Monthly Archives: June 2018

Push For “Gaming Disorder” to be an Official Diagnosis

Through the sheer coincidence of getting new furniture & thus having nowhere else to sit in the house but at the dinning room table, I had a rare viewing of CNN last night just in time to see a bit about the World Health Organization (WHO) drafting the definition of “Gaming Disorder” to be included in upcoming 11th edition of the International Classification of Diseases (ICD-11).

According to Dr. Vladimir Poznyak, the representative from WHO’s  Department of Mental Health & Substance Abuse, there are three key diagnostic features of Gaming Disorder:

  1. “Gaming behavior takes precedence over other activities to the extent that other activities are taken to the periphery.”
  2. “Impaired control of these behaviors.”
  3. “The condition leads to significant distress and impairment in personal, family, social, educational or occupational functioning.”

The gist of the “disorder” is that the person in question chooses gaming over all other activities, including those that are necessary for their well-being, such as proper personal care & family/career/educational responsibilities.  And even though the person knows there’s a problem, they not only continue to engage in the problematic habits, but actively seek ways to streamline their lives further to devote even more time to gaming.

Regardless of my feelings both professionally as a psychologist or personally as a gamer, I will applaud WHO on their intent.  Rather than looking toward studies that try to blame social ills on gaming, they’re more concerned with the overall health of the individual.  They’re not saying video games shouldn’t exist or even dictate what should be allowed in the games, but rather pushing for a healthy balance, which is not an unreasonable goal.  Dr. Poznyak made a point of stating in the article that, even among avid gamers, it’s actually rare for their hobby to reach the stage where it’s dangerous.  According to the CNN article, the goal of the Department of Mental Health & Substance Abuse is:

That the classification of gaming disorder means health professionals and systems will be more “alerted to the existence of this condition” while boosting the possibility that “people who suffer from these conditions can get appropriate help.”

For those of you lucky enough to never have to deal with the insurance, the ICD-9 (current version) is what most insurance companies look to when deciding what they will & won’t pay for.  Unless you have an officially recognized diagnosis & are following one of the agreed up treatments for said condition, insurance won’t pay.  It’s only recently that insurance will even pay for regular psychological therapy or substance abuse treatment.  If you really want them to pay for people to receive treatment for “gaming disorder” it needs to be a medical diagnosis.  So from that perspective, I appreciate what WHO is trying to do.

And, if we’re being honest, we could all probably point to stories that illustrate gaming gone too far.  I’ve read news articles where someone’s gaming caused real problems for them, either because they were so fanatically devoted that their health & finances deteriorated, or a child was neglected, or even lashing out at others in real life.  I’m sure most of us, if we knew these people, would say, “Dude, you need help.”

However, some psychologists are hesitant about grouping this as a medical diagnosis.  The consensus among this group isn’t that there aren’t people who need help with their overwhelming habit, but that the gaming itself isn’t the problem.  Rather, it’s a symptom of another problem.  According to Dr. Anthony Bean, a clinical psychologist who’s a bit of an expert on working with gamers (including having written a book on the subject that I’m eager to read), problematic gaming is actually a coping mechanism to deal with anxiety & depression.  It’s an escape from other problems, & as the problems aren’t addressed, the person loses themselves in their games.  For anyone familiar with substance abuse, this shouldn’t come as a surprise.  People rarely become substance abusers just for the hell of it.  Often, it occurs comorbidly with other issues.  Treating the underlying cause is crucial for real recovery.

I’d also argue that, on a fundamental level, I don’t agree with calling it an addiction.  People throw around the term “addiction” without really understanding medically what it means.  Without going into too much jargon, “addiction” is when you’ve altered your brain structure by the repeated use of some substance to the point that your body cannot function properly without it + generally requires an increasing dosage of said substance to maintain equilibrium + if you stop you’ll experience withdrawal symptoms, & thus you continue to engage in behaviors to seek out said substance.  As an easy example, when you drink alcohol, you’re chemically altering your brain, & if you do it enough you can permanently change its very structure so that you can’t function without it in your system.  (For the record, WHO uses “dependence” instead of “addiction” but means the same process.)

Now, with that knowledge in mind, do you think you can become “addicted” to gaming?  Does gaming physiologically alter you?  It’s hard to say.  Certainly gaming stimulates the pleasure centers of you mind, as does anything you do that gives you joy.  But can enough of it actually come to mean your body will stop producing endorphins (the chemicals in your brain that make you feel good) without games?  Would you go through actual withdrawal symptoms without it?  Even accepting terms like gambling addiction, I find it’s a hard sell.

Furthermore, who’s to decide what’s “problematic”?  Gaming is one of my biggest hobbies, & I can honestly say in a lot of cases I’d rather stay home & play video games than socialize with people.  My mom certainly questions why I prefer to play games versus anything else.  Would she say I have a disorder?

