Based out of his research lab, Gazzaley Lab at the University of California, San Francisco, Adam comes to us describing a not-so-distant future in which we can expect video games to be therapeutically integrated into our everyday lives, helping us remodel and revamp the most important organ of our bodies, the brain. Having already achieved success with the acclaimed video game NeuroRacer, this new area of cognitive science is just getting started – and has government bodies and pharmaceutical companies weak at the knees. We spoke to the man at the centre of this new field, asking what lies ahead for the human brain and why what he calls “digital medicine” might be a reality in just a few years.

I understand that you explore the areas of neuroscience specifically related to gaming, with a special focus on technology and the impact that it has on humans – things like attention, reasoning and working memory. Maybe you can tell us a bit about how you got started in this field, and why this particular fascination with this area of work.

Well, I started my career in more traditional neuroscience approaches and methods, but from the very beginning my interest has always been around plasticity in the brain – the ability of our brain to remodel itself on many different levels, in response to stimulation and other types of interactions – as well as ageing and networks – thinking about the brain as a network rather than these isolated islands of activity. Those research questions I have been pursuing for 25 years now.

What’s really interesting to me is that – we’ve spoken to a fair number of neuroscientists and the understanding of the brain, the science around the brain, has gone through somewhat of a revolution in the last one or two decades – ‘plasticity’ was a term people were afraid to use in particular scientific circles. I just think it’s so wonderful now that the brain has a new light shone on it and there’s this flurry of activity around it, would you agree with that sentiment?

Yeah, we’ve learned a lot about the human brain over the last couple decades, particularly with new methodologies like functional MRI; a resurgence of EEG and the analytics surrounding it; brain stimulation, both magnetic and electrical. These tools have allowed us to appreciate that there is retained plasticity of the brain throughout our lifespan. Many people look at it as an exciting opportunity to figure out ways to harness that plasticity to improve our function. There are many challenges a long the way that we are still facing, but I agree that it’s an exciting opportunity to empower ourselves with our own ability to change.

That kind of leads into my next question, which is about the gaming industry itself – the games industry is extremely new in a sense – building a moral compass into it is even more progressive. There seems to be a real impetus on using games for therapy, now with the introduction of pain-management games like SnowWorld, and Foldit which is about protein structures. I’m interested to know your opinion about this current gaming revolution.

I’m deep in it. I’ve approached it from pretty much every aspect of my career and my life, from my research laboratory, the company I started, Akili – which is building therapeutic video games – to the many groups I advise for. All are about the potential of interactive media and how delivering it in the fun, engaging way of a video game offers a tremendous opportunity to create these powerful experiences to harness plasticity. That’s basically what I’m devoted to now; figuring out the best way to do that. It’s an immensely exciting opportunity with potential across multiple centres; from health to wellness to training to education. That promise that I hope we’ll be able to deliver on is really what drives me.

What do you suspect is the biggest unknown about the brain, moving forward in your line of work?

There’s so many things; the general question of what guides our consciousness or identity, even our memory and attention are still very complex questions that we don’t have definitive answers to; how the mind really emerges from the brain’s networks is still a really important research topic at a very basic level. But, the question that drives me is – we know the brain is plastic, there’s no neuroscientist in the world who would disagree with that, as far as I know – begging the question: how do we optimally harness that plasticity to directly improve the functions along the most powerful path? We don’t know how to do that. I would say that people have not even been trying hard enough to do that.

You’ve said that technology complicates some of our most basic tasks, like attention and focus. I personally feel like we as a society have misread the affect technology has had on us. I’m a big fan of technology; I also see the inherent risks it has. Do you think society is perhaps a little too preoccupied with the negative influences of technology, because I feel like it’s flattened and globalised and allowed us to interact and communicate in positive ways as well?

