The Nintendo Wii as a Therapy Tool?
By Carolyn Spring
First there was Freud and the ‘talking cure’, then Rogers’ core conditions, then
CBT. And now? Now there is the Nintendo Wii ...
Unless you live a pathologically sheltered life, you cannot fail to have heard of
the Wii. Yes, it is pronounced ‘wee’ – apparently to represent the fact that it’s
for everyone, and not that it will cause loss of bladder control. Despite mockery
of its name, it sold 20 million units last year alone, and 70 million altogether
since its launch in 2006.
When I was a kid we had Pong: two rectangles moving up and down a screen and a square
‘ball’ that bounced between them. We controlled the paddles with a stick of plastic
ironically known as a ‘joystick’. This was fun, cool and cutting-edge. Then there
was Space Invaders – rows of blocky aliens criss-crossing the screen and our pixelated
‘spaceship’ blasting them with a single dot shooting up the screen.
Games consoles were for kids, and mainly kid boys. Then as those boys grew up (or
at least got older), the games consoles developed with them, providing better graphics,
better soundtracks and the genesis of an entire industry which now makes more money
per year than Hollywood: strange, but true.
But it’s this image of a geeky techno-nerd playing shoot-‘em-ups in a litter-strewn
adolescent bedroom that the Wii was designed to seek and destroy. Nintendo were aiming
specifically for a wider demographic, and so TV adverts have recently starred the
entire Redknapp clan – Spurs manager granddad Harry, his pin-up TV-pundit son Jamie,
the Revlon-beautiful wife and the spiky-haired handsome children. This is non-nerd,
aspire-to-be-like-them territory, and oh aren’t they all having such fun playing
on the Wii together: I must get one! One newspaper even reported that the Queen
commandeered Prince William’s Christmas present, she enjoyed it so much. Everybody
has got a Wii now, haven’t they?
The paradigm-shifting feature of the Wii is its motion-sensitive control. Rather
than the thumb- and finger-waggling dexterity possessed only by ten-year-olds, the
Wii provides 3D motion control so that arm flapping, wafting and waving translates
from your hand directly to the screen. This allows semi-realistic attempts at bowling,
tennis, archery ... Of course there were the early lawsuits against Nintendo as
the wrist-straps failed and folk lost their grip on the controllers in mid-backhand
volley: “The fun stops when the Wii remote smashes through the beautiful plasma television
hanging on the wall,” observed one commentator wryly.
And driven by the young and even not-so-young women who were buying and playing on
the Wii came the add-ons aimed at the weight-loss and slimming market. Enter the
‘Wii Fit’ balance board, a sort of intelligent ‘bathroom scales’ type of device,
which transmits pressure-sensitive data back to the console. Not only can it tell
you how much you weigh (with depressing accuracy), but it can also monitor your balance
as you sway backwards, forwards and sideways. The bundled ‘Wii Fit’ game itself
provides three categories of activity – balance, cardiovascular and a simplistic
take on yoga. In the balance games there is for example ‘football heading’ – the
aim being to lean to the left or right with precision and good timing to ‘head’ the
footballs that hurtle towards you from the screen, whilst simultaneously dodging
the randomly-thrown boots and drinks bottles. Or with the ‘table-tilt’ you control
the platform with your leaning/balancing/toppling to guide the balls into the holes.
This requires very fine movements, co-ordination and balance, and it also happens
to be lots of fun.
But what relevance does any of this have to adults in therapy?
What the Wii did was to shift games-playing from a principally sedentary, non-somatic,
cerebral activity into a kinaesthetic, whole-body experience. And this in one sense
correlates to a move in recent years away from traditional ‘talking therapies’ (sedentary
and non-somatic) into more holistic approaches which involve and include the body
in recovery, especially in healing from trauma. Pioneering work by Peter Levine and
Ron Kurtz paved the way for the work of Pat Ogden and others, resulting in somatic
treatment theories such as Sensorimotor Psychotherapy.
The premise of SP is that the body has been left out of the ‘talking cure’ and that
somatically-focused treatment, which hones in on both the physical and psychological
manifestations of trauma, results in more integrated healing. SP declares that the
body needs to be fully engaged in trauma recovery as it holds memories, it ‘enacts’
our experiences and beliefs, and working through the body can be a powerful and non-retraumatising
method of processing and resolving traumatic material. Rather than just talking
about trauma using the ‘top-down’ language-processing centres of the brain as ‘traditional’
therapeutic approaches might, SP takes a ‘bottom-up’ approach through the body. At
its best it circumvents the trap-doors of dissociation, denial and other cognitive
defence mechanisms which hinder the narrative approach of some mainstream psychological
therapies.
Dissociation is the inbuilt coping mechanism of choice for trauma at any stage of
life but particularly in childhood, protectively separating out the ‘self’ from the
overwhelming experience, especially in terms of Behaviour, Affect, Sensation and
Knowledge (BASK). This separation of thoughts and feelings can often be seen most
clearly in a disengagement from the body, an inability to notice or feel that the
body ‘belongs’. It has at its root, obviously, a disavowal of acts perpetrated upon
the body, by a disavowal of the body itself. Later in life this can manifest as
marked somatisation of affect leading to somatoform disorders; eating disorders located
in an inability to feel either full or hungry; or self-harming which attempts to
either numb out psychic pain through the release of endogenous opioids, or an attempt
to ‘wake up’ the body from a disengaged, nebulous floatiness.
