One of my responsibilities as Narrative Designer at Blowfish Studios has been to write and design an example/official campaign for Gunscape, which is an FPS level-builder and multiplayer game that heavily references a lot of iconic FPS of the past, and is now only two weeks away from full release!
When I started working on deciding what sort of campaign we might have (keeping in mind that this was late in the development cycle, and there was limited scope for new features), I decided that a good place to start would be to review the games that we were referencing art-wise, to see what patterns I could find in them.
I found that each fell generally into one of two narrative structures. Interestingly, it struck me that these two narrative structures correlated to two concepts described within Trauma research.
Disclaimer: I haven’t played all of the games I researched. I often had to rely on transcripts, level breakdowns, or synopses. Also, the quality or methods of storytelling is incidental to this observation of narrative structure.
Hyperarousal
One of my earliest memories of playing computer games was Wolfenstein 3D, released in 1992. I remember FPS being called “Doom-Clones” as a genre. This is the narrative structure where you are the Only One Who Can Save Us, where things just seem to get worse and worse, the attacks get stronger and stronger, and it is utterly merciless. As a player, you’re constantly on alert. You’re likely to turn the lights down low, put the headphones on, and pride yourself on how well you can frighten yourself and get past it and through to the end.
Hyperarousal is a key symptom of PTSD, commonly thought of as being stuck in the Fight/Flight/Freeze response. Peter A. Levine writes on and treats the hyperarousal form of PTSD. As a sufferer of PTSD with hyperarousal, you’re constantly on alert.

Moral Injury
2007. I didn’t need to play Bioshock to know its storyline. Or, most importantly, about that key betrayal by a trusted guide. It was like someone had taken everything players had ever learned about being the Only One Who Can Save Us, and then taken advantage of us. It happened again that year with Portal, even though the betrayal reveal wasn’t as sudden. Marathon and System Shock, from 1994, have parallels with them both (I wonder whether there’s anything behind the fact that each of these pairs of games were released in the same year?). I’m sure we’ll see this again and again.
Moral Injury is often co-morbid with PTSD, but is considered a separate syndrome. As the name suggests, rather than being a physiological injury, is a form of cognitive dissonance caused by what Jonathan Shay describes as the betrayal of “what’s right,” and more often than not, it is a betrayal by a trusted guide, a superior or similar, often in a high-stakes situation.

Is it mere coincidence that the game genre most associated with War and Military activities actually mimics some of the negative outcomes Veterans can suffer? Regardless of the fact that these two concepts of Trauma were noted in relation to Military Veterans, we can all suffer from experiences that can tax our reserves and get worse and worse and never stop, we can be let down or betrayed by those who we believe we should be able to trust to help, lead, guide, and protect us. If we can experience these types of feelings in a safe way–a way that won’t devastate our real life, that we know we can escape from at any time–maybe we can learn how to better cope with those experiences when we really do encounter them.
Gunscape is due to be released on March 2nd 2016 for XBox One and Playstation 4, and is already available as Early Access on Steam.