Suffering from a phobia - i.e. the irrational fear of something - is something few people want to admit. Many phobics fear ridicule just as much as they fear their phobia trigger. This can result in phobics suffering in silence. How much a phobia impacts a person’s daily life is often dependent on two things - what the sufferer is afraid of and how afraid of it they are. For example, someone who is somewhat afraid of snakes can probably function perfectly well if they live somewhere where snakes do not. They might be unable to watch some nature documentaries or visit the reptile house at the zoo, but neither is likely to present a problem in everyday life. However, an intense fear of something that cannot be avoided can significantly negatively impact someone’s life. Intense agoraphobia, for example, may prevent someone from living a normal life by preventing them from going to work, attending education or engaging in social activities.

For some people, video games offer an escape from their fears. An agoraphobe may be more comfortable traveling the wilds of Skyrim than they are visiting a city center for example. However, for some, gaming offers no such solace. Quite the opposite in fact. Video games may expose them to their fears in a way that everyday life in the real world does not. For these people, playing video games can become a frightening and stressful activity.

In this mini-series, we will investigate both the positive and negative effects video games have on phobias, what game developers can do to make their games more accessible and lastly, how video game technology can be used to treat people's fears so that they are phobic no more. But first, let me tell you a little story about what inspired this article in the first place…

My Experience of Phobias in Video Games

I probably suffer from Acrophobia - the fear of heights. I would like to think that this fear is entirely rational since I’m a rubbish climber, my dynamic balance isn’t great and I’m fairly confident I can’t fly. Therefore, heights are a genuine risk, and perhaps more so for me than they are for most people.

Whilst all three are true and completely rational, my fear of heights manifests in ways that are completely irrational as well. For example, the mountainside "path" sequence from the recent Witcher TV show made me very uncomfortable - my heart was in my throat throughout.

The Witcher mountain shortcut
Don't. Look. Down... Too late.

This makes no rational sense of course - the characters aren’t real - they are actors. The cliff isn’t real either, and the floor of the studio is probably just below the shot and likely covered in big squishy crash mats - just in case. I also knew that at least two of the trio in the image above must survive, for two reasons. Firstly - because it wasn’t the last episode of the series. Secondly, the chronology of the overall Witcher franchise story arc proves they survive. Therefore, on no rational level should this have caused such a reaction. But it did. “Ok, that was odd,” I thought to myself. “Perhaps it will be a one-off.” However this was not the case, because I had much the same reaction when I binged the series a second time a few weeks later.

A similar, but a more extreme version of this happened to me recently. I was playing S.T.A.L.K.E.R. Lost Alpha and had reached the Chernobyl Nuclear Power Plant - a very late-game location with the difficulty to match. There were a lot of enemy NPCs and bloodthirsty mutants around. I spotted a perfect spot to both escape from the mutants and snipe the NPCs. Specifically, this very tall chimney with ladders and observation platforms.

Lost Alpha Tower
I have the high ground!

I had reached the first of the three observation decks with no problem. The vantage point was excellent, however, I reasoned that the next one up would offer a superior vantage point, so up I climbed, and this is when things started to "get weird." During the ascent towards the second platform, I started to experience the same physical symptoms that manifest when I go up high in real life. My heart rate raced, my hand became clammy and a cold sweat soaked my t-shirt. Worse, I was gripped by the same feelings of dread and terror.

“Well, this is a first,” I thought to myself. “Perhaps it will pass in a moment." Nope - it got worse. This wasn’t helped by the sound of the wind which grew louder the higher I ascended. The wind has no physical effects on the player as far as I can tell, but the sound alone was unnerving enough.

Then the rusty ladder I was climbing started creaking alarmingly, giving the distinct impression it might give way at any moment. I didn’t recall previous in-game ladders collapsing, but Lost Alpha’s habit of inserting out-of-the-blue scripted events meant I couldn’t rule it out. None of this was helped by the game’s rather poor ladder-climbing mechanics which conspired to make falling from it all too easy. I managed to reach the second platform then gave up. After giving myself a few minutes to recover I loaded up a previous pre-climb save. I decided to use a completely different set of tactics that were distinctly less "vertical."

Not wanting an irrational fear to get the better of me I attempted the climb again a few days later. This time I was able to overcome the sensations which had been dulled by repetition and familiarity. I made it to the level of the third observation deck, and I was looking forward to taking a picture of the view to share with you all. Unfortunately, the game had other ideas, since there appeared to be an invisible wall preventing me from setting foot on the said observation deck. This left me stuck on the ladder, so down again I climbed. Such is life in the Zone…

This experience got me thinking and two questions sprang to mind; First, “Would the sensations have been even worse in VR with true stereoscopic 3D depth perception?” and secondly, “Has anyone else had an experience like this?” So, like any good journo, I decided to do a little digging. What I dug up was eye-opening…

How Games Have Triggered Gamer’s Phobias

Even a brief internet search answered one of those questions conclusively - yes other people have had experiences like mine. Lots of people, suffering from an array of phobias. Here are some of the most prevalent.

