Alyse Stanley is a Virginia-based freelance games journalist and assistant editor at Unwinnable. At any given moment, she’s probably drowning in her indie games backlog. 

It’s early morning, and I’m trapped by an unlocked door, the front entrance to my home, during a year I’d rather forget. Through the window, a breeze rustles trees heavy with leaves so green and vibrant it pains me to stare at them for too long. They stood bare the last time I stepped outside.

This thought lodges a gag of shame in my throat as I slip on a pair of worn tennis shoes and convince myself that a stroll around the neighborhood is something I do all the time, a decision made in impulse and not in agony. It’s only a door, just a door, I repeat. My anxiety – no, let’s be honest, my full-blown agoraphobia at this point – would not get the better of me today.

I imagine it’s similar to how Madeline felt as she approached the foot of Celeste Mountain, just as determined to best its peak to prove, to herself most of all, that she was capable of doing so. Her journey makes up the bulk of Celeste, a tough-as-nails platformer released earlier this year, though the trials she faces aren’t always physical.

Surmounting her paralyzing anxiety proves every built as difficult as the mountain itself, and through her quest, developer Matt Makes Games depicts some of the most painfully realistic anxiety attacks I’ve ever seen. So I was shocked when I discovered lead developer Matt Thorson, in an interview with Kotaku, revealed his team never tapped mental health professionals to help them portray Madeline’s illness.  

“Our intention going in wasn’t to represent mental illness in general, or to make a ‘how to deal with depression’ guide, and we didn’t think to consult professionals on the topic,” he said.

Still, as I played, I recognized in Madeline’s attempts to overcome her emotions certain teachings from my nearly decade in therapy to address my own anxiety and depression. Unbeknownst to the developers, Madeline’s techniques for battling anxiety borrow heavily from cognitive behavioral therapy, a study I’m intimately familiar with, as it’s been essential in combating my own debilitating mental illness.

~~~

Three steps and I’ve traversed the hallway, but by the time my hand reaches for the knob, I’ve lost something along the way. Wishful thinking proved effective at drowning out my thoughts in the panic leading up to this moment, but, just as I begin to think I’ve convinced myself, I stare too long at what comes next.

Quicker than a breath, an avalanche of new information overwhelms me. My focus suddenly zooms out 100-fold; I’m no more than a speck, microscopic in its scope. And beyond my home, the world gapes open like a wound. Raw and terrifying.

In Celeste, Madeline experiences similar symptoms before her trek up the mountain trail has even gotten fully underway. After taking a nap once she’s conquered the first leg of her journey, her subconscious fears spring forth in a physical manifestation that haunts her dreams. She introduces herself as “Part of You,” her features in dark contrast to Madeline’s own. Simply a “concerned observer” worried about this sudden difficult undertaking. “You are many things, darling, but you are not a mountain climber” she explains, laughing. They should simply go home.

Chagrined and annoyed, Madeline’s first response is to reject this side of her, but her spurn only strengthens the manifestation (dubbed “Badeline” by fans) who launches an attack to make them leave the mountain by force. It’s enough to launch Madeline into flight or fight mode. Her heart rate quickens, her breath turns ragged and short, and the only thought furiously running through her mind is to escape, and escape quickly. Once she does, the nightmare, at first, appears to be over. But further up the mountain, Badeline returns again and again whenever Madeline becomes anxious, existing somewhere between dream and reality, but every bit a real threat.  

After all, “Celeste Mountain is a strange place,” warns the first character Madeline encounters, an old woman living at its base. “You might see things. Things you ain’t ready to see.”

Madeline’s first attempt at overcoming her demons reflects the tenets of traditional cognitive behavioral therapy, or CBT, a short-term psychotherapy treatment. Invented by psychiatrist Aaron Beck in the mid-20th century, it focuses on gaining control of one’s thoughts to correct erroneous thinking patterns that negatively impact one’s emotions.

CBT also posits that outside factors don’t determine how you feel; it’s how you process them, how you think about a situation, that determines your emotions. By first identifying these negative thought patterns, and then challenging them, you can change how you process situations and, ultimately, how you feel and interact with the world around you. This is called cognitive restructuring, with an ultimate goal of replacing the cognitive distortions causing your depression or anxiety with positive ones.

Badeline’s persona gives physical forms to these patterns, as she spouts what Madeline’s thinking but doesn’t want to admit to herself. In her response, Madeline follows CBT perfectly, first identifying her thought patterns with a name, then fighting Badeline’s attempts to wear down her willpower, and finally replacing these negative thoughts by consuming herself with her goal: to climb Celeste Mountain.

And this method works for her. In the short-term at least.

~~~

Clogged in my doorway, before I’ve set a foot outside and seen a single soul, I categorize every judgement they could have that I can fathom categorized by how likely they are to think it and calculate – just as dizzyingly fast – how I can prevent opinions of me from sprouting in their heads, paranoid of making a bad impression. I hyperventilate at the minefield of social cues, certain of my misstep, crippled by the feeling of eyes burning into me from all directions.

What’s the appropriate way to respond; how’s my pitch; what if my voice cracks; will I come off rude if I don’t seem friendly enough; but if I act too friendly they’re only going to talk to me more which welcomes further chances to agonize over my stilted responses. I’m consumed by the need to be perfectly forgettable but I can’t sift through every head I pass, choosing the optimum way to remain unnoticed. So I froth and twitch and frantically flip through a Rolodex of hypothetical encounters for fear of screwing up in the million different ways I’ve already run through in my head. Twice.

