Videogames About Alcoholism, Depression and Cancer; Developers are exploring deeply personal and wrenching stories

August 15, 2013, 6:30 p.m. ET

Videogames About Alcoholism, Depression and Cancer

Developers are exploring deeply personal and wrenching stories



A scene from ‘Papo & Yo,’ about an alcoholic father. ‘That Dragon, Cancer’ is an autobiographical story that puts players in the role of a father whose son is dying of cancer. A new breed of highly personal videogames on topics including depression, autism and cancer are changing what it means to play videogames. WSJ’s Conor Dougherty and game creator Ryan Green join Lunch Break. Photo: That Dragon Cancer.

Among the many videogames at a recent arts and games festival in Baltimore, none was more difficult to navigate than “That Dragon, Cancer.” The challenge: Getting through it without crying. The game is about war, but not the bullet-blazing variety normally associated with gaming. It’s an autobiographical story that puts players in the role of a father whose 4-year-old son is dying of cancer. As Hannah Armbruster sampled the game, using a mouse to move a pixelated dad around its hospital-room setting, her face showed none of the excited contortions that might accompany “Call of Duty.” She took gulps of sadness and at one point rubbed her forehead in disbelief. When the game was over, she said, “Whoo,” removed her headphones and left the computer.Why would anyone want to put themselves through this? “For the same reason you’d want to read a novel about something really heavy,” says Ms. Armbruster, a 20-year-old college student. “There’s something really satisfying about experiencing narratives that are outside your own experience.”

More than four decades after Pong, players are tackling a range of heady subjects including cancer, depression and alcoholism. Instead of pumping adrenaline, these “empathy games” use the videogame form to tell stories that are far more personal than the Hollywood tropes most big budget games still rely on.

There are games about depression (“Depression Quest”), other maladies (“Tourette’s Quest”), immigration (“Papers, Please”) and being multiracial and transgender (“Mainichi”). “Gravitation” uses a game of catch between father and son to simulate the difficulty of balancing work and family. “I Get This Call Every Day” has players take on the role of a call-center operator. “Cart Life” challenges them to provide for a family while working as a street vendor. “Papo & Yo,” which can be downloaded through the PlayStation, is about a former Electronic Arts designer’s alcoholic father.

“You now have at least two generations of people who have grown up with games and feel so strongly about them that it is part of their DNA to want to express themselves in that form,” says Tracy Fullerton, a professor at the University of Southern California’s Interactive Media & Games program. “The bandwidth [of videogame emotion] is usually tension and competition—a sense of aggression. That’s changing now.”

Behind these games are big shifts in the gaming industry. With the top videogames now as expensive and risky as movies, many of the mid-tier game studios have gone out of business while the dominating survivors pare back the number of offerings and mass-produce sequels. At the same time, game-making software is now cheap and easy to use, allowing amateurs to easily create their own titles and distribute them online.

“The lack of choice is driving people to consider other types of game experiences, and indie games are filling that void,” says Michael Pachter, an analyst at Wedbush Securities.

Few should expect to see their teenage son forsake “Grand Theft Auto” for “Depression Quest” any time soon. The entire universe of independent games is infinitesimal compared with the estimated $65.5 billion that will be spent on videogames this year, according to market researcher PwC.

But mainstream games are also pushing into deeper emotional territory, playing with new kinds of story telling that go beyond fights and races.

Running and shooting still reign, of course, but videogames are already no longer simply “games.” They are interactive narratives using a combination of game play and cinematic techniques to tell layered stories that are rich with fear, surprise and sadness.

In a pivotal scene in “The Last of Us,” a post-apocalyptic adventure that is one of the year’s top-selling games, a teenage girl kills a stalking cannibal with a machete. But she is not unaffected: When it’s over she collapses in tears as a father-like companion grasps her in his arms. In the following scenes she is haunted and silent.

“What [independent game developers] are doing is the same thing we’re trying to do, which is to create a connection with your characters so that the player is immersed,” says Bruce Straley, the director of “The Last of Us.”

Some developers cite actual therapeutic effects. Zoe Quinn, maker of “Depression Quest,” says she’s heard from depressed players who had fallen out of treatment and said the game inspired them to go back into therapy or start taking medication again.

