compulsion in gaming

From a therapeutic perspective, there are several angles worth exploring when clients raise issues relating to compulsion when playing what we generically call ‘computer games’.

The platform used is irrelevant, be it PC, Mac, PS5, Switch, etc. The feelings of the client are what matter first and foremost when they choose to talk about their use of gaming. It is often because they perceive a ‘problem’ relating to it.

The media will often talk of ‘gaming addiction’ but this can be profoundly unhelpful in a therapeutic context. Counsellors are not medical professionals able to diagnose anything. A counsellor should not assume all problems relating to gaming involve addiction. They do not. They should also not translate a client’s statement of “I’m addicted to it” as equating to actual addiction. “I’m addicted” can often be shorthand for a client recognising there’s a problem. One does not need to be addicted to something to experience problems in relation to it.

Gaming is, usually, a fun activity. It may alleviate anxiety and/or depression and provide useful distraction; it may also increase or introduce anxieties and distract individuals from other important aspects of their life. As with so much in life, context and personal histories need to be considered, as do current environments – at home, at work, and socially.

Gaming, as an activity, can be perceived of as being good, bad, or both at the same time. Consider the humble pencil: it can be used to write and draw, but it can also stab someone in the eye – or the telephone, which can be used to communicate and facilitate understanding and community but can also be used for spam and other nuisance calls. Tools and toys are intrinsically without conscience or meaning or even use until we apply ourselves to them.

In the first instance, the act of listening without judgement in a safe, therapeutic space is itself a hugely significant engine of change for the person being listened to who informs that they see a problem relating to their gameplay. What is explored in therapy in relation to gaming depends on where the client is in terms of insight, motivation for change, and emotional safety.

This article outlines things to consider for clients and counsellors alike in approaching the topic of gaming.

1. Compulsivity vs. Coping Mechanism

When a client labels their gaming as a compulsion, there’s often a coping aspect involved, be it around performance, self-worth, emotional regulation, or all those things. They may feel a need to pursue ever-higher scores or keep going if their score goes down, or they fail to defeat a boss at the end of a level. An intended two-hour gameplay session may go on for several hours more.

 It might be useful to explore:

• What rank or achievement means to the client emotionally (e.g., is it tied to competence, identity, self-esteem?)

• Whether perceived failure or ‘net loss’ at the end of a gaming session links to deeper emotional patterns (perfectionism, fear of failure, childhood expectations, etc.)

• How compulsivity functions for the client – is it providing a sense of control, predictability, or temporary relief from feelings, worries, or specific circumstances?

• What would the client want their time and energy to go toward if not gaming, or not gaming as much?

• Externalisation – naming the compulsion (e.g., ‘The Boss Monster’) to build awareness and separation

• Behavioural experiments – gentle ‘what if’ tests, or trial runs, like leaving gameplay at a negative rank or undefeated boss, and then writing down how it felt, mentally, emotionally, and physically

• Encouraging the client to conduct their own reading and exploration around the topics of gaming addiction, compulsivity, and (if appropriate) neurodivergent traits, sharing what they’ve learned and conclusions they have drawn in their therapeutic sessions.

2. Dissonance & Executive Function

Dissonance means a clash between two thoughts or feelings. For example, “I want to stop playing” but also “I feel like I can’t stop until I win.” That inner conflict can feel uncomfortable or stressful. Executive function refers to the brain’s control system. It helps with things like starting tasks, stopping them, switching focus, planning, or managing emotions. If it’s not working well, someone might know they want to stop doing something but still not be able to act on it.

Executive function is something neurodivergent people (such as those who are autistic or have ADHD) often struggle with, although one can experience difficulties without being neurodivergent (such as being a poor timekeeper). Those who are neurodivergent tend to experience executive function difficulties across the board, or in many aspects of their lives, when we call it executive dysfunction. The majority of people who are not neurodivergent – the term neurotypical is sometimes used for them – may experience executive function difficulty in just one aspect of their lives. For the neurodivergent individual, executive dysfunction is systemic, while for the neurotypical individual their executive function difficulty is not all-encompassing and is a singular challenge.

It follows that a person can be neurodivergent or neurotypical and have a problem with their gaming. The neurodivergent person, however, will have other challenges as well – perhaps around organisation, timekeeping, impulsivity, and compulsion. A counsellor should ask:

• Whether the client experiences their issues relating to compulsion in other areas of life (e.g., in relation to food, sleep, social interactions) – and invite exploration of these, considering the similarities and differences in feelings, triggers, approaches

• Does anything help the client to override their compulsion when gaming, even for short periods of time?

3. Somatic (Body) & Emotional Signals

Clients may be able to explore and identify a growing chain of emotional distress or frustration, ways of thinking, and physical symptoms before they reach maximum compulsion – that is, the stage at which they feel they cannot pull back and stop gaming.

