The Smartphone Psychiatrist

Smartphones are our constant companions.

For many of us, their glowing screens are a ubiquitous presence, drawing us in with endless diversions, like the warm ping of social approval delivered in the forms of likes and retweets, and the amplified outrage of the latest breaking news or controversy.

Today’s programmers are taking this device a step further to help us lose weight, save energy, and cut back on our vices by incorporating a rash of new games.

The person leading this charge is Jane McGonigal, a 42-year-old with a Ph.D. in performing arts, dyed strawberry blond hair, and a riveting tale about how a bump to her head led her to invent a new way to save lives.

Following her concussion in 2009, McGonigal was stuck in bed, wrestling with non-stop headaches, nausea, memory loss, anxiety, and depression. “I couldn’t read, write, or sleep,” she told Forbes.

She asked her family and friends to call her every day with “missions” to complete, like look outside the window and enjoy the view. Forbidden from drinking coffee, caffeine became a “bad guy,” while baking cookies for the baristas down the street was a source of points.

In 2012, she turned her unique recovery process into a game: SuperBetter.

The Rise of Gamified Apps

Anxiety encapsulates a range of disorders, from social anxiety to specific phobias. Its symptoms can be physical (like chest pain or insomnia) and mental (like chronic worry or fear of losing control).

The 2010s has witnessed an explosion in anxiety-reducing apps like “Headspace,” “Personal Zen,” and “Stop, Breathe & Think.” The popular term for this new breed of apps is “gamification”—the application of classic gaming elements, like badges and leaderboards, to address real-world problems.

"As people grow disenchanted with pharmaceuticals and their side effects, they're buying fidget spinners, weighted blankets, and apps."

All of this can strike a nongamer as a bit much, particularly for anyone who’s managed to raise children, grieve for a loved one, or survive an illness without techniques from a game. Writing in Slate magazine in 2015, Heather Chaplin described SuperBetter as sad.

“What, you couldn’t just pick up the phone?” Chaplin asked.

But for a generation raised on gaming, SuperBetter has clear appeal. Therapy is expensive and time-consuming, and medication often comes with a negative stigma. As people grow disenchanted with pharmaceuticals and their side effects, they’re buying fidget spinners, weighted blankets, and apps.

The exercises in these apps make use of techniques in cognitive behavioral therapy. In Personal Zen, the player has to navigate a desolate landscape by following a trail of happy faces while avoiding the angry ones. This trains the brain to recognize sources of motivation and filter out negative stressors.

In a 2017 study published in Biological Psychology, the game reduced the level of cortisol (thestress hormone) in pregnant women after a month of use.

Engagement vs Addiction

Gamification boosts motivation and user engagement. It’s how Tinder keeps us swiping even after we’ve found a good date, and Duolingo uses it so we don’t miss a single day of language-learning.

McGonigal, however, designed SuperBetter so people can use it for 10 minutes a day, not 10 hours. “We have a recommended dose of engagement: You do three power-ups, one quest, and battle one bad guy a day...it isn’t meant to be used forever.”

Studies in psychology have shown that avoiding our feelings increases anxiety, and that often happens when we escape into our phones. That goes against what most app designers want, which is to “hook” users to maximize profit. There’s certainly an irony in the tech world offering to solve a problem that it contributes to.

Although we need more data to determine the extent to which smartphone use may be driving spikes in anxiety, it’s reasonable to say that technologies purposely designed to be addictive have been a contributing factor.

But McGonigal has no doubt that for her, at least, turning her battle with anxiety into a game has taught her how to suffer less. With a laugh, she tells her audience in her 2019 TED talk how she just celebrated her “traumaversary,” the 10th anniversary of her concussion.

“I think I can finally say now—given the good that it led to—I’m happy it happened.”