Jerald Block MD first came to Destructoid's attention earlier in the month when Haley ran a report on the Oregon psychiatrist and researcher's latest work on the Columbine massacre. Published in the American Journal of Forensic Psychiatry, Block's paper Lessons From Columbine: Virtual and Real Rage takes the stance that rather than being incited to violence by the violent gaming content they had a predilection for, killers Dylan Klebold and Eric Harris actually used their admittedly obsessional Doom fandom as a sanctuary from the real world and a way to funnel their real-life rage.

He theorizes that after becoming so wrapped up in the both the escape and empowerment offered by this digital security blanket, it was actually the cold turkey situation brought about by the boys' banning from their computers as a punishment which played a large part in pushing them over the edge. At 42 pages, the report is a chunky text, but its also very accessible and worth a read. I'd recommend that you check it out.

While Dr. Block is open about the fact that his analysis is speculative and invites further studies to debate his work, the man does make some interesting points, and it's refreshing to read a report on the tragedy which comes from a technology-led angle without blindly laying the blame at the feet of gaming. And whether you agree with what he says or not, it's also good to read a report of this kind from someone who actually knows games and the industry.

Destructoid: Could you start with giving me some details of your professional history and background?
 
Jerald Block: I am a Board-Certified Adult psychiatrist. I have a private practice and I see adults and adolescents of age 14+. My practice is a mix of prescribing medications and/or doing therapy. I am an advanced psychoanalytic candidate at the Oregon Psychoanalytic Institute and I am also on the clinical teaching faculty at Oregon Health & Sciences University. Prior to becoming a doctor, I was an industrial engineer and worked as a computer consultant. As a hobby, I used to board game and computer game fairly heavily. I even reviewed a computer game for a magazine, awhile ago. Now I don't have that sort of time.
 
In general, I spend about two thirds of my day seeing patients. The other third I use for research. The research is generally related to my clinical work and unfunded. I do it because I enjoy it. 

Destructoid: What prompted your investigation into the causes of Columbine eight years later? Were you always dissatisfied with the explanations presented at the time? And what inspired you to pursue a technology-led angle?
 
Jerald Block: I have been interested for years on the impact of technology on people. Perhaps that is the engineer in me. Essentially, I've believed for some time that human society has embarked on a grand experiment with computers and tech but we have not really know how it effects people, for better or worse.
 
I started doing formal research into technology and people in medical school in 1993. At that time, some colleagues and I looked at "compulsive computer use" using a survey on Prodigy.  The data was interesting - perhaps even alarming. But, it was also procedurally flawed, and we never tried to publish it. The research interest stayed with me and, upon finishing my medical training, I returned to it. In my practice, I kept seeing patients that could not control their computer use, asking me for help. Unfortunately, there were few solutions that I could offer them. As a result, another doctor, Rich Goldstein, and I formed a company and hired programmers / staff to make software that would allow people to self-impose limits on their computer game use - limits on the basis of weekly budgets or time of day. (SMARTguard Software – the company closed down this year)
 
While making that product, there was much ballyhooing about how "violent media makes for violent people." People were asking me if they should use our software to limit access to "violent" content. Clinically, I had seen games seemed to calm people down, not agitate them.    So, I was curious and started to look at the literature. I was unimpressed – probably a better word would be "disturbed" - with the quality of what I saw.
 
Around this same time, the Columbine diaries and legal records became publicly available. I knew that Eric Harris and Dylan Klebold played many computer games. I had even played some of the same games. So I was curious and began reading the data…It was consuming, compelling, and disturbing reading.

Destructoid: Videogames have come in for a lot of unfair demonizing in the past, but while most of this has come from uneducated knee-jerk opinions, there have been scientific attempts to back up this point of view. You state early on in the paper that the most damning attempts so far to prove a causal link between video game violence and real world violence have contained "incorrect statistical calculations and overreaching conclusions", and say that if there is a link, it "appears to be a weak one". Can you possibly embellish on this for our readers, and explain why you take this stance?

