Can't Just Stop

by Sharon Begley

  Whether fishing, taking the mound at Yankee Stadium, or stepping onto center court at Wimbledon, the power and even the rationality of rituals derive from the sense of control and thus confidence they give their practitioner, both of which translate into better performance. A fisherman who believes his amulets and incantations protect him from a rogue wave is, thanks to his sense of control and confidence, less inclined to panic when one approaches and thus more likely to save himself. A hitter who believes in the power of his chicken dinner might see the ball better, igniting a mean hitting streak.

  My Rituals, Your Compulsions

  In certain contexts, compulsive behaviors are not only far from pathological: they are so commonplace as to go unremarked. We call them cultural rituals. Viewed from outside the culture in which they’re entrenched, they may seem . . . well, interesting, in an anthropological sort of way, and perhaps even expressions of OCD, as researchers suggested as recently as the 1990s. In an influential 1994 paper in the American Anthropological Association’s journal Ethos, Siri Dulaney and Alan Page Fishe argued that features that “typify rituals . . . also define a psychiatric illness, obsessive-compulsive disorder,” and that there is a “common psychological mechanism” between rituals and OCD. Indeed, the idea that cultural and religious rituals resemble the rituals performed by people wrestling with a compulsion goes back at least to Freud, who contended that in both cases people suffer qualms when they do not execute the ritual and are extremely conscientious in carrying it out. Rituals, Dulaney and Fishe wrote, “are inherently compelling.”

  But are they manifestations of OCD? At first glance, there are indisputable similarities. Pick your favorite culture, exotic or familiar. Perhaps the ritual bath, or mikvah, that orthodox Jewish women immerse themselves in to regain their “purity” after their menstrual period or after giving birth—or perhaps just the ritual lighting of the Sabbath candles that even moderately observant Jews do unfailingly at sundown every Friday. Or perhaps the communion that devout Catholics take at mass, or the prayers that Muslims make five times a day while facing Mecca. Farther afield, Sherpas in Nepal attempt to placate demons and induce them to depart by means of a ritual in which they arrange 100 tiny clay shrines, 100 cakes, 100 butter lamps, and 100 effigies made of dough in a precise pattern of four concentric rings. The Hindi-speaking Gujars of Uttar Pradesh attempt to prevent harm from befalling them by executing a precise bathing and cleansing ritual involving offerings of black rice, black sesame, black flowers, black barley, and seven black cows to a deity, after which they circle an image of the deity seven times counterclockwise. One more: in the Shalako ritual that the native American Zuni perform to ask the gods for rain, health, and well-being, participants make ritual offerings at six points around the village, take six puffs on a special cigarette and wave it toward the Zunis’ six compass directions, and watch as six masked figures enter six houses to dance and chant to a six-beat rhythm.

  I suspect Shala Nicely—who believed that fours, eights, and sixteens had special power to ward off disaster—would know just how the Zunis would feel if they were forced to stop puffing the ritual cigarette after five drags or found their chants accompanied by a five-beat rhythm. The power of the ritual would deflate as quickly as a popped balloon, leaving its adherents on edge, unfulfilled, anxious, and worse. Such commonalities between rituals and pathological compulsions led Dulaney and Fishe to argue that if rituals “lacked cultural legitimation . . . they would be symptoms of OCD.” Indeed, they add, “every kind of symptom that is diagnostic of OCD” appears in accounts of rituals from every culture.

  Except for one key symptom: OCD, you’ll recall, is ego-dystonic, its insidious demands so at odds with what the sufferer knows to be true (stepping on a sidewalk crack will not make death and destruction rain down upon the stepper’s family) that it feels as if they emanate not from oneself but from a neural interloper. The demands of a ritual, in contrast, feel right and, absorbed through cultural immersion and teaching, an unquestioned part of oneself. Even practitioners who harbor doubts about the purpose of a ritual nevertheless find comfort in it. Before she died, my aunt patiently indulged my persistent questions about why she lit Sabbath candles. No, Evelyn certainly did not believe God would strike her dead if she skipped a Friday night or two. “But it would feel wrong,” she said. “If I didn’t light the candles, then for the rest of the night I would feel that I had left something undone, as if I were watching myself from outside my body and waiting for this person I’m observing to push open a door after she had unlocked it, or hang up a phone after she had said goodbye, or take some other action that’s just hanging out there.” It felt, she said, like hearing the opening G-G-G of Beethoven’s Fifth: you have a desperate need to hear the resolving E-flat. Without her weekly ritual she would feel an anguished sense of incompleteness, a twitchiness that something was amiss.