I think over-preoccupation with the positive or the negative is probably unwarranted; as with anything in nature, it’s a yin-yang; there’s going to be positives, there’s going to be negatives. A balanced view that’s informed is the appropriate way of looking at it, as with anything. There are foods that are good for you and foods that are bad for you. There’s a way of navigating through our environment and all those pluses and minuses in a way that is going to be most optimal for your happiness and your success in life. I think about technology in the same way. I love technology as much as anyone I know; more than probably a lot of people. But, it doesn’t diminish my affection towards it to recognise that it does challenge me in some ways. That very knowledge of those challenges makes technology even better because you learn how to interact with it in a very ideal way.

What have the conversations been like so far, if you’ve had any, with pharmaceutical companies or government policy makers, in terms of the practical uses of your work in society?

The conversations I am having are very positive. I met with multiple heads of pharmaceutical companies, multiple government officials from the White House to state government, travelled extensively around the world over the last several years, and I think across the board there is great enthusiasm for this emerging field.

So what will it look like, say 30 years from now? Would there be something that you can go to your doctor and get or is there something you can go to a healthcare practitioner and talk to about?

I would hope that this would be in the next 4 years; this is the immediate future. We’ll start seeing a different class of medicine, what I would call a ‘digital medicine’ that builds on experience and interactivity, being part of what doctors feel comfortable prescribing. I would hope that future is within the next 5 years.

You’re talking about the games specifically?

Yes.

A specific area you focus on is multitasking. You said something that I found very interesting in a talk recently, which was, “We don’t ever multitask; we automate. There is such a thing as a central bottleneck that we activate that allows us to do certain things at one time, but never multitask.”

Taking this example within the brain, the complexity, would there ever be a case where we could loosen that bottleneck for potential implications?

Well, I definitely spend more time thinking about the multitasking side than the episodic memory side of it, but, on that note, I can say that we in the lab are doing some pretty exciting work using multiple approaches from neuro-feedback to video games to brain stimulation, and in combination, to understand what of those limits and bottlenecks in multitasking can be overcome by harnessing plasticity.

Because you work so deeply in the core of the brain, has there ever been a discussion with you around tackling mental illness? I know that sits a bit on the periphery of what you do, but you do work within multitasking, focus and attention, so I wondered if that was part of what you do?

Yeah, that’s pretty much what our main objectives are. If we could use our knowledge of the system to create a relationship through interactivity and the other technologies I’ve described to you. And to improve the function and to minimise the limitation, we think that it could have great impact in the mental health world. That’s a conversation I have daily with the scientists that are in the psychiatric or neurological domain; how these tools could be part of the medicine they are using in the near future.

Could you give us an idea of how that discussion looks, what would be the implementation in an ideal world?

The most concrete one would be where a doctor would feel comfortable pulling out a prescription pad and writing down an iPad game for 1 month with the data streaming into their office during each gameplay, with or without a medication as a drug along side it. I think that would be an exciting future, to understand how these worlds will interact with each other; will they be prescribed together or independently? Would you start with the game because it had no side-effects then come in with a drug if needed? All of these are unknowns but very exciting.

So what do you work on right now, what’s a specific focus area for you?

Our lab is very large, so there are six faculties in the lab. There are many projects, there are close to maybe 20 projects going on now, so it’s hard for me to say what the focus is. The general approach most of the lab is devoted to is the creation of new games. There are multiple new games, 5 in our lab, that are mobile, because that has great accessibility, but many of them are trying to capitalise on advances in consumer-facing technology, like motion-capture, like virtual reality, augmented reality. There’s great interest in creating wearable physiological devices including EEG and skin-response and heart-rate. So, that’s what we’re doing. There’s a lot of effort in development and equal method in the scientific validation in doing those empirical studies that we feel are critical before we move our creations into the public space.

It seems like LucasArts and the WIRED magazines of the world are very positive and encouraging of what you’re doing in helping you develop what you want to achieve?

Yeah, there’s great enthusiasm from the technology world in terms of people, often the higher-level people who have been through this once before in the entertainment domain who want to reinvent themselves with their skill-sets and have a positive impact on people’s lives – we see that all the time.

Any specific entertainment individuals you’re referring to?

