Levelling Up Mental Healthcare: Bridging the Gap with Gaming and Evidence-Based Therapy - with Dr Bee Lim

Levelling Up Mental Healthcare: Bridging the Gap with Gaming and Evidence-Based Therapy – with Dr Bee Lim

There are many myths associated with gaming and the use of video games. But many studies are now showing game play can be helpful in minimising fatigue, stress and burnout. But how and what role can gaming play in promoting mental health? That’s the topic of this episode when Jo is joined by Bee Lim, Ph.D. In this wide-ranging conversation, Jo and Bee also explore the implications for health professionals who don’t start embracing technology and AI.

Bee Lim, Ph.D., is a clinical psychologist, private practice owner, co-author, and innovative entrepreneurial clinician. With expertise in psycho-oncology and positive psychology gained through her postdoctoral fellowships, Bee brings a fresh and unique perspective to the field of mental health care. Hailing from Malaysia, her proficiency in various Asian dialects enables her to effectively bridge cultural gaps and promote inclusivity in her work. As a featured guest on SBS Radio and an avid researcher, Bee leverages her platform to de-stigmatise mental health and inspires hope among diverse populations.

You can connect with Bee on LinkedIn or via the website thebetunedgame.com

Resources mentioned in this episode:

If you know you need more support, please visit my website at https://jomuirhead.com

Transcript

Jo:

It’s an incredible honour to bring to you another episode of the Entrepreneurial Clinician Podcast. This is episode number 29, and I’m still loving this whole podcasting thing and this morning I am interviewing an incredible human being who I have gotten to know over the last couple of years who is doing very different things here in Australia in terms of mental health. Her name is Dr. Bee Lim, but I’m gonna get her to introduce herself to you. So take it away, Bee. Who are you? What do you do? How are you turning up in the world?

Bee:

Hi everyone. Hi Jo. It’s an honour Jo to be on your podcast. Thank you. I’m Bee Lim and it fits my name. I tend to wear a few different hats. <Laugh>, I’m a clinical psychologist, so I’m a group practice owner. And at heart I’m very much a scientist practitioner. I’m very passionate about looking at evidence-based innovative approaches to enhance reach and also to improve mental wellbeing of our users. I grew up in Malaysia. It’s a beautiful blend of cultures, languages, and foods. And it has afforded me the abilities to speak a few different languages and also several Asian dialects. And I think that is a very important part about bridging the cultural gaps in mental healthcare. I often joke about, in terms of the proudest moments that my late father had of me, it’s not about all the alphabets behind my names, but it’s when I shared with him an experience of doing a psychological assessment and mental health first aid with a refugee of Cambodian backgrounds.

So I think the diversity, the inclusivity about mental healthcare is a very important part of my work. And I have my training in psycho-oncology and positive psychology. And I think the intersection of these two areas have really shaped my work as a trauma therapist. In my everyday work I work with people who experience complex trauma and it’s humbling. It’s profound. And this is the place where I really witnessed that incredible strength and resilience of people who’ve been through dark times. And then also then we get to the interesting part, <laugh> and why I’m here today. Last year with encouragement from yourself, Jo, and also a few of the health professionals that we are friends with, I decided to take a leap into starting a venture that feels mobile game technology and evidence-based therapy. I do firmly believe that we can make mental health accessible anywhere, anytime, but also fun, enjoyable, and if I dare say delightful <laugh>.

Jo:

Oh, wow.

Bee:

Yeah. Imagine therapy experience as play that transforms lives.

Jo:

Imagine therapy as play, but it transforms lives. We could just hit stop now and people would be walking around going, imagine that. And this is why I’m so excited to have you here today because when you came to me and said, Jo, I’ve got this idea. I’ve thought about this, I’ve got some research which we’ll get to. And you started explaining it to me and we were talking at the time about a specific population. So we were talking about early entry, early career doctors in our off the back of the pandemic. And they were turning up into your clinic and they are just running from trauma to trauma to trauma to trauma. And you were witnessing some of the behaviours that they were using to try and slow their brains down and slow their heart rate down. And you went, there’s gotta be a more effective way that is helping their brains right now. Can you give us a little bit of insight into what you were witnessing to bring about this gamification of therapy?

