First-person shooters make me sick.

I don’t mean that I’m disgusted by them. I mean that games with a first-person perspective actually make me physically ill. I first realized I had a problem years ago, when my coworkers were taking a “Quake break” and wanted me to join. I watched the screen for a bit, got a headache and went back to work, dismissing first-person games as something that “wasn’t my thing.”

Then I played Star Wars Galaxies, my first true departure from the safe, comfortable isometric world of Ultima Online. It, too, made me sick at first, but my desire to play with my friends somewhat offset the symptoms. I thought getting sick was a fluke due to stress and general insomnia, so I kept playing until I had largely acclimated to the sensation.

When World of Warcraft came out, however, my patience finally broke. I wanted to know what could be done about my symptoms, and this led me into a well-documented field of research. Finally, it had a name: simulator sickness.

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Virtual Simulator Sickness (VSS) is a type of motion sickness and a well-documented effect of simulator exposure. The symptoms are practically identical to typical motion sickness: nausea, vomiting, confusion and general discomfort. But unlike traditional motion sickness, VSS does not require any physical movement. It comes out of nowhere and can happen to anyone, much to the chagrin of lifelong gamers. It’s also a lot more common than most people think: One study conducted by the U.S. military claims 20 to 40 percent of tested pilots suffer from this malady. With a large variety of simulators for different purposes available to the general public, the problem is likely more widespread than those estimates suggest.

Researchers still disagree on the exact cause of VSS. The most common explanation is the “cue conflict” theory. Cue conflict occurs when input from different senses are in conflict, resulting in an inconsistent perception of movement. Other scientists claim that the “cue” theory lacks the ability to reliably predict which situations will invoke a mismatch of cues – or the severity of the results. Most literature and research, however, relies on the cue conflict theory because it has enjoyed large exposure to the public and is the best fit for much of the available data on the topic.

For gamers, VSS can be quite a nuisance. In a fight that is dependent upon any sort of 3-D movement, VSS can slow your reaction time and make it harder to move to a safe spot. It can be frustrating and occasionally disastrous in a group setting, but you can overcome it with enough patience (both on your part and from your teammates).

Unfortunately, many game developers seem oblivious to the plight of those who suffer from VSS. There are several fights in World of Warcraft that involve flying or piloting vehicles. They’re designed to showcase the variety of ways your character can interact with the world. But for someone susceptible to VSS, they’re extremely difficult. By building fights that depend on “first-person” mechanisms into a massively multiplayer game, the developers insist the affected player suck it up or avoid the situation all together. For example, the final phase of Malygos, the last boss of the Eye of Eternity, requires everyone to mount flying drakes and stay clustered together in the air. It’s inevitable to hear the healers shouting “Group up! Group up, dammit!” but there’s only so much you can do when twisting around in the air makes you queasy.

After tackling Malygos, I thought I was done with the stupid stuff. Then came Ulduar, an instance whose first fight involves prolonged vehicular combat. To me, making such a fight mandatory in an instance filled with other, easier, optional bosses was deplorable. The first few attempts left me curled up in a ball in my computer chair with my eyes closed until the “all clear” came out over vent. With a couple weeks of adjustment, I could participate in “the gauntlet” without debilitating VSS but I knew I had fallen behind the learning curve as a result.

People don’t usually choose to endure VSS unless there’s some incentive, whether it’s playing with their friends or simply seeing new content in a game they otherwise enjoy. The developers of Mirror’s Edge helped promote awareness of the condition by explaining some of the measures they took to help combat VSS during development, such as removing head bobbing. The reaction was predictable. “Why would they take out head bobbing? Screw people getting sick,” and “Why would anyone have a problem with bobbing being an option? If you don’t want it, turn it off!” DICE studied the issue extensively, giving players the option to have a reticule to focus on and in using the camera to simulate the player’s eyes, not the head. To combat disorientation, the game provides expansive views of the city that help preserve a feeling of stability even when the player moves quickly. As a result, Mirror’s Edge, wasn’t nearly as sickness-inducing as it could have been.

For players who experience simulation sickness, there’s an abundance of well meaning advice, though it’s rarely helpful. Articles on the topic suggest straight infusions of ginger, Dramamine and even acupressure wristbands. These are gimmicks based on traditional motion sickness remedies and unlikely to cause anything beyond temporary relief. The only things that work reliably for most players is time and patience . Each new 3-D game requires a short “adjustment” period of playing in stages until the sensation becomes more and more manageable. Unfortunately, adaptation skills don’t always transfer between games, because not all 3-D games affect a VSS-prone gamer the same way.

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I’ve trained myself to play plenty of games over time, but every single one takes patience, and even new content packed in old favorites has the potential to set my brain askew. Mirror’s Edge, whose demo initially caused me to flee towards a darkened room, has finally become playable for me. DICE’s innovations in this area should not be overlooked by other developers of first-person games. There’s no reason to exclude a portion of your audience because you’re unaware of their needs.

Gamers with VSS want to experience new content. We want to be just as good as our friends and enjoy the same games they do. We’re just wired differently.

Research Manager Nova Barlow is still considered a hardcore gamer by many, even if she had to play Portal by proxy.

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