- Is Mario a narcissist or is he someone
that has an identity disorder
and he's constantly forgetting who he is?
Hey, this is Dr. Sam Greenblatt.
I'm back with another video.
I'm a clinical psychologist.
I specialize in anxiety disorders, things like OCD,
but I also use psychology to help E-sports players
improve at their performance.
Today, we're gonna be taking a look
at some video game characters,
and I'll be kind of assessing them with a clinician's eye
of what diagnostic traits they kind of exude.
Let's get started and diagnose some fictional characters.
(upbeat music)
The Last Of Us, a classic.
(Joel pants)
So already, you know, this is Joel,
he's just lost his daughter.
It's such a great way to introduce PTSD,
you know, post-traumatic stress disorder.
He has a startled response.
That's one of the things we look for with PTSD.
You get PTSD from something where you really experience
this profound sense of a loss of control.
You lost your daughter-- - Baby!
- Very traumatic for him.
Startling noises, giving him a big startled response.
That's already kind of a hallmark sign
of what he is dealing with.
That's a generous pour
of whiskey. - Want one?
- I'm not here to diagnose her.
A lot of times when you have PTSD,
there is the proclivity to seek out similar experiences
to almost downplay to yourself the importance
of something that happened. - Stop, stop, stop!
- It turns into this kind of ironic sense
where the person ends up increasing the chances
that they get re-traumatized and re-traumatized.
That could certainly be a reason why Joel starts
to take upon this life as a smuggler.
- Get the fuck away from her! - Hey, hey, hey.
- Ellie is so well-written, too.
You really have to grow up fast
when you go through a life of trauma.
I think Naughty Dog really does a good job
showing a young child with so many
of the characteristics of an adult.
The writers do such a great job
at showing kind of the sloppiness of what it can be
to experience and to process
through these difficult emotions.
Joel never really recovers from his trauma.
He uses Ellie as almost a placeholder, almost a band-aid,
to patch it up.
- I need a gun.
- No you don't.
- Joel. (sighs) I can handle myself.
- No.
- It's almost a arc that is more showing the consequences
of PTSD rather than how to kind of adaptively live with
and cope with PTSD.
And I kinda like that because it's dirty,
it's sloppy, but it's a real experience.
Portal 2, one of the greatest games ever made.
- [GLaDOS] Sorry about the mess.
I've really let the place go since you killed me.
- I just love the writing for this character.
The difference between her tone
and what she is communicating is just so expertly done.
She's passive aggressive to 1000%.
- [GLaDOS] Do you know who else murders people
who are only trying to help them?
Did you guess sharks? Because that's wrong.
The correct answer is nobody.
Nobody but you is that pointlessly cruel.
- What we're looking at, for sure, personality disorder,
typified by intense interactions with other people
that can be characterized by very strong emotions
or trying to affect strongly the emotion
of the person that you're talking to.
Clearly, GLaDOS is trying to do this.
She's using her language as kind of an attack here.
When we're looking at something else, like depression,
generalized anxiety, social anxiety,
they're a little more nuanced in that you apply it
to specific situations.
When we're talking about a personality disorder,
it applies to more or less your whole personality.
- [GLaDOS] If it makes you feel any better,
science has now validated your birth mother's decision
to abandon you on a doorstep.
- And so here we have some gaslighting, right?
That's not a psychological term,
but it's that colloquial term for when you're trying
to convince somebody else that reality
is not exactly as it seems.
You hear about gaslighting a lot in abusive relationships.
Just a classic technique that folks
with anti-personality disorder stereotypically
are more likely to use.
- [GLaDOS] I've heard voices all my life
but now I hear the voice of a conscience
and it's terrifying because for the first time,
it's my voice.
I'm being serious.
I think there's something really wrong with me.
- So they blocked off her own conscience.
They put in these kind of emotional cores
to try to influence her decisions.
I can certainly see how that's maddening.
She didn't really have that ability to kind of just observe,
sit back, and to watch those voices in her head.
She was just immediately participating with them
and she kind of lost her own voice along the way.
- [GLaDOS] The surge of emotion that shot through me
when I saved your life taught me
an even more valuable lesson,
where Carolyn lives in my brain.
- [Computer] Carolyn deleted.
- So there's the difference between the rational mind
and the emotional mind a little bit, right?
Usually in therapy, we talk about being able
to recognize what voices are coming from the rational part
of your brain and to kind of listen to those voices
a little more strongly.
Sounds like, GLaDOS, in this situation,
chose to just keep her emotional mind
and to delete the rational, which makes for a good story
but bad therapy.
Final guess, antisocial personality disorder,
'cause she wants to hurt a lot.
So we've got Max Payne.
Hyper-masculine, voice dripping with testosterone,
just like mine.
- [Max] It was a long time ago.
Let it go, seriously.
- Maybe a little trauma with, "Let it go."