Jerald Block: Well, let's start with your premise – that a lot of the criticism has been "unfair."  I don't agree with that. Game developers know when they are pushing the envelope – putting in plot or graphics that will offend some people. Indeed, most developers do so purposefully, for specific reasons. Perhaps they want to distinguish their game's "realism" from others. Or, they want to ally with the gamer against "repressive" society, earning the gamer's loyalty and future sales. I'd argue that several successful companies, like Take 2, have used such marketing strategies. And they expect the criticism, maybe even like it for the free PR, though sometimes they get burned. The companies figure it is worth it. The problem is that the entire gaming industry then gets predictably (ie, not unfairly) attacked. But, I agree.  The criticism is often couched in claims about the scientific data - the data, as I will discuss, is too weak to do that…at least today. Rather, I would argue that the games that offend violate some sort of social norm and, really, it then becomes a political issue. Are they offensive enough to warrant restricting them, in the same way we limit access to porn? Our country has a long history of censorship that I will leave to others to discuss.

Now, to the gist of your question. There are several examples of the scientific literature having serious flaws but I'll focus on the one that really upsets me. Bushman and Anderson are two researchers who have taken a strong position, stating that the exposure to media violence causes violence. They have written several important articles together. Perhaps the most referenced one is titled, Media violence and the American public: Scientific fact versus media misinformation (2001, American Psychologist). In this article, which has been cited over 100 times and spoken about before the US Congress, the authors reviewed the literature on media violence, documented several new and original research results, and showed how weak correlations are really quite powerful. This was their key point – weak correlations may still be strong enough to scientifically justify political policy. [Note for your readers: correlations are a measure of how strongly associated two events are. They vary from -1.0 to +1.0.  A correlation of zero would mean no relationship exists. A correlation of 1.0 means that every time X occurred, Y also occurred. If violent media created violence, a variable representing exposure should have a sizable correlation to a variable measuring of violence]

The article was startlingly effective. Bushman and Anderson had produced a bar graph that showed media violence was almost as linked to violence as smoking was to lung cancer.  I was shocked. So, I started looking up the referenced articles, to see how the authors justified the poor correlations.

To my surprise, I found most of the articles never calculated a correlation. Moreover, they did not offer even enough data to calculate one. With few exceptions, I found the chart to be totally unfounded and irreproducible. (see attached graphic) Indeed, I was unable to reproduce any of the original research in that article. Now, fast forward almost two years. Bushman and Anderson now claim that they modified their data; the published correlations were actually estimates.  Never mind that they never documented any such alterations in the data – one should wonder how well they estimated. Usually in science, we tell people that we are estimating and the accuracy of the estimate. Not here.  So, how well did they estimate?
 
Very poorly. There was one study with enough data so that somebody could actually calculate a real correlation – it was a classic article linking smoking to lung cancer. In this study, Bushman and Anderson estimated a correlation at 0.4. The actual correlation is 0.9. That is a world of a difference.
 
Originally, Bushman and Anderson told us 2+2 equals 11. Upon being called on it, they correct themselves, saying 2+2 equals about 11.  It is sort of funny until one considers that these are professors that teach statistical methods to other researchers. Sorry about being so verbose but it bothers me. And, when the leaders in a field are reporting completely suspect data, I am not sure who to believe. At present, I tend to trust my clinical experience and analysis as presented by people like Freedman and Olson.

(For more info on this see the Response to Bushman and Anderson section on my website, www.jeraldblock.com)

Destructoid: While you seem to disagree with the idea of videogames inciting violence, the major theme of your paper is the idea that Harris and Klebold immersed themselves heavily in the virtual world of Doom and game-modding in a retreat from a real world they found abhorrent, and that it was their forced removal from the virtual world which pushed them over the edge. You also state on several occasions that interaction in a virtual world can have a healthy and cathartic effect on the player, providing a safe outlet for aggression. To that end, is it possible that the tragedy at Columbine was postponed by Harris and Klebold's gaming, and if so, how long do you feel that situation could have been maintained?

Jerald Block: I don't know. To answer would be pure speculation. I wish we knew more about the life history of people who are pathological computer users, like Klebold and Harris. How many continue to use indefinitely, "burn out" and move on, or come to some bad end (suicide, a switch to drugs, etc)? And, what happens to those people that get restricted from the computer early in their habit? I do believe, however, that the therapeutic recommendation to Harris' father to restrict the computer was ill-informed and dangerous.