Thalassophobia - the fear of deep bodies of water - appears to be particularly common. Or more accurately, it appears to be the phobia that video games most frequently trigger. This is likely due to so many games featuring deep bodies of water at some point in their campaigns, maps and levels. For some players, even relatively small bodies of water can pose a problem if they are unable to see the bottom. One oft-cited example is the (Go Fish) side quest in TES IV Oblivion. The limited vision created by the murkiness of the water appears to be a major stimulus for Thalassophobe players.

Games that are predominantly set underwater, such as the aptly named Subnautica, were particularly troubling. Subnautica’s deeper, darker and murkier later sections were all but impossible to endure for some players. The symptoms they described were much the same as the ones I had halfway up that chimney.

Subnautica Screenshots 13
Subnautica. The inability to see the bottom when looking down is particularly frightening for some

What is interesting is that the deep-water effects needn’t be photo-realistic, or even set in a believable environment to trigger a Thalassophobic response. For example, some have stated that they found the underwater sections of Mario 64 were enough to generate feelings of panic and fear, despite the level featuring the same cartoony aesthetic as the rest of the game. This illustrates one of the most challenging issues facing people who suffer from phobias - the fear isn't rational.

JollyRoger
Mario 64 Jolly Roger

Arachnophobia - the fear of spiders - is another phobia that is frequently provoked by video games. Again, the problem is frequency. Many games include spiders or spider-like enemies. The giant spider from Limbo has been cited as particularly terrifying due to its legs and movements so closely mimicking that of real-world spiders. Its relative size combined with Limbo’s generally foreboding atmosphere probably did not help.

Limbo spider
Limbo spider

In-game enemies that are not true spiders, but have a spider-like appearance and movements have also been cited as a trigger. The poison Headcrabs from Half-Life 2, which resemble overgrown tarantulas or funnel-web spiders, have also stimulated arachnophobia in some players. This is not helped by the poison Headcrab having the same markings on its back as a real-world spider.

Poison Headcrab
Poison Headcrab

Acrophobia - fear of heights - was also cited as a fear prone to stimulation by video games. Scenarios that involve climbing high and then balancing on a narrow platform or ledge appear to be the worst culprits, which is to be expected. The crane and skyscraper sequence from Dying Light is particularly terrifying for some.

dl the following screen 1 4k
Dying Light

Intriguingly, games that do not punish the player for falling appear less likely to elicit a response. I can personally attest to this from some of the games I have played, with Aliens vs Predator 1 and 2 being excellent examples. Xenomorphs in either game can seemingly fall from any height and suffer no fall damage whatsoever. This is perhaps why I didn't find encountering precipitous drops when playing as an Alien scary, but I did when playing as a human. In fact, as a Xenomorph I deliberately jumped down a multi-story industrial elevator shaft since it was quicker than waiting for the lift. Games that allow the player to fly or glide likewise appear to provoke less of a response. It is likely therefore that the fear of heights is at least in part the fear of injury or death when falling from such heights.

Phobia OF Video Games

You might be wondering if there is a named fear of video games themselves. Apparently, there is, and its name is Ludectrophobia. I haven’t been able to find much information on the subject. It does not appear to be listed as a recognized disorder by the WHO (unlike gaming disorder), nor is it listed in the DSM-5.

Reports from self-diagnosed individuals vary considerably. Some have cited specific in-game enemies and environments, such as the spiders and deep water discussed earlier. This may suggest that they are actually suffering from Thalassophobia and Arachnophobia respectively. Fear of dark spaces in video games was also cited, suggesting these players were suffering from Nyctophobia - fear of the dark. In these instances, it appears sufferers are afraid of what the game might contain rather than of the game itself.

One recurrent theme appears to be the fear of the unknown and a lack of control. The unpredictability of some games, and thus the possibilities of chance encounters with triggering enemies and environmental factors, can be particularly worrisome for some. Games with more predictable encounters or repeat playthroughs appear to ease these symptoms.

Another recurrent theme was the fear brought on by isolation. Minecraft was mentioned frequently, with players stating their solitary isolation in an open landscape causing significant distress. The day-night cycle was also cited as a significant stressor, due to most of the game’s enemies being nocturnal. This forces the player to create a suitable shelter by nightfall.

Phobias and VR

The increased immersivity of VR, combined with the stereoscopic 3D effect, can truly put the player "in among the action’" and "in the moment". This is both a blessing and a curse when it comes to phobias. On the downside, it can enhance a phobic response, and even create a fear response in non-phobics as well. The aforementioned headcrabs have also been particularly triggering in the VR title Half-Life: Alyx.

Conclusion of Part One

That brings us to the end of the first part of our investigation into phobias and video games. We saw that phobias, by definition, are irrational fears. As such, even something as wholly artificial and objectively harmless as a video game can trigger a phobic fear response. We also saw that the more realistic and immersive a game is the greater the phobic response it can provoke. We discovered that the fear of deep water, spiders, isolation and heights are the most commonly stimulated phobias in video games, and that some people are afraid of video games due to the chance they may contain these triggers.

In the next article we will investigate what developers and gamers alike can do to make their games "phobia friendly", and how therapists are using video games and VR to treat patient’s phobias. See you all there.

What are your thoughts on this subject? Do you have a phobia that is triggered by games, or know someone who does? If so, what is the trigger and how do you/they overcome it? Have you ever had to stop playing a game outright due to a phobia, or know someone who has? Feel free to share your thoughts and experiences in the comments section below.