Better anger management through video games

I’m playing Space Invaders on a laptop in front of a group of psychiatrists and social workers, and frankly feeling pretty nervous. My finger is attached to a pulse oximeter, which measures my heart rate. As I struggle with the arrow keys to hit the incoming targets, I notice I’m shooting blanks. I take a deep breath to try to calm down.  My heart rate drops, and once again I’m firing real missiles, scoring hits.

This same game, adapted from the old 1978 Space Invaders, is being tested in young psychiatry patients here at Children’s.  It’s called Regulate and Gain Emotional Control (RAGE Control), and was thought up by Joseph Gonzalez-Heydrich, chief of Children’s psychopharmacology program, in discussions with software engineer Jason Kahn. Could insights from neuroscience about how the brain processes emotions be brought into a computer game to teach children better emotional control?

The idea is simple: give kids a fun, enticing way to practice the ”de-escalation” skills they need to handle stressful or anger-provoking situations. “We all have to get our fight-or-flight hormones and neurotransmitters up a bit to focus and do hard things,” says Gonzalez-Heydrich. “But some kids get flooded with emotion when they do this and then get hostile or aggressive.”

Relaxation techniques, such as visualization, can be taught in psychiatry and counseling sessions. But the children who most need de-escalation skills find the techniques boring, and most don’t bother to practice them at home. And any emotional control can quickly vanish in the face of a challenge.

“You can teach them relaxation techniques in the office, but when they need to use them in the outside world, in the heat of the moment, they can’t recall them,” says Elizabeth Wharff, director of Children’s emergency psychiatry service, who, with clinical social worker Peter Ducharme, is introducing the game into clinical use.

Yet the same kids who have trouble mastering their anger will spend hours trying to master a video game. RAGE-Control gives them instant feedback on their emotional state, and to do well in the game they must be able to control it.

The game is usually introduced at a beginning level so the player can enjoy some initial success.  It can be modified to set a lower target heart rate – making it more challenging – or by adding little twists, like “curve balls” that are harder to hit. Eventually the team would like to develop a version that doesn’t involve guns and shooting.

Some young adults roll their eyes when they see this game with its primitive effects and bad renderings, but retro as it is, it hooks the kids in. It could be a great way to reduce the use of psychotropic meds, something the team is working on testing.

The first of a series of clinical trials has begun to see if the RAGE-Control video game, and the psychotherapeutic intervention of which it is a part, can help kids with severe anger control problems. The five-day intervention will combine 15 minutes of gaming with a half-hour of talk therapy. At the beginning and end of the week, the children will be tested for their emotional reactivity and rank themselves on an anger scale.

You can read more about all this in the Boston Globe. In the meantime, it’s easy to imagine lots of adults who should play this game: day traders on Wall Street, air travelers, out-of-control executives. In fact, it’s estimated that 16 million adults in the U.S. have rage disorder (scary, isn’t it?).