Stones in Our Pockets: Mental Health Dimensions of Grief in Contemporary Video Games

Abstract This article combines the expertise of games studies scholars, medical ethicists, and clinical psychologists to analyse representations of grief in contemporary video games. Grief is a universal human experience, but navigating its psychological, social, and embodied effects can be a challenging task. Constructionist approaches to grief therapy emphasise the importance of metaphors for understanding the experience of loss (Nadeau 2006; Young 2008; Neimeyer 2010; Southall 2013). Paying attention to the metaphorical language used by a client can provide a therapist with key information about the client’s personal and cultural perspectives and world view. Equally, a therapist can work with clients to devise metaphors that shift their perspectives and aid the process of meaning-making. Video games provide players with new metaphors to express and explore grief. Since video games communicate across audio, visual, verbal, haptic, mechanical, and performative modes, they can offer a complete gestalt that touches on the physical, emotional, practical, and systemic impact of loss. In this article, we survey the multimodal metaphors for grief that appear in 14 commercial-off-the-shelf (COTS) video games and identify recurring tropes and themes. We consider 1) what is illuminated by these metaphors? 2) what is obscured by these metaphors? and 3) what are the therapeutic implications of these metaphors? We conclude with a set of recommendations for game developers who want to design ‘serious games’ that explore emotionally fraught topics, and a set of recommendations for grief and bereavement therapists seeking to integrate video games into their practice. Competing Interest Statement The authors have declared no competing interest. Funding Statement This work was funded by the MRC/AHRC/ESRC Adolescence, Mental Health and the Developing Mind Programme (Project name: ATTUNE: Understanding mechanisms and mental health impacts of Adverse Childhood Experiences to co-design preventive arts and digital interventions. Grant number: MR/W002183/1) and supported by the NIHR Applied Research Collaboration Oxford and Thames Valley at Oxford Health NHS Foundation Trust. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript