Rachel Feltman: For Scientific American’s Science Quickly, I’m Rachel Feltman.
Last April I spent a harrowing hour of my life trying to get tickets to a show at Madison Square Garden in New York City. I walked away with the cortisol levels of someone who’d just been hunted for sport and feeling lucky that I’d only spent, like, twice what I’d expected to.
And sure, that’s a pretty typical story these days, but I wasn’t trying to snag tickets to see Taylor Swift or Beyoncé—I was competing with tens of thousands of people to go watch other people play Dungeons & Dragons.
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[CLIP: Cheering]
Brennan Lee Mulligan: No, I did not think that would happen! I did not think that I would be DMing at Madison Square Garden. How could you—imagine, ugh, the gall! Ten years ago I’m like walking past Madison Square Garden to hit up another frozen yogurt shop for free samples because I can’t afford lunch. I’m like, “One day, baby, I’ll be in there playing D&D. Count on it. Bet on that.” No, I would never have anticipated.
Feltman: That was Brennan Lee Mulligan, a professional dungeon master, or DM. That means his job is to facilitate the playing of D&D. Brennan has made a name for himself through his work in “actual play,” which is an entertainment genre, mostly podcasts but also streaming shows like his creation Dimension 20 on Dropout.tv, where people actually play D&D—and other people just take it in.
That might sound bizarre if you’re not super familiar with D&D, so I asked Brennan to give us a quick crash course on the game.
Lee Mulligan: D&D is, first of all, an acronym, which is short for Dungeons & Dragons. And it is a tabletop role-playing game, so it is a game in which players gather around a table, either virtually or in person, and play the role of heroic adventurers being led through a series of stories and adventures and encounters by a dungeon master, who is running all of the non-player characters: the monsters and allies and enemies that they might meet in their adventures. So it is a way of collaboratively telling a story while also engaging in a game of tactics and strategy and magic and puzzles and problem-solving.
Feltman: Quick note here: Dungeons & Dragons is a specific gaming system and one of many tabletop role-playing games. People refer to individual games—as in, “I’m playing a game of checkers”—as campaigns, and they usually play out over many sessions. Some campaigns have been running for years.
And you can theoretically play campaigns with all sorts of themes and motifs using the D&D system, from the classic elves and wizards and bards and rogues high-fantasy stuff to, say, a story about superpowered animals living in the ruins of a nuclear research facility, which you can find on Dropout.tv.
But there are also lots of other tabletop role-playing games—some of which are played with dice like D&D but have different mechanics, and some of which are totally different.
Lee Mulligan: “Tabletop role-playing game” is the broad category, of which there are vast and sundry brilliant and incredible—from huge, crunchy, sci-fi space-adventure games to beautiful, lyrical indie games to everything under the sun in between. There are so many amazing games to play, all of which center, again, around that tabletop, which is that communal, shared experience, and then also the RPG aspect, where you’re playing some kind of role or character.
Feltman: A lot of the research we’re going to talk about today is probably applicable to lots of different tabletop role-playing games, or TTRPGs. But because D&D is far and away the biggest household name in TTRPGs, most studies have focused on that system, and I’ll probably say “D&D” a lot when I could say “D&D and probably lots of other TTRPGs” because, unlike many sessions of Dungeons & Dragons, this episode can’t be five hours long.
Because D&D is designed to feature complex storytelling arcs and offers tons of opportunity for character development, all of which will be unique to a particular campaign, it’s basically like improvised theater. So when you pair a talented DM with players who are great actors and improvisers, you end up with a really compelling show.
According to Polygon, actual play as we now know it first cropped up on YouTube and Twitch in the early 2010s, and the show Critical Role made a big splash a few years later. Brennan created Dimension 20 for the late Internet comedy company CollegeHumor in 2018. But D&D lovers agree that actual play took off in a whole new way—like a selling-out-MSG kinda way—during COVID lockdowns.
