Tetris is one of the world’s best-selling video games and even the subject of a recent film—but the beloved 1980s digital puzzle may also help improve your mental health. More specifically, psychologists are studying whether playing Tetris can help reduce the number of flashbacks, or intrusive memories, people have after a traumatic experience, such as sexual assault, a car accident, combat, a natural disaster, or a difficult childbirth.
Most people—roughly 70 percent—have had some traumatic experience in their lives. But only a small fraction of the population, around 4 percent, will develop post-traumatic stress disorder (PTSD), a diagnosable psychological issue with symptoms ranging from sleep disturbances to self-destructive behaviors.
But whether trauma leads to full-blown PTSD or not, painful memories can spring to mind without warning. Flashbacks are not only emotionally distressing, but they can also make it difficult to concentrate, which can lead to problems at work or school. These intrusive memories often pop up as a picture or a short movie in our mind’s eye.
Against this backdrop, British psychologist Emily Holmes wondered if she could reduce the number of flashbacks people had by giving their brains a competing image to focus on shortly after they experienced trauma, while their memories were still forming. The painful recollection would still exist, it just wouldn’t intrude as often. “The human mind isn’t like a video camera—it doesn’t just immediately record everything we’ve experienced,” says Holmes, a psychology professor at Karolinska Institutet and Uppsala University in Sweden. “It actually takes some time, possibly hours, before a memory gets solidified into mind. What we were interested in was: Is there something we can do as the memory is still consolidating that would help it not become a flashback?”
A ‘cognitive vaccine’
Her team began testing an array of visuospatial tasks that involve generating or manipulating images in the mind’s eye, such as imagining a constellation or tapping out a complex pattern. One day, a student suggested they try a video game—and Tetris became the obvious answer. “It involves colors, it involves space because you’re having to move blocks around to complete lines and, critically, it requires you to rotate the shapes in your mind’s eye,” Holmes says. “You really have to use your mental imagery skills because you’re trying to fit the blocks into the right place.”
They started to experiment with Tetris—first, in the lab, by showing participants a traumatic film and, later, in the real world, by meeting with people in hospital emergency departments who’d just been in car accidents. In both settings, people who played Tetris within hours of the trauma experienced significantly fewer flashbacks over the course of the next week compared to those who didn’t (58 percent fewer in the film study, and 62 percent fewer in the car accident study).
Based on the promising results of this proactive, preventative approach—which Holmes describes as being like a “cognitive vaccine”—they next turned their attention to established memories. “The reality is, we’re not going to be able to get to most people within a few hours of a traumatic event occurring,” she says. “People can have intrusive memories for years or decades, so clearly we need to do something for those older memories.”
In one study, Holmes’ team asked people receiving treatment for PTSD to focus on a specific flashback while playing Tetris for 25 minutes once a week for several weeks. By the end of the experiment, participants saw a 64 percent reduction in the number of times that specific memory popped up, as well as an 11 percent reduction in memories they hadn’t targeted. In another study, they worked with intensive care unit nurses who had established intrusive memories—including many that were more than three months old—of traumatic events from the COVID-19 pandemic. After four weeks, nurses who played Tetris experienced one-tenth the number of intrusive memories compared to those who did not play; they also reported improvements in other symptoms, such as insomnia, anxiety, and depression. Overall, nurses who played Tetris saw a 73 to 78 percent reduction in flashbacks.
As Holmes points out, there’s probably nothing special about Tetris specifically. She suspects any task with high visuospatial demands—like drawing, doing a jigsaw puzzle, or making mosaics—might achieve similar results. However, tasks that are verbally distracting, like doing a crossword or reading, probably wouldn’t work as well.
Tetris as a coping tool
Importantly, in their experiments, researchers aren’t just handing over a Game Boy and telling people to start playing Tetris. Rather, they first ask participants to call to mind a particularly bad piece of a memory, called a hotspot. Then, during gameplay, they instruct patients to mentally rotate the shapes, called tetrominoes, in their mind’s eye before they fall into the field of play. They also ensure participants play Tetris for a sufficient length of time, usually between 10 and 20 minutes. So far, all of their work has involved this procedure, which the researchers suspect is important to achieving results. “Historically, intrusive memories of trauma are quite difficult to treat because they’re stuck in your mind for a reason—your brain’s gone into red alert and is trying to keep you safe,” says Holmes. “They’re just really tricky things to alter. So if you’re just playing a game, it may help take your mind off things or reduce distress, but it might not help stop the flashbacks from intruding in the future.”
Still, playing Tetris on your own, without following the research procedure, likely won’t hurt you—and it may even help you feel better. Canadian therapist Morgan Pomells recommends it to her clients as a coping tool for soothing feelings of anxiety or hyperarousal. She doesn’t use Tetris during therapy sessions but, rather, suggests it as a potential option for moments when distressing memories or mental images arise during daily life. “It’s one of the tools in the toolbox,” she says. “A lot of people find it to be really helpful. Especially people who have a really visual element to some of the symptoms they experience, turning to Tetris and being able to really sink into that game, even just for a couple minutes, allows them to feel a little safer and it really quiets their minds. And when they resurface, they’re in a calmer state and actually able to take stock of their surroundings.”
But, Pomells cautions, Tetris or any other type of coping tool is not a substitute for seeing a therapist. Holmes echoes that sentiment, adding that people who are suffering from flashbacks should first seek evidence-based treatment from a healthcare provider. While Tetris may eventually become an evidence-based treatment itself, right now, researchers are still in the early stages of gathering clinical evidence. “This is more of a journey of curiosity,” says Holmes.
Additional clinical studies are underway now. In the future, researchers also hope to test the long-term effects of Tetris on flashbacks, as well as understand what’s actually happening in the brain. More broadly, they want to see if Tetris is effective at reducing intrusive memories related to other conditions beyond trauma, such as substance abuse disorders and depression.
“Mental images can haunt people in a variety of forms and I think it’s a real scientific challenge of the future,” says Holmes. “It’s like being a physicist some centuries ago. We’ve just started to see the stars and planets, now we’ve got to go explore them.”