What can be useful for the client in this is finding the anchor point – that specific moment of feeling they identify as being, to write colloquially, ‘when it all kicks off’ for them.  It could be, for example, a gut feeling or clenching in the jaw. Whatever it might be, it is the fork in the road for them, when they may still feel able to make a choice, sticking with the metaphor, to go left or right, rather than straight ahead.

Another way to think of it is as a ‘tell’ – a term used by some in relation to epilepsy, where many who suffer from that condition do something – always the same something – immediately prior to a seizure, that they or others recognise mean it is about to happen.

The counsellor can support the client dealing with compulsion in gaming to gain a better understanding of their own process in the following ways:

• Help them to map these sensations more precisely and track them earlier

• Explore interoception –  can they identify earlier body cues to intervene sooner?

Interoception is an unfamiliar word to many, so bears explanation. It is the sense that helps you notice what’s going on inside your body. It’s how you know you’re hungry, thirsty, tired, or need the toilet. It helps you feel things like stress or calm. If someone has difficulty with interoception, they might not realise they’re hungry until they feel faint or not notice they’re anxious until they’re completely overwhelmed.

4. Developmental Threads

Gamers will often report that playing helps them to unwind or level out. This can relate to sensory regulation, symmetry-seeking, and a need for ritual and structural stability.

It might be worth in the therapeutic space considering:

• Exploring to see if there is continuity between childhood behaviours and current patterns; some neurodivergent people carry out rituals to ‘reset’ or ‘even out’ how they are feeling

• Noticing whether certain rituals ‘fade’ over time or transform rather than disappear; ritualisation begins in early life for neurodivergent people, subject to development and change over time (as in, what works for a pre-schooler is unlikely to work for an adult)

5. Relationship Dynamics

A client may already be exploring their thoughts, feelings, and experiences in relation to gaming and compulsion with friends or family members, if those individuals are seen to be invested in their wellbeing – engaged, curious, and supportive.

Where that is presented as the case, consider the following:

• How does the client experience these conversations – do they feel supportive or pressurised and exposing?

• What is the relational dynamic around performance or self-monitoring – for example, is there something happening in the relationship between the client and the other person(s) that might influence how the client performs or behaves, especially when being observed or questioned?

• Looking at performance, does the client feel like they have to ‘prove’ they are trying hard, being good enough, or not failing in front of the other person(s)?

• When it comes to self-monitoring, does the client become more heightened in awareness of what they’re doing (or not doing) because the other person(s) is/are watching or asking questions?

It’s important to underline, these questions are not about blame but about noticing whether the client’s gaming behaviour is shaped in any way by how they feel they are being seen by others in relation to their gaming activity. Sometimes people feel pressure (spoken or unspoken) to justify themselves, or they feel ashamed when someone they care about witnesses them struggle. That dynamic can affect both the behaviour itself and how much control they feel over it.

6. Ultimately, What is the Goal?

Clients may express different goals in raising their self-perceived issues around gaming – what they may call gaming addiction, or compulsive behaviour around gaming. They often have a primary goal not of achieving abstinence – though for some people they may come to recognise that as appropriate for themselves – but rather, to be able to continue enjoying gaming and the benefits they perceive they get from it, while gaining control over when they stop, how they conduct themselves when playing, and the emotions they feel surging through them in response to losing rank.

A counsellor might want to consider exploring the following:

• The client’s values in general and in the context of gaming, and how they might separate those from the symbol of ranking or boss-beating. This can open space to feel accomplished without needing to end each session as they started or higher in terms of rank, or having beaten the boss at the end of a level

• The introduction of self-regulation checkpoints – body check (“Am I thirsty/hungry/needing the toilet?”); mood check (“Am I finding this fun, or frustrating, am I getting angry?”) – and exit points (e.g., “If I’ve lost three times in a row, I pause – not necessarily quit, just pause – and go do something else for a while.”)

• Building tolerance of the feelings that come with loss or outcomes perceived as unfair, using tools like ‘name it to tame it’ (“I’m feeling cheated, not ashamed!”); reframing rank loss as data, not judgement; becoming mindful around urges (noticing the pull to keep going but not acting on it)

• Looking at pattern curiosity, through the use of journaling – asking questions like, “When do I get stuck gaming?” or “What’s happened in the day before I sit down to play a game?”

Get in touch with Xander for a free 30-minute initial assessment and to work out a fee that’s right for your circumstances should you decide to proceed further. Xander has spaces currently available to welcome new clients.

Xander, trading as xph therapy, offers integrative counselling, which means working with multiple therapy types, including CBT, psychotherapeutic and person-centred to develop a therapeutic pathway just for you, whatever outcome you’re hoping to achieve.