Running Head: TETRIS FOR ADULTS WITH PTSD 1

Tetris for Adults with PTSD

Should Tetris be used as a supplement for treatment options for adults with PTSD?

Word Count: 2009

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Today, more than 24 million Americans suffer from post-traumatic stress disorder, also

known as PTSD (“PTSD Statistics,” n.d.). Several different treatment options have been

explored in order to treat PTSD such as cognitive behavioral therapy, prolonged exposure, eye

movement desensitization, and reprocessing therapy (“PTSD Treatments,” 2017). Although these

treatments are effective, several forms of other treatments are being researched to decrease the

individual’s symptoms more effectively and quicker. One form of treatment for PTSD that has

been debated about being used is the neurologically stimulating video game, Tetris. This video

game involves strategically placing a geometric shape which is made up of four squares

connected orthogonally into a straight horizontal row without any empty spaces before

surpassing the skyline or the game ends (“What is Tetris?” n.d.). There have been many studies

regarding the effects of using Tetris to treat PTSD, but concerns have been raised about using

Tetris such as the fear of video game addiction. Several studies have shown that using Tetris as a

treatment for PTSD occupies cognitive resources which leads to the brain focusing solely on

Tetris rather than the traumatic event, minimizing the intensity of said traumatic event (Haier,

Karama, Leyba, & Jung, 2009). Ultimately, these perspectives leads to the question: Should

Tetris be used as a supplement for treatment options for adults with PTSD? Overall,

psychological, social, and neurological perspectives support the idea that Tetris should be used

as a supplement to existing treatment options for adults who have been diagnosed with PTSD.

Tetris would give those diagnosed with PTSD another treatment option, allowing them to

exercise all options given which would help them recover quicker and more efficiently than

those without the supplement of Tetris.

Several treatments have been used to treat PTSD including cognitive processing therapy,

prolonged exposure therapy, and eye movement desensitization and reprocessing (“Posttraumatic
TETRIS FOR ADULTS WITH PTSD 3

Stress Disorder (PTSD),” n.d.). The most common treatment is cognitive processing therapy

which is generally a 12-session long treatment that has been proven effective in reducing PTSD

symptoms originating from a traumatic event through the understanding of the event to reduce

the negative impact it has on the person suffering from the symptoms (“Cognitive Processing

Therapy,” 2017). Prolonged exposure therapy is another effective treatment which involves

having individuals face their fear irectly instead of avoiding it to decrease PTSD symptoms by

gradually approaching all the trauma-related aspects of that individual’s life (“Prolonged

Exposure,” 2017). Eye movement and desensitization and reprocessing (EDMR) helps reshape

the way individuals react to memories of their trauma due to their PTSD. EDMR therapy is

based on stimuli including sound, movements of the eyes, and hand taps while discussing the

individual’s memory (“Posttraumatic Stress Disorder (PTSD),” n.d.). All of these treatments are

considered as highly effective treatments and the use of Tetris as an additional therapeutic form

will not only make the treatments more effective, but also have the individual’s symptoms

decrease significantly in a shorter amount of time.

In Jane McGonigal’s TED Talk, “Gaming Can Make a Better World," she states the use

of video games is focused on improving society through decision making skills in global realistic

situations as she argues that games can have a beneficial influence on society. Video games are

often seen as the enemy in society, but McGonigal argues that video games can have a

significant impact on improving the general public (McGonigal, 2010). Not only can video

games be used to solve the problems of the world as McGonigal claims, but video games, such

as Tetris, can be therapeutic by helping those who are suffering from PTSD.

Tetris is helping solve an important widespread issue, mental illness. Researchers

worldwide are working to find an efficient treatment for PTSD that will actually be effective and
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help in a shorter amount of time, and Tetris has been discovered to do this. As McGonigal claims

that video games, including Tetris, will make a better world, Tetris will revolutionize the lives of

those suffering from PTSD.

Tetris should be used as a supplement to existing treatment options due to the fact that

Tetris is a video game with high visuospatial demands. According to a study done at Oxford

University by accomplished researchers, Tetris competes against traumatic memories for

cognitive resources such as attention and information processing. The study was led by Lalitha

Iyadurai, a clinical psychologist at Oxford University, who came to the conclusion that Tetris

was very effective in reducing the amount of traumatic memory. When competition for

neurological resources occurs, a patient cannot focus to the same degree on traumatic scenes

while playing Tetris, minimizing the intensity of a traumatic memory. The researchers studied a

randomized controlled trial where one group used Tetris-based intervention, while the other used

attention-placebo control. After analyzing all results, significant decreases in symptoms had been

shown after a week for the group that used Tetris. Tetris disrupts the sensory elements of trauma

memory reducing intrusive memories and it was seen that after a week there were significant

reductions in PTSD symptoms proving it can work effectively and efficiently (Iyadurai et al.,

2018). Another study led by Emily A. Holmes, a clinical psychologist and neuroscientist and a

professor in the Department of Psychiatry at the University of Oxford, concluded that “the brain

has selective resources with limited capacity” leading to the visuospatial aspect where the study

identified the components and the competition for these selective resources over the resources

with visuospatial images (Holmes et. al, 2009). Both of these studies came to the conclusion that

Tetris would help decrease the intensity of the traumatic memory and other symptoms it brings,

including flashbacks. Due to the visuospatial needs that Tetris demands, the neurological view
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would observe the individual’s brain focusing on Tetris instead of the traumatic event because of

the limited capacity of cognitive resources. Tetris would therefore be beneficial if supplemented

to PTSD treatments due to the fact that it would reduce the memory of the traumatic event

therefore reducing the symptoms of PTSD.