Alcohol is a very common way to deal with trauma.
It could be really painful to kind of experience it,
so using something to kind of numb yourself
so that you don't experience those intrusive thoughts.
Trying to deal with trauma in this way,
it's like you're taking a balloon,
you're trying to hold it under water.
You could kinda suppress it for a few seconds,
but it's gonna pop up and it's gonna pop up
twice as hard.
These are short terms solutions to trauma
that create long-term problems.
It's so often romanticized in men to respond to trauma
in an angry kind of way.
So many movies championed that kind of reaction.
It makes for a good story,
but sometimes could lead people astray a little bit.
How is he that jacked, though, if he's drinking that much?
There's no way.
There's two types of theories on the way the world works.
There's an internal or an external locus of control.
Locus of control is what do you ascribe kind of the blame
or the responsibility to?
If we have an internal locus of control,
we say I'm responsible for myself.
I'm gonna make all of these decisions.
If we have an external locus of control,
what we're saying is it's kinda society's fault
for the way that I feel and all the actions
or reactions that I'm gonna do.
It's not 'cause of me.
Adopting an internal locus of control
helps you kind of ride your own rollercoaster
rather than just reacting to the things
that life is throwing at you.
Sounds like this dude's got an external locus
of control for sure.
This is one of the least interesting characters for me,
as a psychologist, to watch because I've just seen it
played out so many times.
I don't think that he's gonna have a narrative arc
where he understands or processes his emotions.
I think he's going to deal with everything
with his fists and a gun.
It's just kind of counter-therapeutic a little bit.
- Ah, Floyd!
- I heard that those conferences
are regular little fuck fests, huh?
Can I come in?
- I mean, he's so similar to the Max Payne
kind of character.
Toxic masculinity, he's already making sex jokes,
I'm sure he is an alcoholic.
- And I had a tough upbringing. My daddy was not nice to me.
- I think GTA does it in a way that's more comical
than some other kinds of representations here,
but it's that one character
that we've seen a thousand times.
- [Man] What have you got all over yourself?
You're all red!
- The fact that this dude does not realize
that Trevor's covered in blood.
I don't know that many people are that uninsightful here.
- [Trevor] You can't rely on anyone. Anyone except me.
- Some more gaslighting. "Can't rely on anyone except me."
That's so typical of an abusive relationship.
My assessment of this is similar
to the other Rockstar game.
Rockstar loves this male fantasy, doesn't it?
Max Payne, I would say, is a little more PTSD.
Trevor is more antisocial personality disorder.
You could imagine Max Payne
having an adaptive conversation with somebody else,
whereas, with Trevor, you can't really imagine Trevor
being in a situation where his personality
wouldn't come out.
That personality disorder kinda bleeds
into every single interaction.
Celeste is great.
It does a great job at mental health representation.
They put in kind of game mechanics that represent
this internal narrative arc of being able
to overcome some mental health challenges.
(wind blows)
The external representation of her kind
of mental health struggles is so great, too.
So frequently, a goal of what we're doing in therapy
is we're trying to externalize what is the most challenging.
So a lot of times when I'm leading somebody
through a experience of getting in tune with their anxiety,
they'll have them describe it.
You know, where do you feel your anxiety right now?
Is it static, is it changing?
If it had a texture, you know, what would you give it?
Really being able to kind of look at the anxiety
and know every detail of it could help you
establish a healthier distance from it
and can really help you deal with these things
a little more adaptively.
The imagery here, mindfulness, picture a feather
floating in front of you.
I love how they kind of bring it into the game
and you kind of have to kinda keep it balanced.
It's even different, right?
She's using imagery and she's kind of picturing
the feather floating to ground her.
But for the player, you're even doing a different kind
of mindfulness because you're really focused on this task.
So it's not just imagery for you as the player,
it is kind of this task that you're bringing
your attention to, your brain can't be tasked
at that ruminative spiraling cycle.
You give it kind of a forced break
and it could be a great grounding exercise.
Of all the clips that we watched today,
just an A-plus example of mental health,
of mental health struggle.
If any game does it right, it's Celeste.
The kind of arc in which she recognizes her anxiety
and she works her way through it
shows the time the dedication, the struggle,
and the challenge that it does take to get better,
but it also shows the message that it does get better.
If you put in a lot of time and energy
into your mental health, you absolutely should get a return
on that investment.
I think really what stands out from looking at these
is the wide gap that video games have
in accurately describing mental health challenges.
In some ways, some video games are just like action movies,
where everyone is just so tropic
and exactly what you would expect.
In other ways, everything is really nuanced.
The video game becomes this great art form
where it expresses and conveys an idea
in ways that other media couldn't.
Not every game has to.
Some of it is just kind of fun entertainment.
But the games that really do focus on it, like Celeste,
I think, really do a great job.
(upbeat music continues)