Your AR overlay provides the next lines, “I have a recommendation for you.” The AI counseling partner, Eliza, tells you to suggest that the client try performing some breathing exercises and to ask their doctor about some conspicuously name brand medication. “Have a wonderful day,” the script prompts, “Goodbye.” Another successful session, granting you a boon of experience points and a few medals to add to your AR profile. Your rating isn’t great, but you snagged a $5 tip, so at least there’s that.
In this near-future snapshot of Seattle from Zachtronics’ new game, Eliza, you play as Evelyn, a worker in the ever expanding rhizomatic gig economy. Recently contracted to serve as a human proxy for the AI-power therapy system of the future (the titular Eliza), Evelyn ventures adrift into a world she helped build but that she feels deeply and troublingly disconnected from. Previously one of the leading engineers on the project, Evelyn left the company creating Eliza, Skadha, behind her, only to return to see what her project has become in her absence. What follows is a harrowing tale about the value of human connection, the troubling state of what the mental health system has become, and how we can try to better the world for one another. Writer Matthew Seiji Burns paints a picture of a world not quite dystopic, but more reflective of our own current societal state and the path that those at the top of the tech industry are leading us towards at a worrying pace.
Spearheaded by the massive tech industry boom currently defining Seattle, Skadha presents Eliza to the public as a boon for accessible mental health care. With their unlicensed contract workforce serving as liaisons between Eliza’s text-based responses and clients as well as a vital human touchstone, Skadha swiftly secures the position of front-runner in the field. People come to the Eliza office in droves, so much so that Skadha plans to open new locations to meet demand as quickly as possible. However, through your time at the company as a proxy, your meetings with old coworkers, and brushes with prospective new technologies challenging Eliza, the thin veneer of the painting Skadha would have us see begins to peel away, revealing that perhaps all is not as it seems.
Rendered in gorgeous brushwork, Eliza portrays Seattle in beautiful hues of greens and greys. Refining their style emerging in SHENZEN I/O and Opus Magnum, it’s no surprise that Zachtronics decided to go all-in on a visual novel given the abundance of talent they’ve gained from the burgeoning story elements of those aforementioned titles. Foregoing the puzzle elements that have been the signature of their brand altogether, their focus on plot and storytelling proves to be a runaway success. Eliza is not only stunning in its artwork, but also jaw-dropping with its writing and character development. Each person you encounter during your workday oozes personality along with the unforgettable cast of friends you meet during the 6 – 8 hour runtime of the story.
Its impressive how well Eliza handles real-world issues without becoming overwrought or cliché. Having the story set in Seattle is a very deliberate move, as tech giants such as Amazon or Microsoft are defining companies for the city. The story manages to touch on many of the myriad issues that have flooded Seattle throughout its emergent tech boom, bringing into beautiful focus our continued atomization and alienation as a society. Beyond the problems plaguing the industry regarding long work hours and the call for unionization of both warehouse workers and game developers, Seattle itself has had a massive shift in its cost of living, with skyrocketing rent prices and the associated displacement of the less fortunate onto the streets or out of the city altogether contributing further to that sense of internal social alienation that runs like tendrils through every aspect of urban life. Positioned as being a cheaper, more accessible alternative to a run-of-the-mill therapist, Skadha brings mental health into the gig economy, subsidizing the massive cost through contract workers and its proprietary software; a solution that, in its own way, contributes to the underlying problems it seeks to palliate.
One of the most interesting ways in which Eliza poses the juxtaposition of these two industries is through the way in which it utilizes gamification for its human proxies. Much like how Amazon has gamified the order fulfillment process, those who facilitate Eliza are met with a “rewards” screen following each session. Here, they’re granted a set of medals based on their performance with the client that translate to experience points raising an overall level, alongside their rating and tip. It feels absolutely bizarre to be granted a “Sympathetic” medal after a client has just stormed out of the office profoundly upset because they were collapsing into a depression spiral that the system can’t meaningfully handle.
Beyond the oddity of gamifying such a personal process, Eliza also seems to have shortcomings in the ways with which it handles patients. As our supervisor and the system insist time and again, proxies are to stick to the script that is provided to them by Eliza during sessions. Often, this script feels like it oversimplifies the issues it’s presented with, and even regularly comes across as condescending. Nearly every session concludes with either a video game being prescribed as a mindfulness activity, or with the patient being directed to ask their doctor about medication. Outside of the shortcomings of Eliza’s problem-solving capabilities, the reliance on medication with no reasoning outside of “I believe it will help ease your situation,” comes off as exceptionally cold.
Having been through several therapists myself, it’s very easy for the system to feel like something of a Mental Health Industrial Complex. The cynical among us will feel good about discussing our issues with an objective outsider but will potentially see medication as either a cop-out or “easy fix.” When taking into account how psychopharmaceutical companies dump egregious amounts of money into advertising medications such as anti-depressants to not only consumers but providers as well, it’s hard not to wonder whether a specific prescription is pushed to you because of a benefit that the doctor sees from promoting the med. While this explicitly is never explored outright, Eliza only ever suggests a very small pool of medications for clients, and if one subsequent interaction from a recommendation is indicative of a greater trend, it also pushes medications that can be extremely costly with no generic alternatives.
For the Eliza system, there are seemingly just as many critics as there are supporters. Amongst the detractors is your old project lead, Soren, who helped lead the Eliza project to fruition originally. Having left behind the pompous atmosphere of Skadha, he plans to deliver a next-level technology for this burgeoning field of techno-therapy: a headset that connects directly with your brain to simulate experiences via a dream-like state. He offers you a position at the top of his new venture, but, he’s not the only one with eyes for Evelyn. On the other side of the court lies Rainer, the CEO of Skadha, who has noticed your return to the lowest level of the company and is desperate to recruit you back to your old position. These two present warring ideologies of how to deal with the mental health crisis our world is dealing with, either furthering the possibly lacking Eliza software or pressing forward in the name of “ending suffering” for the whole of humanity.
Between them lie a few other anchors, such as spunky, rebellious Nora who used to work with you on Eliza, and your supervisor at the Eliza office, Rae. These two provide more ground-level perspectives on the companies you’re torn between, both wanting the best for people as a whole but who see the path to achieve their goals very differently.
In the end, Eliza provides a profoundly good story about the human condition and where the lines of humanity become blurred in terms of our continual automation of society. Despite speaking to a real live person in Eliza sessions, the patient is still met by a proxy expected to follow directions word-for-word with no room for deviation. Rigid rules provide what higher-ups see as extreme success for the system, but outliers and your own experiences prove otherwise. Wherever you fall in the argument for or against AI-powered therapy, Eliza explores the topic to all logical endpoints with no stone left unturned. It’s a story with themes that need to be explored at our current cultural crossroads, and an extremely well done one at that. You’d be hard pressed to find a better visual novel covering such grounded, realistic topics, and I highly recommend you take the time to check in with Eliza.
Eliza is available now on Steam.
Catherine Brinegar is a trans game developer and filmmaker who explores the surreal and abstract in her work. Beyond her creative endeavors she enjoys losing herself inside other worlds, interactive and not. Finding inspiration in everything, Catherine aims to see all the world has to offer, through the continual conversation of art. You can keep up with her on twitter @cathroon.