In the end, I agree with Dr. Bean that it’s a slippery slope, regardless of intent.  Why stop just at gaming?  Maybe I think it’s a disorder to pay thousands of dollars every year on sports tickets.  It’s certainly a disorder when you get so mad your team lost (or so happy they won?) that you start a riot.  By the WHO’s own logic, anything can be a disorder.  And that’s not a road I want to go down, because then everything will be a problem.


WHO classifies ‘gaming disorder’ as mental health condition“, CNN

Addictions“, American Psychological Association

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Breathing New Life into the Land of the Dead in Grim Fandango Remastered

It’s hard to believe that, with all the accolades, Grim Fandango is the first Tim Schafer game I’ve ever played.  Known for his quirky style & underrated yet highly acclaimed games, they’ve frequently been on my radar yet I’ve never gotten around to playing them.  I even have a few in my Steam library.  So what was my experience with the remastered version of one of his earlier games, Grim Fandango?


 Set in the Aztec afterlife, you take the role of Manuel Calavera, a skeleton who is less the Grim Reaper (despite his get-up) & more a travel agent.  After dying, every person must travel through the afterlife to the gates of judgement, though how long this takes depends on the life they lived.  A just soul can earn a ticket on a luxury bullet train to reach the gates and their eternal reward, while someone who wasn’t so good may have to walk the four-year journey.  Eager to pay off his time for whatever he did in his life, Manny scoops up a saintly client, but in doing so uncovers a criminal plot to rob souls of their just rewards.

Grim Fandango is an old-school LucasArts adventure game, & as such follows the expected conventions.  Though in the remastered version you can choose point-&-click controls, I believe tank controls are also available.  As with all adventure games, most of the gameplay revolves around finding the correct item to overcome an obstacle, though there are a few that rely on timing as well.

As I never played the original version, I can’t compare it to the remastered version to the original.

20180512165508_1Narrative: Tim Schafer has a reputation for interesting stories, & Grim Fandango did not disappoint.  I found one of the greatest strengths of the game to be its characters &, in particular, its world.  For the land of the dead, it’s certainly a lively place.  I don’t know how much is based on Aztec myth, but it’s an interesting interpretation.  It’s good at playing with expectations, & knowing how not to always take itself so seriously despite some of the themes.  The first time we see Manny, he’s decked out in full grim reaper attire, complete with robe & sickle.  But the sickle is less for killing people & more for cutting them out of their odd death cocoons.  Death is a salesman, & our lives are just files & reward points.  Get enough good deeds on your life card & you can earn a sweet ride to whatever awaits on the other side of death… which actually isn’t explained.

I really love the characters in this game.  Their personalities are just so distinct.  Even the bad guys are fun to listen to, especially with some of the dialogue choices.  Manny is a very enjoyable protagonist.  He’s a generally nice guy, but flawed, making him relatable.  He’s a little selfish, & I got the impression in his life he was probably a smooth-talking conman.  But he’s not so bad to make him unlikable, & it’s nice to see him progress from being selfishly motivated to trying to do what’s best for all the people he’s come to know during his journey.  After all, that’s supposed to be the point of the journey the souls take.  A time of reflection.  It’s a nice way to tie in the theme of the word Schafer built while also giving the player a better goal than some nebulous endgame.  Characters are defined by their actions, & that’s well on display on Grim Fandango.  Manny is a character of action.  He doesn’t sit around & complain, but is always looking for the next thing to do.  He felt like an active participant in the story, rather than just someone things happen to.

A large part of this enjoyment comes from all the characters’ quick wits & playing off each other, which couldn’t be done without some excellent writing.  The writing in the game is very strong, & fun to mess around with.  I got a real kick in the Second Year choosing random lines of poetry to read at a dive bar & listening to the deadbeats hiss me off the stage.  It’s nice to see a game embrace its setting & remember that videogames are supposed to be fun.

That being said, however, I did have a few problems with the story.  I think it mostly comes down to structure.  The levels are set up as four separate years.  Each level ends with you helping Manny find a way to overcome whatever obstacle is preventing him from moving on to the next stage.  The first year ends with Manny reaching Rubacava & getting a job as a janitor while waiting for Meche, the saint, the second year ends with him finding a boat to go after Meche, and the third ends with them breaking out of some weird prison.  These divisions in themselves aren’t a problem, but more the fact that the game doesn’t pick up again until a year later, leaving a jarring sense of change.  While I didn’t find this a problem for the changes to the world, as those are pretty well fleshed-out, some of the changes between characters felt a bit much.  Yeah, I would expect certain changes after traveling together for a year, but it would be nice to see the build-up.  I think my problem was mostly with the romance between Manny & Meche.  Sure, I expected it, in the same way I expect the sun to come up every morning, & it makes sense, but it’s just like suddenly they’re in love.  I could understand how on Manny’s side his desire to find Meche to get his job back could become this odd pining, but when they do meet again Meche hates him, then she realizes she was wrong & suddenly loves him?  Again, traveling for a year together can do that, but it would’ve been nice to see it.

