Reality Is Broken: Why Games Make Us Better and How They Can Change the World (21 page)

So that’s where SuperBetter comes in.

SuperBetter is a superhero-themed game that turns getting better into multiplayer adventure. It’s designed to help anyone recovering from an injury or coping with a chronic condition get better sooner—with more fun, and with less pain and misery, along the way.

The game starts with five missions. You’re encouraged to do at least one mission a day, so that you’ve successfully completed them all in less than a week. Of course, you can move through them even faster if you feel up to it. Here are excerpts from the instructions for each mission, along with an explanation of how I designed it and how I played it.

I chose
Buffy the Vampire Slayer
as my story line. That made me Jane the Concussion Slayer, and that made my symptoms the vampires, demons, and other forces of darkness I was destined by fate to battle against. The point of this mission is to start seeing yourself as powerful, not powerless. And it underscores the fact that you
are
heroic for choosing to persevere in the face of your injury or illness.

As Jane the Concussion Slayer, I recruited my twin sister as my “Watcher” (Buffy’s mentor in the TV series). Her mission was to call me every single day and ask for a report on my concussion-slaying activities. She should also give me advice and suggest challenges for me to try. Before playing SuperBetter, I hadn’t known how to explain to her that I really needed daily contact, and not just to hear from her on the weekends.

I recruited my husband as my “Willow” (Buffy’s smarty-pants best friend who’s also a computer geek). His mission was to do all of the score-and record-keeping for me, read me interesting articles, and in general help me with anything I wanted to do on the computer without getting a headache. Finally, I recruited my friends Natalie and Rommel, and their miniature dachshund, Maurice, as my “Xander” (he’s the comic-relief character). Their mission was to come over once a week and just generally cheer me up.

Why recruit allies? Social psychologists have long observed that one of the hardest things about a chronic injury or illness is asking our friends and family for support. But reaching out and really asking for what we need makes a huge difference. It prevents social isolation, and it gives people who want to help, but don’t know how, something specific and actionable to do.

And why have achievements? Every fiero moment helps increase optimism and a sense of mastery, which has been proven to speed recovery from everything from knee injuries to cancer. But achievements feel more meaningful when someone else gives them to you—that’s why it’s important to have a friend or family member bestow them upon you. Kiyash gave me my achievements based on the titles of episodes of
Buffy the Vampire Slayer
. (For example, I unlocked the “Out of Mind, Out of Sight” achievement for ignoring my e-mail for an entire day, and “The Harvest” achievement for eating vegetables for dinner instead of cookies and ice cream, which was one of my favorite postconcussion ways to drown my sorrows. At the time, both of those felt like epic struggles.)

My list of bad guys at the start of the game focused on activities I kept trying to sneak in even though I knew they made me feel worse: reading and responding to e-mail, running or doing any kind of vigorous exercise, playing
Peggle
, drinking coffee.

The better you can identify triggers of your symptoms, the more pain and suffering you’ll avoid. And making a great escape turns a potential moment of failure—
This is harder than it should be,
or
I can’t do what I want to do
—into a moment of triumph:
I succeeded in recognizing a trigger and vanquished it before it did too much damage.
One of the highlights in my recovery was when I enlisted the entire crew at the Peet’s Coffee down the block to help me modulate the amount of caffeine in my morning iced coffee, which I was really reluctant to give up. It was their idea to start me off with 90 percent decaf with just a splash of caffeine so that I could work my way up to half and half, and eventually full caffeine when my brain was finally ready to be stimulated again.

For my concussion recovery, I focused on things I could do with my senses that weren’t affected by my head injury. Touch was fine, so I could sit and cuddle with my Shetland sheepdog. Hearing was fine, so I could sit by the window and listen to a podcast. And the biggest superpower I discovered had to do with my sense of smell: I really started to enjoy smelling different perfumes. I would go to a perfume counter, spray samples of a dozen perfumes on cards, then take them home and smell them throughout the rest of the evening, to see how they changed and to learn the different notes. It was one of the most engaging activities I could do without hurting my brain at all. And eventually, once my vertigo was improved, I was able to add to my power-up list long walks up San Francisco hills with my husband.

The power-ups are meant to help you feel capable of having a good day, no matter what. Having specific positive actions to take increases the odds of doing something that will break the cycle of feeling negative stress or depression.

This final idea was inspired by a question I’d found on the website of a New Zealand occupational therapist. “If I can’t take your pain away, what else would you like to improve in your life?”
⁸
It’s one of the abiding features of a good game: the outcome is uncertain. You play in order to discover how well you can do—not because you’re guaranteed to win. SuperBetter has to acknowledge the possibility of failure to achieve complete recovery. But it can also make it less scary to fail—because there is an abundance of other goals to pursue and other rewarding activities to undertake along the way. That’s why it seemed essential to make part of the game a project to discover as many positive activities that it was still possible to do. It increased my real hopes of enjoying life more, no matter what else happened with the recovery or treatment.