  Ted Witzig, who led the session on the scrupulosity form of OCD that I described in Chapter 2, was adamant that even “extreme observance,” as he called the religious rituals that mark the exceptionally devout, arises not from anxiety but from faith and devotion. It is a source of “meaning and purpose,” he insisted. I kept pressing him: from watching my own devout family and friends, it seemed that at least some of what they do is driven by the anxiety they imagine feeling if they do not do it. Just try getting between a Jewish mother and her Shabbas candles at a minute before sundown. Witzig relented: “Well, if you tell someone she can’t do something that is typical of her religious group, then yes, anxiety would be the normal response.”

  Scientists have found much the same thing in their investigations of rituals. Because rituals instill a sense of control over a chaotic and unpredictable world, they arose over the centuries for a similar purpose as compulsions: to keep anxiety at bay. Their ability to do so becomes clear not only when we follow rituals during the passages that mark our lives—christenings, bar mitzvahs, weddings—but when we seize on them after devastating losses that seem to pierce our world like a lightning strike on a peaceful afternoon. When Michael Norton and Francesca Gino of Harvard Business School had 247 volunteers write about the death of someone close to them or the end of a relationship, with half of the participants writing only about the experience and the other half writing also about coping rituals they’d performed after the death or breakup, the latter group reported feeling less intense grief about their loss. They were less likely to say they feel that “life is empty without” the dead person, for instance, and felt more in control—not so powerless, not so helpless, Norton and Gino reported in Journal of Experimental Psychology: General in 2014. One participant recounted playing the song “I Miss You Like Crazy”; another wrote about sitting shivah (the Jewish period of mourning) after his mother’s death and saying kaddish on every anniversary of her passing: “She died 21 years ago. I will do this until I die,” he wrote. Engaging in such rituals, the researchers wrote, “serves as a compensatory mechanism designed to restore feelings of control after losses.” People turn to rituals, compulsively or not, in order to establish or reinforce a feeling of being in control of their fate. At least a little.

  And that is hardly pathological, any more than Bianca’s compulsion to keep her world in order is. Quite the opposite. The cultural ubiquity of rituals strongly suggests that humans are wired to invent and follow them, much as we are to invent and absorb language. The specifics of the ritual, like the particular language, are determined by the environment in which we find ourselves, but preexisting neurological underpinnings are ready to encode whichever ones we are exposed to. That wiring can be hijacked in a way that leads to true OCD. But to call mild compulsions a mental disorder—to go the route of “we’re all a little crazy”—gets it 180 degrees wrong. Like culturally sanctioned rituals, mild compulsions are transformative, giving order to our world and a sense that we have a modicum of control over at least one tiny corner of it. Feeling compelled to behave a certain way in order to defuse anxiety is not evidenc
e of pathology. It is evidence of humanness and, more precisely, of being a human in our age of anxiety.

  * * *

  I. Especially since genes for slightly neurotic vigilance, by making our brain pay attention to potential threats, are likely adaptive.

  II. Hence the hospital’s name: saltpeter, or potassium nitrate, is a key ingredient in the manufacture of gunpowder.

  III. Superstitions are the beliefs, usually related to the supernatural, that drive rituals. Rituals are the practices. But rituals can arise from something other than superstitions.

  CHAPTER FIVE

  Video Games

  VIDEO GAMES ARE DIFFERENT FROM other compulsions. Most people do not become hoarders, OCD patients, compulsive eaters or exercisers or shoppers: their psychological makeup does not make them vulnerable to getting sucked into those behavioral black holes because their threshold for unbearable anxiety is sufficiently high. Video games and other electronic Sirens, in contrast, exploit aspects of human psychology that are nearly universal. I’ve said earlier that just because someone behaves compulsively doesn’t mean his brain is broken; to the contrary, that reaction to otherwise unbearable anxiety is adaptive.