Destructoid: Could you embellish on your statement that videogames can provide a harmless outlet for aggression? Many - myself included - feel that violent media can have a positive cathartic effect in a modern society in which actual violence has no place. How far do you think videogames, violent or not, can play a therapeutic part in human life?

Jerald Block: I think they can be helpful, in moderation. This works in at least two ways:  First, life is spiraling a bit out of control. Random people are trying to kill us, crashing airplanes into our buildings, setting off bombs to create terror.  Bird Flu, global warming, nukes, etc. It is hard not to feel somewhat weak and vulnerable. When we use the computer, we can feel more empowered as we fight on a virtual battlefields. Nobody is actually harmed and our defeats can be reset and rerun.

Secondly, when we feel angry, we can delay acting on the emotion and, instead, exhaust ourselves on the computer. As long as the underlying conflict – the source for the anger – is resolved, the delay is probably very good.

On a different note, there are some interesting Virtual simulations that are being used to treat Post-Traumatic Stress Disorder and various phobias.

Destructoid: In your conclusions you say that virtual worlds can be allegorized with alcohol. A moderate amount can be "healthy and helpful" whereas excess can be "destructive and isolating", with cold turkey causing heavy users to feel "lonely, insubstantial, anxious and angry". How strong do you feel that risk is? Do you think those symptoms are something every heavy videogame player is at risk of, or do you feel that a minority are predisposed, as is the case with other addictions?

Jerald Block: Consider a patient who has lost a lot of blood. Some, like those who had stabbed, lose it very quickly.  The blood loss, alone, can put them into shock. Then, there are those patients that lose the same amount of blood but slowly, over months.  Perhaps, a gastrointestinal bleed. They walk around, like everyone else. Maybe they complain of fatigue.  I think that obsessive computer users are a lot like the slow bleeders. They are functional, hard to identify, and hugely underdiagnosed. We have no idea how many people are walking around with pathological computer use, but I think the numbers are high. We will not know just how many until clinicians start asking the right questions.

And, yes, I am very concerned by the situation such people face. It is a difficult dilemma:  continue to use the computer and feel bad vs. quit and become completely miserable for a significant period of time. (see my article in the Psychiatric Times titled Pathological Computer Game Use) In that way it is identical to the situation faced by other forms of addiction. However, with "pathological computer use" there is no serious wake-up call. There is no near-death overdose, or seizure, or motor vehicle accident, etc. So, most heavy users just keep using and there is an insidious drain on the person and society.

[Harris' napalm test notes]

Destructoid: Throughout your report, you list several possibly contributory factors to the tragedy. The police were often ineffective in their investigations of the boys. Klebold's parents failed to react when his disturbing writing was brought to their attention by the school. The boys had self-hatred issues stemming from bullying. Harris was taking Serotonin Reuptake Inhibitors which some believe to be contributory to violence and suicide. Internal peer pressure between the boys may have forced them to continue with the plan despite personal misgivings. Amongst these, relatively how serious do you think the deprivation of the boys' virtual sanctuary might have been as a factor? Was it the fuse that lit the whole bonfire, or was it just one of many equal causes?

Jerald Block: With two exceptions, I discount most the other proposed causes. They are not particularly compelling. The exceptions are (1) peer-pressure and (2) copycatting of prior school attacks. Klebold and Harris entered into a pact to commit the attack a full year before they did so. They were clearly aware of prior attacks and considered these while making their plans. Once they decided to kill, they then wrote and talked about it, over, and over, and over. By the time the date of the attacked neared, both adolescents would have felt they completely committed. This is the same process used for training modern day suicide bombers – constant reinforcement of the message in relative isolation of other, competing messages. I think, unconsciously, both killers were looking for an out. That would explain some of their disturbing papers, hoping on some level somebody would see through the writings and divine their plan. I also suspect Klebold and Harris were hoping for a last minute excuse to pull out – perhaps forming a sexual relationship at their senior ball. It did not happen and the attack occurred soon thereafter.