One of my easiest superhero to-dos was baking cookies for people who live in my neighborhood. I liked it so much, I did it three times. A more challenging to-do was finding an opportunity to wear my favorite pair of purple leather stiletto boots, which meant getting up the energy to go out and see people. (I crossed this one off my list by going to see a movie with a big group of friends. I was a bit overdressed, but I felt great anyway.) The biggest superhero to-do on my list was, of course, to finish this book.

Once you have completed the five big missions, your challenge is to stay in constant contact with your allies, collect power-ups by battling the bad guys and making great escapes, and tackle items on your superhero to-do list. You might want to “lock in” your gameplay by keeping a game journal, posting daily videos on YouTube, or using Twitter to announce your achievements.

Near the end of every day, hold a secret meeting with one of your allies. Add up your great escapes, your power-ups, and your superhero points.

Talk to your other allies as often as possible, and tell them what you’ve been doing to get superbetter. Ask them for ideas about new things to add to your to-do list.

Be sure you have at least one ally who is giving you daily achievements. Share these achievements with your friends online, using Twitter or Facebook status updates, to keep them posted on your progress.

So that’s how you play SuperBetter. But does it actually improve the reality of getting better?

The first few days I was playing, I was in a better mood than I had been at any time since I hit my head. I felt like I was finally
doing
something to get better, not just lying around and waiting for my brain to hurry up and heal itself.

My symptoms didn’t improve instantly—but I was so much more motivated to get something positive out of my day, no matter what. Every day, no matter how bad I felt otherwise, I would score at least one great escape, grab at least one power-up, rack up some points, and unlock an achievement. Doing these things didn’t require being cured; it just required making an effort to participate more fully in my own recovery process.

There’s not a whole lot you can prove with a scientific sample of one. I can say only that, for me, the fog of misery lifted first, and then, soon after, the fog of symptoms started to lift as well. Within two weeks of playing Jane the Concussion Slayer, my symptoms were improved by roughly 80 percent, according to the log Kiyash helped me keep of my pain and concentration problems on a ten-point scale, and I was up to working as many as four hours a day. Within a month, I felt almost completely recovered.

I can’t say for sure if I got better any faster than I would have without playing the game—although I suspect it helped a great deal. What I can say for sure is that I suffered a great deal less during the recovery as a direct result of the game. I was miserable one day, and the next day I wasn’t; and I was never that miserable again as long as I was playing the game. When my allies joined the game, I finally felt like they really understood what I was going through, and I never felt quite so lost in the fog again.

After declaring my victory over the concussion in a Twitter post, I received dozens of requests to post all the rules and missions, so that other people could game their own injuries and illnesses—for everything from chronic back pain and social anxiety to lung disorders, migraines, the side effects of quitting smoking, newly diagnosed diabetes, chemotherapy, and even mononucleosis.

I published the rule set on my blog, and I gave it the more general name SuperBetter (after all, most people probably don’t dream of being like Buffy the Vampire Slayer).
⁹
I suggested that people use the hashtag “#SuperBetter” for their own videos, blog posts, and Twitter updates, in case they wanted to find each other online. (A
hashtag
is a way to easily add context to your online content, and to find other people talking about the same topic.) And that was it. I didn’t build a Web application, or develop an automated scoring system, or even set up a social network for playing the game. A game doesn’t have to be a computer program. It can simply be like chess or hide-and-seek: a set of rules that one player can pass on to another.

An alternate reality game can be as simple as a good idea, a fresh way of looking at a problem. SuperBetter, of course, isn’t meant to replace conventional medical advice or treatment. It’s meant to augment good advice, and to help patients take a more active role in their own recovery.

When you’re sick or in pain, getting better is all you want. But the longer it takes, the harder it gets. And when the tough reality we have to face is that getting better won’t be easy, a good game can better prepare us to deal with that reality. In an alternate reality linked to our favorite superhero mythology, we’re more likely to stay optimistic, because we’ll set more reasonable goals and keep better track of our progress. We’ll feel successful even when we’re struggling, because our friends and family will define fiero moments for us every day. We’ll build a stronger social support system, because it’s easier to ask someone to play a game than it is to ask for help. And we’ll hopefully find real meaning and develop real character in our epic efforts to overcome what may be the toughest challenge we’ve ever had to face. And
that’s
how we get superbetter, thanks to a good game.