We Are Not Therapists: Gaming and Trauma

I remember about a year back or so I saw someone saying their GMs should basically have therapy tools on standby as they only played TTRPGs to explore their trauma. At the time, I made a "gross" face and moved on. More and more of these types of statements began to appear. People were playing games to explore their own traumas. Often, they were doing it at conventions, in larps, and in spaces where they were the only ones aware that they were deliberately entering into a potentially triggering situation and would need care if something hurt them or re-traumatized them. They were using gaming as exposure therapy.

A few months later I was having a conversation with my girlfriend about scopes of practice in our health care jobs. In health care, and I assume in other careers, you have scopes of practice. These are things in your job you're allowed to do and anything that falls outside of that scope is something you shouldn't do. Like, as an RMT, I'm allowed to clinically assess someone through tools and tests, and give an impression of what I think may be wrong. But I'm not a doctor. I can't actually diagnose. So I can say things like "Maybe it's this but you should go see a doctor" or "it could be this other thing, but you should see a doctor."

This is what scope of practice means. It's the things we're permitted to do, as healthcare workers, to give us a clear guidelines to work within. When I open up a new gaming book, I read the rules. But the rules never really tell me what my scope is as a GM. I understand I'm there to facilitate a game. The rules will tell me when I should talk and when my players should talk. They will tell me how to make conflict and how to teach my players to resolve that conflict. It might even tell me how to use a safety tool to prevent trauma or to stop unfun play.

What most games don't tackle is how humans play these games, humans that are full of experiences and emotions. As a community and subculture, we're beginning to have these conversations, but we have a long way to go. We talk about lines and veils, x-cards, consent flowers, cut and break... we have safety tools to help mitigate the conversation around the human element. Many of these games also talk about what they're doing, in some detail, to get full buy in from the people reading and in hopes, the people playing. They spell it out, because some of these games have some pretty brutal content.

And I feel I've done it right, to the best of my ability. I do the lines and veils. I ask for hard limits in an anonymous way. I call people in and out. I do check ins. I do the x-card at every game. I explain it. I ask if anyone has anything they want out of the game. I take breaks and ask how people are doing. I make sure everyone knows what we're doing before we play and that I have consent and buy in for the game.

Despite all of this, there are always occasions where things just... fucking spiral. If you've ever been in one of those games, you'll know what I mean.

You mean well, everyone's apparently bought in, but someone isn't quite okay even though they say they are. Then you're playing and it's getting rougher and rougher and instead of anyone tapping the x-card, we play chicken with ourselves and watch it blow up spectacularly. It's so painful and so brutal. Someone's not okay by the end. That someone is quiet or volatile, they're unloading and unpacking and often? Well, they unload their trauma that lead them to this point.

There's a habit of gamers to engage in their trauma via gaming. Not in a way that I've seen to be healthy or productive. Sure, there are a few of us who are working with a therapist and know that gaming allows us to explore and respond to our trauma in ways that can be safer. Yet how many of us talk about that when we head into the game? How many of us go into a game where we're risking triggering ourselves and haven't told our GM or fellow players? How many of us then talk about our trauma with the GM, the designer, or our fellow players without asking? How many of us assume people want to hear our war stories?

Almost two decades into gaming and I can recall every time this has happened to me. I can talk about, with a strange clarity, each time someone has unloaded their trauma on to me after a game has knowingly hit those beats for them. They pushed the game in that direction and they focused the narrative into a space where they could do some exposure therapy while also playing a role playing game. Did they ask me if I wanted to do this with them? Did they ask the table? Did they even ask themselves?

Those are some of the hardest questions to answer when it comes to people exploring trauma at the table. I know I have played games where I was deliberately angling to enter a space I could explore my hangups in. I know I have also played games and designed characters that dealt with stuff that was familiar to me, not with the intent of exploring it, but just because it was familiar, and sometimes that got out of hand. And sometimes because someone pushed in a direction I didn't account for. There are lots of ways for it to go sideways.

When I made my character who had an abusive father, I didn't even consider how I felt about abusive parents. My father was emotionally abusive and while he never hit me, I was always slightly afraid he would. In game, the scene turned into my father raising his hand to hit me after I came home late (oh Monsterhearts) and I realized I needed to stop. This was before I had really used an X-Card and I remember going, "Hey, I can't do this. I need to veil this." I had made this character who was dealing with an abusive parent and I realized, partly, this was because I was also dealing with the memories of an abusive parent.

I didn't ask anyone else if that was okay. Instead, I forged ahead like I knew what I was doing and that I was fine. I would walk away feeling shaken and sickened after a game, even though nothing had really happened.