For me as a survivor of extreme physical and sexual childhood trauma, suffering now
in adulthood from a dissociative disorder, my disengagement with my body has been
significant and at times pathological. Often unable to identify somatic feeling
states – whether I am hot or cold or tired or ill – I have had a perpetual sense
of strangeness about my body, as if it belonged to someone else: always with me,
but never ‘mine’. Mostly it would feel unreal, as if the brain impulses that control
its movements were happening outside of myself. I had difficulty ‘feeling’ or ‘locking
onto’ parts of my body – I responded in surprise during an early therapy session
to the suggestion to focus on my feet; my spontaneously honest yet bizarre response
was, “I don’t have any feet!” (Actually, you’ll be relieved to know, I do.)
Even standing upright was difficult: I had a lack of balance, a sense of weakness,
as if my body would just crumple under the drag of gravity. I tried sensorimotor
‘grounding’ exercises, to feel the earth supporting me, to feel my spine straightening
up to the sky, but I quickly became triggered and dissociative. For weeks at a time
I would grapple with self-harm, a desire sometimes to punish but sometimes to connect,
always with a sense that my limbs and hands were ‘not me’, were cut-off, alien. And
I would fail to take any exercise at all, battling against agoraphobia or just a
generalised anxiety of the outdoors, and when I did exercise the increased heart-rate
would itself be triggering, a reminder of something that I couldn’t remember and
I certainly didn’t want to. Going to a gym proved problematic, with a hypervigilant
fear of strangers, sweaty men, and a profusion of shame-inducing mirrors. Added
to all of this was a general sense of malaise and chronic medically-unexplained pain:
my body crying out, but with me unable to hear.
And so, despite my conviction that there is much that is good and true and helpful
in the sensorimotor approach to trauma therapy, I would sit on my therapist's settee
utterly confused at her suggestions that I 'track' feelings within my body, that
I become mindful of them, be curious, see what happens next. What feelings in what
body? Worse still, the over-flood of shame at merely focusing on my body would trigger
me dissociatively and I would drift off, unable to stay present, or stay in the present,
and engage with the work.
And then the Wii and balance board. I did not invest in one so much as tick a box
and receive one as a 'free gift' as part of a mobile phone contract. But then it
came, plastic wrappers and polystyrene waste and a sensor bar for the top of the
telly and handheld remotes ... I began to launch around my box-filled living room
slamming serves down a two-dimensional tennis court whilst narrowly avoiding the
light fittings. And soon I was perching and posing and bending and losing my balance
in a most undignified manner trying to get the dratted ball just right a bit, up
a bit, left a bit... too much .... aaargh!
The Wii is predicated on developing mind-body co-ordination, and the instant, visual
feedback provided by the console on the TV is an essential, simple way of improving
one's ability to focus on the body and learn. I had to listen to my body, and I
had a type of 'mirror' in front of me that was minutely reflecting my actions – but
without it being an actual, shame-disclosing mirror – which told me how I was standing,
whether I was leaning to one side, whether I was toppling forwards. And here I was,
doing a bit of exercise, with neither agoraphobia nor the panic of being amongst
other people. The gently increased heart rate was tolerable because my concentration
was fully engaged in following the complicated visual and verbal instructions on
screen, and so I either didn’t notice I was breathing harder, or I construed it neither
as arousal, nor a response to threat, nor incipient panic. Having to concentrate
so hard kept my front brain, my pre-frontal cortex, engaged and online, thus preventing
a traumatogenic, limbic-system-based escalation out of my 'window of tolerance'.
So instead of spacing out, dissociating, tumbling into ever-increasing panic, I
was able to tolerate the exercise and, because of the 'fun' aspect of it, the competitiveness
inherent in the 'Wii Fit' game, I was even able to enjoy it. I began to experience
feelings of enjoyment originating in an achievement of the body. This was new, and
very very different, and even quite good.
And through it all I also observed another wonder – the incredible plasticity of
the brain. Games at which I was embarrassingly, cringingly rubbish to start with,
I slowly conquered. It encouraged me regarding the work of therapy itself, which
as someone once said to me is simply a case of developing new neural networks. If
I could learn to balance and sway to pop a ball in a hole on the telly, perhaps I
could learn new ways of relating, new self-conceptions, new behavioural patterns?
So I found myself putting the words ‘enjoy’ and 'body' in the same sentence, and
it was all so innocent, so 'childish' (in the positive sense of that word) and totally
without threat or shame. With the boxing games I vented my anger, punching imaginary
perpetrators or 'blockages' in the air with my Wii remote and ‘nunchuk’ controllers
in either hand. And of course there was the positive, well-known mood-enhancing
benefits of exercise that releases endorphins.
I returned to work in Sensorimotor psychotherapy with a different sense – that I
had a body, that I belonged in a body, that the body was not the source merely of
bad feelings and shame and guilt and terror, but that it could also be the source
of pleasure and laughter and enjoyment. I became more 'tuned-in' to my body, more
able to make the connections, to see that this was my body that I was controlling,
that I had agency because it responded to my commands – that it responded exactly
to my commands, and that I could command it. I was beginning to be ‘mindful’, to
be able to track somatic sensation without dissociating.
The Wii obviously wasn't the therapy, and it didn't replace the therapy. But it
enabled me, in the privacy and safety of my own living room, with no-one else watching
and no pressure and no triggers, to begin to engage with my body and receive accurate
visual feedback on what I was doing. And it allowed me to begin to explore the concept
of 'having fun' with my body, an experience totally contrary to my early life experiences.
It enabled me to engage further in my therapy and to begin to sense the feedback
that my body was giving me, cues and signals that I had shut out and dissociated
from for years – feedback such as being tired, or emotions somatically expressed,
or 'gut instincts'.
Alone the Wii won’t solve the trauma, but I believe that it could be used successfully
by some clients, especially those who like me have experienced severe bodily trauma,
as an adjunct to therapy, a way of learning in a safe, positive and enjoyable way
to become ‘mindful’ and to connect with the body. Oh, and did I mention that it’s
fun too?
© Carolyn Spring 2011
First published in TAG e-newsletter February 2011
