Over the past two years, we’ve been combining psychology, fantasy and play with one simple goal: to make mental resilience epic.

Taking guidance from psychiatrists Dr Sachin Shah and Dr Stephen Kaar, we’ve recently launched Betwixt — a multi-sensory choose-your-own-adventure story that our testers compare to Myst, Skyrim, Riven and Lord of the Rings.

In Betwixt, you play as a lone figure trapped in a strange, magical world that responds to your emotions and makes real what you think. Along the way, you meet a mysterious guide known as "the voice" who helps you wrestle negative thoughts and feelings, and master the psychological superpower of self-awareness.

After a great response from early testers, Betwixt has finally launched on the AppStore and will be showcased at CHI, the leading international conference on Human-Computer Interaction.

We're here to answer your questions about:

  • the role of narrative and (game) play in personal change;
  • fantasy writing and interactive fiction;
  • targeted journaling;
  • the game mechanics and/or psychological mechanisms in Betwixt.

Here are three of us today:

Elitsa Dermendzhiyska (u/Ellie_D; she/her): I left my cushy job in 2016 to research mental health. After many interviews and research reviews, I became convinced that games have the potential to be a great wellbeing tool.

Natalia Theodoridou (u/n_theodor; /he/him or they/them): I am a fiction author (World Fantasy Award winner) and game designer (Nebula Award finalist). I’m writing the Betwixt narrative.

Hazel Gale (u/HazelGale; she/her): I am an author, ex-athlete turned cognitive hypnotherapist and lifelong game lover.






Android users, we haven’t been able to build across both platforms just yet, but we will! Sign up to get notified about future releases on our site: https://www.betwixt.life

  • Tell us your thoughts: When you play Betwixt, we really want to hear your feedback. We don’t have that much money, but because we know this takes time and effort, we’d like to give $50 to the three best (i.e. most useful, interesting or creative) pieces of feedback we receive. You’ll find links to send feedback on the Home and Profile pages in the app. Thank you, and we can’t wait to hear what you have to say!


Thank you everyone for stopping by. It has been a lovely time! We'll step away for a few hours now but will check back soon, so if you want to ask us something in the meantime, feel free to!

Comments: 57 • Responses: 15  • Date: 

Ni4oSw12 karma

Two of you seem to have no background in game development. Did this help or hinder you?

Ellie_D15 karma

Ha, that's true! I think it helped us a lot, actually, because it meant we didn't have all this pre-conceived knowledge about what games are and aren't, what you should and shouldn't do, etc. So we could try new things that would probably sound crazy or heretic to someone who has learned a particular framework and can't shake it off to see things from a new angle. That said, Hazel and I both had experience with writing and we knew how stories worked, and this turned out to be really useful when we were designing Betwixt. In fact, the first challenge we set ourselves was to see if we can come up with a story that could engage even hardcore players on its own, without any bells and whistles, and we put this on Facebook Messenger. Then we got 50 gamers from Reddit to try it out and it was because of their positive feedback that we decided to keep going.

Leap_Year_Creepier10 karma

Hello! I’m familiar with your app and love what I’ve seen so far. Can you explain a bit about your writing process, specifically the balancing act of creating a compelling narrative that also provides the opportunity for self-examination? Thank you for doing this, btw!

Ellie_D8 karma

Thank you! Glad you've enjoyed the app so far.
That's a great question and one that Nassos may have insights to share from the writing POV. When we started this, we didn't know if it would work at all and it seemed quite possible that you actually can't combine play, fantasy and creativity with serious personal issues. At the same time, we were inspired by games such as Papers, Please, Her Story, Gone Home and others that were pushing the bounds and showing the potential of the medium to communicate real-life situations. We also knew - from our experience with therapy and personal development - that learning about yourself can be one of the most deeply satisfying, engaging and exciting things anyone can do. So, it was really a matter of finding the right narrative framework to do this so we could empower players to engage with their own lives as the heroes of an epic tale.

Leap_Year_Creepier2 karma

Thank you very much!

Ellie_D3 karma

You are most welcome!

microwavedcashew7 karma

Hi! I’ve loved testing Betwixt and am so happy to see it out and about! A question I have is, what advice would you give on translating what we learn in Betwixt into reality? That is, how to use it in journaling, communication, etc..

Ellie_D5 karma

Hi! So glad you've enjoyed Betwixt! I think that Hazel can answer this more fully but here are my two cents:
Part of what makes the game work is that by engaging with it as the heroes of an epic adventure, players begin to see their struggles as challenges to be figured out rather than as problems that crush them. In other words, you develop a game mindset to take to your real life. There's also a very useful psychological distance you develop as you look at your inner world from the point of view of a character in a game: it makes it easier to take a step back in real life when you feel like you become too bogged down in upsetting or frustrating situations.

QEDthis6 karma

How did the idea come about?

Ellie_D5 karma

Well, I left my job in 2016 to study mental health and I spent a few months talking to people to understand how they deal with mental health. It turned out that a lot of people were playing video games instead of using mental health apps specifically designed to help them. So then I started looking into video games and talking to gamers, and it became obvious to me that they held enormous potential as a tool for personal change. Then I met Hazel, who was a passionate game lover and an experienced therapist, and she was using storytelling and creativity to help her clients engage with sensitive personal issues. With our meeting, the dots in my head immediately connected and we came up with the very first version of Betwixt.

chaoslive6 karma

Can you talk about what research-based psychology this leverages and why the game format is so useful for this approach? I tried out your early version and really enjoyed it!

