EPILOGUE

Reimagining Your Body through Video Games

THIS IS NOT THE CONCLUSION. I WANT THIS book to start conversations, not end them. When it comes to the general subject matter—namely, video games and their relationship to disability and mental health—I have already written what I wanted to write. I now look more broadly at what all this means, what ability machines mean for us now, and how they can mean better things in the future.

I want us to reimagine our bodies through video games, not because we can but because video games require it. They change what we understand about our bodies and abilities, whether we want them to or not. The current state of video games, accessible interactive design, interactive portrayals, gaming culture, and the gaming industry all force us to reconsider our abilities, both mental and physical. My goal with this project has been to map the ways games do this very thing. So let’s see the map (see fig. Epilogue.1). Let’s zoom out and look at what my attempt at cartography has produced. Implicit in this map is that video games are more than what you see on a screen. Video games are a media phenomenon that spans culture, the game development industry, and design theory.¹

First, video games are products of culture. They grow from culture, and they help create culture. And as cultural artifacts they teach us about our shared values. Chapter 1 examined disability through the lens of video game culture, and it found the values of self-congratulation, fetishization, advocacy, and problem solving. The values of self-congratulation and fetishization pose problems. Self-congratulation forms a part of a toxic optimism that ignores the continued challenges faced by people with disabilities, especially from society itself. In video games culture, self-congratulation means talking about accessibility in a way that erases responsibility for future improvement: a more accessible game or redesigned controller appear to further proclaim video games as an inclusive mecca for all people. It is easy to hyperfocus on success, especially regarding ability in a medium that continually excludes people of various abilities. Fetishization is a gross obsession with body difference that objectifies people with disabilities. Perhaps this fetishization exists primarily in video games culture and not in other parts of society, but I would be inclined to doubt that. Games require a lot from our abilities, and so when a person with disabilities plays video games, especially in ways and through means that highlight their disabilities, gamers go nuts. Playing games in spite of physical challenges is certainly worth acknowledging. But often games culture treats people’s bodies as objects on display or something strange to look at, especially in the form of gaming news photos. While gaming culture is where I found self-congratulation and fetishization, it is not unreasonable to assume that these cultural values grow from broader social tendencies. Video games simply bring these somewhat unsavory tendencies to the surface given their reliance on ability.

Figure Epilogue.1. This chart includes three key words: culture, industry, and design. Stemming from culture is the phrase “values about disability in games culture.” Connecting culture and industry is the phrase “mental health issues in game production and entertainment.” Stemming from industry is the phrase “game streaming and disability identities.” Connecting industry and design are first the phrase “ground floor of accessibility” and the term “reparative games.” Stemming from design is the phrase “depicting disability and mental health.” Chart created by author.

Second, culture and the gaming industry meet, in my map, through emotional labor, crunch time, and burnout. Games are not just ability machines when being played: they demand as much if not more from the people who make them. Streaming and game development are rife with challenges to mental abilities. Emotional labor, crunch time, and burnout all feed into an invisible monster that continues to gobble up lives and livelihoods. I suggest several ways streaming platforms and game development companies can improve in this regard. Streaming platforms should place stricter limits on lengths of streams and on the number of streams allowed in a period of time. Their promotional algorithms should also incentivize streamers to take breaks and not stream nearly constantly every day. Algorithms are not value-neutral: they prioritize the values we code into them. And these values should include streamers’ mental health as a high priority. Similarly, the game development industry should acknowledge its role in fostering crunch time and causing burnout, and these companies should address these challenges as issues related to mental health and not just worker productivity.

Third, streaming changes what disability means for players with disabilities. As I argue in chapter 3, participating in the physical challenge of video games with a disability changes the nature of disability just as having a disability changes the nature of gaming. The challenges presented by gameplay increase further through the strain of putting on a compelling stream, complete with entertaining commentary, managing lights, microphones, monitors, and software, and interacting with viewers. Streamers with disabilities communicated a desire to inspire others, with that desire stemming from their overcoming of personal challenges related to their disabilities and gaming. The streamers also used gaming to overcome personal issues, such as social isolation or loss of employment opportunities. Put simply, streamers with disabilities approached game streaming as one way of talking about their disability, including how gaming has changed how they understand their own disabilities.