Bee:

Right. And I think Jo, the interesting thing is that I’m not a heavy gamer myself. <Laugh>. I’m not a heavy gamer. I’m not a serious gamer myself. And the first piece of research studies that actually really came to me was when I was an intern psychologist. I was doing a late night <laugh> playing. Tetris.

Jo:

That took us all way back, didn’t it?

Bee:

But I think that first piece of research papers was really showing that it has the ability to reduce trauma symptoms in veterans. And I went, what? <laugh>

Jo:

Did everybody just hear that? Like this research when Bee was an intern psychologist, so it wasn’t yesterday right. <Laugh>, but there was actually research that was demonstrating that veterans playing Tetris was helping to reduce their symptoms. All right, tell us more. I just wanted to make sure we didn’t lose that. Please keep going.

Bee:

I love your enthusiasm <Laugh> around it. And I was in the middle of the night so excited, definitely emboldened by the findings, and I took the findings to my workplace and very boldly suggested that we turn one of our meeting rooms into a Tetris playing rooms. Imagine that scene, you have therapists, you have clients, and we are bonding, playing falling blocks of Tetris at that time. I can’t explain why it was, and you can imagine that the idea did raise a few eyebrows.

Jo:

<Laugh>

Bee:

And didn’t gain any traction at that time. But I think like through different years of like training and also my own experience of therapy and all that, which I’ll love to share in a bit more details at the symposium as well, is that it’s really just kind of come together to show that I think if we can combine video game play to deliver a mental health solutions. Clients can be more engaged. And I don’t have to have professionals come into my office totally burnt out and then have to shamefully tell me that, oh my goodness. Bee I played video games last night and the response that I often gave them really surprised them ’cause I go like, oh, you played video games? Tell me more. <Laugh>.

Jo:

Yeah. Nice. But again, what I love about it and why I get so excited and I’m so enthusiastic is because we hear so much negativity about gaming and, and yes, we’ve got some dangers there. Like we can’t ignore the fact that we’ve got young people who are being influenced in unhelpful ways. We can’t ignore the fact that gaming has created a whole new addiction that we need to be mindful of. But again, you are going to the heart or to the soul to meet people where they’re at and going, your life is already so hard. And if we talk about doctors who we know have incredibly high burnout rates, unreasonably high suicide rates like that research is terrifying. And we’re saying to them, please turn up with a hundred percent of your mental acuity after you’ve worked an 80 hour week and look after the next trauma patient that comes through the doors. To actually then say, could you please come and do your trauma homework? And your trauma homework is going to be A, B, C, and D. You can imagine these people just going, I just want some space in my head. I can’t even remember the last time I saw a whole human body with all of its limbs intact. Like, and I’m not saying that to be horrible or to be triggering, but this is some of the stuff that your people were coming to you with. Am I right?

Bee:

Yeah. I think at the same time, I hear your concern and as a parent with a young child, I definitely think about this in terms of like what level of screen time is okay or what level of gaming is okay. So that we don’t develop into some internet gaming disorder. But research has again and again shown, and even longitudinal studies have shown, that from a youth gaming perspective, youth that play more than 35 hours a week, potentially they will develop an internet gaming disorder. But as long as we play less than 19 hours per week, none of those people in that group eventually move into pathological gaming. So, I think like there are all these different ideas, the debates from like two ends. And oftentimes I think like in therapy we talk about that with clients as well in terms of any behaviour that has two ends to it. And what we are trying to do is that we are trying to find a healthy medium and what is that healthy medium that allows us to have the benefits, but then also not kind of going into a stage of dysfunctions or clinical disorders.

Jo:

Right. I love the way that you’ve brought me back to earth there. You can’t see, but I did actually plant my feet firmly on the ground then. And I went, you’re right. We always talk about the extremes. Like neither extreme is good, right? So, and this is one of the reasons why I’ve created the symposium, thank you for bringing that up, is because we need to be talking about and thinking about these issues. We need to be getting better at having conversations with anybody who turns up in our clinic or in our waiting room who’s gaming. Like how many times do you see people sitting in your waiting room stuck on their phone? Are you ever interested in what they’re doing? Like walking around the street, standing in a queue?

