This is not medical advice
Parts of this interview have been edited for brevity.
Where The Flower Blooms
Ryan Earl, better known online as “Dr. Mick”, is a Twitch streamer and content creator, while also a licensed marriage and family therapist with a PhD in Human Development.
During the day, Ryan runs Starline Therapy with his wife Ali. The two boast over 20 years of shared experience for individuals online and those located in Illinois, Nevada.
As a content creator, Dr. Mick plays through both popular and indie titles while reacting with his “therapist hat” on – a series he calls Game Sessions With a Therapist. His goal with these streams is to take current happenings in the moment to moment story and circle them in to psychological concepts.
Dr. Mick also creates music, his latest album releasing at the end of 2024 titled In the Search of Patterns That Don’t Exist.
In December 2024, I had the opportunity to interview Ryan and discuss a variety of things: from creating content as a licensed therapist, to working with and talking to game developers, and the ethics behind creating content online.
We connected with Dr. Mick through my former coworker and good friend Sean; Dr. Mick’s editor and channel manager (Shout out to Sean).
The Interview
As a video game centered magazine, the first thing I asked Dr. Mick was about his relationship with gaming, both related to streaming and in his free time.
Dr. Mick said that his time with gaming goes all the way back to when he was 5 years old and got a Sega Genesis for Christmas with Sonic The Hedgehog 2 and World Championship Soccer.
“It was over from there, video games have been a core component of my life ever since”.
When it comes to gaming on his own time compared to gaming for content creation, Dr. Mick says he love to play looter shooters, specifically Destiny 2. But when it’s time to stream, even if a game has the chance to be dissected and broken down for it’s unique moments, it has to be fun to play.
“If I don’t enjoy playing a game it’s miserable for everybody because I don’t hide my disdain or boredom for a game very well”
He continued, “Disco Elysium is a good example of a game that gets requested all the time, but after giving it an hour and a half I just can’t do it”.
When it comes down to choosing games that he does feature on Game Sessions With a Therapist, he said it mainly comes down to the titles he wants to play or are recommended to him by a trusted source. At the moment, he’s playing Ghosts of Tsushima, a title that came heavily recommended to him, but something he already had on his radar.
For games like Destiny 2, Dr. Mick says he has nearly 4000 hours played and “know[s] nothing about the story”, he finds it easy to separate the titles he just wants to play for fun and not analyze. But, when a game does make it to the stream, Dr. Mick says he finds it easy to connect with.
“I feel a greater sense of connection with what’s going on, there is something about where I get into this zone and its really me immersing myself into it because I know I am creating a piece of entertainment for other people to enjoy. Something about that helps lock it in compared to playing a game by myself because when I’m sitting there by myself I’m not analyzing the psychological components of it even remotely compared to when I am playing it for a playthrough.”
A New Leaf
Before starting his Twitch career in 2018, Dr. Mick says he didn’t have much experience with the live streaming platform as a viewer, but he says his experience creating content was similar to most:
Streaming to little to no viewers.
“I had no idea how involved live streaming was. I didn’t know how much equipment you needed, I just didn’t know.”
The turning point for Dr. Mick’s streams was a post he made to Reddit that helped him to get the ball rolling. People fell in love with the blending of psychological analysis and gaming content he provided.
Since then, his stream has evolved, especially when Mass Effect Legendary Edition came out in 2021. He says when the game was released, he wanted to play it again, but this time through the lens of a therapist. Since then, Dr. Mick started to grow and form the style that Game Sessions With a Therapist is now.
During these last 3+ years, Dr. Mick has learned that just about any game has something to offer. A weird example of that? The Callisto Protocol.
While it wasn’t the most positively reviewed game of all time, Dr. Mick says he and his community were able to have an interesting conversation about trauma. He said he found that his community was surprised that there was something to be extracted from the game that many wouldn’t have pinned at first glance.
“As long as a game has reasonably accurate representation of reality, I can find something in it”.
One of the games that Earl found to be most productive for his channel and had a lot of “meat on the bone” was God of War: Ragnarök. He found that the game had real taken a real strong approach to the topics it handled and had real care taken to many of the dynamics between characters throughout the game.
Something I was curious about when for someone in Dr. Mick’s very specific situation was if he found that there are more games or fewer games that offered good talking points?
“Yes.”
“Something that comes up often on our streams is how many games come up with really good quality depth without the developers intent.”
Dr. Mick went on to talk about how games like Psychonauts and God of War, two games of which he was able to speak to the developers of about, had many moments with the intent being focused on psychological concepts; yet he found plenty of talking points that the developers themselves hadn’t even thought of. A goal of his is as the channel grow is to be able to interface more with some of the developers behind these games, similar to how he was able to do so with Double Fine and Sony Santa Monica.