Back in my home, these anxieties stream through my mind like ticker tape too fast to understand, until I’m hunched over on the floor gulping down air, the door still just as closed, my face wet from panicked tears I don’t remember crying. My perspective jumps, now once removed, and I’m staring down at the pathetic image I cut on the floor. An anguished cry as alien as it is animal stuns me silent. My mouth creaks closed. I return to my bedroom to sleep away another day. That way, at least, I find some peace.

My therapist called this the rebound effect, when the thoughts you try most vehemently to avoid insist on returning, often with a vengeance. Madeline’s first attempt to flee her other half only causes it to multiply before pursuit. And while she succeeds in shaking them, later while riding a gondola further up the mountain, a bit of vertigo cracks the floodgates holding back her pent-up emotions.

When the gondola stalls, her vision blackens at the edges, until all she can see is the source of her immediate discomfort. This kind of tunnel vision is a common symptom of anxiety, and her other symptoms return in full force as well. I recognized what it was immediately, as I’d been in its throes more times than I could count: Madeline was having a panic attack. Her friend Theo coaxes her to try a deep breathing exercise, another CBT technique, where she concentrates on holding an imaginary feather aloft with her breath. And the therapy works, again. But not for long.

The next time Madeleine meets her other half in a dream she rejects the negative side of her, determined to leave her behind and override her existence with positive thinking patterns, just as CBT teaches. But Badeline fights back.

“You think you can blame everything on me? You think you’re above me?” She spits, squeezing the life out of Madeline with a monstrous tentacle.

Madeline retreats to her newfound breathing exercise, desperate to regain control. The feather floats for a moment, then falters, and finally Badeline’s voice breaks through her focus, mocking her attempt before ripping the feather in half.

“You are not above me. And you can’t climb this mountain. It’s time to accept that,” she screams before throwing Madeline back off the mountain. Back in reality, the cliffside she’s sleeping on crumbles, toppling her down, down, impossibly far down. The therapy didn’t work.

~~~

What ultimately does both for her and for me, however, is a method that grew out of CBT in an attempt to address some of its shortcomings: dialectical behavioral therapy, or DBT. Instead of rejection and replacement, DBT focuses instead on acceptance to ensure patients feel supported and validated before being asked to focus on change.

Psychologist Marsha Linehan originally developed DBT in the ‘80s as a treatment for female patients with bipolar disorder that didn’t respond to CBT. Many of her patients considered the concept of replacing their thought processes as invalidating, as if it was their fault they were mentally ill in the first place. To combat this, Linehan focused on incorporating a dialectics into her therapy, an ancient philosophical perspective concerned with balancing two opposing views at once to eliminate black-and-white thinking. In DBT, these competing ideas are acceptance and change. Gone is the need for controlling one’s thoughts that’s essential to CBT. Instead, this therapy teaches you to “[a]ccept thoughts, feelings, and situations as they are. Change emotions, thinking patterns, and situations,” Lineham writes in DBT Skills Training.

But accomplishing this requires a couple of tools developed through therapy, the most important of which are mindfulness techniques.  DBT believes that only through experiencing your emotions can you possibly learn to address them. As such, practicing mindfulness is throwing yourself completely into an experience without judgement, becoming consumed by what you’re doing as if it were the most important thing in that moment. And as for any discomfort:

“Purposely look at your emotions, pay attention to them, notice them, accept them for what they are, and let them come and go,” Lineham writes. My therapist and I called this the conveyor belt; as the uncomfortable, worrying thoughts come, I see them, acknowledge them, then place them on the belt for concern somewhere in the ethereal “later.”

Over a campsite fire with Theo, Madeline struggles to voice her reason for attempting to climb Celeste Mountain. He jokes that she spends too much time stuck in her thoughts, and it’s then she realizes that’s her reasoning: scaling the mountain gets her out of her own head, a place she’s desperate to escape.  

“I’m going crazy,” she tells Theo. “I can’t stop thinking about dumb stuff that doesn’t matter. My brain fixates on these stupid things that happened forever ago.”

Reading these words unleashed a raw pang of recognition as I remembered the thoughts that strangled me that day, overwhelming me with how wrong everything felt, how wrong I felt. But, just as Madeline did, I learned how to identify and accept these thoughts, pushing them along their way just as fast as my mind could fathom them. And let the conveyor belt take them away.

When asked about how she experiences her mental illness, Madeline’s answer is as chilling as it is familiar to me: “I’m at the bottom of the ocean. I can’t see anything in any direction. It’s claustrophobic, but I feel exposed.”

The only possible hope she has over climbing Celeste Mountain is by working with her other half, accepting its feelings as her own, and throwing herself into her experience despite that. At Celeste’s climax, she combines with the part of herself that’s been bringing her down both literally and metaphorically, that incessant voice of worry in her head. Only then, with those thoughts droning off into the ether, acknowledged but not limiting in her ability, can she become 100% focused on her task, and mount that summit.

~~~

It’s another early morning, and a door stands unlocked before me, an entire world beyond its frame. I hear the tittering chatter at the back of my head, accept it, and let it continue unchallenged. What extends beyond that threshold scares the hell out of me, I’m well aware of that. With that in mind, I reach for the handle. And step through the door.