The Dangers of Advising “Powering Through” Motion Sickness

As many of you who have followed my work for years may know, I suffer from pretty bad motion sickness when gaming, particularly when playing first person games without decent motion sickness mitigation settings available.

Around ⅓ of the global population are estimated to be highly susceptible to motion sickness, a condition where a mismatch of signals between different sensory systems creates sensations of nausea, dizziness, and other negative symptoms. At its most basic, it’s caused by the vestibular system in the ears which detects head motion not lining up with what your eyes are seeing.

Either you’re feeling motion but not seeing it, such as reading a book while sitting in a car, or you’re seeing motion without feeling it, such as playing a first person video game while sitting stationary. The clash of data causes many people like myself to feel acute nausea.

For those of you who don’t suffer from acute motion sickness, it might be worth explaining how much it can negatively impact gaming. Using myself as an example, at its worst it’s not simply a brief unpleasant sensation, it can leave me feeling close to physically vomiting, overheated, dizzy, and physically drained. If a game triggers a major motion sickness episode I often have to lie down in a dark room with a fan pointed at me for at least a few hours for the initial symptoms to subside, and have to delay returning to the game in question likely until the following day to minimise the risk of my symptoms very quickly returning.

Motion sickness mitigation settings are undeniably accessibility options. Without them, some games are fundamentally unplayable for me.

There’s a lot of causes that can lead to someone having acute motion sickness, some of which we understand but many of which are a lot more nebulous. For me, I can identify that some of my motion sickness sensitivity is caused by a couple of eyesight problems, and are exacerbated by a lack of sleep and rest.

I have one eye slightly farsighted, and a degree of binocular vision dysfunction which is apparently not uncommon in autistic people. This basically means that my eyes have for years been working at slightly different focal distances, and not moving quite in sync with each other, causing strain and effort to create one stable image, both of which contribute to motion sickness when gaming.

So for me glasses have been a recent tool to help with some of my motion sickness mitigation, as have spirit level glasses when in a car to provide a visual cue that matches the movement that I’m feeling in my ears. This paired with plenty of sleep, fresh air, and gaming sessions of a sensible length all help to mitigate motion sickness onset, while not completely erasing the condition for me.

However, today I’m not here not to talk about reducing motion sickness symptoms, but instead to talk about actions which can risk dramatically increasing your susceptibility to motion sickness onset, severity, and slowed recovery.

Let’s talk about the risks of trying to “power through” motion sickness.

Back in November of 2019, I was working as a freelance reviewer for Polygon. One of the games I reviewed for the site at that time was a game for the original PlayStation VR titled Golem.

In Golem you play a young girl remotely piloting a giant stone golem to battle monsters and explore ancient ruins while physically at home in bed. The game involved slow and clunky sword fights with other stone golems, as well as environmental puzzle solving challenges involving reasonable amounts of backtracking.

Golem was unique in how badly motion sick it made me feel to play. Certain design decisions such as the default movement scheme being leaning forward to walk, head tilt being the only method to turn your character causing unintended drift strafing, a lack of ability to teleport or turn your character view in fixed increments, and headset motion lag all contributed to make a game that, even when functioning as intended, ignored a LOT of VR game design comfort best practices.

Add onto this the fact that the game occasionally bugged out and inverted look direction, and the baffling choice to have the little girl’s bedroom visible in the periphery of the Golem’s vision if you moved your head too quickly, and the game felt purpose built to trigger motion sickness even in those not as easily prone to suffering from it as I.

I tried my best to play through Golem, as I had a paid assignment to cover it for work. Myself and my wife took turns handing the headset back and forth in half hour gameplay segments so we could rest if we started to feel too ill. I made far more of an effort than I should have to power through and play the game despite it triggering extreme motion sickness symptoms in me.

Because I had a work obligation to review the game, I ignored what my body was trying to tell me, and tried to power through. I regret playing as much of Golem as I did even now, five years later.

I didn’t play Golem through in its entirety. After three days of playing the game on and off, I emailed my editor and explained to them what I was experiencing, and the reasons that I felt justified in attributing my struggles to design decisions the game had made rather than it simply being an issue on my end. That editor agreed, and we worked on a review that acknowledged that I’d been unable to complete playing it and why.

After that review was published I received social media comments from VR evangelists telling me I was at fault. I should have tried harder to keep going. If I didn’t keep trying to power through motion sickness, I would never get my “VR Legs”, a term that they used to mean no longer feeling motion sick when playing games in VR that are not built with VR comfort in mind. I was called a failure for not continuing to play a game that, more than once, made me feel like I was imminently going to vomit.

Here’s the thing, my motion sickness symptoms have been much worse ever since I played Golem. I noticed a dramatic uptick in the speed that motion sickness symptoms manifested, a worsening of their impacts, and a slower overall recovery. My motion sickness symptoms are worse, and I feel confident that trying to ignore my body’s signals and power through motion sickness while playing Golem is directly responsible for that worsening of my symptoms happening.

Trying to power through motion sickness seemingly made my body push back, making its warning signs more dramatic to force me to protect myself from a percieved threat. Trying to power through made me suffer more in the long run.

This experience with Golem happened in late 2019, a few months before I started recording episodes of Access-Ability in the spring of 2020. I’ve thought about recording this episode for a very long time, but largely held off on it because I was unsure how much of my personal experience was anecdotal, how much was me attributing to one game what might have just been explained by simply getting older, and if there was any scientific backing to legitimise what I felt had occurred to me.

While I’ve struggled to find any scientific research on the topic, I have in the past few months spoken to several other people with stories very similar to my own. I’ve met other people who can point to a single specific game that they tried to power through motion sickness with, ignoring their body’s signals to stop, and years later still find they get motion sickness more easily than they used to. It’s not any kind of quantifiable study, but knowing that I’m not alone in this experience has made me feel more confident about discussing what I experienced, in the hopes of protecting others from similar situations.

While some people in the VR space in particular will insist that, for them, ignoring motion sickness feelings and powering through them helped them to get past the feeling and enjoy VR games more comfortably, this is far from a universal experience, and particularly for those of us already acutely impacted by motion sickness may make things dramatically worse.

It’s not a fun feeling, noticing something already debilitating has gotten noticeably worse. It’s a whole different thing to know exactly when it started, and knowing that ignoring your body’s self defence signs led to that worsening of symptoms.

I’m making today’s video after many years as a warning. I don’t want anyone to go through what I and others did. I don’t want any of you to find yourself getting worsening motion sickness symptoms, because you think that ignoring your body’s screams that something is wrong will make that feeling go away or settle down.

Over time I’ve found ways to mitigate some of my motion sickness symptoms. I play first person games with a fan pointed at my face, I take ginger capsule supplements before playing as ginger has anti-nausea properties. I play these games when well rested, and for shorter bursts of time. I wear my new glasses, and those definitely help a lot. When games offer the ability I increase my Field of View, turn off certain visual effects like motion blur, and reduce camera sway or head bob effects

But still, when motion sickness strikes it’s faster, stronger, and slower to settle than it ever used to be.

As someone who professionally consults with game developers on how to make their games more motion sickness friendly, take it from me, it’s not worth risking trying to power through motion sickness. If you spend a few days like I did trying to break through that barrier, you might just find your body forever pushes back a little harder.