplay, the stunning graphics or anything else, we're a main character. Sometimes we're even playing shoulder-to-shoulder with other main characters; social worlds can take interaction and kick it up a notch.

"The thing about social worlds, there's nothing to do," says Wilson. "We make things to do." And developers do. Oh, how boring the either a real or digital world would be without games.

It's clear when someone jump from consoles, or a MMO game with clearly laid-out goals -- to something like Wilson's There.com, or Linden Labs' Second Life. Until someone gets wrapped up in some player-made distraction, there's really nothing to do.

Players go for the sense of space; now more than ever, games are transforming into something more than just chess. Beyond the effort that goes into creating a game, or any other subtlety, games are creating something new.

People who want to somehow regulate away video games tend not to have even a vague idea of what a game is. "Is it even up to society to decide that someone can't play?" asks game designer Nathan Franklin.

Questions on regulation and choice are legitimate no matter how you slice it, but especially once a game creates a new kind of social space. Developers have a vast range of opinions on game addiction, or what sometimes gets bandied as game addiction.

There are serious reasons that we haven't heard the bulk of these thoughts, not the least of which being that in the current atmosphere, most shouldn't see the light of day. A number of people reading this article are salivating at the thought of having something that they can use against the industry.

A Noble Feud?

Games make a magnificent target. It doesn't have to be addiction, violence, or any one thing. Games have taken ridiculous hits at least since Dungeons & Dragons. In 1989, after having lived through a lot of that flak, Gary Gygax wrote words that still ring true.

"Oddly enough, we don't seem to have progressed far beyond the Salem witch-hunt stage, 'Thar's demons in them-thar games!' cry the fanatical opponents of RPGs... How can anyone alive today retain such quaint superstitions? But once you're on the receiving end of their hysterical attacks and the target of the propaganda they dish out, those notions won't seem either quaint or democratic."

Gygax's notion, so well put in his book Master of the Game, still seems branded into the minds of gamers and developers. Are the developer haters and player haters all dark-hearted cretins, or are their attacks a viable occupational hazard of working with technology and art?

Comics, D&D and pretty much all new popular music styles have been washed in battles between the innovation of the pioneers and the doubts of the collective; the war itself goes beyond the staples of nerd culture, popular culture and even our millennium. Art and media have always had their critics.

Figureheads of western philosophy have joined in to float their criticisms, many making valid points. Socrates, in Plato's Phaedrus, criticizes writing as a technology which displaces memory. Even this Gamasutra article, by Socrates' argument, merely appears to discuss the topic of game addiction. This article cannot speak, answer questions, or defend itself. Conversation was Socrates' weapon of choice; he felt it far better a tool, in that the author of the written work can share a true knowledge of their tangible learning.

Games have already weathered their share of criticisms. Raph Koster makes a magnificent argument against game violence being patently wrong and evil. Though there's an ethical question in presenting any kind of image in any kind of art, players do often see power ups rather than hookers that can be run over. Or bunnies to be saved.

They're meeting game goals, and the icing over the top tends to be secondary. Jerald Block has also done great work at pointing out some of the flaws that have been carried on by game violence researchers thus far. He shows that though pundits, politicians, and researchers will go back and forth on the violence issue, the link between games and violence is tenuous, if only for the time being.

There's no real pussyfooting around uncontrolled gaming, because many nasty anecdotes can be tied directly to video games. Video games may not have been the cause of the problems, but presenting a balanced case isn't a journalist's first concern with a breaking story. It's definitely not a politician's concern when fishing for support.

The man who died of 86 straight hours in a Korean PC-room was autopsied after all of the sensational press reporting; what the news media failed to come back and tell us was how he died. It was deep vein thrombosis (DVT), the disease made famous by Dick Cheney. At twenty-five, this man had died of a disease normally reserved for genetically-inclined forty-plus-year-olds.

Other incidences have been found in longtime gamers, without any family history of the disease, for whom too much sitting was most likely causing premature DVT. Sitting isn't unique to gaming in this day and age, and some of the people surveyed worked desk jobs, but this example stands out as a reason to seriously examine the health of the player.

And the programmer, for that matter. These issues shouldn't be taken with a grain of salt. If gaming is impacting health in negative ways, then shouldn't notions of what constitutes "good game design" change with it?