  Nothing illustrates that more clearly than the seductiveness of video games, which are so compelling because their designers have figured out how to tap into universal aspects of brain function. As a result, almost anyone can feel the pull and feel powerless to resist it. As John Doerr, the famed Silicon Valley venture capitalist whose firm invested in Zynga, told Vanity Fair in 2011, “[T]hese games are not for everyone, it’s true, but [they’re] for more of everyone than anything else I know.” I hoped that game designers and a new breed of researchers called game psychologists could explain why. But first, I had to be sure that games have the requisite anxiety-quelling component to qualify as compulsions rather than, say, addictions.

  In a 2012 New York Times Magazine story, critic-at-large Sam Anderson described his compulsion to play Drop7, a puzzle game released by Zynga in 2009 in which players manipulate discs falling from the top of a seven-by-seven grid, somewhat like Sudoku. “I was playing when I should have been doing dishes, bathing my children, conversing with relatives, reading the newspaper and especially (especially) writing,” Anderson wrote. “The game was an anesthetic, an escape pod, a snorkel, a Xanax”—a digital antianxiety drug. He found himself self-medicating, turning to Drop7 “in all kinds of extreme situations,” such as “after an intense discussion with my mother; shortly after learning that my dog . . . was probably dying of cancer.” One online commenter confirmed that, for him at least, video games have the sine qua non of a compulsion: they “reduce my anxiety, so I justify playing Bejeweled that way,” the commenter explained. “I wasn’t really concerned about how much I was playing Bejeweled until I found myself playing it on the exercise bike at physical therapy” and fell off. Or as Neil Gaiman put it in his 1990 poem Virus, “You play through the tears, the aching wrist, the hunger, after a while it all goes away./All of it except the game . . . /There’s no room in my mind any more; no room for other things.”

  Tens of millions of us can relate. In May 2013 Dong Nguyen, a previously unknown game designer based in Hanoi, Vietnam, released Flappy Bird, which, he told reporters the next year, was “pretty much the simplest idea that I can think of.” It was the epitome of what serious gamers had begun dubbing “stupid games,” whose absence of narrative, aesthetics, and programming sophistication was matched only by the utter mindlessness of their goals. In Flappy Bird, players tap the screen to make a barely animated bird (it doesn’t even move its eponymous wings, which are nearly invisible) fly through a gap between vertical green pipes. Yet despite—or because of—its stupidity, the game struck a chord: in early 2014, it soared to the top of both Apple’s and Android’s lists of most popular downloads, mystifying even its creator. “The reason Flappy Bird is so popular is unclear to me,” Nguyen told the Washington Post. Ian Bogost, a professor of interactive computing at the Georgia Institute of Technology and a video game designer, wrote that countless players “have expressed astonishment and distress at their simultaneous hatred for and commitment to the game,” which inspired a web page on the British gaming site n3rdabl3.co.uk called “I Hate Flappy Bird, But I Can’t Stop Playing It.”

  Of course, people also play video games to decompress after a tough day, to feel a tiny sense of accomplishment, or simply to relax and zone out. And not every excessive behavior is a compulsion. Excessive use is not proof of compulsivity (even leaving aside the problematic subjectivity of “excessive”). There is a long list of reasons why people play video games to the exclusion of other activities and to the detriment of their work: to relieve boredom or procrastinate, to avoid social interaction or relieve loneliness. But as the anecdotes above suggest, and as analyses of the psychological allure of games show, for some people video gaming is indeed a compulsion and, for some, a destructive one: since the first decade of the twenty-first century “boot camps” in South Korea and China, with names like “Jump Up Internet Rescue School,” have treated children unable to shake the compulsion to spend hours and hours playing video games.

  That is not to say, however, that that compulsion constitutes a mental disorder. An expert panel deciding which disorders belonged in the latest edition of the American Psychiatric Association’s diagnostic manual reviewed some 240 studies purporting to describe “Internet gaming disorder,” but declined to include it as a scientifically validated mental illness, agreeing only that it merited additional study. For now, all science can say is that you can be perfectly sane and nevertheless get sucked into compulsive gaming.

