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Twitch and Mental Health: the Parasocial Paradigm

When I’m not playing video games, I am a research assistant on the eBRAIN study, researching adolescent brain development and mental health in London. I am a huge advocate for mental health and tackling the stigma around it. In my previous blog, I talked about the reality of feeling suicidal and how services like Maytree play a vital role in suicide prevention.


In this blog, I’ll be discussing the rise of livestreaming as a popular form of online media and communication, the parasocial interactions between streamers and viewers, and how this new platform has impacted the conversation around mental health. Parasocial relationships are one-sided psychological bonds between members of an audience and the entertainer or performer, where the audience feels they know the performer, and in some cases, feel they are their friend, but these feelings are not reciprocated.


As somebody who spends quite a lot (a LOT) of time playing video games and consuming gaming-related content, I have first-hand experience of being part of online gaming communities and the positive effects it can have on your life. Some of my closest friends are people who were once strangers I met through playing online multiplayer games.


The evolution of these communities and the global shift of human communication throughout the years has been monumental and rapid, particularly over the past year where we migrated online for school, work and recreation, in the form of virtual coffee meetings and zoom quizzes. Not being able to see our friends, family and colleagues in person for such long periods of time has inevitably invoked feelings of loneliness and a lack of true human connection.


Many of us found solace and safety in our online communities, whether it was within the gaming sphere or elsewhere. In fact, the number of monthly active users on Discord, a voice over internet protocol platform designed with gaming communities in mind, doubled by the end of 2020, reaching 140 million people! For those who find socialising in real life difficult or daunting, being able to hang out with your mates online is a godsend. Discord and similar platforms provide a space to build meaningful relationships, friendships and thriving communities, in spite of physical distance.



Another space frequented by gamers is Twitch, one of the most popular online livestreaming platforms today, with a focus on video games, esports tournaments and IRL streams, involving various activities and hobbies. Livestreaming video games really took off in the mid-2010’s and has solidified its place in the online entertainment industry, with 7 million creators streaming monthly on Twitch alone. Although watching content on Twitch is free, creators or streamers can earn money in several ways, whether it’s donations and subscriptions from viewers, rolling advertisements, acquiring brand sponsorships, or selling merchandise. Even conventional celebrities regularly stream on Twitch, notable favourites being Doja Cat, T-Pain and Logic.



Parasocial Paradise


What’s so enthralling about Twitch is the variety of streams and entertainment available, and the individual reasons why you might watch them. Is it the streamer’s personality, relatability, and charm? Their raw gaming skill or knowledge? Or is it the comfort that their presence on the screen brings?


When we react intensely to the latest episode of [insert your favourite TV show or podcast here], the last thing we’d expect is for the characters or hosts to respond to us, no matter how personally connected to them or their experiences we may feel. On Twitch, this isn’t the case. Livestreaming presents a whole new kind of interaction, where the normally very palpable barrier between the content creator and the content consumer (the audience) has been dissolved.




Each stream has its own unique chat room where viewers, also referred to collectively as ‘chat’, can interact with each other and the streamer, who can react in real-time. Viewers can support their favourite streamers through monthly subscriptions or monetary donations, where they can add a personalised message for the streamer to read, an attractive proposition for viewers who are drawn to these opportunities to interact. However, by design, Twitch isn’t an ideal platform for one-on-one interactions, especially in busier, more popular streams, where there are often tens of thousands of viewers in the chat.


This relationship between creators and viewers is very much one-sided. Viewers can develop interest in the streamer and learn about them, their hobbies and interests, their personal lives. Streamers, on the other hand, will not have the same level of interest in their viewers.



These mediated, one-sided relationships can be referred to as parasocial. The concept of parasocial relationships or interactions is far from new, having been coined in the 1950’s to refer to the psychological relationship between an audience member and performers on TV or voices on radio. Unlike TV, Twitch offers a level of social reciprocity and the opportunity to be noticed and acknowledged by streamers, which can potentially lead to the development of an unhealthy attachment with said streamer, seeing them as a friend rather than entertainer. Parasocial interactions aren’t inherently damaging but they can become problematic depending on the specific circumstances.



Mental Health Discourse


Twitch, and platforms like it, can provide respite, distraction, and escapism, similar to that provided by video games, and can be a huge support when coping with difficult life events. In fact, the mass parasocial interaction between streamers and their viewers has facilitated discussion around mental health, and even allowed individuals to anonymously open up about adversities they are facing and their own mental health problems.


Twitch has been highlighted as a ‘popular platform for mental health discussions’, depending on the streamer, the theme of their channel, their content and their communities. This shift of mental health talk online is, in my opinion, a valuable one and not exclusive to gaming communities or services like Twitch. Mental health discussions have also taken place on Twitter and other social media websites. The anonymity or even visibility attainable online can be comforting to those who may struggle to disclose their troubles in person or reach out to relevant services for help.


A streamer who I find particularly interesting is Dr. Alok Kanojia, otherwise known as Dr. K or ‘HealthyGamer_GG’ on Twitch, a Harvard-trained psychiatrist who livestreams interviews with well-known gamers and streamers, and creates educational content regarding mental health, tailoring it for gaming culture. The co-founding of Healthy Gamer with his wife stemmed from his own gaming addiction and need to understand it. As a mental health professional and advocate, Dr. K has streamed to thousands of viewers tackling various topics, such as depression, anxiety, and suicidality, as well as things like procrastination (something I am very familiar with) and meditation.


“The more overwhelmed I’d feel the more I’d play video games. And the more I’d play video games the more overwhelmed I’d feel. And it turned into a vicious cycle” — Dr. K

Through his content, Dr. K has been able to guide many people within the Twitch community and hopefully leave them feeling more comfortable with tackling their mental health problems and accessing appropriate services. He has created room for vulnerability and real conversation about the kinds of struggles that we all face.


“You be vulnerable, you share, don’t worry alone, remember that your struggles are a multiplayer game, too. If you want to help someone, start by asking for help.” — Dr. K

The benefits of engaging with livestreams are undeniable, especially during a pandemic. Whether you are visiting a stream for relaxing entertainment, expressive information sharing, escapism, trends, companionship, social interaction or as a habitual time pass, the sense of community and the value of the space that comes with it is unique.


It is, however, always important to maintain a balance and to implement healthy boundaries with livestreaming, both as a viewer or streamer. My hope is that these platforms and new ways of communicating continue positively contributing to the discussion surrounding mental health in a digital age.


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