The Armored Core games, from Dark Souls's developer From Software, give players the experience of controlling a giant mecha. As you can imagine, giant mechas are complex machines and, thus, so are Armored Core's controls.
The above photo appeared on Japanese forums recently during Armored Core V discussions. According to Mecha Damashii's Ollie Barder, this photo (and similar photos of the same ilk) are AC players being somewhat jokey.
"Basically, fans took the piss out of the fact that the game required you to have about 15 fingers and that 'this' was the only solution," said Barder. "It's one of those satirical gaming points I think as I've never seen any of my AC playing friends in Japan playing the game this way—bear in mind I've participated in tournaments back in the PS2 days too!"
(Top photo: 名無しさん必死だな | 2ch)