Several concerns about video game addiction have been raised when considering whether

Tetris should be a supplement to existing treatment options. Different sources have come to the

conclusion that Tetris is to be considered a highly compulsive addictive computer game and are

concerned whether using Tetris as a coping method will lead to addiction. Tetris, as well as other

games, offers desired rewards for different goals established during the game, whereas society

does the opposite. Society offers weak rewards for arduous tasks, which results in being seen as

frustrating for an avid Tetris player. In Jane McGonigal’s TED Talk, she also discusses how

rewards offered in video games could help motivate people change society positively, but

moving to higher Tetris levels, interpreted as rewards, do not have a real-life equivalent for the

player. The addiction to Tetris will cause the individual to lose touch with reality, where their

digital world will begin to take over their real, physical world (Doan & Strickland, 2013). Tetris

might make the individual too comfortable with the game where they begin to feel as if

everything around them is decaying as they play to cope with their trauma, leading to abuse of

the game that was supposed to help them (Dodds, 2015). However, what this argument fails to

consider is that video game addiction to Tetris would not happen if the treatment was closely

monitored by their therapist. Tetris would be administered during therapy with a therapist

monitoring the patient and having time restrictions. The individual using Tetris would have a set

time period where they can play per day according to what their therapist sees fit, and not long
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enough where other health concerns might be raised because of the amount of hours spent

playing Tetris.

Not only should Tetris be used as a supplement to other pre-existing treatments for PTSD

due to the high visuospatial demands, but also the visual memories of traumatic experiences. A

team, led by Professor Henrik Kessler and Dr. Aram Kehayan from the Department of

Psychosomatic Medicine and Psychotherapy at the LWL University Hospital Bochum,

conducted a study with twenty patients who were diagnosed with PTSD, being hospitalized

already around six to eight weeks for regular therapy (Kessler et al., 2018). Along with the

regular therapy, special intervention using Tetris was done by having the patients write about one

of their stressful memories, tear up the paper, and play Tetris for twenty-five minutes. These

special interventions using Tetris were weekly and the results of the study was that the number of

flashbacks concerning the specific content had decreased in the following weeks since. All other

traumatic memories which were not targeted had remained unchanged but as the special

intervention went on, different flashback events were targeted after another. The final result of

the study was that flashbacks for the targeted memories decreased by an average of 64%

meanwhile the untargeted ones fell by 11% (Kessler et al., 2018). The researchers who

conducted the study explain that when the patients try to visualize the traumatic memory, the

neurological visuospatial processing area becomes active which is used while playing Tetris as

well. Both tasks compete for the attention and whenever a patient remembers the traumatic

event, the memory trace becomes temporarily unstable. The interference, Tetris, could weaken

the memory trace even more occurring at the same time. This would ultimately lead to fewer

flashbacks which reduces their PTSD symptoms (Kessler et al., 2018).

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However, one limitation of this research regarding using Tetris as a supplement for PTSD

treatment options is that there are not enough case studies conducted with PTSD patients using

Tetris to help with their symptoms. Critics argue that the studies lack credibility due to the

minimal amount of studies done, but these critics fail to notice the amount of trials performed

during these different studies and the broad scope of PTSD patients that participated in the

research who all had different complex forms of PTSD.

Others also argue that the decreasing amount of frequencies of flashbacks are due to the

already ongoing therapy for the patient’s PTSD. However, what this argument does not address

is that when Tetris was used with the specific targeting of a memory, the frequency of the

flashbacks fell by 64%, meanwhile the flashbacks that were being treated with an existing form

of therapy commonly-used for PTSD, such as group therapy, had been affected by only a 11%

decrease. These different margins indicate Tetris is responsible for the quick decrease in the

number of flashbacks, making it useful as a supplement to other treatments (Kessler et al., 2018).

Ultimately, there have been different views on whether Tetris should be used as a

supplement to treatment options for adults with PTSD, but a solution to the issue has never been

reached. The importance of mental health and awareness marks this issue as one that must be

recognized and be resolved. Although Tetris should be used to supplement PTSD treatments for

adults, several different solutions can be proposed to enforce this.

One solution includes having Tetris supplement every treatment being used to treat

PTSD. Along with whichever PTSD treatment is being used such as cognitive processing therapy

or group therapy, Tetris would be used in order to lessen the symptoms and help the patient cope.

Tetris would be administered and monitored by a physician who would supervise the treatment
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as well as specific time restrictions per gaming session. These time restrictions would be

determined by the physician based on the severity of the symptoms.

A different solution is having Tetris be used by targeting specific traumatic events instead

of having Tetris supplement the other treatments in general. Adults with PTSD would have

specific targeted treatment at least once a week and it would help the patient in lessening the

flashbacks of that specific traumatic event (Kessler et al., 2018). The specific targeted treatment

would continue until all traumatic events experienced by the patient have been targeted and then

all of these memories would have reduced flashbacks, helping the patient specifically through

their traumatic memories as well as on an overall scale. The targeted treatment would be very

effective because not only would the patient be playing Tetris for a certain amount of time but

specific memories would be targeted making the treatment more effective.

Overall, Tetris should be used as a supplement to existing treatment options for adults

diagnosed with PTSD due to Tetris’s effect on reducing traumatic memories by using the limited

capacity of cognitive resources and the competition over visuospatial attention.

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References

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Dodds, L. (2015). The healing power of Tetris has its dark side. Retrieved from

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Tetris-has-its-dark-side.html

Haier, R. J., Karama, S., Leyba, L., & Jung, R. E. (2009). MRI assessment of cortical thickness

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Holmes E. A., James E. L., Coode-Bate T., Deeprose C. (2009). Can Playing the Computer

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… Holmes, E. A. (2018). Preventing intrusive memories after trauma via a brief

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