10/02/2026
When did coping become pathology?
Increasingly, I am seeing children, particularly neurodivergent children, described as having a “gaming addiction” without the depth of formulation that such a label demands. As clinicians, we should be cautious about pathologising the very strategies that may be keeping a young person psychologically afloat.
Behaviour cannot be understood outside of nervous system state.
Children recovering from autistic burnout, chronic anxiety, or prolonged school distress are not operating from a place of readiness. Their systems are organised around safety. Until safety is re-established, the developmental agenda must shift from participation to stabilisation.
From a clinical standpoint, online gaming can serve profound regulatory functions:
• It introduces predictability into an otherwise overwhelming world
• It restores agency where helplessness has taken hold
• It enables experiences of competence and mastery, often absent elsewhere
• It provides social connection with reduced interpersonal threat
• It creates a low-demand recovery space in which the brain can begin to reorganise
This is not a trivial pastime. For some young people, it is sophisticated self-regulation.
I am currently supporting a child who has been referred for a gaming addiction assessment. Yet a careful formulation tells a very different story: gaming is not replacing a rich life ; it is scaffolding a nervous system that is still in recovery. At present, local services have been unable to identify alternatives that feel neurologically safe or achievable.
If we remove the scaffold before the structure is stable, collapse should not surprise us.
Of course, no clinician is suggesting that a young person’s world should remain permanently confined to a screen. But expansion is only possible once regulation is secure. Attempting reintegration before stabilisation is not therapeutic; it is destabilising.
The work of MindJam, alongside Andy Smith at Spectrum Gaming, has repeatedly highlighted something the field is only beginning to articulate: online spaces can function as legitimate relational environments. Within them, young people can experience belonging, identity formation, collaboration, humour, and trust — all core developmental tasks.
We must therefore ask ourselves an uncomfortable professional question:
Are we sometimes too quick to treat difference as disorder simply because it sits outside our own developmental expectations?
The presence of gaming is not, in itself, evidence of addiction.
A more useful clinical question is:
What would this young person lose if it disappeared tomorrow?
If the answer is community, competence, predictability, and their primary experience of success, then our role is not immediate reduction. Our role is careful, attuned expansion i.e.building a life around the bridge before asking the child to step off it.
Because sometimes gaming is not avoidance.
Sometimes it is adaptation.
Sometimes it is protection.
Sometimes it is recovery.
And good clinical practice begins not with judgement — but with curiosity.