Lee Mulligan: What I think the innovation of actual play is, is it says, “Here is a high-octane, epic, fantasy-genre fiction story like the ones you grew up loving that is going to be profound, it’s gonna say things, and you will fall in love with these characters—and it will, because of the nature of how it’s being played, you will set-dress it yourself in your own imagination. You will be able to get lost like you did when you were, like, reading under a tree as a kid. And it is also going to have this other show, which is a reality show about a group of friends who genuinely love playing together.”
I said one time, like, “Imagine being, like, a groundling at the Globe Theatre and the first time Juliet dies, the other actors onstage go, ‘Oh, shit, we didn’t know that was gonna happen!” You know, like, that idea of that other level, which is this reality show—I think that moment during lockdown when a lot of people wanted storytelling but also wanted to feel like they had people on their side, didn’t want to feel alone.
Feltman: And actually playing D&D became really popular during the pandemic, too. The game’s parent company, which is now owned by Hasbro, reportedly saw a more than 30 percent jump in D&D-related sales in 2020. Digital tools and platforms designed to help people play the game remotely already existed, and joining a campaign was a great way to socialize with your friends and add some routine back into your life during lockdown.
That got a few tabletop-loving scientists thinking: Could they bring their favorite pastime into their research?
Órla Walsh: I was interested in the mental health aspect of playing D&D and how playing impacted players’ lives outside of the game, as well as while they were playing.
Feltman: That’s Órla Walsh, a fourth-year Ph.D. researcher at University College Cork in the south of Ireland. In 2024 she published a study on D&D after interviewing 10 players from Ireland, the U.K. and the U.S.
Those players said D&D had a positive influence on their mental health, which tracked with Orla’s own experience with the game. She also noticed a trend of players using their D&D characters to explore aspects of their own identities. One of her interviewees said D&D helped them come out to their fellow players.
Walsh: They made a character who was coming out and used that to explore how it would feel to have people react to you coming out and was able to do that and afterwards say to their friends, “Hey, that was actually real for me. That was actually me coming out,” and they found that that really just gave them the tool to do it.
Feltman: She says that another player had just started a new job where she was the only woman, and she felt her confidence waning. She created a super confident, super assertive character, and when things got tough at work she’d ask herself what that character would do.
Walsh: So they used role-playing as a tool for practicing skills or navigating real-world problems. And for me, that was the standout thing that was maybe unique to role-playing, or fantasy role-playing.
Feltman: The world of D&D science is still small, but it’s absolutely surged since the pandemic began.
Alyssia Merrick, a Ph.D. candidate at James Cook University in Australia, published a tabletop study of her own in 2024. Her team recruited 25 community members to play eight-week campaigns.
Alyssia Merrick: While they were completing their sort of mini campaign they were filling out surveys that looked at their mental health, and by about the eight-week mark, so when they finished the whole intervention, we saw improvements in all of the scales that we were looking at.
Feltman: A month later scores from participants who followed up were still generally above baseline, though the researchers saw the biggest impact while the campaign was ongoing.
Other studies published in recent years have suggested that TTRPG players are more empathetic than most and that these games can help people build group cohesion, improve their communication skills, enhance their critical thinking and explore aspects of their personal identities, including gender and sexuality.
I’ve always been impressed with Brennan’s ability to pull really deep emotional issues and profound conversations into his campaigns, so I asked him to tell us a little bit more about that aspect of the game.
Lee Mulligan: For me, I often think about things I’m wrestling with, so it’s not that I’m going to, like, a deep and profound point of, like, psychological pain to, like, put forth and be like, “This is all your problem now!” but instead looking at, like: I will find creative fuel in building a character around something that I am struggling with or thinking about or an interesting ethical problem.
I played a character called Evan Kelmp in a game who was a cursed, haunted wizard who wanted to be heroic, and that struggle between, “Here’s what my innate gifts are like: they are pretty bleak and haunting. Here’s what my inner desire is: it is a desire for warmth and closeness, connection and belonging,” that struggle will keep being interesting because it’s not resolvable.