  Flow, Intermittent Reinforcement, and Angry Birds

  Nikita Mikros, T-shirt drenched with sweat and helmet tucked under his arm, is walking his bicycle down the hallway toward where I’m waiting to meet him inside an old waterfront warehouse in DUMBO (Down Under the Manhattan Bridge Overpass), one of Brooklyn’s hip neighborhoods, lined with cobblestone streets and coffee bars.

  Mikros, who has been creating video and arcade games since the 1990s, had invited me to spend a morning with him learning things like why Candy Crush Saga, made by mobile-games behemoth King Digital Entertainment, had 66 million players in 2013, why players like actor Alec Baldwin feel so compelled to keep playing Zynga’s Words with Friends that he gets thrown off a plane waiting for takeoff, and why Tetris was voted the most compelling video game of all time. “We’ve learned a lot about how to make games irresistible,” Mikros had told me by email. “Unfortunately, some of it makes my skin crawl.”

  Mikros ushered me into the offices of his game-design company, Tiny Mantis, two rooms with just under a dozen workstations. He is widely known among gamers for creations like Dora Saves the Crystal Kingdom, Dungeons and Dungeons, and Lego Dino Outbreak. The offices were filled with flat-screen monitors surrounded by plastic Brooklyn Roasting Co. coffee cups, all framed within exposed piping, painted brick walls, holes in the ceiling, and posters of Mr. Spock and a panda. After Mikros excused himself to change into a dry shirt, he reemerged a minute later in a black version adorned with a Mona Lisa dripping blood. I expected to spend the morning watching him blitz through Diablo and Angry Birds, but instead he booted up a PowerPoint presentation he’d done for me. Rather than ripping the guts out of monsters, we were deep into Mihaly Csikszentmihalyi.

  Csikszentmihalyi is a psychologist who invented the concept of “flow,” a state of mind characterized by total absorption in an activity. When you experience flow, you are so immersed in what you’re doing that the outside world barely penetrates your consciousness, no other thoughts engage your mind, the sense of time evaporates, and even feelings of hunger and thirst fail to register. After a flow experience it’s not unusual to feel, Holy crap, where did the time go, and why am I starving?

  The best game designers, Mikros explained, put players in a flow state. “You experience a loss of self and a transformation of the sense of time,” he said. “You start playi
ng a game and before you know it, bang, it’s morning. The experience becomes an end in itself. But different people have different envelopes of their flow zone. If players are challenged too much they have too much anxiety and they give up, and if they’re not challenged enough they’re bored and they stop. But if they’re in a middle zone they’re happily engaged.” Flow is so compelling that it produces a sticky experience, one that people can’t easily escape.

  One way to keep players of different skill levels within the “flow envelope,” Mikros said, is by constantly adjusting the degree of difficulty. The 1980s classic Crash Bandicoot did that. If a player was pathetically inept at, say, leaping onto moving ledges, the game took pity on him when he lost a life by not sending him too far back toward the start and making it easier to navigate its many obstacle-strewn environments. On the other hand, Crash got harder if a player was nailing it. “Some players like that,” said Mikros. “They think, ‘I’m getting better, so I want tougher challenges or this will be a walkover.’ ”

  Another way to keep players in a flow state is to reward them for, say, defeating a monster by bestowing a new skill on them, and then using that skill exclusively in the next few situations. “Your powers are upgraded so a monster you couldn’t defeat before is now beatable,” Mikros said. “Good designers channel you through the flow zone by ramping up the difficulty and then giving you something that’s a little easier, then ramping up the difficulty some more before giving you another something a little easier.”

  But designing games to put us in a flow state sounds fairly benign, I said. While I could see how these design features are necessary for a game to be compelling (it has to be enjoyable enough to keep players playing long enough to get sucked in), I didn’t see how they could be sufficient. There is no surefire recipe, Mikros said: “If we’d figured it out perfectly, every game would be Angry Birds.”