Blocked-in syndrome: Another look at Game Transfer Phenomena

Back in the early 1990s, I used to play the video game Tetris on my handheld Nintendo Game Boy. Although I say so myself, I was a really good player and I used to play for hours every day. When I went to bed I would see falling blocks as I closed my eyes. I often experienced the same thing when waking up. What I didn’t realise was that many other gamers experienced this too and that it had a name – ‘The Tetris Effect’. According to Wikipedia,the Tetris effect occurs when people devote so much time and attention to an activity that it begins to pattern their thoughts, mental images, and dreams.”

In the late 1980s I started researching into the area of video game addiction. One of the papers I cited a lot in my early research concerning the side effects of excessive playing was a 1993 case study published in the Irish Journal of Psychological Medicine by Dr. Sean Spence. Dr. Spence reported the case of a female video game player who was diagnosed as suffering from persecutory delusions, exhibiting violent behaviour, and experiencing constant imaginary auditory hallucinations triggered by the music of the Super Mario Brothers video game. This case study and the Tetris effect are both examples of what I and my research colleague Angelica Ortiz de Gortari call ‘game transfer phenomena’ (GTP).

These phenomena tend to occur when video game players become so immersed in their gaming that when they stop playing, they sometimes transfer some of their virtual gaming experiences to the real world. These phenomena can occur both visually and aurally as well is in the form of unconscious bodily movements.

We have been researching GTP for a number of years and our first published study in 2011 made worldwide news. Some of the press coverage was both sensationalist (“Gamers can’t tell real world from fantasy, say researchers) and misleading (“How video games blur real life boundaries and prompt thoughts of violent solutions to players’ problems) and angered some of the gaming community. Our first published study in the International Journal of Cyber Behavior, Psychology and Learning was an exploratory study in which 42 gamers were interviewed. Although the sample was small, we reported that all our participants had, at some point, experienced some type of involuntary sensations, thoughts, actions and/or reflexes in relation to videogames when not playing them. For instance, one gamer reported witnessing a mathematics equation appearing in a bubble above his teacher’s head while another reported health bars hovering over football players from a rival team. However, this didn’t stop some of the press coverage being derogatory (Unscientific survey of 42 gamers concludes video games interfere with perceptions of reality).

Since then we have published three more studies from a self-selected dataset of over 1,600 gamers’ experiences (all of who had experienced some form of GTP) in various academic journals (International Journal of Human Computer Interaction; International Journal of Mental Health and Addiction; International Journal of Cyber Behavior, Psychology and Learning). Our findings have shown that some gamers (i) are unable to stop thinking about the game, (ii) expect that something from the game will happen in real life, (iii) display confusion between video game events and real life events, (iv) have impulses to perform something as in the video game, (v) have verbal outbursts, and (vi) experience voluntary and involuntary behaviours.

While some gamers qualify their experiences as funny, amusing, or even normal, others said they got surprised, felt worried, embarrassed and their experiences were a reason to quit playing. Based on our research so far, Game Transfer Phenomena appear to be commonplace among excessive gamers but the good news is that most of these phenomena are short-lasting, temporary, and appear to resolve of their own accord.

Despite instances of GTP elsewhere in the psychological and medical literature, we argue that there are important reasons for not using the ‘Tetris effect’ concept when studying game transfer effects. Among the most important are that: (i) the Tetris effect definition is very broad and does not emphasize the importance of the association between real life stimulus and video game elements as a trigger of some of the transfer experiences, (ii) it does not make a clear distinction between sensorial modalities in the game transfer experiences or talk about players’ experiences across sensorial modalities (e.g., hearing a sound and visualizing a video game element), and (iii) the name itself is inspired by a one specific stereotypical puzzle game (i.e., Tetris). This simple name indicates that it is repetition that triggers the transfer effects but there are other factors involved in game transfer experiences. Furthermore, modern video games use more than abstract shapes and offer more flexible scenarios compared to Tetris and similar games.

Our latest study that surveyed over 2,500 gamers is currently being analysed but preliminary results indicate that game transfer phenomena appear to be common among players – especially those that play heavily. It could be that some gamers are more susceptible than others to experience GTP. Although for many gamers the effects of these experiences appear to be short lived, our research also shows that some gamers experience them recurrently. More research is needed to understand the cognitive and psychological implications of GTP. Our studies to date show there is a need to investigate neural adaptations and after-effects induced by video game playing as a way of encouraging healthy and safe video game playing.

Note: This blog is an extended version of an article first published in The Conversation

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK 

Further reading

Gackenbach, J.I (2008). Video game play and consciouness development: A transpersonal perspective. Journal of Transpersonal Psychology, 40(1), 60-87.

Griffiths, M. D., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.

Ortiz de Gotari, A., Aronnson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Nova Science

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Parfitt, B. (2011). Metro “can’t tell real world from fantasy”. MCV. September 21. Located at:

Purchase, R. (2011). Prof clarifies Game Transfer Phenomena. September 21. Located at:

Spence, S.A. (1993). Nintendo hallucinations: A new phenomenological entity. Irish Journal of Psychological Medicine, 10, 98-99.

The Tetris Effect. Located at:

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 600 research papers, four books, over 130 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on September 30, 2014, in Case Studies, Computer games, Games, I.T., Mania, Online gaming, Psychology, Technological addiction, Technology, Video game addiction, Video games and tagged , , , , , , , , , , , . Bookmark the permalink. 1 Comment.

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