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Game designer says medium can provide empathy, dialogue and increased self-awareness

Doris Rusch
Doris C. Rusch, the creative director of DePaul's Deep Games Lab, spoke about game design at TEDx DePaul University in 2017. (DePaul University/Jeff Carrion)
Video games can be used for more than just entertainment, they can also help raise awareness for mental illness and diseases, says Doris C. Rusch, an associate professor of game design in the School of Design.

A DePaul faculty member since 2011 and the creative director of the university's Deep Games Lab, Rusch has helped create games such as "Blood Myth," which examines living with sickle cell anemia; "Soteria" and "Zombie Yoga" about anxiety; and "Perfection," a game that addresses the eating disorder anorexia nervosa. Her current project aims to help players understand the mechanisms and emotional dimensions of emotional abuse in intimate partner relationships.

In this Q&A, Rusch explains why this medium is so important, the process for creating a game, how games can be an avenue for healing and what she hopes her games will accomplish once released.

Why is it important to you and the other researchers and developers in the Deep Games Lab to create games for more than just entertainment?

Games are the cultural medium of our century and we should use it for something. It's great to have things that just entertain you, but there's so much more they can do for you, so why not? Our games make one point and can really help conversation, dialogue and empathy. I think that's totally worth doing.

What's your process for creating a game?

The process depends on whether I pick a subject that I already have some personal experience with or whether a client or stakeholder brings a subject to me. If it's personal, coming up with a metaphor is a very natural process. The experience is already on my mind and to make sense of it, I'm playing around with metaphors and systems all the time. What does it feel like? How does it work? Images tend to just bubble to the surface that illuminate salient aspects of the experience. Then I go from there and explore the image further.

I also use structural elements of games to get a grip on a concept. What's the goal, the win/lose state, the conflict? Sometimes there is no goal. Or no win state. That tells you something about the kind of system you're modeling. As an example, making games about bipolar disorder or attention deficit disorder, there is no clear "win state" as the illness can't be beaten, only managed. But eating disorder - as a more addiction-based issue - can have a win state.

When I make a game about a subject that is brought to me, I spend a lot of time talking to various experts, primarily people with lived experience of the issue, but also doctors, family members, friends and others. I'm trying to get as much of an understanding as possible about "what it's like" and the implications of the issue for personal life and social context before I even think about a game or mechanics. Throughout the design process, there is a lot of playtesting that involves subject matter experts, especially when I make a game on a subject I don't have lived experience with. I want to make sure those who do feel as accurately represented as possible.

What's your hope for a game once it's created?

My main hope is that people who might benefit from them in one way or another play my games. I know our games are not for everyone, and that they are not for every mood. You've got to be ready for them and open to experience something that's not just entertainment. The target audience varies from game to game, of course.

For example, "Elude," a game about depression, was specifically designed to facilitate dialogue and increase understanding between people with lived experience of depression and their friends and relatives. It's the dialogue that will deepen the experience and complete the game's purpose. The game in and of itself is only a conversation starter. "Soteria," a game about anxiety, was mostly made for people with anxiety disorder to promote readiness to embrace being unsafe and uncertain. However, you don't need to have an anxiety disorder to benefit from the experience in some way. We all have things we shy away from or don't feel comfortable with. So, the actual audience for it is broader than those the game was originally designed for.

For the complete Q&A with Rusch head to To play some of the Deep Games Lab video games check out

Doris C. Rusch is among the hundreds of DePaul faculty who offer their expertise to members of the news media through the DePaul Experts Guide. Are you a faculty member interested in speaking with the media? Learn more about the guide in Newsline.