Like my husband plays a game on his phone all the time and we all know I have a dog, his name is Smudge. Smudge and I wanna knock it outta his hand. We just wanna knock it. And he’s like, this is how I relax. This is how I tune out. Just leave me alone to do this. I’m like, huh. After talking to Bee and Jake who’s been on the podcast before, this isn’t actually unhealthy. I have a problem with it. <Laugh>. So talk to us about your concept. Tell us what it is?

Bee:

So the concept of it is really thinking about the elements of light gaming and also blend it with evidence-based therapy and the evidence-based therapy that is of choice at the moment. EMDR, just mainly because that is my special interest. I work with people with complex trauma. But I do hear you Jo around this just mainly because I think there’s so many myths around video games that I’m so looking forward to actually having conversations with people about. And my husband <laugh>, he is totally sick of me talking about it. <Laugh> You talk about your husband playing Jo, and we always thought that video games are for kids. And even when I talk about these ideas with my colleagues, they go like, oh, is it gonna to be a game for children or adolescents?

And I go no, it’s for professionals. So potentially like the 15 to 35 year old that is experiencing burnt out from their day-to-day work. And they did a fascinating study a few years ago with 2,842 full-time white collar workers. 8% of the study population were actually high level executives. So we are talking CEOs, CFOs, presidents of big organisations. This group actually reported higher frequency of casual gameplay. And the most important, or the most sighted reason for them engaging in casual gameplay is to give themself a mental break so that they can go into their work being more able to solve problems, being able to think creatively. And I think this piece of research will be so interesting to you and your listeners, Jo, that they look at laparoscopic surgeons who are gamers <laugh>.

Jo:

Wow.

Bee:

And so laparoscopic surgeons who were gamers were shown to be able to perform their surgery quicker while maintaining the necessary position in the operating room. So if you think about it, if I were to be on the operating table, I want my surgeon to have positive emotions. They have taken their mental break. They have actually played a game and they’re also enjoying positive mental health.

Jo:

Yeah. I want that. In fact, with all the surgery that I had over the last couple of years, I made sure I was the first person on the list. Like I demanded that because I didn’t want my surgeon turning up after already being at it for hours. So this is fascinating, and we will make this research available on the podcast, but we are gonna be talking into more depth in this symposium. So I know that this is gonna be fascinating. Now, I know it’s not your area of expertise, but do you think that there will be correlations about gameplay and about incorporating gameplay with the evidence base of EMDR, but also for people like first responders. Okay, you’re nodding your head.Okay. You can see it moving into those populations?

Bee:

There are some touches, <laugh> with ICU stuff and with first line responders and the results are fascinating and it’s amazing. And we are not thinking about games as a replacement for therapy. But we want to be able to have the first responders or help professionals who are really burnt out to be able to access some of this way of relaxation, mental break and potentially some level of therapy as well, just so that we are better equipping them to be able to go back to do their jobs. I just read about this piece of research yesterday that I thought you’ll find interesting ’cause In Mount Sinai hospitals in the States, they’re actually starting to turn some of the rooms into what they call recharge rooms and the recharge rooms.

The staff could actually book in like 15 minutes of time in the recharge room to engage in an immersive environment to be able to relax, to be able to unwind in those rooms. And sometimes these rooms have different kinds of therapy whether it’s in terms of people being able to play games, like listening to music, there’s aromatherapy and different things like that. But I think that is definitely a space for creating some of these experiences that the professionals can unwind, take a break, but not disengage or dissociate because of a busy workday.

Jo:

Wow. I’m now struggling to formulate the next part of my questions. So I guess, you know, I’m a middle aged, white woman with a 23 year old child, I’ve always had this belief that gaming is unproductive. That it’s going to foster laziness, it’s going to destroy brain cells. And I’m being extreme, but it’s like we’ve all heard our grandparents say, just go outside and play in my day. We used to just play. But what you have very clearly said is that this is about helping people engage in play. And in 2023, this is how a lot of us play.

Bee:

That’s right.

Jo:

So the days when I used to play with physical dolls and dress them up or have tea parties or go outside and make mud pies, ’cause I was that kid, thanks mum. Or be climbing trees like that was me in my day. But that’s not how people play. What is our experience of play in 2023? What do we do?