Fourth, the gaming industry connects to game design theory and practice through two key ideas: reparative games and the ground floor of accessibility. Reparative games, as discussed in chapter 5, are one underutilized means of changing our relationship to mental health and ability. The act of making games can take inspiration from reflective writing or other reparative artistic practices. The concept of reparative games is perhaps more useful than empathy games. Empathy games either fail to induce empathy or, if successful, do little else than make players feel self-actualized without improving the lives of the people making the games. In my own experience of making a reparative game, D.Personal, I found a sense of voice through the game design process. I was able to conceptualize something I had difficulty putting into words. And as I was finding a voice to these issues, I also found a community with which I could find comradery and actual empathy.

The ground floor of accessibility also speaks to design theory and practice. Accessible game design changes our relationship to media and shapes how we see ourselves. Widespread adoption, and later legal requirements, regarding closed-captioning of television is one example of how accessibility can dictate the nature of our own abilities, who can participate in culture and art, and what it means to have a disability. Video games are caught within a whirlwind of accessibility challenges, and while many games are succeeding in their accessible design, others are flailing without focused guidance. As with the history of closed-captioning, I argue that video games are a mass medium that requires societal oversight in order to provide improved access for all. But since each video game comes with different challenges to accessibility, I suggest a ground-floor approach that does not solve every accessibility issue. Instead, it provides a starting point that any game can get to with its accessibility. Good subtitles for all spoken language, visual clarity, input remapping, and difficulty adjustment should be design requirements for all video games. And with those most basic accessibility expectations in place, designers and development studios can go significantly further depending on each game’s accessible design needs.

Fifth, design invites us to critically examine game portrayals of disability and mental health. Interactive depictions of disability and mental illness is more or less lacking. Games that interactively portray physical disabilities are few, most likely because interacting with games is an act of expressing and testing abilities. Purposefully changing what ability means in a game’s interactive systems may seem counterintuitive for many game developers. And games that portray mental illness abound, but rarely with any depth to their interactive mechanics. Most games’ portrayals of mental illness stick to pure narrative depictions and only rarely rely on interactive mechanics. Since video games are, at their core, about ability—they not only require our abilities to operate but also both express and test our abilities—they are the perfect media to portray disability and mental health. Game designers and development companies must demonstrate some courage and begin to explore how video games can better use abilities to depict abilities.

Following the Map

These six key takeaways are map markers for how video games invite us to reimagine our bodies and abilities. What happens when we follow this map? Like all cartography, it cannot be a perfect representation of reality. But it can point to interesting paths. Allow me to get a little reflective and personal as I follow this map on five mini-journeys. As I have already stated, I want this epilogue to start conversations, not end them. Consider my account of these mini-journeys as my initiating a conversation about ability machines. Note that one part of the map, the section regarding game streaming and disability identities, is absent in these journeys. I chose to avoid experimenting with those ideas given that I do not have a disability, and so that is not my experiment to make.

Values about Disability

Near the beginning of this book, I wrote about how gaming news websites, as central hubs in gaming culture, approached the concepts of disability and accessibility. Among several key themes, two meta themes were a bit unsightly: fetishization, or the treatment of disabled folks as objects of obsession or wonder, and self-congratulation, or the general feeling of accomplishment regarding accessibility advocacy. Looking beyond gaming culture, I wondered if general societal trends reflected these themes at least in journalism. I searched for the same keywords as I did in the original study—disability and accessibility—on news websites for the New York Times, Fox News, and CNN to see if these trends hold true.

I am happy to report that broader US culture avoids the sometimes-ugly themes found in gaming culture. The New York Times featured articles that almost exclusively spoke to issues of disability advocacy, which avoided fetishization or assumed we have already solved cultural challenges to disability. The results on CNN were similar to the New York Times except for being a bit more politically motivated. Fox News was not as progressive in this area, as would be expected, with some articles that drummed up fears of people fraudulently obtaining disability benefits in the United States. But there were barely any articles that played on fetishizing people with disabilities, and none that I found that evoked self-congratulation regarding advocacy.

I believe it is worth repeating what I stated early in this project: since video games truly are ability machines, technologies that rely on, test, and evoke abilities, discussions in gaming culture about disability, accessibility, and gaming see disabled gamers and accessibility equipment as surprising and even fascinating to the point of fetishizing disability. Any accessibility improvements in gaming, from varied accessibility options added to game software to accessibility hardware, are seen not as necessary but as being generous to folks who gaming culture would normally assume do not belong in their little club. Games are all about abilities, and so gaming culture otherizes different abilities. This otherizing leads to fetishizing those people and becoming overly self-congratulatory when any progress is made regarding accessibility.