But conducting balanced research on game issues is like trying to swim up Niagara Falls. So far, too many have taken the approach of blaming someone -- rather than trying to understand why some players can't control themselves. Make no mistake, there's a feud a'goin on.

There are people who want to dismantle the gaming industry, without giving games a second thought. It's called misoneism -- an unquantifiable yet undeniable fear of the new. We humans are built to protect the hive against something foreign. When games don't get an unconditional clean bill of health, and especially when presidential candidates blast video games as dangerous, the collective is in danger of turning into a wolf pack.

The people pelting games tend to misinterpret what a game is, because they're distanced from its structure yet close to the problems games are perceived to create. A lot of people hate Liz Wooley, a woman who has crusaded against the games industry because her son committed suicide while playing EverQuest. Outright hatred of somebody in her position seems amiss. Nobody has to like emotional and anecdotal approaches to the problem, especially when backed up by emotional and anecdotal evidence.

The mob responds readily to these stimuli. Most people out there aren't developers, gamers or researchers. They aren't interested in grasping a game's richness, but they can imagine being in Wooley's shoes. If regular people don't dismiss such critics, the industry can't afford to either.

"Never argue with such individuals, but feel confident to debate in public forum with them," wrote Gygax. "The weight of medical evidence and scientific fact are the best ammunition to use."

That's good advice, but whose evidence are we going to use? Most of the books on gaming issues are punctuated by doom and gloom, and at least two more such books are forthcoming this year. Even great scholars are strong-armed by popular medical journals to use the phrase "Internet Addiction" (IA) when referring to heavy game use. This is despite serious and ongoing concerns over many different elements of IA's validity.

The researchers themselves too often seem distanced from any real understanding of gaming, creating data that serves to label gamers, misrepresent games and further mislead the public. Worst of all, some gamers clearly have problems. Until we explore this topic cogently, we're not in a position to help them.

We can't say with any measure of certainty whether the games are at fault, which makes the emotional attacks all the more frustrating. The critics of gaming often have few qualms about leaning on adrift research, which leaves the industry in an awkward position.

Meanwhile, the issues raised by excessive gaming appear very real in the eyes of the South Korean, Chinese and Singaporean governments, whether or not the analysts at the helm have an adequate understanding of gaming. Korea currently treats "Internet Addiction" (again, games inclusive) as one of its chief public health concerns. South Korea has poured money into the research, and as a result they've gone past the pigeonholed Western gauges for IA.

The government then used that gauge of IA, which was renamed the K-Scale, in order to assess what it sees as a pandemic. Whether or not these governments see the legitimacy in gaming, the primary concern is public health. And that's sensible. Good health is part of good entertainment. The two compliment each other.

Just as too many governments, researchers and regular folks seem distanced from games, developers seem to sometimes distance themselves from a game's potential for causing problems.

If certain parts of a game can take a gamer in good mental and physical health, and make them crave game time to the point that they could sacrifice real-world health and wealth, then do those elements constitute a design flaw? One designer remarked that in large development houses, part of the focus is to consider how a game influences positive play.

These developers aren't thinking in terms of just addiction or violence, but rather the overall quality and brand. In smaller houses, however, there can often be chaos as less experienced teams simply rush to release a product. If certain teams have functional insight into gamer health, then maybe it's high time we heard from them.

In my own research into how MMO games might influence addiction, which you can read about on this site, players who preferred goal-oriented groups, or "hardcore raid guilds" were statistically more likely to sacrifice things like food, sleep and other real-world necessities (in regression analysis -- which isolated those guilds from other game elements that might have otherwise contributed).

Rather than Internet Addiction's eight-question-survey (originally, you only had to "think about games" while not playing in order to be addicted), a 29-item questionnaire was used. Though that data had limitations, it's probably worth following up. If certain pieces of certain games do take "the perfect game" and turn it into "the perfect storm", then designers might consider some light conversation on the topic of creating a critical language, something that we can use for discussing how to better balance games with reality.

That language becomes another tool in the belt of the man or woman who yearns to create fulfilling entertainment. If research shows that there really are no problems in today's games, then that becomes an equally invaluable tool. Any way you cut it, learning more about the relationship between healthy play and design seems to have few pitfalls.

Ernest Adams wrote that, "It's almost impossible to make a game addictive on purpose." He suggests that most people who try are wasting their time, "It's a bit like the Tao: those who set out to look for it are guaranteed not to find it." Good game designers tend to come upon great designs just like any other artist.

