When he was a young private in the U.S. Army, Erik Johnson was involved in what he describes as "a bad car accident." He suffered 25 percent burns on his body, including his hands and arms.
He underwent multiple surgeries and spent long months in hospital. He was miserable, a young, active man, in a great deal of pain, suffering from the anxiety of a life turned upside down.
During his long recovery, one of the tasks he was given by the doctors was to re-establish use of his right hand. He found that playing video games helped. The doctors, somewhat bemused, allowed him to explore this self-discovered treatment.
"Being able to bring my thumb across and hit the stick and hit the buttons helped me," he recalls. "It gave me a goal. I need to get further around the controller. I need to be able to tap the grenade throw or kick with this button."
In hospital, he also discovered another benefit from playing video games. In the bed next to his, a young soldier was undergoing cancer treatment. They passed away the long, dull hours playing a recently released game from Japan, Final Fantasy 7.
"We were both miserable," he says. "But the one thing that helped us was playing Final Fantasy 7 all the time. The game didn’t do me any specific good as far as physical therapy, but mentally it created a bond between myself and that friend of mine when we were both going through a really hard time.
He had testicular cancer, he was going through chemotherapy. I was working through my own injuries. Being able to connect using games was very powerful. It gave us a way to get our minds off what it meant to be in our situations."
Today, U.S. Army Major Erik Johnson is Chief Medical Officer for Operation Supply Drop, a nonprofit that sends video games to soldiers on deployment, and those recovering from injuries. Johnson, an occupational therapist, believes that games can be especially useful in helping soldiers who are recovering from physical injuries and from the mental strain of combat.
Johnson visits wounded soldiers and works with them, to find ways to connect them with games that can help both physically and emotionally.
"If you have an amputee who has recently lost several limbs, they'll often have a hard time being able to identify themselves with the ability to do anything else in life. They’re often very despondent," he says. "Video games help them reestablish themselves as an able person who can enjoy things they used to enjoy."
He also uses activity games, especially those on Nintendo Wii, that help patients with physical problems.
"First-person shooters aren’t 100 percent negative for people with PTSD."
"If you have an amputee who’s trying to learn how to stand and he’s working on balance, he’s going to have an easier time if he’s engaged in some kind of fun activity. His mind won’t be on the balancing action so much as playing the game.
"I can take the Nintendo Wii and have him play the bowling game. In his mind he’s just bowling, but for me, he’s going to be working on balance, on weight shifting, on standing tolerance and endurance. It can be very beneficial physically."
Johnson also works with older veterans, who may have never played games in their lives.
"I was in a clinic two days ago where I had a 90 year old veteran who'd served in Korea. I introduced him to video games for the first time. He looked at me like I was insane, but I said, 'hear me out'.
"He was de-conditioned. I wanted him to be able to build a bit of strength and exercise. Putting him on the Wii, he was able to exercise without having to go outside, ride a bike, something like that. He was so excited about it. His eyes brightened up. We laughed together. It was good for his mental health, good for his cardio. He didn’t know he was having therapy done. He just thought we were playing games."
Johnson is currently cataloging all the games available on major modern consoles, according to how each of them might help particular injuries. He's cataloged around 100 games, and how they might be used to help particular injuries and ailments.
"I want to take any commercially available game and break it down to show what its therapeutic benefit could be," he explains. "One of my big missions is that I’m going to break down as many games and constantly evaluate them to show therapeutic potential, whether for cognition, physical disability, mental health, problem-solving, memory.
I'll take any game and say, the therapeutic implications of this game are as follows. It can help with dexterity, with strengthening your brain, with depression, with your range of motion in your upper extremities. Maybe it’s a good tool for cardiovascular exercise.
The military has a long history of finding activities for soldiers who've been injured or who have returned from combat with signs of mental strain. In the First World War, PTSD or "shell-shock" was still misunderstood and mostly mishandled. But the military did make the useful discovery that taking stressed but active soldiers away from the front line and giving them tasks like sewing seemed to help take their minds off their troubles.
These makeshift strategies couldn't reach those individuals suffering severe mental shock, but Johnson says that helping make soldiers feel useful almost always has positive benefits.
"Therapists would bring soldiers off the front lines and engage them in activities to get their minds off the rigors of war and kind of reset their brains so that they were refreshed," he says. "We're essentially doing the same thing. They’re coming off the battlefield, getting their minds off the stresses of war and their finding an outlet where they can recuperate, build bonds and go back out and do their job."
Many popular video games offer violent portrayals of war and killing. Is it possible that these games might have a negative effect on men and women seeking recovery and escape from the stresses of combat? Johnson has a surprising take on this.
"We don’t want to use something that causes harm," he says. "But there’s a big misconception about PTSD and military shooters. The idea that playing a Call of Duty game might bring back PTSD issues and trigger something is not necessarily the case.
"The reality is that most people who been to Afghanistan or Iraq, who’ve fought in wars, they know it’s very different, taking fire from an enemy, than just being in a video game. Being immersed in an environment where you can die and respawn and die and respawn, it’s not the same situation.
"Certainly there are triggers here and there and we want to make sure we identify those, things to watch for. But I also want to dispel some of those misconceptions. First-person shooter games aren’t 100 percent negative for people with PTSD."
In the meantime, Operation Supply Drop is still dependent on donations, many of which come from people who play games and who appreciate their value.
"We’re trying to expand our program so we can reach more veterans, " says Johnson. "We’re a nonprofit organization. The more donations we have, the more progress we can make with our supply drops and the requests we get.
"We’re going to reach out to all the military medical facilities in the U.S. Not only are we doing supply drops for them, but I’m going to go in and teach the therapists how to use all these games in their rehab setting.
"Now we can send them with a very specific message. This is a therapeutic tool for you. Let me teach you how to use it, so we can optimize what you get out of it. We want to help anybody and everybody we can.
"But also just donating video games. Consoles, games themselves, peripherals, all kinds of stuff, is fantastic. If people want to get involved, we’re building teams in communities. We want to get as many people involved in doing that in cities across the US and across the world."