Mental Health Issues in Game Production and Entertainment

As I do not work at a large game development company, I tackled the online entertainment side of game production by hosting a live stream. My original goal was to stream for six hours, a common full day of streaming for many professional streamers—even though there are others who stream for significantly longer, even up to ten or twelve hours per day—but I ended my stream after only four hours and forty-one minutes. I just could not last that long. In chapter 4, I stress the importance of changing the game streaming landscape, arguing that streaming platforms have the power to cultivate more ethical—and for streamers, more mentally healthy—streaming practices by capping stream lengths and altering how streams are promoted to viewers. I came away from my day of streaming with new insights into that landscape.

It was much more mentally demanding than I had originally thought it would be. I have streamed before but never longer than an hour or two and mostly as a learning exercise for my students. I had a goal to achieve: a full day of streaming was on the agenda. I had planned on six hours of constant streaming, but I fell short of that goal out of necessity: it just got too hard. I played online chess for the stream, which some readers may assume must be much more mentally demanding than other games. But at the level I play at, which is around 1,300 Elo points on Lichess.org, it is mostly repetitive and focused on fundamentals. Compared to, say, playing a competitive online first-person shooter, chess at my level is relatively relaxing. After two hours, it was tiring. After two more hours, it was exhausting. And after forty more minutes, I was numb, both mentally and physically considering that I had been sitting in the same position for that amount of time. My brain was incapable of focusing on anything that was happening on the screen, and so, out of necessity, I ended the stream well before my original target of six hours.

Ending early punished my streaming performance because it was at around the three-hour mark that I received my first viewer. Streaming platforms incentivize long streams by promoting them, and I can only assume that during the first three hours I was not being promoted in search results or stream category lists. After my first viewer arrived, I slowly started to gain other new viewers. Some left, some remained, and I peaked at four or five viewers. It was at the four-hour mark that some of my viewers began to participate in the chat. While I ended after streaming for four hours and forty-one minutes, I am convinced that I would have continued to receive more viewers, and more engaged ones at that, if I had continued to stream for more hours. I could imagine Twitch.tv as a robot overlord who was tempting me with more viewers if only I kept streaming for longer than my body could manage. And if I was a professional streamer, I would be expected to repeat that performance nearly every day.

I offer an important caveat here: streaming is not the most mentally or physically demanding work in the world. There are plenty of other jobs that challenge the mental health of workers even more perniciously. I am not arguing that streaming is special in this regard. For example, I remember my time working in a shipping center where I had to stand in the same position, repeatedly filling boxes with packing material, for eight or nine or ten hours per day: of course that would be challenging to my mental health! Instead, what I argue is that game production, either in the form of online streaming or game development, is assumed to be a dream job without any meaningful drawbacks. And that assumption creates environments where the mental health of laborers remains undervalued: if they fail to do the work for the sake of their health, there are plenty of others who will take their places. I am simply calling attention to the fact that game production hides issues regarding mental health. Whether it is crunch time or burnout in game development, or the uncompromising, punishing, and algorithmically driven incentive systems on game streaming platforms, making gaming content can be damaging to mental health. There is something about the word “game” that makes that hard to believe, but my hope is that I have offered enough evidence, both empirical and autobiographical, to support my claim.

Ground Floor of Accessibility

Input remapping, visual clarity, subtitles for spoken language, and variable difficulty: these four guidelines are purposefully meant to be simple to implement and not totally inclusive of all accessible design. Designers and game development companies should certainly reach beyond the ground floor of accessibility. But they should also not fall below this benchmark. That is the purpose of these suggestions: to create a base level of expectations regarding accessible video game design. And a key benefit of these guidelines is that any game, including super small independent games like the ones I make, can implement them.

I am currently, at the time of writing, working on a prototype game about writing conclusions. You can probably see where I got the inspiration. In the game, players must type a set number of words to finish a fictional conclusion. That is it. Players just type, and the game shows what players are typing and counts the number of words completed. I am far from completing the game, and I may never finish it: I prototype five or six different games before I find one that I want to finish. But I have argued for a ground floor of accessibility. If I were to finish making this game, how would I implement input remapping, visual clarity, subtitles for spoken language, and variable difficulty?

