The Development of the Self in the Era of the Internet and Role-Playing Fantasy Games

Sara E. Allison, M.D., Lisa von Wahlde, L.M.S.W., Tamra Shockley, M.S., and Glen O. Gabbard, M.D.

Sara E. Allison, M.D.

Mr. A was an 18-year-old Caucasian adolescent, a recent high school graduate from the Pacific Northwest, who was referred to the Baylor Psychiatry Clinic for a focal evaluation. This outpatient multidisciplinary assessment was conducted over 3 days and involved psychiatric interviews by three psychiatrists, psychological testing, and social work evaluation of his family. Mr. A’s parents sought psychiatric evaluation for their son because of concerns regarding his “obsession” with online gaming, which seemed to have overshadowed all other priorities in his life. Mr. A’s parents were particularly hoping that the evaluation team would view his game-playing as a manifestation of treatable obsessive-compulsive disorder (OCD), but they worried that it might be a form of addiction. Mr. A reported that his life had been taken over by the game-playing: “I play 12–16 hours a day, I do not sleep, and I’ve never had a girlfriend.” He said he wanted to “figure out what the problem is, take care of it, and be successful in college.” He dreaded that he’d repeat his high school pattern of “making only 2 days of class per week” when he got to college and end up “stuck at home.”