First there was Freud and the ‘talking cure’, then Rogers’ core conditions, then CBT. And now? Now there is the Nintendo Wii …
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?
HOW DOES IT WORK?
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.
THE WII BALANCE BOARD
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?
HOW IS THE NINTENDO WII RELEVANT TO THERAPY?
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?