They don't know where the magic comes from, and digging up the design factory in order to find out isn't exactly their priority. Would using design tools to prevent excess play be just as cataclysmic to game design as working towards it? Or, could a deep design discussion add more magic to the designer's secret lair?

On the one hand, maybe all this talk of Internet Addiction and gaming addiction will just blow over. On the other, what happens if a presidential candidate gets draconian on video games? What if they propose to regulate games in ways that fundamentally limit what the designer can do?

It seems bad for players either way. If the issue blows over, then there won't be any pressure to have a serious discussion on designing for health. If something gets the angry mob on overkill, then our discussions are going to be about designing around federal mandates, something already required for Chinese designers and localization teams.

Right now, the industry is kind of waving in the wind, like a cocktail napkin before a hurricane. We can treat this issue with our usual curiosity and creativity, or operate on the flipside of our biggest opponents: well-versed in the games, but with no clue of how the problems function.

Games aren't drugs, nor are they a horrendous new weapon. They are a new technology, however, one with thrilling subtleties. What we can't forget is that humans have good reason to be skeptical about new technologies -- at least until they feel convinced that there's no danger.

The USA still relies on coal power, despite the nuclear plants that dot its countryside. We're built to question new technologies, meaning that it's completely valid for consumers to want answers. They want to know that developers aren't just programming hooker-kill-zones, but rather vivid new social spaces, engaging game systems and a form of art that allows pure experience.

Through history, the artist hasn't had to explain his or her work, nor understand how it affects physiology. That's a view that the industry can take, though in some ways gaming goes beyond art. It's not a view that can hold up with respect to the longstanding feud between innovation and caution.

Playing two days straight tends not to be fun; equally un-fun is being abruptly disconnected after you've played your daily allotment of X, Y or Z hours. While the collective can't do much about the people making nuclear weapons, harvesting killer viruses or filming Saturday-night sci-fi movies, it can influence the ways in which people use video games.

Game dependency, whatever might invite it to spring up, is most certainly a textured and subtle effect. It's influenced by social, economic, psychological and other rich dynamics. Games are a subtle new place to interact, but regular people won't care about that. If they get a bad gut feeling, then most move on.

If a game bites them, then they bite back. It's natural, and the voices of the bitten are drowning out the voices of the artists, programmers and publishers who work hard to make games.

In the face of this feud, noble or not, there are people who would take a critical design discussion out of context.

Rally

The forces that be make certain pieces of this topic near-impossible to discuss publicly, but it's an issue that deserves refinement. Between developers, addiction isn't a breathlessly exciting or fun topic -- but it's one that can come up. If that happens in good company, then don't parry or force it away.

Let the conversation flow, just like any other. If you get the thumbs up from your personal subconscious, then see where the conversation takes you. Yammering opinions to the press can sometimes hurt the industry, but that's not what we're talking about here. We're talking about putting the player's health first, attacking addiction with creativity and keeping distance from the fanatics. At least until more reliable research can hit the scene.

The industry understands the games, yes, but we're no better than game-hating fanatics when we scoff at understanding the problems that may be caused by games. If you have thoughts that you think could help to shape these conversations, you can voice your thoughts in the comments below.

If the game industry is going to be sustainable, and if games are going to live long enough to meet their potential as a form, then society has to understand the health issues in gaming. They need to be responsible, but so do we.

Facing the issues may be as simple as showing that games aren't the cause, but it's our level of concern that's more likely to win the heart of the mob. Yes, regular folks need to educate themselves; gamers, parents of gamers and game developers also need to educate themselves.

No, the quality of the information in 2008, especially how it's presented, is not perfect. What can we do about that? As we can understand ways to separate problem gaming and amazing gaming, like wheat from the chaff, certain developers might play a serious role in encouraging more responsible play and design. Over anything else, whether we win or lose will depend on how we play the game. The actions of developers and their players will speak loudest.

Game developers aren't crack dealers. The people who make games are giving us something to do, and they're good at what they do. While there are serious considerations to weighing in on addiction, sooner or later the industry will want to engage critics in dialogue.

If the research can't pony up and provide reliable information, then it won't hurt to have discussed health issues freely and openly among colleagues. Some kind of language for discussing excess-balance might be a byproduct of those conversations, but it's a distinct possibility that there wasn't much to talk about in the first place. What are the truths and fictions behind the anecdotes?

It's high time someone figured that out.