The Therapeutic Potential of Tetris in Treating PTSD

Written By JC Pass MSc

Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition that affects individuals who have experienced or witnessed traumatic events. Symptoms include intrusive memories, flashbacks, avoidance behaviors, and heightened arousal, significantly impairing daily functioning (American Psychiatric Association, 2013). Traditional treatments for PTSD include cognitive-behavioral therapy (CBT), exposure therapy, and medication. Recently, researchers have explored unconventional interventions, such as the video game Tetris, for their potential in alleviating PTSD symptoms. This article examines the scientific basis and therapeutic potential of Tetris in the context of PTSD treatment.

The Psychological Basis for Tetris as a Therapeutic Tool

Visuospatial Working Memory and Intrusive Memories

Intrusive memories are a core symptom of PTSD, where distressing recollections of the traumatic event involuntarily invade the individual's consciousness (Ehlers et al., 2004). The theory behind using Tetris as a therapeutic intervention lies in its demand on visuospatial working memory. Playing Tetris requires substantial cognitive resources to manipulate and fit shapes, which can interfere with the consolidation of traumatic memories in the brain.

Holmes et al. (2009) conducted a seminal study demonstrating that engaging in a visuospatial task like Tetris shortly after a traumatic experience could reduce the frequency of intrusive memories. The researchers posited that Tetris competes for the same cognitive resources needed to encode and consolidate traumatic images, thereby preventing these images from becoming entrenched in memory.

Cognitive Load and Dual-Task Interference

The cognitive load imposed by Tetris can serve as a form of dual-task interference, where the brain's processing capacity is occupied, leaving fewer resources available for the consolidation of traumatic memories (Engle, 2002). This interference can disrupt the vividness and emotional impact of these memories, making them less intrusive and distressing.

James et al. (2015) expanded on this research by showing that playing Tetris within a six-hour window after trauma exposure significantly reduced the number of intrusive memories over the following week. This finding suggests a time-sensitive window during which Tetris can be particularly effective in altering memory consolidation processes.

Empirical Evidence Supporting Tetris for PTSD

Experimental Studies

A growing body of empirical evidence supports the use of Tetris as a post-trauma intervention. For instance, Kessler et al. (2018) conducted a randomized controlled trial involving patients who presented to the emergency department after a traumatic event. The study found that those who played Tetris reported fewer intrusive memories and PTSD symptoms compared to those who received standard care alone.

Further research by Horsch et al. (2017) involved women who had experienced emergency cesarean sections, a potentially traumatic event. Participants who engaged in playing Tetris showed significantly fewer intrusive memories compared to those who did not, indicating the game's efficacy in diverse trauma contexts.

Longitudinal Studies

While short-term benefits of Tetris on intrusive memories have been well-documented, longer-term studies are still emerging. One longitudinal study by Iyadurai et al. (2018) followed individuals for one month post-trauma and found sustained reductions in PTSD symptom severity among those who played Tetris shortly after the traumatic event. This suggests that the intervention's benefits may extend beyond the immediate aftermath of trauma.

Mechanisms of Action

Neurobiological Underpinnings

The neurobiological mechanisms underlying Tetris' therapeutic effects are still being elucidated. However, it is hypothesized that playing Tetris may influence the brain's memory processing regions, such as the hippocampus and amygdala, by engaging visuospatial processing pathways that compete with the neural circuits involved in traumatic memory consolidation (Schwabe et al., 2012).

Psychological Mechanisms

From a psychological perspective, Tetris' engagement in focused attention and problem-solving may promote a state of flow, reducing anxiety and arousal levels associated with PTSD (Csikszentmihalyi, 1990). Additionally, the game's repetitive and predictable nature may provide a sense of control and mastery, counteracting feelings of helplessness often experienced by individuals with PTSD.

Clinical Implications and Future Directions

Integration into Treatment Protocols

The promising findings on Tetris as an adjunctive therapy for PTSD suggest that it could be integrated into existing treatment protocols. For instance, emergency departments and trauma centers could implement Tetris interventions during the critical hours following a traumatic event. Moreover, mental health professionals could incorporate Tetris-based exercises into therapy sessions to complement traditional therapeutic techniques.

Limitations and Considerations

Despite the encouraging results, several limitations need to be addressed. The effectiveness of Tetris may vary depending on the timing of the intervention, the individual's engagement with the game, and the nature of the traumatic event. Further research is needed to determine optimal protocols for different populations and trauma types.

Future Research Directions

Future studies should explore the long-term effects of Tetris on PTSD symptoms, the neurobiological mechanisms involved, and the potential for integrating other similar visuospatial tasks into PTSD treatment. Additionally, research should examine how Tetris can be used alongside other therapeutic interventions to enhance overall treatment efficacy.

Simply Put

The use of Tetris as a therapeutic tool for PTSD represents an innovative approach to trauma treatment. By leveraging the game's demand on visuospatial working memory and cognitive resources, Tetris has shown potential in reducing the frequency and intensity of intrusive memories. While further research is needed to fully understand and optimize this intervention, current evidence suggests that Tetris could be a valuable addition to the repertoire of PTSD treatments.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596

  • Csikszentmihalyi, M. (1990). Flow: The Psychology of Optimal Experience. Harper & Row.

  • Ehlers, A., Hackmann, A., & Michael, T. (2004). Intrusive re-experiencing in post-traumatic stress disorder: Phenomenology, theory, and therapy. Memory, 12(4), 403-415. https://doi.org/10.1080/09658210444000025

  • Engle, R. W. (2002). Working memory capacity as executive attention. Current Directions in Psychological Science, 11(1), 19-23. https://doi.org/10.1111/1467-8721.00160

  • Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009). Can playing the computer game Tetris reduce the build-up of flashbacks for trauma? A proposal from cognitive science. PLoS ONE, 4(1), e4153. https://doi.org/10.1371/journal.pone.0004153

  • Horsch, A., Vial, Y., Favrod, C., Harari, M. M., Blackwell, S. E., Watson, M., & Holmes, E. A. (2017). Reducing intrusive traumatic memories after emergency caesarean section: A proof-of-principle randomized controlled study. BJOG: An International Journal of Obstetrics & Gynaecology, 124(3), 492-500. https://doi.org/10.1111/1471-0528.14247

  • Iyadurai, L., Blackwell, S. E., Meiser-Stedman, R., Watson, P. C., Bonsall, M. B., Geddes, J. R., ... & Holmes, E. A. (2018). Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: A proof-of-concept randomized controlled trial. Molecular Psychiatry, 23(3), 674-682. https://doi.org/10.1038/mp.2017.23

  • James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science, 26(8), 1201-1215. https://doi.org/10.1177/0956797615583071

  • Kessler, H., Holmes, E. A., Blackwell, S. E., Schmidt, A. C., Schweer, J. M., Bücker, A., & Herpertz, S. C. (2018). Does playing the computer game Tetris reduce the build-up of flashbacks for trauma? A randomized controlled trial. Cognitive Therapy and Research, 42(6), 714-725. https://doi.org/10.1007/s10608-018-9933-y

  • Schwabe, L., Nader, K., Wolf, O. T., Beaudry, T., & Pruessner, J. C. (2012). Neural signature of reconsolidation impairments by propranolol in humans. Biological Psychiatry, 71(4), 380-386. https://doi.org/10.1016/j.biopsych.2011.10.028

JC Pass MSc
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