Ellie_D4 karma

Thank you! So, there are a number of research-based techniques we are using (from positive psychology to meditation and cognitive methods), but perhaps my favourite (and the one most relevant to games) is psychological self-distancing. The idea is that when you take a step back from your problems, you can see them more clearly and regulate your emotions more effectively. (Ethan Kross and Ozlem Ayduk have published some great research on this.) Games can be the perfect vehicle for self-distancing because they allow you to slip into a character and to create a safe remove from an upsetting situation. In Betwixt, we have embedded additional techniques into the narrative that teach players how to create psychological distance in their daily lives.

TheyAreOnlyGods5 karma

I love the app, and am so excited to see things like this taken seriously both as art and as a tool for healing! I have a couple questions:

  1. In the testing process, were there responses from the users that surprised or even confused you?
  2. Was there a video game you found was a common choice for people trying to soothe their mental illness?

Ellie_D5 karma

Happy to hear you've enjoyed Betwixt, and great questions!
1. I think there were two-three responses that most surprised me. One was when people said "I know I'm talking to a machine but it feels like there's someone real on the other side." And the second was from people who told us they weren't visual yet they could vividly imagine the world of the game. And then there were people who were going through depression and naturally withdrew from friends and family. They said that the game - and especially the conversations with "the voice" - provided them with just the right amount of connectedness while they were working through the depression.

Ellie_D5 karma

And regarding your second question, no, I didn't find one specific game that was common, but it did surprise me at the time that it wasn't necessarily the big titles (I had assumed people would try to escape their problems with the latest, most escapist thing) and there was a lot of roleplaying, pen-and-paper affairs...

stilusmobilus3 karma

Good morning. I just tried to install this on my iPad mini and was informed my device isn’t compatible. I might just try it again anyway. You think it will work?

There’s a couple of things that tweak my interest here but I won’t know how applicable they are till I test this. I’ve always liked fantasy. I play PokémonGo so I’d like to see if this kind of game would have an AR application. I like AR, it gets you out and about.

The other question I have for myself and I guess for you and your dev team would be how an autistic teen might benefit from this kind of game. What are your thoughts on both the AR possibilities and diving into the autism spectrum?

Edit...yeah, after a second search can still find no option to get it on my iPad. Shame, I’d like to try this

TheRocketSummer3 karma

i have an new iPad pro on the latest iOS version and also cant download it. Something in the requirements says only iPhone, yet you have iPad screenshots as well. Help!

Ellie_D3 karma

Hi! Yes, it's only available on iPhone at the moment, I'm afraid. The reason you see iPad screenshots is that Apple automatically does this, even if you want to release only on iPhone. I'm sorry about that!

Ellie_D3 karma

Hey, sorry! No iPad version available at the moment. It looks like there might be because when you release on iPhone, Apple makes you add iPad screenshots, but we haven't optimized it yet for this device.

stilusmobilus3 karma

That might actually be an advantage. Some iPads use Apple Pencil so you might be able to explore that also. Time is always useful.

That’s cool, thanks for letting us know.

Ellie_D2 karma

Yes, exactly. Thanks for stopping by!

Embarrassed_Paper_533 karma

Who/what were your influences or inspirations in the development or writing of the game?

Ellie_D3 karma

In terms of the overall concept, we were inspired in part by those choose-your-own-adventure stories that some people may be too young to have had the pleasure of seeing! We wanted to create a modern twist on those. Other influences were A Dark Room, Lifeline, Paper, Please...

Cannot_Think-Of_Name2 karma

Hi, I've never heard of this game before now, but it looks fascinating. 2 questions.

  1. How's does this game coordinate personal growth or targeted journaling with fantasy choose your own adventure? It feels like these are unrelated, yet you claim to integrate both of them.
  2. I do not have an apple, nor am I planning to get one. But it's feels like a game with this much research into it would have multiple platforms. Are there currently any way to play on PC/switch/android, and if not, what is your current plan to do so(I know of course that these plans can change, but would I be waiting weeks, months or years)?

n_theodor3 karma

For 1: I think of it as roleplaying yourself within a fantasy setting that can act as a safe environment within which you are gently but firmly prompted to work on your personal growth. And it's fun, which makes it more likely you'll stick with it!

Ellie_D3 karma

Ha! A much less rambling version of what I just said!

Ellie_D2 karma

I love the first question! So, there are two main parts to the answer. One aspect is that people take their personal troubles too, well, personally - and so it's very hard to see things from a different angle. Fantasy, on the other hand, allows you to loosen up, play with possibilities, explore other ways of being in a safe, creative space. So, we asked ourselves: what if we could combine fantasy and reality? Wouldn't it be cool if people could see their lives from the point of view of a fictional character? The idea came from someone I knew who was using roleplaying games with his friends to engage with things in he life that he would otherwise try to keep hidden.
Now, one approach we've seen is to create a character who is struggling with something and get the player to empathize. We took a different route because we didn't want to label players' problems or impose our own views on them. So, instead, there are prompts in the game where you can type in your own responses and co-create the world, so that the story that results is your own and the game universe is used as a creative structure to explore and think about your own life.

Hope that makes sense but it's really hard to explain, unless you actually play Betwixt. Which leads me to your second question. We are going to start building the Android version soon (I'm an Android user myself and I'm really pushing for this to happen!).

Cannot_Think-Of_Name2 karma

"Soon" haha nice vague answer. All right, I won't push for details.

Ellie_D3 karma

Haha, I should never have tried that on Reddit. I knew it!
But it's true, actually. I can't say anything specific because one thing we've found about development is it always takes much longer than expected.