And the parts of that that feel real to me in terms of my own life and being like, “I so desperately want to be social and be a part of things and be useful and helpful and constructive, and at times I don’t always feel like I belong,” and that is a contradiction, and how do you navigate that? And so that does feel like a personal thing that you can, like, use games to explore, which is, like, what art is for, for me, what storytelling is for, for me.
Feltman: Some researchers have looked at D&D as a therapy tool for people with autism spectrum disorder and found that the game allows players to practice recognizing social cues, having conversations and considering other people’s points of view. Studies have also suggested that having a character as a buffer helps people with autism spectrum disorder feel more comfortable expressing their feelings.
Orla says those findings resonate with her own experience.
Walsh: I just finished a series of co-design sessions with autistic people and with experienced D&D players. Interestingly, I recruited for experienced players and there’s only one neurotypical person in that group. There must be something drawing us [laughs] to the game.
I’m autistic myself, and I like routine, and I find the game does have structure, and you have freedom, but you also have a structure that feels safe. And that’s something that I find really beneficial, and I know others do as well.
Feltman: So what is it about D&D that makes it good for us mentally and emotionally? Orla and Alyssia are part of a growing group of researchers who are working on figuring that out.
Alyssia’s Ph.D. project involves a randomized control trial designed to get into the nitty-gritty of D&D’s benefits. And Orla is digging into which elements of gameplay are most important for helping players improve their mental health. But the two of them do have some instincts about what’s going on.
Merrick: I’ve spoken with other colleagues, mostly within Australia, and we’re all sort of looking at two major theories. Looking at self-determination theory, so, you know, the idea that we need to be related to others, you need to have autonomy and freedom in your actions, and you need to feel competent in what you’re doing.
And then the other one is flow theory, so where you’re so, you know, focused on the activity that you’re doing that you just forget everything that’s happening in the real world. But for some people it is really more beneficial just to take that time away and ingrain yourself in that character’s mentality and fight whatever they’re going to be fighting.
Feltman: Or maybe D&D just brings together the benefits of lots of different types of hobbies all in one place.
Walsh: One of the people that I interviewed had a really nice description of what it is about D&D that he finds so amazing. He described it as a bee going around to lots of different flowers getting pieces of pollen and said you could have a bunch of different hobbies that you can get different things from—so you could get creative expression from one place, you could get social support from another place—but D&D, as the player described it, was going straight to the honeypot.
Feltman: I also asked Brennan to weigh in on this because while he might not be a psychologist, he’s definitely a D&D expert—and he also plays a really good guidance counselor on TV.
Lee Mulligan: Without necessarily going out on a limb and being like, “This game will heal you—guaranteed!” I think that really what it comes down to is: storytelling obviously serves a profound psychological, cultural need. And I say this as—let me be very clear—a, like, philosophy-flavored comedian, you know? [Laughs] Like, I am not an academic or a doctor by any means. But I’ll speak to my own personal experience, which is that, yeah, these games were transformative to my life and my mental health, right?
And the way I relate to storytelling is often as a zip file for hard-won lessons and cultural information, for values, for ethics, right? How do we talk about what matters to us in a way that is—forget being persuasive to other people—that is persuasive to us. How do I tell myself what matters to me in a way that makes it cohere into a set of values? Often I think storytelling, even self to self, is how we do that.
And here’s, like, the real beauty of tabletop role-playing games: I am simultaneously audience and storyteller. I am gasping at a choice being made across the table and then able to share my reaction to it. There is an incredible democratization of the values that we encode into a story.
Feltman: While there’s still plenty of research to do, therapists are already working on harnessing the potential benefits of D&D for their patients. So-called therapeutic DMs, many of whom are licensed therapists, psychologists or other mental health professionals, run campaigns meant to help players gain confidence in their social skills, work through anxiety, manage PTSD symptoms and more.