Bee:

Play is still really importantAnd when I was thinking a little bit more about the concept of play and even slides in terms of it, we call it like the happy child <laugh> in schema therapy. And they kind of consider like, what’s play and play looks very different for different people. And we need to actually tailor it to ourselves, to our clients. And this is a fascinating kind of case study <laugh> or story as well. So we talk about some of the games, say for example, like Pokemon Go. So it’s a game where people will go around and collect different pokemons. We actually have a friend who is a full-time software developer holding a job, having all these different responsibilities, walk 500 kilometres to collect 140 Pokemons. And he became one of the first people in New Zealand to collect all the pokemons. And, it’s quite an achievement in itself. But if you unpack it, then we go like, who walked 500 kilometres? What can motivate you enough to walk 500 kilometres? And I think the motivators for us are all different for me, potentially can be food, <laugh>, or coffee <laugh> for some of these people is games and that’s totally okay. Or for some other people it can be for nature or scenery. And it doesn’t have to be limited to just one thing. And I definitely hear in terms of going outside and playing and all that, but the truth is that if you are two o’clock midnight and you are in your bed and you’re feeling that distress, I wouldn’t necessarily encourage anyone to go out and hike <laugh> the mountains to have that experience or play <laugh>. I want them to have something that is accessible that can bring them to an environment that’s still infused with nature that they can regulate in many ways.

Jo:

Gosh, this is a powerful conversation because I have walked the length of the Camino this year because of a game.

Bee:

Oh, wow. <Laugh>.

Jo:

So, it’s called the Conqueror Challenge. And so as a rehabilitation professional, I’m like, we no longer take dogs for a walk. As our first step in getting people moving, we now go play Pokemon Go. Like, this is now something we can almost inverted commas “prescribe”. It’s like, this is how we’re gonna get, especially some of the young people that we work with and who have got a range of problems with going outside and being a part of the world. I’m just sitting here going, oh my God. Imagine that. Imagine being able to come back to them and go look at how much activity you’ve done this week. You’re feeling better, you’re breathing better. I guess you’ve got a little bit of discomfort in your legs, but you know what that’s called. You know, delayed onset muscle soreness. And you used to get that when you went to the gym. Like there’s so many conversations we can have about that. See this is why this podcast is amazing. My tool belt for my clinical work is just expanding. And that way I don’t get stale and grumpy and old <laugh>, which is very cool.

Bee:

Jo you definitely bring up a really good point about that as well is that when we work with older clients, oftentimes what’s their motivation is that quality time with the younger ones. And a few years ago we had another colleague working on a game called Flutter about butterflies and I think it’s a collaboration with National Geographic as well. And when he talks about it in terms of some of these young children collecting butterflies through a game. And then being able to go to their grandparents’ house and pointing to the wall and go like, this is that species that I collected in my garden grove or in the forest. And being able to have those conversations and engaging their grandparents in that, I think those are priceless.

Jo:

Oh, I’m sorry, I’m getting a bit weepy now. Because helping older people connect with their younger people around things like that. Like what a beautiful way to go, I can’t relate to my grandparents. They’re old, they don’t know what to do. I can’t relate to my grandchildren because they can pick up any piece of technology and press buttons so fast I can’t even keep up with the screen. But now we’ve got this beautiful way of decreasing isolation, which we know leads to increased mental health pressure of increasing inclusion. I now have visions <laugh>, for my return to work patients going, right. You know what we’re gonna do? We’re gonna actually start playing Pokemon Go with your kids. Because one of the things my rehabilitation clients will say, especially those who are parents, is I feel less than ’cause I can’t do the things with my kids the way I used to, right? I can’t train soccer. I can’t drive all the places that I used to take all my kids, but I’m like, do you reckon we could play Pokemon? Go with them and I reckon that’s gonna take off and I know my team are gonna listen to this and they’re all gonna be going, let’s download the app right now. I feel like we’re on to a winner here, Bee <laugh>.

Bee:

A video game is really a tool. It’s not the be all and end all. And I think like it’s any tool, but it’s even in terms of now we are talking about AI and all that, it’s a tool that, if it’s in the good hands, if it’s in people that want to use it for good, it can be for good.

Jo:

So thank you for bringing that up. Now you are not prepared for this question, so permission to take a big deep breath. What do you think the implications will be for health professionals if we don’t start embracing things like technology and AI?