A good friend of mine, Matt Omernick, who was a lead at LucasArts now works full-time at the therapeutic game company that I co-founded, called Akili Interactive. There’s someone who was building triple-A video games for their whole career and now has applied his skill as chief creative officer in a company that’s building games that are going for FDA approval – not even focusing on consumer at all.

I think that’s really wonderful. I’m really interested in the area of mindfulness. I know you’re doing this game called Meditrain with Jack Kornfield – a brilliant guy – what are your thoughts generally about the potential of this area?

They’re very high; I’m very very optimistic about the potential to help translate elements of contemplative practices into a format that can be readily delivered to people to help improve their brain function and stress levels and other aspects of their quality of life. My interactions with Jack – I’ve met many of these folks now – are that they all see the potential and they’re excited about it. I work very closely with Jack; we meet regularly and brainstorm how to bring our worlds together and we have a long list of exciting ideas that we’re working on. My goal is to not just say, ‘let’s see what changes with the brain with traditional mindfulness practises’, but rather to use modern technology to come up with new practices that are informed by these ancient traditions that capitalise on our advances with plasticity and interactivity where ever we go, to basically create an entirely new form of practice and validate that carefully. So, that’s my main goal.

On the flip-side, when you see a news article that says, ‘This 17-year-old went out and shot 20 people today because he played a bunch of video games’, what’s your initial reaction?

Well, media hype and sensationalism is rampant across every domain, so I just take things with a pinch of salt – it sells stories. But, the reality is that video game use is incredibly high, so it’s really challenging to pin its influence on these acts of violence, which are worthy of deep thought and understanding.

My own interaction with that conversation is that when we’re building games, and we build many games in our lab, we do not have violence in them. I personally don’t think that violence is a critical active ingredient in having a game that can improve the brain, and also we know that many of the population that we want to impact don’t love violent video games. So, we think that with high levels of art, music, and other critical elements of video games, we can accomplish our goal. I don’t study violence in video games, I try to build games that will have their positive effects without them.

What’s the biggest fear about the work you do, if you have any?

My fear is that over-enthusiasm has the potential to lead to some over-inflated hype and inappropriate claims which could lead some to want to throw out the baby with the bath water. That sort of tension can lead us to not do what needs to be done, which is a careful, rigorous approach to validation, and it’s going to take time and that’s okay; I think that the win is worth that investment. I just hope that we find a way to be both excited but also cautious.

It seems like science, technology and medicine is in harmony about optimising every part of the body and we’ve always had this understanding that entropy is just a natural part of the body’s evolution. But, I find it so interesting that with you and other scientists that we’ve interviewed, it’s always about how to optimise certain parts of the body. Do you have an opinion about where the body and the mind itself is heading over the next few decades?

I hope that with that optimisation we get an increase in quality of life and in happiness. For me that’s the ultimate goal. I’m not really interested in ways of making people live longer, I really want people to live better. That’s the hope; that this will translate into that. My wish in all of this is that all this optimisation teaches us to live better lives, to connect with each other more deeply.

Who else’s work do you find really pivotal or fascinating in this broad field?

I’ve recently gained an interest in the world of artificial intelligence. It’s often seemed parallel to my work, that you could build intelligence systems out of silicon, then there’s my world which is making our intelligent biological systems more effective. And now I’m interested in bringing those two worlds together – that’s very new thinking for me but it’s something I am entertaining.

Do you share these fears of AI becoming overly intelligent or awakened?

Most of my opinion about that are focused on not the threat of AI but the optimal use of AI. I think we need to spend more attention to better humanity and help all these optimisation goals we have; if it’s directed towards that it will somewhat mitigate that potential threat.

What do you like to do when you’re not working on the brain?

Well, the reality of it is I spend a lot of time outside being in nature, music events, dinner – I like socialising. I am a major extrovert, I get empowered by ideas and conversations and I bring that into my lab and company and I try to close that loop.

Is that in some way related to trying to raise funds?

I mean, running an academic lab is a full-time fundraising operation and we have been successful with that, in relation to philanthropy and working with governments and individuals – we’re building our network constantly.