Visual clarity would be the easiest to build into the game. I simply would need to ensure that I avoid color combinations typically associated with color blindness and to use strong backgrounds that contrast with interactive foreground elements. All this feature takes is a little forethought.

Subtitles are the next easiest feature to implement. If I choose to include spoken language, such as narration that describes my process of writing a conclusion or epilogue, I would simply need to add text box objects that accompany each line of spoken language. I did as much in my game XXMormon (2021). Other recent games I have made, such as Amelia Is Hungry (2021), do not include any spoken dialogue at all, and so I just designed all written text to be large, legible, and contrasting against the game’s visuals.

Variable difficulty presents the first design hurdle, but it is not insurmountable. This feature of the ground floor of accessibility asks designers if their game requires any test of skill, and, if so, it asks that designers give players tools to manage or alter the difficulty of that test. In my game, players merely type words, but that itself is a test of skill. Typing is difficult. Not everybody can type. And some people with fine and gross motor disabilities might find typing on a keyboard to be challenging. To apply variable difficulty to my game, I would include a menu wherein players can change how many words are required to finish the game. Initially, I was planning on a required word count of one thousand words. But in this menu, players could change that number to anything below a thousand. I would, of course, include a brief explanation about the purpose of the number I initially chose and how this feature is included for players who might find typing a thousand words to be prohibitive to completing the game. From that point on, players would then be given the freedom to play the game any way they liked, even if it just means ending the game by inputting a single letter.

Input remapping requires a bit of creative problem solving. The game is about writing a conclusion by typing. But players already may use any letter or number key on their keyboard to type. The game does not check to see if the words players type are actual words: any letters or numbers, followed by a space, count as words. In my game Amelia Is Hungry, I give players the choice to play with keyboard controls or with a computer mouse. To gesture toward input remapping in this prototype game, I would add something similar. Players would be able to choose from an in-game menu if they would rather use mouse button clicks that automatically add words from a prewritten chunk of text. This text would repeat, of course, but at least this feature gives players who cannot comfortably use a keyboard an option to use their mouse to complete the game.

Hopefully this hypothetical design description illustrates how the ground floor of accessibility may apply to a wide range of games, even weird little games like the ones I make. These features certainly require some extra effort on my part, but that is the cost of ethical design: it takes some effort. But if that effort includes players that would otherwise be excluded from playing the game, then that effort was worth it.

Reparative Games

Reparative games find use with topics beyond mental health. As described in chapter five, the rise of small, independently produced, and personal games came from the queer game design scene in San Francisco in the mid-2000s. Those games concerned queer identity, other games such as my project D.Personal were about mental health, but reparative games can express a varied range of personal topics.

The game I made after D.Personal, released two and a half years later in 2021, was XXMormon. I again found myself in a position where I could not really articulate how it felt to go through a relatively major faith transition after an entire life of all-in commitment to a high-demand religion. I designed XXMormon to explore Mormon iconography and the feeling of taking back control of my own interpretations of that iconography (see fig. Epilogue.2). The game is a matching game. Players click on blank tiles to reveal pixel art versions of iconic Mormon imagery, such as the CTR logo and a classic white and gold temple recommend card. Players can click on cleared images to read and listen to brief audio descriptions about what these images mean. I recorded the audio descriptions myself, and in them I implicitly call out the racism, homophobia, and ill-formed nature of some of the ideas I used to cherish as a believing member of the Church of Jesus Christ of Latter-day Saints. After matching all of the tiles, two larger tiles appear with the words BEFORE and AFTER on their respective tiles. Obviously, since they do not match, the tiles do not clear. The game then ends with a written description, and audio recording, of how my way of thinking after leaving Mormonism simply cannot match how I used to think before my faith transition.

Figure Epilogue.2. The image is a screenshot of the gameplay of XXMormon. It is matching game with blank tiles to the left and matched images to the right. On the top of the game screen, instructions read “match the tiles” and “click on the cleared tiles that appear here to learn about what they mean.” Screenshot by author.

In chapter five, I argue that reparative games can offer voice, community, healing, and hurt to people like me through the act of making games. Does this argument hold up with a game not about mental health? It absolutely did. I was able to articulate feelings I could not put into words, and upon posting this game to some online forums, I was validated by community members’ comments of support. I felt a sense of partial healing from the personal trauma of a high-demand religion, and making the game reminded me of some trauma I had yet to work through. Making games, which is one of the many expressions of ability machines, expanded my ability to communicate and find support for my personal lived experiences. Reparative games are sites of ability that function beyond the realm of disability and mental health: they are as fundamental to human nature as art and personal expression itself.

