Games and aggression: Is it a bad thing?

I am often asked what I think about video games and aggression. It is a funny question because how can I say that games can’t make you aggressive if I also think games can affect what you do and think? I’d like to take this opportunity to resolve this seeming contradiction.

First of all, I would like to begin by saying that I do not believe that aggression, per se, is “wrong” or “bad.” I believe that there are situations where aggression is inappropriate and can lead to negative consequences. Likewise, I also believe that there are many situations in which aggression is appropriate and leads to positive outcomes.

We focus a lot on how aggression is negative. Clearly bullying, domestic violence, date rape, pedophilia, murder, drug-related violence and genocide have negative consequences for individuals and society. Dominance, aggression and violence are inappropriate from a moral, ethical, legal and societal standpoint in these examples.

But all humans are capable of aggression. After all, aggression has evolved as an adaptive behavior. Humans as well as other primates and other species demonstrate aggression when they compete for resources (food), protect their territory, assert their status, and seek mating options. They demonstrate high levels of aggression when they are faced with threats to their survival and, in the cases of females, threats to the survival of their offspring. Humans and other species are on the earth today because aggression has helped them survive.

Mother bear protecting cubs

I believe that aggression is also a very important active stance to take when battling a life-threatening illness such as cancer. In fact, there are research studies that have shown that patients who are more active and believe there are things they can do to fight their cancer, fare better. With this as a guide, along with a brilliant team of researchers, patients, healthcare professionals, game developers, artists, voice-over actors and a generous philanthropist, I had the honor of working on a Teen-rated game for young people with cancer. This game, Re-Mission, is considered to be a violent game because in it the player shoots cancer cells with chemotherapy, zaps tumors with radiation and blows up stool jags (a.k.a. poop) with stool softeners.  Please watch the video to see what one patient thought of it.

Doctors treat cancer very aggressively and these young people with cancer should be working with these doctors to do the same. But they often don’t know what they can do to fight their cancer. Re-Mission helps them understand what is going on inside their body and what they can do about it. In the game, they metaphorically fight the enemy, cancer and its side effects, aggressively.

We did a large randomized trial on the game and found that it had a number of positive effects on the patients with cancer who played it. They not only increased their knowledge of cancer and confidence in their ability to fight it, they also took more of their antibiotic medication and maintained higher levels of chemotherapy in their blood compared to patients in the control group. Increased treatment adherence to antibiotics and chemotherapy is related to improved survival outcomes in this patient population. So it seems that the aggression that Re-Mission promoted to counteract a very aggressive enemy, cancer, was appropriate and positive in this patient group.

Before I close, I do want to say that this does not mean that I think parents should let their young children play violent video games in general. Parents should be protecting their children from being unnecessarily exposed to violence whether real or simulated. If a parent doesn’t have time to monitor what their child does every minute, the least they can do is not buy Teen- or Mature-Rated games for their underage children. If they do have time to monitor their children, they can make sure that their kids aren’t getting a hold of those games some other way and playing them. And if their teenage children are faced with an aggressive enemy, I would also like them to consider that taking an aggressive stance against the enemy could be adaptive and appropriate…but under their supervision as well.

In sum, I hope we can consider both the positive and negative effects that video games or any other new media can have on all of us. I want to spend my time getting the most positive effects from video games that I can. As I do my work, I also have to acknowledge that video games have been shown to be associated with negative outcomes with certain people under certain circumstances. I think that taking an extreme position in either direction is unhelpful and does little to advance our understanding of video games as problems or solutions. So I am not going to take a stand to say video games are good or video games are bad. I am going to say that I think they hold a lot of promise to do some amazing things if we can balance the “good” and “bad” and use them appropriately and with care.

By pamkato

I am a Harvard- and Stanford-trained Ph.D. psychologist, social entrepreneur, and serious game visionary. I want to work with other people to change the world while having fun doing it.


  1. I am always surprised by the unbelievable amount of violence in video games in general, I haven’t had experience with serious games. But I can understand how it could work. If I listen to very upbeat music, somewhat ‘aggressive’ music, it makes my adrenaline flow and want to persevere. I presume it gives patient the needed aggression to stick to their regime and follow through with the treatment. It may just give you the strength the endure another round of chemo when you have really had it. And with children it is probably a good way to help them visualize the enemy in their body.

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