Content warning for discussion of mental health (particularly depression, anxiety, and PTSD)
Roguelikes (or Procedural Death Labyrinths, which is my new favorite term) are an odd genre of video games, in that they are generally defined by the mechanics of one game, Rogue (1980). While many of the specifics vary from game to game, there are three particular characteristics that generally remain consistent. First, the game consists of procedurally generated “dungeons” or levels. Second, there are a variety of different weapons and power-ups you can pick up to customize your character. And third, permadeath is an essential component of the player’s experience. There are no savepoints or revives (or at least, significantly less than would be available in most other dungeon-crawls), only a brutal end, after which you have to start from the beginning again to keep playing.
The following week, we were given four examples of Roguelikes: Hades, Slay the Spire, Dead Cells, and The Binding of Isaac. I chose to play Isaac, and wow, did that inspire me to dive much deeper into my psyche than I expected to for this class.
The Binding of Isaac
From the beginning, I was out of my depth. After showing you an unsettling opening cutscene about Isaac’s murderous mother– made only more unsettling with simple, childlike drawings– you’re suddenly in the game. Isaac doesn’t give you much explanation of anything around you, just a simple graphic in the starting room that shows the most basic features. In order to learn anything, you have to start playing.
Along the way, you begin to figure things out and get more help. You can find power-ups, coins, and consumable items in various rooms and from killing various monsters. Granted, unless you have a wiki page pulled up, you don’t know what the power-ups do until you take them… and sometimes they turn out to be more inconvenient than useful.
Of course, I did have some more help than most new players. I was lucky to be able to stream this game to people I know who had already played it (shoutout to my girlfriend for her near-encyclopedic knowledge of power-ups). As frustrating as this game was at times, it was still easier to manage with help. There were many times where I wanted to quit, but was encouraged to keep going. Which brings me to my next point:
What in the world does this have to do with mental health?
Somewhere around my 30th run of Isaac, I remember unexpectedly dying in the first level of the game and thinking to myself, Why haven’t I gotten better already? That thought gave me pause, particularly because it’s not an unusual one for me. Usually, though, it comes with a lot more baggage: missed deadlines, sensory overload, or a day spent doing absolutely nothing at all. It felt strange to have such a strong emotional reaction to a game; not just the story of the game, but the gameplay itself. I realized that the cyclical nature of the game and the frustrating lack of “real” progress were a little too similar to some of my fears about my own life.
Many mental illnesses are similarly cyclical. There may be periods where everything seems okay, or like life is progressing normally, but there will always be another time where you hit a wall. Whether that wall is a panic attack, or a depressive episode, or a trigger of PTSD, any of it can cause your life to come to a sudden standstill. For me, this is the metaphorical permadeath; while you don’t actually die, it certainly feels like you do. From there, all you can do is start over. You feel weak and helpless all over again, and you have to struggle to get yourself back to where you once were.
But just like in any roguelike, you aren’t truly starting from the beginning. You may have lost your items, but you’re equipped with new knowledge, instincts, and a sense of your own limits. You’ll find a support system to keep you going, whether that’s your friends or a forum thread. You’ll take things more carefully next time, and the time after that, and the time after that. In a game, you’ll learn what each of the different power-ups does and whether they fit with your playstyle. In life, you’ll learn new coping strategies and whether or not they work for you. Sometimes, you just learn to accept your fate: you don’t have enough hearts to last through this boss fight, and you don’t have enough “spoons” left to go to that social event. Even if some runs end more quickly than you wanted them to, you’re still making progress.
Final Notes
While I tried to generalize this account to most roguelikes, there’s a lot more I could say about how the specific aesthetic of Isaac matches up with my mental health recovery theory. For one thing, the first weapon you start with (and spend the most time using) is quite literally your own tears. The only way you can survive is to cry and let your emotions out. The whole game is flavored with the innocence of childhood, while the player takes the adult-looking-back perspective of “oh God, that was actually really messed up”. Some of the items you can get in-game are literal pills. Trying every mystery pill only to get a debuff gave me unfortunate flashbacks to my own medication journey, but you just have to keep trying them. Eventually, you’ll find one that works out, even if it doesn’t do exactly what you wanted.
Edmund McMillen’s endings of Binding of Isaac aren’t quite as optimistic as I am, but for my intents and purposes, the author is dead. Besides, if you just subscribe to the theory that Isaac survived but is going through his own psychological recovery cycle– reliving his trauma about what could have gone wrong in the past– then every ending is canon.
I really like the idea of how you interpreted the permadeath in a metaphorical way, corresponding to frustration and mental breakdown in our own lives. While the whole game could be seen as a fantasized biblical story in a child’s mind (of course, with a lot of stress, fear, and disappointment), the players put themselves into the position of Isaac (both in the game and in the biblical story.) My opinion about the ending, however, would be more pessimistic. Though the players could arm themselves with different combos of items, they all return back to their initial state, regardless of what skills and knowledge they possess. The death, the breakdown, is inevitable in the sense that there is no TOTAL recovery. The trauma and the nightmare continue regardless of the actual in-game progress or the improved knowledge.
First of all, thank you for sharing your vulnerabilities and writing such a thoughtful and deep post! I really agree with your point that even with perma death, you don’t start over at zero after you die because you still have the knowledge, memory, and experiences from previous games. I think its the same in life (or at least my Tibetan Buddhist view of life). Life is the repetition and endless cycle of highs and lows, successes and failures, happiness and sadness… But each time you’ve made a full circle, you are not the same you as before because you have one more experience than the old you. Another thing that the game Binding of Isaac does is pointing out the traumatic experiences parents could have on kids. Many people’s mental health issues STEM from their parents and their upbringing, and it is a real issue that needs to be addressed.
Thank you for this post, it was really wonderful. Something that I read recently that this (and another blog post about roguelikes and tetris) reminded me of is the emergent research on PTSD and Tetris. I’d like to qualify this with two things: I am not a psychologist, and that these are very preliminary findings, but there have been studies that show that playing Tetris 24 hours after a trauma greatly reduces the odds of developing PTSD from that event. I’m not quite sure why, I didn’t understand a lot of the stuff mentioned, and like I said it is very preliminary and also hard to test for. It did make me think though, about games not only representing mental illnesses, but also helping to cope and/or treat them. There’s a lot of stuff being done in this vein, like the Center for Brain Health uses virtual reality grocery simulations in order to help veterans with PTSD navigate these social spaces. This is a super exciting space for research and hopefully new ways to help people come out of games 😀
I think I remember that Tetris article. I think the theory was that playing Tetris forces your mind away from the trauma, stopping the player from dwelling on their trauma, and associating more and more negative experiences to the trauma as they keep their immediate past in mind.