As is the case with most self-published works, the scope and quality of empathy games vary widely. Many are made by people with no formal training in game development. The games can be just a few minutes long and have graphics that would have looked dated on the Atari.

Others, like “Papo & Yo,” are more polished. The game, about alcoholism and child abuse, was created by designer Vander Caballero, a game-industry veteran who spent eight years at gaming giant Electronic Arts, where he worked on the series “Need for Speed” and “Army of Two.” The “Papa & Yo” game costs about $10 to download through the PlayStation Network.

“Papo & Yo” was inspired by Mr. Caballero’s alcoholic father, he says. Players control a South American boy who roams a shantytown with a giant pink monster. The monster is mostly docile but has an appetite for frogs that the player has to keep him from. That’s because whenever Monster eats a frog he bursts into flames and attacks.

For anyone who doesn’t get it, there are brutal images of the boy’s memories—such as a man beating a child with a belt—along with a sequence near the end where players throw whiskey bottles down a pipe only to see them emerge as frogs on the other end.

“It’s one of the most difficult things in life to let go of somebody that you love and hate at the same time,” says Mr. Caballero. “I’ve been in psychotherapy for 10 years. I took every single thing that worked for me and made it interactive.”

Few games are more wrenching than “That Dragon, Cancer,” which is being developed by designers Ryan Green and Josh Larson. The game is about Mr. Green’s son, Joel, who has a rare form of brain cancer that will almost certainly kill him.

Mr. Green says that while the game is meant to be sad, it isn’t meant to be hopeless. Yes, he wants players to feel how brutal it is. But the greater goal is for them to see how the Christian faith helps him cope. “If you boil down the game, it’s facing the fear of death,” he says.

Messrs. Green and Larson plan to sell the game when it’s finished, and this week announced that they’ve received an undisclosed investment from Ouya—a $99 game console that launched in June—which will allow them to finish development.

It begins in a hospital room. Your baby son is wailing, and you’re the only one there. Using a mouse, players click through highlighted arrows to search the room for solutions. But nothing works. Bounce the baby and you get giggles that fade to tears. Click on a juice box and the baby throws it up.

“You realize ‘I can’t solve this,'” Mr. Green says. “As a player that’s jarring. In games you’re used to thinking that if you’re good enough you can solve the puzzle. The thing you learn quickest with cancer is it’s out of my hands. I can love him. I can’t fix him.”

Thus, the only way to “beat” the level—to make the child stop crying—is to put down the juice, put the baby in the crib, and click on an icon that reads: “Pray.”

About bambooinnovator
Kee Koon Boon (“KB”) is the co-founder and director of HERO Investment Management which provides specialized fund management and investment advisory services to the ARCHEA Asia HERO Innovators Fund (, the only Asian SMID-cap tech-focused fund in the industry. KB is an internationally featured investor rooted in the principles of value investing for over a decade as a fund manager and analyst in the Asian capital markets who started his career at a boutique hedge fund in Singapore where he was with the firm since 2002 and was also part of the core investment committee in significantly outperforming the index in the 10-year-plus-old flagship Asian fund. He was also the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. Prior to setting up the H.E.R.O. Innovators Fund, KB was the Chief Investment Officer & CEO of a Singapore Registered Fund Management Company (RFMC) where he is responsible for listed Asian equity investments. KB had taught accounting at the Singapore Management University (SMU) as a faculty member and also pioneered the 15-week course on Accounting Fraud in Asia as an official module at SMU. KB remains grateful and honored to be invited by Singapore’s financial regulator Monetary Authority of Singapore (MAS) to present to their top management team about implementing a world’s first fact-based forward-looking fraud detection framework to bring about benefits for the capital markets in Singapore and for the public and investment community. KB also served the community in sharing his insights in writing articles about value investing and corporate governance in the media that include Business Times, Straits Times, Jakarta Post, Manual of Ideas, Investopedia, TedXWallStreet. He had also presented in top investment, banking and finance conferences in America, Italy, Sydney, Cape Town, HK, China. He has trained CEOs, entrepreneurs, CFOs, management executives in business strategy & business model innovation in Singapore, HK and China.

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