[Extract from Klebold's yearbook. Writings by Harris.] 

Jerald Block: I am not sure which of the two passages from Harris you are referring to on page 18 but I think they both illustrate the same point.  Harris had just been banned from the computer and the game. In its absence, he was keeping the game alive, refusing to give up his Virtual life and the degree of power he felt there. By merging it with the Real, he did not need to give it up.

He does not sound desperate to me – Klebold often sounded that way, verging on suicidal.  Rather, Harris sounds enraged. The Real world was telling him he was a juvenile delinquent; in contrast, he believes he has "god-like" power. His power, though, was all based in the Virtual. He had to either make the Real world appreciate his Virtual accomplishments or transform the Virtual into the Real. As he was banned from the computer, he was left with the latter. Either that or he had to acknowledge that he really was a grandiose social outcast who had just graduated to petty theft, and got caught.

[Extract from Harris' yearbook. Writings by Klebold.] 

Destructoid: On p.16 you state that Harris and Klebold's writing became "markedly angry, violent, and disturbed" following their computer-ban in January 1998, theorizing that "The mechanisms that were being used to manage their anger lost their utility. Either they were no longer available because they were banned from their computers, or the virtual world could no longer contain their rage." Given the string of trouble the boys had already had, is it not feasible that it was merely the very process of being punished so severely that pushed them too far? No-one likes being told what to do, particularly adolescents. Is it not possible that a restrictive punishment of any kind would have incited the same angry reaction, regardless of computer involvement or not? Or do you feel that the interactive "virtual world" nature of their hobby made it a bigger loss?

Jerald Block: Ask any parent. Punishments will always lead to reactions. Hopefully, the response is for the better. But, frequently, there can be an unintended worsening in behavior. One thing that helps things go better is if the loss is acknowledged as such. If a student is suspended from the football team because they are caught drinking, pretty much everyone would acknowledge how severe a punishment that was, even if appropriate. But when Klebold and Harris are kicked off their computers, few, if any, would recognize just how important their Virtual lives were to them. Most people wouldn't even know they were in trouble.  That would make the punishment much more severe.

There are two other concepts worth mentioning. For heavy computer users, cutting them off can free up 30 or more hours a week. That is a lot of time to fill, especially for an enraged teen with limited social skills.  Unwise. The second issue is to recognize that computer users have a relationship with their computers. Consider the last time your hard drive failed and how you felt. Or, the frustration you felt when your cursor went crazy until, after several hours, you realize the battery in the wireless mouse was low on juice. As silly as it may sound, being cut off from the system might feel something like being cut off from your best friend. Going back to the football player, though suspended from the team, he wouldn't lose his friendships.

With regards to Columbine, all this is complicated since there were two sets of parents, and each family had different solutions to their children's misbehavior. Harris' parents appear to have been fairly strict and imposed firm limits, as best they could. Klebold's had the opposite philosophy and tried to minimize such prohibitions. In that context, it is interesting to note that upon Harris' death, there was one computer in his house. It was upstairs, in an office next to the parent's bedroom.  On the other hand, there were five computers in the Klebold home, three of which were in his room. Obviously, neither parenting strategy was effective.

Destructoid: On a similar note, you theorize in your paper that those who partake heavily in the virtual worlds provided by technology can end up partitioning their whole reality into separate sections for the virtual worlds and the real world, functioning in both independently. You note in support of this that Harris and Klebold went as far as creating separate "god" identities for themselves and compared and contrasted the two worlds frequently in their diaries and blogs towards the end, often using Doom terminology to describe people and things in the real world. Is this indeed a sign that they perceived the game world as an alternative to the real world - and maybe even saw the two as converging eventually, or is it possible that they were simply using a shared lexis in order to cement a separate group identity for themselves in the way that many sub-cultures and hobbyists do?

Jerald Block: I see three distinct phases: In the first, Harris kept his two worlds separate.  When he made attempts to talk about his Virtual life, it appears he felt invalidated. At one point, Harris wrote about people not understanding how important the game Doom was to him.

As the teens got restricted from the computer in their Junior year, they entered a second phase. Here they had very limited access to the computers; the only way to keep that world "alive" was to merge it into the Real. They continued to talk and write of Doom, but now in the context of planning the attack on their classmates and others.  

