Candy Crush swept the nation in 2012, and by 2013, had been downloaded more than 500 million times. I managed to resist the pull for quite some time, smugly telling friends, “Oh, I don’t play that game, I’m too busy.” While my superiority rooted in pride at abstinence was fulfilling for quite some time, my desire to be part of a group of people I like called to me further, and one night while hanging out with three people I like very much who were all talking about the game, I felt left out and downloaded the game that night after urging from one friend. Thirty levels and three hours later, I was hooked and fascinated by this colorful game.
The game has provided endless hours of entertainment and time killing for me, but has also had some unexpected benefits. One, the game is a connector- anyone who plays it has a little bit of instant kinship with another who does and understands the astonishingly simple appeal of matching three same colored candies in a row and the whizzing colors that fly by when you complete a level.
Two, the game helps with executive functioning skills. Sure you can play the game haphazardly, matching up candies here and there, but you are unlikely to easily clear levels in this way. There is a fair amount of planning and strategy involved. There is always a certain number of moves you need to clear the board in, and the ability to think several moves ahead and realize when you need to be playing a long term strategy versus short term and how you can do both at once is integral to succeeding at the game.
Nothing illustrates this so well as playing a “jelly level.” When you are playing a level that has this classification, your goal is to clear all the jelly by matching up candies over the jellies or by making “special candies” that can clear a much larger number of jelly squares. Of course, these “special candies” typically take a little extra work to make. You have to scan the entire board, and often can take two or three moves (or even more!) to make where you might not be directly clearing any jellies. But once you have you special candy made, and you activate it, BAM! You might clear a whole board.
Pretty much everyone who plays Candy Crush for even a little while knows that these special candies are the key to clearing levels easily and getting a high score. Sure, you might make a move here and there that clears one jelly or two at a time, but with the constraints on number of moves, you often have to know and implement your overall strategy early in the game.
If you look at the board pictured here, there are a few different moves you can make. Several of them, while moving candies around, don't seem to do much for clearing the board, such as the moves that could be made in the upper left corner of the game, lining up three red or green jellies. The most direct move you could make would be to swap the red candy directly to the right of the blue candy with it, which would immediately clear a jelly in the bottom row. It would also activate the striped candy jelly, which will clear anything in that vertical row, but wouldn't clear any more jellies. Another move you could make would be to move then purple candy in the second row into the bottom row, activiting the special striped purple candy which will hit every jelly in the bottom row, successfully clearing two jellies with one move. A third move you could make is by moving the green candy in the middle of the board into the middle of four other green candies to match five of the same color candy in a row, creating a special candy called a “Color Bomb” that when swapped with another candy will clear every candy of that color on the board. This move will clear zero jellies this round, but has the possibility of removing a much larger number in the next round. What move do you think that most Candy Crushers would want to make? What move would you make?
I think most people would want to make the Color Bomb. Even though it doesn’t clear any jellies in this move, in the long run (even in the short term) it has more power to clear more jellies with less effort and cost. But what if we wait to make the special candy until after we clear the jellies? Don't we want to make those moves that create a direct result first? Completing the moves that would clear the jellies immediately first would move several of the candies that are needed to make the Color Bomb into different spaces, making it impossible to make the special candy in the next round.
I was thinking about this phenomenon, and the widespread understanding of what move is the most beneficial among Candy Crushers, and I was surprised when I realized that this strategy has been all but decimated in mental health. So often any more, we strive to target direct mechanisms- that is, we strive to clear jellies with each move. And that works great if you have a simple board, with only a few moves to make, or if you are at the end of the game and are down to a very few jellies to clear that require specific moves.
In mental health, there has been a strong call to move towards addressing disorder specific direct mechanisms, and eating disorders, especially Anorexia Nervosa are no exception (Knatz, Wierenga, Murray, Hill & Kaye, 2015). We are often finding ourselves teaching specific skills or providing very specific interventions right away to people who find themselves in treatment. For example in a person with an eating disorder, a person showing up for treatment will likely be given CBT or DBT right away. For someone who has been brought to treatment early, and has an uncomplicated case, the direct mechanisms that are used in these therapies target symptoms and can bring about rapid change and may be all a person needs to recover.
But for someone who has a more complex case (and we know with eating disorders that co-occurring disorders are the rule rather than the exception) targeting direct mechanisms of behavior provides some relief, but leaves the client with a lots of other symptoms that haven’t been cleared.
When you have a limited number of moves, you have to make them count for as much as possible. Implementing global interventions early on while also realizing that targeting direct mechanisms could have a major impact in the overall symptom reduction of eating disorders, especially in those cases where there has been a long standing disorder can only better serve those we are trying to help.
This idea has important ramifications for the application of treatment, training of mental health professionals, and possibly treatment outcomes. Oftentimes, novice therapists are employed to provide lower cost manualized treatment protocols that are easily covered by insurance which can be provided through a relatively quick training. The art of conducting psychotherapy that comes with age and wisdom often hasn’t been fully learned. While these manualized interventions are effective in targeting specific behaviors, the overall landscape of what is being presented for treatment isn’t addressed.
Mental health treatment is both a science and an art, and the two interact in profound ways. An important step in helping people get the most out of treatment is to ensure that novice therapists continue to be taught the importance and skills in connection, genuineness and empathy, as well as “overall strategies” and "making special candies" that help “clear the board” through systemic interventions in addition to targeted mechanistic interventions. Therapists need as much to learn the art of healing in addition to the science of why we use the treatments that we do, when we do them and how to do them. With the majority of current eating disorder patients not recovering during treatment (Murray, 2019), the effects of these global strategies cannot be understated. Looking to combining specific mechanistic interventions with global humanistic strategies that can be implemented in one hour might seem like a tall order, but is possible. Training therapists to make the global changes whenever you have a chance while still working at mechanistic changes can help. While the impact of this kind of strategic global strategy may not be seen in a move or two, they are game changers when you are playing to win.
1. Knatz, S., Wierenga, C.E., Murray, S.B., Hil, L. & Kaye, W.H. (2015). Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder. Dialogues in Clinical Neuroscience, 17(2), 229-236. PMID: 26246796
2. Stuart B. Murray (2019) Updates in the treatment of eating disorders in 2018: A year in review in eating disorders: The Journal of Treatment & Prevention, Eating Disorders, 27:1, 6-17, DOI: 10.1080/10640266.2019.1567155
#mentalhealth #eatingdisorders #metaphors #therapists #counseling #psychology #mentalhealthtreatment #neuralmechanisms
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