80s Flashback? Using tetris to treat PTSD
Yesterday I had to use some skills I hoped I would never need, as a man collapsed in front of me while I was walking to work. Rolling him in to the recovery position revealed a deep and profusely bleeding wound to the head, which I tried to stem as another passer-by called an ambulance. The crew arrived within minutes, and the man began to regain consciousness.
As I got home and removed a stranger’s blood from my hands and clothes, I kept getting visions of that same blood pouring from the back of his head. Then, I remembered a talk by Emily Holmes I had seen a few months ago, and the fantastic suggestion she had for preventing intrusive flashbacks: TETRIS!
Yup, you read that right. Tetris as a treatment for post traumatic stress disorder (PTSD). The rationale is beguilingly simple. Flashbacks are intruding visions of an experienced trauma, and are one of the main symptoms of PTSD. In her papers, Holmes describes them as ‘sensory perceptual visuospatial mental images’. Since we only have a finite capacity to process visuospatial information, if the encoding of the images that will become flashbacks could be prevented, perhaps this could be used to treat PTSD. Holmes describes tetris as a potential ‘cognitive vaccine’; treat the flashbacks before they start by using a visuospatial game to take up the cognitive space, preventing them from being encoded. If it works, it would be really easy to implement in all sorts of situations; advice after terrorist attacks for example, or even on the battlefield.
In fact, Holmes and her lab have run a couple of experiments investigating this idea. So far, they’ve only done this (that I can see published) in a healthy population. They showed them a traumatic video, called ‘The Trauma Film’ described as an experimental analog for PTSD (I couldn't find it online, but I imagine it’s something akin to The Ring). In the first experiment, half an hour after watching the film, one group of participants played tetris for 10 minutes, while the others did nothing. Flashbacks were then monitored for a week, in both groups. Holmes et al. found that those who played tetris after watching the film experienced fewer flashbacks than those who did nothing. They also showed that it wasn't just that the tetris group remembered the film less well; the groups were no different at recalling details when prompted.
While this suggested that the tetris may be having the effect they expected, Holmes and her lab wanted to be sure it wasn’t just doing something that had the effect. They ran the same experiment again, this time giving a third group a different computer based task, a ‘pub quiz’ game. They also added a further experiment with a larger time delay between watching the film, and playing the game; 4 hours. Again they found that those in the tetris condition had fewer flashbacks, but the pub quiz game didn’t reduce flashbacks (indeed, in the short timescale experiment it seemed to increase their number). Also, tetris was still effective at reducing flashbacks, even 4 hours after watching the film.
Holmes theorises that it’s the cognitive visuospatial load of tetris which gives it this property, and that it’s effective a few hours after trauma means it could be clinically useful. In the discussion of the paper, Holmes suggests the next step is to test the application in those who have recently experienced real trauma, rather than after watching a film. So, in the name of science, after having a cup of tea, I played tetris.
Only slight problem is, when I tried to go to sleep, all I could see were colourful blocks!