In the third phase, the computer became a less of a relationship and more of a tool. When they eventually regained access to their computers, the Virtual no longer was as satisfying. At this point, the computer switched from being a source of entertainment to being a device used to research weapons and practice their attack without drawing attention. A different way to view this is that they became disenchanted with the illusionary power that the computer gave them and, instead, decided to grab it in the Real. Supporting this is the substantial amount of damage the two shooters caused to technology in the school; when they stopped trying to kill people, they started shooting at computers, video equipment, and TVs. They were enraged by both people and technology.

That being said, I would also agree with your excellent point. The lingo that Harris and Klebold created helped bind them in their friendship. Much of these code words, such as "zombies" or "NBK," were based on the lexicon of Doom, the movies they watched, and on the music they listened to.

Destructoid: Your report states that gamers segment their virtual and real world lives due to an inability to discuss or gain recognition for their virtual achievements in the real world, and cites that perhaps this lack of crossover helped push the boys further into the virtual. With games now evolved far past what they were in 1998, into a very mainstream activity with huge online communities such as Xbox Live, is that risk increased or decreased? Gaming is much more normalized now, and people now play together online in vast social networks and can actually gain and compare ratings and scores for their in-game achievements. Do you feel that this increases crossover between the virtual world and the real world, or does it create a separate online world, running in parallel to the physical one? Or has gaming become so accepted in the mainstream that the question is now arbitrary?

Jerald Block: Very good questions. I've wondered the same. To the extent that the online community has incorporated things like VoIP and guild face-to-face meetings, I think is a good thing. A very good thing. Also the professional circuit is probably a good change. And, yet, many people are still gaming with few real world interactions.

I don't know if this example holds up but I frequently think about it. In Eve Online, Corporations are sort of like nation-powers and subversive elements, like the mafia, are allowed within the game's rules. In one highly written about case, a mafia-like group took on a contract to kill a enormously powerful corporate leader within the game. The group infiltrated the avatar's company for about a year (real-time) and, in a few hours, destroyed him as completely as possible. Overnight, he had lost something like $15,000 worth of real dollars assets. The next morning, what does this man/woman/child feel? Betrayed? Shame? What of this event can they tell others? How much would they understand? Would it feel like a dip in the stock market or something far more personal?

Or, consider the closing down of the MMORPG Auto Assault later this summer. I have no idea if there are Auto Assault enthusiasts out there, in the way WoW collects them, but we should wonder…how will they react? One minute you might be enormously powerful online. The next minute, the plug is pulled and your entire Virtual existence is deleted away. We should expect such events to make people question what they have they been doing with their lives for the past year(s). Imagine the day when that happens to WoW. It might seem unlikely but… suppose Blizzard gets sued and needs to shut its servers down… will we have 9 million infuriated people across the globe?

Destructoid: Whenever we have a violent tragedy involving young people, violent media and particularly games are blamed to some degree, at least by certain areas of the media and political world. What message to you have for those looking at media such as gaming in relation to these incidents? What can we learn from Columbine and what should we focus on in preventing future cases of youth violence?

Jerald Block: As I hope I have made clear, I think the issue is far more complicated than we generally hear. "Violent media" as a research topic has become politicized with its leading "researchers" and associated special interest groups trumpeting bad research while playing the wrong tune. I believe the primary issue is not the violent content. The problem is how seductively immersive technology can be. It becomes our best friend, our container for aggression, and the place we spend time. For many of those immersed, they go into crisis when they lose access to it. Clearly, we need more research exploring and confirming my analysis. In the interim, I'd suggest moderation, both in computer use and when putting limits on gaming.

One immediate step that professionals need to take is to start asking questions like "how much time are you on the computer?" and "when?". This is rarely done. As a result, most physicians and therapists never learn that a significant amount of their patients are up at 3AM, every night, playing on the computer. Doctors need to start paying attention to how their patients are using the computer.

Destructoid: Dr. Jerald Block MD, thank you very much.

[Massive thanks to Mr. Haley for setting this one up. You're a scholar and a gent.]