Depicting Disability and Mental Health

I adore the design ideas that students from the University of St. Thomas and the University of Utah contributed to this book regarding how video games could better portray disability and mental illness. But I am also a game designer. I have already made a game about a mental illness, and I dedicated an entire chapter of this book to discussing it. But I have not yet made a game featuring disability. Continuing in the energy of this epilogue, with the goal of starting conversations and not ending them, I would like to present my pitch for a game that better takes advantage of interactive mechanics in its portrayal of disability.

In terms of contextualizing this game, I do not have a disability, but I do have significantly limited movement and strength in my left arm. It is mostly invisible. I have felt a level of consistent pain in my left elbow and significant frustration when I struggle with, or completely fail at, banal tasks. To this day, I get red-faced and angry when I try to lower my shirt collar over my necktie. I get frustrated when I cannot properly apply sunscreen to the back of my neck. But it is these banal tasks that nobody around me is interested in hearing me complain about. Asking for help is often met with confusion.

My game about disability would depict what it is like to live with an invisible physical disability. In this game, players would play as a character with chronic joint pain in their wrists, elbows, and shoulders. This chronic pain inhibits many parts of their life, but most people are unaware of these challenges. Players would play a series of mini-games that depict everyday tasks such as changing clothes in a gym locker room, working on a keyboard, and cooking dinner. In each mini-game, there would be a countdown timer representing how quickly people around the character are completing these same tasks, but the mini-games would require a significant amount of button presses, randomly assigned to keyboard inputs, to complete the task. Imagine a prompt on a screen telling players to press the keyboard keys J, B, 3, A, and so forth. When a part of the task is inhibited by chronic pain or immobility, players would need to repeatedly press the same button over and over—such as A, A, A, A, A—to evoke the frustration and intricacy of performing these everyday tasks. Audiovisual design, such as sound effects for the character’s vocalizing of their pain and color blasts on the screen, would emphasize that pain and frustration.

I argue in this book that games, as ability machines, can reimagine disability because they rely on ability to operate in the first place. But without interactive mechanics, or other characteristics exclusive to gaming, portrayals of disability and mental illness are impotent. The challenge is set, and I invite game developers, as well as independent game designers, to rise to that challenge: make games about disability and mental illness that use interactivity to depict disabilities.

Starting Conversations

The primary question of this book is, what do video games mean for disability? With the entirety of this book’s content in mind, allow me to list some answers:

Video games highlight issues of accessibility for people with disabilities.

Video games attract commentary about abilities, including disabilities.

Video games present challenges to mental health.

Video games reimagine what a disabled identity can mean.

Video games can help people work through hurt stemming from mental illnesses.

Video games provide alternative ways of depicting disability and mental health.

Video games are at the forefront of digital media accessibility and advocacy.

Video games are an ability-centric media technology. What they demand of our abilities, what abilities they produce in us, and how they challenge what we understand about our abilities feed into a matrix of intersecting points of discussion. I have attempted, throughout the course of this book, to participate in some of those discussions.

Those discussions do not end here. Perhaps some readers will participate in the conversation by establishing higher accessibility standards for the games they make. Perhaps other readers will express to friends how video games have changed how they understand their own disabilities. Perhaps some readers will join the conversation by using something they read in this book to launch a research project and publish an academic article. Perhaps other readers will reach out to me directly to continue to discuss issues related to disability, mental health, and video games. Perhaps some readers will experiment with the book’s findings, just as I did in the previous section. Perhaps other readers will continue the conversation through social media posts, video essays, or news articles.

As these conversations continue, I urge readers to remember that disability advocacy has not ended: people with disabilities, and their allies, continue to work toward greater equity in spaces ranging from education, transportation, medical care—and, of course, media such as video games. A central feature of this work is recognizing that these conversations cannot happen without including people with disabilities and mental health challenges. I included interviews in this book with folks invested in these subjects, including people with disabilities, for that very reason: I wanted this book to be a megaphone for other voices besides mine. While video games are ability machines, people are still people. Let’s use these conversations to improve people’s lives.

Note

1. Kline, Dyer-Witheford, and de Peuter, Digital Play.