No Rx Needed: A Therapist Recommends Games

No Rx Needed: A Therapist Recommends Games

This guest feature was written by Kim Shashoua, LMSW. Kim Shashoua, LMSW is a therapist who specializes in working with teens. She has presented at the GDC’s Narrative Summit, academic conferences, and to many 15-year-olds.

Disclaimer: This article is meant to be informational and not serve as assessment, diagnosis, or treatment of mental illness. If you feel you need help with a mental-health-related issue, you are encouraged to seek the professional expertise of a qualified mental health professional.


No Rx Needed

Welcome to No Rx Needed: A Therapist Recommends Games. We explore the themes of a game, related therapeutic principles, then provide a recommendation as you would to a friend. You know when a friend hands you a book and says “read this, it helped me get through a hard time”? Well, that’s what we’re doing with games.


The Game

The Walking Dead: Season One, initially released in five episodes from Telltale Games, is a popular zombie survival horror game based on The Walking Dead comics. You play as Lee Everett, a man on his way to prison when the zombie outbreak occurs. You find yourself protecting a young girl, while navigating this new world. This dangerous landscape is full of threats, from hidden zombies and waning resources to former allies.

Whereas many survival horror games focus on fighting, this adventure game’s life-or-death choices come at you through quick-time events. Selecting your actions and dialogue may not require a lot of dexterity, but these choices are far from easy. Will you defend a boy who might be bitten? When having to choose between two people in a zombie attack, who will you try to save?  You have a limited time to pick a response. These actions impact your relationship with other characters and affect in-game events down the line.


(C) TellTale


The Walking Dead: Season One is a stressful game with a strong narrative and emotionally resonant characters. It takes place within a zombie apocalypse that gets more grim with each episode. This is not a game that would help you unwind at the end of the day. Still, It provides an experience that is equally punishing and worthwhile.



How much can we control? Can we control what happens to us? To others?

Choices and the idea of control are central to this game’s mechanics. Throughout playing, the game specifically tells you that your words will affect others and have consequences. One of the ways the game does this is by showing a message about character’s responses, such as  “Clementine will remember that” after telling her about the man you killed or “Duck thinks you’re incred­i­bly awe­some” after giving him a high-five.

What separates this game from many choice-based games is that there is no “good ending,” at least in the traditional sense. While the game affirms the power of your choices, there is no way to escape the world’s horror. Characters will die despite your best efforts, in ways that you can’t always see coming. No matter your choices, the game will not deliver a “happy” ending.

This quality makes it a great means of exploring the psychology of control. When the game tells us that our choices matter, it primes us for feeling like we have more control than we actually do. This inflated sense of control is often called “The Illusion of Control.” There are many wide-ranging examples of people thinking they can control things that they cannot. Superstitions are one, such as thinking that wearing a “lucky” shirt can influence whether your team wins. Other examples involve choosing “random,” rather than sequential, numbers when picking the lottery or throwing dice harder to get higher numbers.


(C) TellTale


More complex examples of the illusion of control involve reflecting on regrets and tragedies and thinking you had power power than you did. Survivors of a tragedy often feel that if they did something differently, other people would have survived, too. People look back and see options that they didn’t think of at the time and feel guilty, like they “just should have” seen them. These incorrect beliefs cause a lot of pain and the self-blame can keep people from getting professional help.

When someone sees a trauma therapist, they often will identify (and latter, challenge) these incorrect beliefs. For example, we might be physically capable of responding in a certain way, but options that didn’t occur to us weren’t, in practical sense, options at the time. In times of stress, we fall back on familiar patterns. If I’ve never learned how to use a fire extinguisher before, I might mess it up, even if the instructions are on the canister. If a supervisor makes an inappropriate comment, I would probably not be able to figure out in that moment how to navigate the complex social/work dynamics, so I might just stay silent.

While the game lets us know that we didn’t overlook an option (all options are given), it does foster a the sense that what happened is somehow our fault, even it, by design, it was inevitable. In the game, we meet a woman who has been bitten and is desperate to prevent herself from becoming a zombie. She asks to use our gun to kill herself before she turns. We can decide whether or not to give it to her, but ultimately our decision doesn’t prevent her from getting ahold of it one way or another. We can make a choice, but any control over the situation is an illusion.

Why do we tend to overestimate the control we have over situations? The answer becomes clearer when we look at people who feel like they do not have much control. People who experienced paralyzing traumas, such as being unable to escape abuse, often carry a sense of learned helplessness throughout their life. When they encounter challenges in the future, they often will not try to find solutions because they feel like their choices don’t matter.

The game, through affirming your responses, aims to keep the player engaged, even when a “good” ending isn’t possible. If you feel that nothing you do changes anything, why bother? If you were told that none of your choices in the game mattered, how long would you continue playing? Would you just hit the same button over and over again to speed through the dialogue options?

The Walking Dead: Season One, supports that old axiom: “you can’t control what happens to you; you can only control how you respond.” You can’t always control who gets bitten or who dies in the game. You can’t control what tragedies happen in life. You can only decide how you (or your character) reacts.


Who this game is for?

This game would provide a reflective experience for people who are struggling with feeling like they made the right choice, whether in a crisis or everyday perfectionism. Almost everyone is familiar with the feeling of “if I just was good enough, then things would be easier/better.” This game is a direct challenge to those beliefs. Your choices affect the storyline, but a happy ending is still impossible.

I would recommend any player wanting to reflect on their perfectionism think about the expectations they have in the game and life. What do you think might happen if you make this choice in life or the game? Is it reasonable? Even possible?

I would not recommend this game to people who are sensitive to death and horror games in general. This is not a light or playful game. Anyone looking for a life-affirming experience will not find it here. As always, I would advise caution and not push yourself if you feel yourself getting overwhelmed.