Doing a Zoom interview with Tim Schafer was something that he couldn’t believe he had the opportunity to do.
Following up on that, I asked if there was anything in particular that he looks to bring or get out of these conversations with game developers.
“Man that’s a good question.”
Dr. Mick said before pausing for a moment.
“I always say at the end of every playthrough that if there are any developers watching that would value having someone with my eyes take a look at their game from a character and interpersonal stand point I would be happy to do that.”
He mentioned how important he finds theses topics and how they are covered in games. His goal: providing accurate representation.
While collaborations are, of course, special for Dr. Mick, he is also very picky about who he is collaborating with and why he is collaborating with them. He mentioned that a lot of collaboration requests he receives look to have him throw the weight of his credentials around, leading to him having to carefully pick and choose who he is involved with.
When it comes to developer intent, a topic that we spent a good portion of our time talking about, Dr. Mick highlighted that every playthrough of his is a self contained experience and that he doesn’t compare games to other games; rather strictly following the story that is being told within the game.
In regards to streaming multiple playthroughs at a time yet not relating games to each other, Dr. Mick said:
“I really try to appreciate the game for what it is in isolation. Every once in a while I will make allusions to other games but I really try and focus on appreciating each game for what it is.”
The Sun and The Moon
As a licensed therapist and online content creator, Dr. Mick sits in between to realities; one where he handles very personal stories in one on one settings, and the other, an online personality that takes pride in being an arbiter for disseminating information about psychological concepts using video games.
As for which is easier to explain to the other audience?
“My own parents don’t even totally understand what I do!”
As a content creator with a sizable following, while being the owner of Starline, I asked Earl if it was ever mentally taxing to balance both.
“The more ethical you are the easier it is. I am aware that when I am streaming or doing anything, I am a representative of my license. I am always a therapist, I don’t ever get to turn that off.”
He continued, elaborating on how it could potentially get complicated or taxing should he practice actual therapy on stream; something he said that he would never go near. One thing he does recognize is that, being an online personality, some of his clients do know of his channel and what he does. As a professional, however, he will never acknowledge someone in his community as being a client.
“I’ve had clients say that I’ve shown up on their ‘For You’ page and that they’ve had no idea what I did. I’ve had to let people know and prepare them, for I may say something on social media that may feel like I’m saying something directed at them, but they should know that I would never talk about them in any capacity.”
When it comes to others online, I asked, with the option to not answer, Dr. Mick if he sees or has seen any “bad actors” when it comes to mental health content creation.
“Yes”, he chuckled.
He followed with even though he creates mental health content online and on TikTok, he tells his community that they should never engage with mental health TikTok, ever.
A quick Google search of “Mental Health on TikTok”, the first 6 results before TikTok itself are articles on “whether or not TikTok is a valuable or harmful tool when it comes to Mental Health”. With the first result making both cases; it may offer some community to those with similar conditions, but it may also “Aggravate Mental Health Conditions”.
Per Dr. Mick:
“There are good people with good intentions that make problematic choices and then there are people who some may say have had a positive impact on their lives but have aspects to them that are not very ethical and there are of course some just blatantly taking advantage of others.”
Branching Out
As a mental health specialist and content creator himself, I wanted to know the advice that he would give to a fellow creator who may be facing burn out, or needed help navigating the online world and their own communities from the perspective of his practice.
“I very much believe that people should be able to articulate why they do the things that they do – understanding why you creating the content that you are creating, It blows my mind how many people are unable to answer that.”
He followed with how he hopes that if someone sees what he’s doing, maybe he can inspire someone to potentially see how not all therapists look the same, and if there is someone like him on the other side, they may feel inclined to reach out and find someone for themselves to talk to.
The other piece of advice he offered, in addition to understanding why you do what you do, is understanding that the creator is the driving force behind a stream, not the audience.
“I think a lot of people get burnt out when they see their viewers as the driver of the stream.”
He added that this is something he had to learn over time, but understands now that there is a boundary to be set between him and the audience.
“If 100,000 people were watching and said ‘Dr. Mick please play Disco Elysium‘ it’s still not going to happen.”
The Harvest
After talking with Dr. Mick, it was clear to me how intentional he, and as a medical professional, has to be. There is no time where he is not a medical professional. At work, or on stream, he has to be intentional with what he says, does, and portrays as it is a reflection of both him and his work.
His journey is ever evolving, from learning how to set healthy boundaries with his stream and companies who seek to work with him. It has guided him to being a clear and concise communicator of, at times, heavy and important mental health conversations. It lends itself to unique and exciting opportunities to interface with some of the most respected game developers that value his opinion and are surprised he is able to find things in their game they may not have originally intended.
Watch Dr. Mick on Twitch and YouTube.
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