In another game, I had a parent get murdered, and as a person whose parent died when I was young, I should have said "no, not this" but instead I thought I'd be brave and just go for it. That game still hurts my heart to think about and that character deeply impacted me.

In both of those cases, I should have thrown up the orange flag and said "Hey, I'm not okay. I have these issues in my life and while I may be okay playing them, are other people okay with the fact I may be triggered?" Why? Because realistically, they're gonna hear about me talking about my trauma. And when we talk about our trauma with people, we inevitably end up sharing something really awful that we didn't ask them to hear. We just... told them. I don't know how many times I didn't ask for someone to listen to me unpack my rapes. I just told them. I should have asked.

Lots of people experience trauma. It's a horrible thing to experience. We are so naturally inclined towards talking about it with others because being understood and being heard can help us process that trauma. And yet, so rarely do we stop to think about consent of those around us. The consent of the listener or listeners is never the topic of conversation. I've seen so many people post on social media about someone unloading their trauma on to them without asking, and now they're unwell and struggling.

Is that what we should do as good community members? Should we see a game about intense and high impact topics as an invitation to unload onto our fellow community members? How do we, as GMs, handle situations where someone is steering the boat towards the disaster they want to retraumatize themselves with through exposure therapy at the table? What tools are there when someone refuses to use the x-card because they want to push the game towards their trauma? How do we stop the train before it crashes?

First of all, let's talk about the scope of being a GM. It's our job, as game facilitators, to know the game well enough to run it (sometimes), to ensure the game runs, to try to make sure folks are having fun, and to be a responsible human being while doing all that (aka, not being a jerk). When someone isn't having fun, you check in and readjust. You listen to when safety tools are used. You adjust the story to your players. You are a constant feedback loop of players and game, moving your way through a story together as a group.

No where in our GMing books or training or experience are we told "Today you will also need to be a social worker, therapist, and doctor." We're not trained to be therapists, nor should we be acting like therapists. Mental health isn't a game and trauma isn't a dice roll. We don't get to tell our traumatized and now triggered players how they should feel or behave, as we're not medical professionals. Many of us want to help when someone at our table is upset, but there are two very not-great things that happen when we try to help them with their mental health and trauma.

The first is that they unload their trauma onto us. What does that mean? It means they tell you what happened to them while you sit and listen and get to imagine that horrible thing happening. It's not good for you, especially as someone who doesn't have the skills to process someone else's trauma. When trauma is heard, we internalize it. In extreme causes, we can get secondary trauma. Now we're traumatized and supporting someone who was traumatized by a game we ran and we're probably dying a little on the inside.

Secondly, we're also now trying to take care of someone who has been triggered. They may be reliving a trauma, or remembering their trauma, or being anxious or depressed because of their trauma and how close to that trauma the game got. They should be talking to someone who loves and knows them, or better yet, a professional who can actually take care of them. And you, as the GM, are naturally going to do your best, or bail, and either way, leave them in a somewhat unsafe position of either being cared for by someone who doesn't know how to do that properly or be abandoned.

Neither of these things are good. Whether it's because someone has come to play a game they suspect will trigger them without getting buy in from the group, or because you've run a game without sign posting that it has triggering content, dealing with a suddenly exploding game and a suddenly hurt person is well beyond your scope of practice as a GM. Too many people like to play therapist and too many people expect gaming to be therapy when they're not using it in conjunction with actual therapy.

Let's stop this whirligig of fun and examine what we can do here. When someone has come to play your game and is sending up yellow flags, mentioning trauma, and saying they wanted to play this game because of what's happened to them, it's probably time to pull them aside and have a chat. You can tell them you're worried, that the game will have content they may find upsetting, and that you want to make sure they can tap out. The bad thing is, sadly, they probably won't tap out. They will probably even do things to steer your game towards their trauma because it's why they're there and heaven knows we love the familiar.

In my experience, there's no way forward that is good. You can either keep running and watch the slow car crash that is your game. Or, and this is what I recommend, you can say you are not comfortable with what's happening and pull the game back from where it was headed.

Either use the x-card yourself, or pull the player aside to tell them you're uncomfortable and worried. No one has the right to make you uncomfortable, even as the GM, and you have every right to stop a game that's headed to No Man's Land. You have the right to stop something bad from happening to you and your players and to that player who's pushing the narrative to a bad place. This is what I do now. Because I am done letting someone use my games as exposure therapy.

The other side of this to be aware of is that you, as a GM, are responsible for posting clear signs on your games about what they contain. If you have triggering content, it is your responsibility to tell your players that ahead of time. When we expect our players to get consent before they play with their own traumas, we must expect us also to get their consent when we're going to be playing with high impact themes. It's a two way street and respect goes a long way. As does trust.

