Reference no: EM133347810

Case Study:

Mr. A was a 16-year-old Caucasian boy. Mr. A's parents sought help for their son because of concerns regarding his "obsession" with online gaming, which seemed to have overshadowed all other priorities in his life. Mr. A's parents were particularly hoping that the team would view his game playing as a manifestation of treatable obsessive-compulsive disorder (OCD), but they worried that it might be a form of addiction. Mr. A reported that his life had been taken over by the game-playing: "I play 12-1 6 hours a day, I do not sleep, and I've never had a girlfriend." He said he wanted to "figure out what the problem is, take care of it, and be successful in college." He dreaded that he'd repeat his school pattern of "making only 2 days of class per week" when he got to college and end up "stuck at home." Mr. A had a lifelong history of school refusal and anxiety about new social situations, in part related to the fact that he was not close to his parents, and family had relocated 14 times in his 16 years of life; the last move was in 2000 just before his eighth grade year. His anxiety led to home schooling off and on throughout his school years. Ultimately, Mr. A elected to enroll in a small private school at the beginning of his freshman year. He received straight A's his first year, leading the school to place Mr. A in accelerated classes. Mr. A was the only son of married parents; his father was employed as a pathologist, and his mother worked as a homemaker. The family practiced orthodox Catholicism. Mr. A reported that for most of his life, he had been a perfectionist. He recalled working to do his best on schoolwork because of "not liking to let teachers down." Mr. A admitted to having "too high of standards" and would sometimes not do something at all rather than perform beneath his expectations. However, the advanced coursework became more than he could manage, and Mr. A began to play Diablo II, an online role-playing game, with increasing frequency until, by the spring of his sophomore year, it was nearly his only activity. His parents objected to this behavior and took his computer away, leaving Mr. A to spend most days in bed. Mr. A barely passed his sophomore year, returning to school only to take his final examinations. Despite promises to "buckle down and study" he would often skip classes and instead go to friends' houses to play computer games or sleep in his car (after staying up all night playing computer games). Mr. A was no longer playing Diablo II but had been focusing on a "massive multi-player online game" called World of Warcraft that he played approximately 12-16 hours per day. In this game, he operated as the character Rava, whom he described as "like a shaman" who was able to "blast fire and ice," walk on water, hurl thunderbolts, heal himself and others, and resurrect the dead. Mr. A stated that he felt "things ha[d] gotten worse" because he had no friends and had not applied for college. Although he endorsed goals such as attending college and finding a girlfriend, Mr. A admitted, "I just cannot picture myself being successful."He acknowledged intense feelings of guilt regarding past behaviors, which at times became so severe that he experienced thoughts that he would be better off dead or even killing himself.

Questions:

1. How did the gaming world allow Mr. A to express aspects of himself? What are both positive and negative aspects of role-playing in games on the Internet?

2. What emotions would you experience if there is a discrepancy between your Ideal Self (virtual world) and your actual self? Explain how in Mr. A's case.

3. How did Mr. A's family and upbringing affect Mr. A sense of self?

4. What was Mr. A's orientation for motivation? How did this belief affect his performance when things become challenging?

5. What was reinforcing Mr. A's behavior in the gaming world? Why would he continually go back and play? What happened to his motivation to engage with the outside world?

6. How can emotion regulation, delay of gratification be shaped in Mr. A?