I also would’ve liked the main bad guy to actually have a presence in the game outside the final level.  He’s talked up through the entire game like I ought to know him, but before the big confrontation he’s only shown in one cutscene, leaving him feeling a bit weak.  There’s also a betrayal at one point that seems out of left-field.  Again, I feel like this comes down to the way the story is structured.

Overall, despite some flaws from the jumpcut-style of storytelling, Grim Fandango is a fun story with memorable, enjoyable characters.

Score: 4


Mechanics: I really need to space out my adventure games, because I’m running out of ways to describe point-&-click gameplay.  You find various definitions of keys to unlock various definitions of doors to progress.  That being said, especially for an older LucasArts adventure game, which could be notoriously thick, the puzzles generally make sense.  Gap + ladder on opposite side + convenient rope?  I need something to tie to the rope to make a grapple.  What do I do with this random rag I found?  Well, there’s a barrel of oil outside & a toaster.  Need to make a sailor disappear?  I bet I can drug him.  For the most part, if you don’t currently have the solution, it just means you haven’t explored or interacted with everything yet.

That being said, there were a few puzzles that rubbed me the wrong way.  A few have to do with timing, which can be difficult without the finicky controls (more on that later).  There was also one puzzle I had to look up, & even after knowing the solution I still didn’t understand how I was supposed to come to that conclusion based on the information the game presented.

Going back to the controls, I believe you can use both point-&-click & the old-fashioned tank controls, but both have their problems.  I appreciate having a run function, but sometimes the game is very picky about where you click to activate an item.  This did lead to some frustration when I thought my solution was wrong, only to find out I just wasn’t clicking the right part of the object.  The clearest example I can recall is when I was trying to get Manny inside an empty wine keg to sneak into the wine cellar.  I’d already cut a hole in the top & was getting frustrated that Manny kept refusing to get in.  Turned out I couldn’t just select the barrel.  I had to select the top of the barrel specifically.  There was another moment immediately after that involved trying to precisely navigate a forklift with point-&-click, & getting annoyed when clicking too far would take me to the next room.

The inventory is also a little hit-&-miss.  I really liked that the inventory is basically Manny pulling stuff out of his coat, even zooming in to show him cycling through all the crap in his pockets.  But again this can be finicky, as sometimes you must have an item in your hand to get the correct dialogue options to progress.  And I kept forgetting that sometimes you have to select the icon that appears to use the item in your hand instead of it automatically activating when you select what you want to us it on.  Consistency would be nice.

Also, for a remaster, it had a lot of glitches.  Character animations frequently freaked out, making them vibrate in place during conversations.  At one point I thought I would have to Ctlr-Atl-Del to close the game because Glottis got stuck turning to talk to me very, very slowly.  Eventually he got there & the dialogue picked up as normal, but it took him walking a centimeter at a time.  The game also crashed several times on me.  While this was mostly a minor annoyance, as I learned to save frequently & the game loads up quick, I expect better of a remaster.  It seemed to mostly happen if I interrupted Manny interacting with something to go in his inventory.

While in many respects Grim Fandango avoids a lot of pitfalls of older adventure games, the controls are too finicky for what it’s asking gamers to do at times, & it doesn’t run as smoothly as a remastered title should.

Score: 3

20180514190843_1Aesthetics: Despite being uprezzed for its updated release, Grim Fandango’s graphics can’t quite compete with modern games.  That being said, I still enjoyed them.  The game has a unique style that fits with its quirky atmosphere.  The designs are simple, clean & unique.  You’d think making skeletons distinctive would be difficult, but they really manage to make them feel alive.  Every character is easily recognizable.  I especially like that Manny is actually a bit short, & has to wear stilts when he’s in his intimidating Grim Reaper get-up.  In comparison to the characters, the backgrounds do look a little fuzzy, but each area is still unique & distinct.

Sound design is also very fitting.  As with the models, the voices are all distinctive & give real characters to the characters.  I actually spent half the game trying to figure out where I’ve heard Manny’s voice from.  Sadly, even after looking up the actor’s IMDB page, I still can’t tell where I’ve heard it from.  Regardless, he’s good.  And the music, while minimal & mostly ambient background tracks, always fits with the scenery.  I appreciate that they made so many different tracks from all the various areas.

Score: 4

Replay Value: Average.  While technically there’s no reason to replay the game, as nothing changes, I feel like it’s definitely enjoyable enough for multiple playthroughs just to see all the interactions with characters.  Plus, all together, it’s not a long game.  My playtime was only 9 hours, & that’s not knowing what I was doing.

Score: 4



Final Score: 4

Last Word: Grim Fandango is a fun little adventure game that is well worth its cult status.  If you already own the original, I don’t think the remastered version updates anything to warrant a new purchase.  But if you missed out the first time around, it’s definitely worth a look.

– GamerDame

Title: Grim Fandango
Console: PC, OS X, PS4, Vita, Android, iOS
Rating: T
Developer: LucasArts, Double Fine
Publisher: LucusArts, Double Fine
Release Date: January 27, 2015

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