On 27th September, at the National Pediatric Innovation Summit, where pediatricians display their wares, a particular exhibit caught my eye: a 2D video game.
A cartoon version of the earth, complete with eyes and mouth floated in space, under ferocious attack from little circular enemies of different colors. They came from all directions, at seemingly random intervals. They had eyes and mouths.
The player had a limited number of ‘missiles’ to shoot them down, but only the red ones counted, as the others did not cause harm. As their speed of approach and numbers increased, it became increasingly difficult, on a cognitive level, to distinguish the colors and shoot the right one at the same time. The game was on a tablet.
Sounds like a straightforward game. Except, there was a breathing component.
The player breathed into the microphone. The feedback created a circle around the earth. How far out it expanded depended on the force of the outbreath. After which, it contracted back.
The game is called RAGE- Control. Neuropsychologists at Boston Children’s Hospital designed it, and others like it to help children deal with anger issues.
According to the exhibit, teaching the brain to regulate negative emotions isn’t too different from “learning to ride a bike.” When angry, our brain has learned a sequence of neurons for anger. And the key is to disrupt this circuit.
Deep breathing helps alleviate stress , but “targeting relaxation alone is not enough, since the child needs access to these skills during the fast paced challenges of everyday life.” So the child must be taught to make “fast paced decisions.”
But wait. As novel as all of this undoubtedly sounds, there’s one thing I haven’t mentioned– the breathing isn’t integral to winning the game.
You’d expect an expanding force-field around the earth to actually do something, like slow down the enemies, or cause some damage. But no. It does absolutely nothing. The brain only receives the visual cue for the expanding force field. If it doesn’t do anything in the game, how will the child associate it with calming anger?
And ‘breathing’ into the microphone is not the right description of the experience. ‘Blow into’ is more appropriate. The microphone’s feedback sucks. (Or was it intentionally programmed that way?)
All this made no sense. So I went up to Jason Kahn, the go-to guy for the exhibit. “I hadn’t really thought of that.” Dr. Kahn said. “To do it, what I’d need to figure out, is how to measure the in-breath and out-breath.” Or something on those lines.
In its present form, the game won’t help a child long term. I’m sure that under controlled conditions a child will breathe because asked. Alone, it will take a child two seconds to realize that the breathing is not helping him win the game and his brain will ignore the cue for breathing thereon.
But this is like yanking the plug from anger. Without the breathing integrated into the game mechanics, the child isn’t ‘learning’ to control rage long term. The game becomes a crutch on which the child has to depend from time to time, to defuse the amygdala. Without the game, how hard would it be to put the plug back in?
If I made a game like this, breathing would have been the central component. The cognitive distractions would be exactly that – distractions. The child would have to figure out how to use breathing to make the game easier as the levels increased in difficulty gradually.
Moral of story: concentrating too much on the brain circuitry can distract from the welfare of patient welfare.
Apparently, there was a previous version where heart-rate was a variable instead of breathing. If I was a kid, I would’ve liked that one better.