Bee:

That we lost that engagement with our clients. If I think about even earlier on as my clinical work as I’m thinking about this podcast today and times that I talk about video games, I very kind of like fondly call my fiancé <laugh> my cultural consultant because I’ll have young men coming in with early psychosis episode and they’re totally shut down. They regulate their emotions through using cannabis. And what is a young female clinician going to do to engage with a young male <laugh> with totally different cultural background in that sense? And and often joke about it in terms of like, I spend half of my time learning about wrestling <laugh>, about video games that they’re playing about different pop cultural elements that we can talk about in sessions to make it come alive to them because when some of these concepts isn’t being brought up with maybe other therapists or with their parents, it’s like, why are you watching wrestling? Or this man fighting with each other. And to be honest, I don’t have any interest in wrestling, but I can see the perseverance, the grit, and sometimes some of the dynamics that’s been played out in a certain tournament. And being able to talk about that, being able to bring it to be real about that, I think it is definitely important. And if we don’t engage in that, then we lose that engagement. And if you don’t even care to find out what makes our clients tick, why do you think they want to stay in session with us?

Jo:

Yeah. Gosh, Bee. Thank you so much for bringing up the Symposium earlier. So can you share just a little bit, like what are you going to be talking about? What would you like people to be able to walk away knowing after that presentation?

Bee:

As I’m doing the research and I’m thinking about this more, I think there’s definitely a lot of myths and a lot of misconceptions that we have about games. And I really love this quote in one of these TED talks. I kind of talk about the idea of broccoli and chocolate

Jo:

<Laugh>

Bee:

As clinicians we’re definitely the broccoli <laugh>. Whether we’re brain scientists, we are neuroscientists or we are rehab counsellors, we are psychologists, therapists. We know what is actually good to help our clients to improve, to gain wellbeing. But something that maybe we are not so good at is the engagement. We talk about engaged clients, but we don’t know quite how to do it. And then she talks about the entertainment software industry as chocolate. They’re so good at creating all these games, all these immersive games that grip us that we don’t want to live in the environment. But we can’t just mix the two together.

Jo:

Oh my god. Chocolate coated broccoli. No.

Bee:

<Laugh>. That is scary.

Jo:

That’s some scary.

Bee:

Definitely. And then we can think about actually creating a new brand of chocolate. That has all these immersive engaging elements, but then also allows our clients to regulate to achieve their positive mental health by playing the games. Think about if they can play their medicine.

Jo:

Yeah. Oh, that’s where this is going. So all the play therapists in the world, we’ve actually just increased their credibility because it’s like, we need you, we need you to start thinking about this. We need you to help us think about this so we can stop being broccoli <laugh> or Brussels sprouts or I’m just thinking of all the vegetables I really don’t like.

Bee:

I like them, I just don’t like them with chocolate sauce. No.

Jo:

That’s okay. So Bee we’re coming to the end of this conversation for today. How can people learn more about you? ’cause I know, especially my American therapist community, they’re gonna be like, who is this woman? I need to know everything. How do they find you? How do they find about?

Bee:

Yep. So I’m, I’m on LinkedIn as Bee Lim and and if you are interested to actually like, help us think about the game that we are designing, we call the game BeTuned. So you can actually find me at www.thebetunedgame.com.

Jo:

Beautiful. I was hoping you would get there. What a fantastic conversation, Bee. Now should be before we go any further. But the day is going to come because, you know, you’re only like 45 minutes to the east of me <laugh>. Yet we haven’t made this happen yet. When we get to a cafe and I’m ordering coffee for you, what am I ordering?

Bee:

Oh gosh. Jo, you and I have known each other virtually for two years and I often joke about myself as someone that you need to find my blood count in coffee streams. So I’m trying to pick a favourite child. So let me think. I think I am a oat milk flat white girl

Jo:

Oat milk flat white. I can do that, that’s what my son has. That’s good. This café, we’re gonna have to take over an entire cafe because of all the people that I wanna get involved in and have this wonderful conversation. Bee, thank you so much for sharing enthusiastically and letting me get enthusiastic with you. I am so looking forward to you extending this conversation. Come September in the Symposium, there will be so much information in the show notes for you, but Bee will be in the Future Proofing Health Professionals Facebook group. So she’s there if you’ve got questions, if you wanna know more, if you just wanna go and check her out, you can do that in the Facebook group. So come by, you can join and we would love to extend this conversation. So until next episode, go be your awesome self.