Donny Youssef, a licensed marriage and family therapist and licensed professional clinical counselor based in California, has been running therapeutic campaigns for a while now. They say that as a longtime player of D&D they weren’t surprised when they found out therapists were using it to help patients.
Donny Youssef: I’ve heard from so many friends in a lot of groups that I’ve played with, they’re like, “Yeah, D&D is therapy,” right? Even before I went to grad school, I was hearing that kind of, like, phrase that, you know, “D&D is therapy.” And a lot of, like, the D&D shows that I watch, they kind of talk about that, too—that, like, this is a place to explore these identities and worlds.
Feltman: Donny runs therapeutic campaigns for a few different groups of patients. They have sessions for community members with mental health conditions that are designed to help with building life skills and managing symptoms. They also run campaigns for trans and gender-questioning folks that give them a safe space to explore their identities.
Donny says it’s a great opportunity for people to get comfortable engaging with conflict and other unavoidable aspects of the real world. For instance, rolling a nat 1—which, if you don’t know, is an absolute disaster—might lead the game in an unexpected direction, but things can still work out okay in the end. That experience may help people learn that adversity can be an opportunity for creativity and sometimes even playfulness.
As for how therapeutic D&D works Donny says it’s really just another modality of group therapy.
Youssef: So the structure of it is: we have, like, an hour of gameplay, and then we have 45 minutes to an hour of debrief, processing. If we’re doing more of a focus on group skills, then we’re doing like, “Okay, what skills did you notice?”
I’ve heard people really explore things in ways that they never thought they would be able to do—even, like, for example, something that comes up a lot is being able to explore conflict within, like, family dynamics, right? Like, being able to create a character that is very reminiscent to your real-life experience and then doing something that you’ve always wanted to do, which might be coming out to a family member, coming out to a parental figure.
And in therapy already, outside of D&D, a therapist sometimes becomes that and will say, “Okay, so what would you like to say to your parent, to your guardian, to your best friend, to your partner? And pretend that I’m that person,” right? In D&D we’re just creating a character—the DM creates a character that is like that, and the player kind of role-plays and imagines what it would feel like to say what they’ve been wanting to say. And then the debrief is like, “Okay, how does that feel? How can you play your character this week, right? How can you embody your character?”
I mean, we do tons of play therapy with children, right? We’re just the same children that we were [laughs] back then, you know? We need that imagination and that play.
Feltman: Donny says colleagues outside the tabletop realm have expressed a lot of excitement about their work using D&D. Given the boom in interest and research it seems likely that clinical uses of tabletop gaming are only going to get more common.
If you wanna check out D&D therapy for yourself, you can search provider platforms like Psychology Today for group therapy sessions built around tabletop gaming. But you don’t necessarily need a clinician’s help to enjoy D&D. Even though we’re still unpacking all the potential benefits of Dungeons & Dragons, one thing is already very clear: you can turn it into whatever game you need it to be.
Lee Mulligan: What tabletop lends itself to is telling the exact story that you and your friends need.
Feltman: So call up a few of your favorite people, get some good snacks, and dive into a campaign of your own—or go watch or listen to one. It might be just what the doctor ordered.
That’s all for today’s episode. Science Quickly is produced by me, Rachel Feltman, along with Fonda Mwangi, Kelso Harper, Naeem Amarsy and Jeff DelViscio. This episode was edited by Alex Sugiura. Shayna Posses and Aaron Shattuck fact-check our show. Our theme music was composed by Dominic Smith. Special thanks to Orla Walsh, Alyssia Merrick, Donny Youssef and Brennan Lee Mulligan for lending us their expertise, and thanks to the folks at Dropout.tv for coordinating our chat with Brennan. Subscribe to Scientific American for more up-to-date and in-depth science news.
For Scientific American, this is Rachel Feltman, wishing all you weary adventurers a wonderful weekend.