Escape from reality or practicing life in the virtual world

Alen Greš1, Dijana Staver2, Branislav Šakić3

1Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Croatia; 2Neuropsychiatric Hospital “Dr. Ivan Barbot” Popovaˇca, Croatia; 3Department of Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia.

Summary. The modern technology contributes to the development of more complex video games, in which the participant can be completely immersed in the game and have the experience of his own presence in the virtual world through his avatar, which assumes the characteristics of the player. A wide range of motives can mediate pleasure in the virtual world. The virtual world provides the illusion of reality. It makes possible to bypass the need for mental processing of connections and transformations that forms a bridge between the inner world of fantasy and objective reality. It is considered that video games shift the focus to control and narcissistic gratification and that communication in virtual reality implies a greater cathexis of skills and performance than emotions and thoughts. Can we understand video games as a type of projective technique? Strategic video games are often among the one of most popular video games. The authors collected data and materials on the mentioned topics from their daily clinical work, and present a case report. Observing video games through virtual spaces and the ways in which young players use them, we can conclude, that they have the capacity to be useful for various aspects of young people’s development, but they can also interfere with it.

Key words. Gratification, motives, video games, virtual world, young people.

Fuggi dalla realtà o fai esperienza della vita nel mondo virtuale.

Riassunto. La tecnologia moderna contribuisce allo sviluppo di videogiochi più complessi, in cui il partecipante può immergersi completamente nel gioco e fare esperienza della propria presenza nel mondo virtuale attraverso il proprio avatar, che assume le caratteristiche del giocatore. Una vasta gamma di motivi può mediare il piacere nel mondo virtuale. Il mondo virtuale fornisce l’illusione della realtà. Permette di aggirare la necessità di elaborazione mentale di connessioni e trasformazioni che forma un ponte tra il mondo interiore della fantasia e la realtà oggettiva. Si ritiene che i videogiochi spostino l’attenzione sul controllo e sulla gratificazione narcisistica e che la comunicazione nella realtà virtuale implichi un maggiore investimento di abilità e prestazioni rispetto a emozioni e pensieri. Possiamo intendere i videogiochi come una sorta di tecnica proiettiva? I videogiochi di strategia sono spesso tra quelli più popolari. Gli autori hanno raccolto dati e materiali sugli argomenti menzionati dal loro lavoro clinico quotidiano e presentano un caso clinico. Osservando i videogiochi attraverso gli spazi virtuali e il modo in cui i giovani giocatori li utilizzano, possiamo concludere che hanno la capacità di essere utili per vari aspetti dello sviluppo dei giovani, ma possono anche interferire con esso.

Parole chiave. Giovani, gratificazione, mondo virtuale, motivazioni, videogiochi.


The development of modern technology also contributes to the development of more complex video games. Nowdays adults and adolescents play video games more and more, and the dynamism, attractiveness of the image and tone attract more and more players, which takes up a lot of time in their lives1. The video game industry is also growing more and more, as evidenced by the data on the total revenue from the USA of 60.4 billion dollars in 2021. compared to the revenue of 56.1 billion in 2020. and 43.4 billion dollars in 2019 year2. The player does not experience the outcomes in his own game as an observer, but can experience them personally. Their action has led to a certain outcome or an outcome that in turn affects the player’s position in the game and action3. Looking at the screen, the video game keeps the player as an active participant solving a specific problem and requires concentration, unlike some other content on the screen TV that can make us a passive observer4. Personality traits play a large role in video game genre selection preferences. However, personality alone is not their only predictor. A very important factor is the type of motivation that drives the players5. Strategy games (Strategy) and real time strategy games (RTS)6 require tactical thinking and devising a plan to defeat the enemy’s army and capture rival territories and resources7,8. In 2018, there was a change in disease classifications, that is the World Health Organization included in the classification a disorder called gaming disorder and it was thus officially recognized as a disease and addiction9.

Case report

The patient is 18 years old who lives with his parents. He is the first year student of physics, not in an emotional relationship and socially withdrawn. He goes to psychotherapy at the insistence of his parents who are dissatisfied with the fact that he spends a large number of hours in front of the screen every day playing strategic video games. His average is four to five hours a day, sometimes more. Mostly, these are games of the conquest type, in which there is a sense of gain and a bit of gratification that he does not get in a real life. In addition, he states that through video games he learns to be patient and persistent. Sometimes, despite the defeat, he doesn’t give up, but just changes the approach and becomes more creative in devising new strategies to solve problems. During psychotherapy, the patient gradually gained insight into the fact that some situations and skills from strategic video games can be applied in everyday life. It has strengthened its defense mechanisms and ego strength. He gradually became more self-confident, improved his organizational and social skills, and improved his grades at college. He also developed insight and gradually reduced the time spending in front of the screen to one to two hours per day.


Achievement is a common motive. It is a desire of players to feel powerful in the game and to be seen as such by other game participants5. Role playing, which refers to the aspect that the player is part of the story and the game, which he then shapes at will through his own participation in the video game10. An important motive can be establishing relationships with other players, with the story of the game, and playing together and socializing online. A less favorable motive can be an escape from reality in the sense that the player temporarily forgets everyday worries and ventilates frustrations from everyday life through participation in the virtual world11. Some players have also a manipulation motive when they abuse other players with the desire to spoil their enjoyment of the game. With such a motive, winning the game is not important, since the desire for power and dominance is here important12. Video games could also encourage associative thinking. For example, some strategy games provide the player with an introduction to history, geography, and an understanding of the basic concept of the functioning of political and social concepts13,14. In contrast to the emphasized negatives of playing video games, some studies suggest that playing certain video games has a potentially positive effect on brain structures and neuroplasticity15 and can lead to improved cognitive functions, which could become one of the more important advantages for young people16. Some US politicians blame playing video games for most problems such as violence in schools, shootings in public places, various patterns of aggressive behavior and obesity17. There is longitudinal study that has shown that playing aggressive video games has no direct effect on aggression in real life18. Video games can also be useful in acquiring new skills that can be useful to us in education. The downside of video games is that they allow us to escape from the real world, and there is a possibility of addiction in adolescents19. From the classic theories of gameplay, one could highlight ego expansion theories, according to which play exercises cognitive skills and encourages the creation of additional skills, which is a natural way to complete the ego and personality as a whole20.


The positive and negative effects of playing video games have been the subject of research almost since video games appeared21. Future research will offer more precise explanations about the causes and consequences of how players choose game genres and how they enjoy the game and experience gratification, or whether playing video games is possibly related to manifestations of aggressive behavior in real life. In addition to providing entertainment, video games can be quite beneficial intellectually and socially.

Conflict of interests: the authors have no conflict of interests to declare.


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