Still, there are those of us who want to use gaming as a therapeutic tool. I support using gaming as a tool, but I come down pretty hard on people who don't get consent before using gaming as a tool (note: Not Therapy) from their group and on people who just spread their trauma around like it's going out of style.

Neither of these things are healthy or being a good community member. That being said, most of us play games, from one time to many times, to explore some high impact content that is directly tied to trauma we've experienced. I'm not saying we shouldn't do that. I think we should. I think it can be used as a tool in conjunction with therapy and good self care to allow for a safe space to explore feelings.

But just like when you go to therapy, you need to get buy in from the people who are about to listen to you. A therapist is someone you pay who is trained to help you unpack and work through that trauma. Your friends love you and want to support you, but aren't trained to be your therapist (nor should they be). Yet it's not likely your therapist is a gamer, wants to game with you, or will cross that client-therapist boundary to play with you. So we're left to use gaming as a therapeutic tool relatively unsafely even though we often find it incredibly helpful. How do we still play games as a therapeutic tool when our therapist can't be there?

We can do a few things. To begin with, we need to make it explicitly clear to our friends (not random convention goers) that we're playing a game that is potentially triggering to us, around specific topics. So when I went to play Bluebeard's Bride, I said to my friends (again, not randos) that I had a history of sexual trauma and abusive relationships with men. I told them it was potentially triggering and that I could possibly need to tap out. I also made it clear I didn't need them to care for me (I'll get there in a second) and that it would simply mean I'd use the open door policy and step away from the game.

They all said they were cool with this. So I prepared to play Bluebeard's Bride.

To prepare, I made sure the game was with people I knew and trusted. Do not go play a game that could hurt you at a convention full of random people. That is bad self care and strangers cannot really consent to you playing a trauma game because they don't know you and don't know what you being triggered could mean. Ensure your friends know what that will look like. When I'm triggered I go quiet and kinda become internal. So my friends knew what to look for, and to ask if I needed to leave (not if I was okay) during the game. This was labour they offered, not labour I asked for.

To be clear, I'm in therapy for sexual trauma. So I had a backup plan. But I also had a set bunch of self-care things I was doing to ensure I was in a good space to play and leave the game. I would eat and have no caffeine so my anxiety wouldn't be up. I would do my anxiety care before game and have it available to me after and during game. I would dress comfortably and drink lots of water. I would have my anxiety meds in case I needed them. I would have a friend who was willing and able to be on call for me in case I needed to call someone to unpack. I would practice breathing techniques during game and bring a project to work on, like knitting, in case I needed to focus on something else for a few minutes just in case. I also made sure I had no responsibilities after the game so I could go somewhere safe (home for me) and just be for awhile.

These were all things I set up for myself. I took care of me. I was responsible for myself.

Sadly, a few players dropped out and people joined I didn't know. It wasn't fair of me to ask random strangers to be present when I could be triggered, so I gently backed out of the game. But that was me being responsible to my friends, to strangers, and to myself by not putting them or me in a situation where they would be at risk of incurring secondary trauma, and I wouldn't feel safe enough to tap out if I needed to. If you're not getting full and proper consent, you don't play. It's really that simple. You do not have the right to force people to engage in your trauma. Ever.

This brings me to my final point about playing with trauma: 
Don't. Unload. On. People. Ever. 

So many of us are strangely excited when we meet someone we assume must be understanding or sharing of our trauma history that we just... open our mouths and let our stories pour out. We basically just throw our trauma at them and say "catch! gotcha!" Which is cruel, when you think about the risk of secondary trauma or, more realistically, the chance of triggering them about their trauma. We are all allowed to share our stories with people, even people we don't know. All we have to do is ask first. Get that buy in. And give them space to say no, accept no, and don't get upset with them if they don't want to hear your trauma. It's yours. Take care of it and deal with it, but don't force others to be your therapist.

Trauma can stay on the table. And it should. But we've hit a point in the community where people are getting hurt by others refusing to be responsible for themselves. I guess I shouldn't be surprised. Gaming has always had an accountability problem. But here I am, bearing witness and being subjected to others' trauma when I go to conventions or when I play at home. I am not a therapist. And therapy is outside of my scope of practice. It should be outside of yours too.

Whether we're designers, players, or GMs, it is our job to acknowledge our trauma and find responsible, consensual ways to process that trauma. Our GMs are not our therapists. And when we play, run, or design games about heavy shit, we need to assert that a game is not an invitation to unload your trauma on others. It is absolutely within our scope of practice to hold space at the table and provide a place for people to play games. And part of that is being protective of that safe space, of saying no, of tapping the X-card, and stopping the car crash.

We're GMs. 
We're not therapists.
Keep yourself and each other safe.