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The Royal College of Psychiatrists Improving the lives of people with mental illness

Playing psychologist in Phoenix Wright: Ace Attorney – Dual Destinies

Athena Cykes is a newcomer to the Ace Attorney series, making her debut in Phoenix Wright: Ace Attorney – Dual Destinies. The game came out all the way back in 2013, but I somehow held off playing it until recently. Athena, being a trained psychologist as well as a lawyer (highly impressive, considering she's aged only eighteen!), certainly caught my attention.

Like the other attorneys you play as, Athena has a distinct ability. It starts in court: your task is to defend a woman accused of setting off a bomb. Unfortunately, this defendant is having difficulty recalling all the facts during her testimony.

 “She's so scared...” Athena notes. “I think she could collapse at any second!”

Phoenix Wright, the titular ‘ace’ attorney, explains that Athena is able to use her finely tuned sense of hearing to “sense how a person is really feeling from the tone of their voice.”

This instantly struck a chord with me because it's what we do all the time within healthcare. True, we lack Athena's finely tuned hearing, but we do have extensive experience listening to people and trying to understand them. It's a very human skill and we all use it in day-to-day life: just by hearing someone talk, you might be able to tell how they feel, without them ever explicitly telling you. When I assess someone's mental state, I make note of several things about their speech, but really we all do the same thing without thinking about it: how fast are they talking; how loud are they speaking; what is the flow of their speech like? It helps a lot in understanding a person's mind.

The game describes that Athena uses analytical psychology techniques, but simply put, what she does is pick up what emotions the witness is expressing (sadness, happiness, anger, or surprise) and compares it to what the witness is saying. If Athena picks up a discrepancy, she can then tease at it to help the witness reveal what they are really thinking. The initial inconsistency you find is when the defendant expresses happiness while describing a memory of rubble falling over her.

In Psychiatry, we also look for inconsistencies between a person's apparent emotion and what they are saying. We call it “incongruent affect”. Here, “affect” is used to mean how a person feels towards something at a particular time. To have an “incongruent” affect means having an affect that is inappropriate for your thoughts. A simple (perhaps overly simple) example would be someone laughing while describing a personal tragedy.

In the Ace Attorney world, an incongruent affect always has a logical explanation. It turns out our defendant was happy when she recalled almost being buried in rubble because she was also remembering being rescued from that rubble by a man (which she previously neglected to mention). But thanks to Athena being able to pick up the discrepancy between the defendant's emotions and the defendant’s testimony, we edge slightly closer to the truth.

When we see people with mood disorders, for example depression, we might find their affect doesn't match the context they are in. But people with depression aren't typically described as having incongruent affect. Remember, incongruent affect is when your affect is inappropriate for the thoughts you are having. What is often the case in people with depression is that their thoughts are just as negative as their affect is (imagine experiencing constant thoughts of worthlessness, hopelessness, and excessive guilt), and so it's entirely appropriate that someone with such thoughts would also have a low affect.

Where we do tend to see incongruent affect is in people with psychosis, who may, for example, laugh or smile without apparent cause. This may be because they are responding to some internal thought process such as hallucinations or bizarre thoughts.

The game is scattered with moments where you, as Athena, are able to check for inconsistencies in a witness's emotions. I feel it is an excellent way of incorporating psychological technique at least on a basic level. I like the concept of working out how a person's apparent emotion betrays their inner thoughts.

Athena shows off her abilities more in the second case. There has been a murder, and your first witness is describing how she came upon the scene... or at least, she's trying to. But she seems to be in a highly agitated state, cowering in fear one moment, and yelling curses the next. Eventually she testifies, “All I know is the room was swimming in demons!” The prosecutor immediately dismisses this testimony as ludicrous and delusional.

But Athena has another explanation. She offers that the witness's memory is simply clouded by fear. “She's obviously not herself,” Athena notes. “The trauma of discovering that crime scene has her dazed and confused.”

Upon analysing the witness's emotions, Athena further concludes that “She's under an uncontrollable amount of distress, which is masking her other emotions. It seems the sheer terror of what she experienced is making her a confused mess.”

What is the game describing, here? In the world of Ace Attorney, the legal system moves very quickly, and the poor witness stumbled upon the crime scene only the day before! It seems the most likely explanation, as far as we can diagnose a videogame character, is that the witness is suffering from an acute stress reaction. It's hard to tell if the writers intended for her to fit the overall picture of this known condition; I suspect they simply intended to show the broad psychological impact of experiencing a severe mental stress (as comical as their depiction is).

And what about the demons the witness believes she saw? Wright, in discussion with Athena, wonders if “all those demons she thinks she saw are a product of rampant emotions?” Athena agrees, responding, “Her fear has instilled in her hallucinations and false memories.”

Here, Athena falters in her elaboration: “She's seeing normal everyday objects as monsters in her mind. It's a form of schizophrenic hallucination brought on by emotional trauma.” While I appreciate the game's attempt at including psychiatric explanations, I don't think what is being described here truly counts as hallucinations, and certainly this is not “schizophrenic”.

In the game, you proceed to point out to the witness the objects in the crime scene that correspond to the demons she thought she saw. As you present this evidence, the witness comes to understand she never truly saw demons.

So why wasn't the witness really experiencing hallucinations? Well, hallucinations are basically things you perceive when there is nothing there to cause that perception. When the witness saw demons, it was based on existing objects combined with her own mental images. These are called illusions, and we experience them all the time. There's different kinds of illusions, and the one the witness seems to have experienced is an affect illusion. This is when your affect makes you perceive something incorrectly. A common example is someone being scared while outside in the dark, and seeing a frightening attacker instead of what is actually a tree. Meanwhile, the witness in the game may have experienced an admittedly cartoonish version of an affect illusion, but it still fits the description.

Thus, admittedly, the game stumbles through some psychological and psychiatric concepts, but it is commendable that such things are included at all. I can’t expect the game’s depiction of psychiatry to be accurate, especially bearing in mind that the Ace Attorney games hardly take place in a realistic universe. It’s also commendable that this is a rare example in videogames of a lead character being a psychologist and using a psychological approach to help others.

I recommend checking out Phoenix Wright: Ace Attorney – Dual Destinies. If you like the sound of Athena and what she does, you'll be pleased to know that despite the name of the game, it really is all about her. The game suffers as usual from some frustrating moments of blurry logic, but the writing is as sharp and endearing as ever.

Authored by Sachin Shah



 

 

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Sin Fai Lam (Higher Trainee in General Adult Psychiatry)

First game ever played?

Double Dragon on the PC

What game made an impact on you?

Indiana Jones and the Fate of Atlantis – for making me wish to become an archaeologist… though I failed miserably in the process...

Where are you now?

On a train getting querying stares as I WhatsApp these answers.

 

Stephen Kaar (Higher Trainee in General Adult Psychiatry)

First game ever played?

James Pond on the Amiga

What game made an impact on you?

Doom – the first game I played in which a digital 3D world started to feel real

Where are you now?

Sat in a café in Camberwell eating falafel.

 

Donald Servant (Higher Trainee in Psychiatry)

First game ever played?

Super Mario Bros on the NES

What game made an impact on you?

Undertale - beautiful music and a vivid cast of characters that the game made me care about.

Where are you now?

Sitting in a café in Camberwell eating chicken shawarma with Stephen and Sachin.

 

Sachin Shah (Core Trainee in Psychiatry)

First game ever played?

Captain Planet and the Planeteers on the Amiga

What game made an impact on you?

Shadow of the Colossus - a game that made me question my murderous actions

Where are you now?

Help, I'm trapped in an infinity machine.


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