Friday, September 25, 2009

Super Better - or how to turn recovery into a multi-player experience

I’m either going to kill myself, or I’m going to turn this into a game. After the four most miserable weeks of my life, those seemed like the only two options left.

It was the summer of 2009, I was about halfway through writing my book, and I got a concussion. It was a stupid, fluke accident: I was standing up, and I slammed my head straight into a cabinet door I didn’t realize was still open. I was dizzy, saw stars, and felt sick to my stomach. When my husband asked me who the president was, I drew a blank.

Some concussions get better in a few hours, or a few days. Others turn into a much longer post-concussion syndrome. That’s what happened to me. I got a headache and a case of vertigo that didn’t go away. Any time I turned my head, it felt like I was doing somersaults. And I was in a constant mental fog. I kept forgetting things – people’s names, where I put stuff. If I tried to read or write, after a few minutes, my vision blurred out completely. I couldn’t think clearly enough to keep up my end of interesting conversations. Even just being around other people, or out in public spaces, seemed to make it worse. At the time, I scribbled these notes: “Everything is hard. The iron fist pushes against my thoughts. My whole brain feels vacuum pressurized. If I can’t think, who am I?”

After five days of these symptoms and after a round of neurological tests that all proved normal, my doctor told me not to worry, I would be fine – but it would probably take a entire month before I really felt like myself again. In the meantime: no reading, no writing, no working, and no running, unless I was completely symptom-free. I had to avoid anything that made my head hurt or made the fog worse. (Sadly, I quickly discovered that computer and videogames were out of the question; it was way too much mental stimulation.)

It was tough news to hear. A month seemed like an impossibly long time to not work and to feel this bad. But at least it gave me a target to shoot for. I set the date on my calendar: August 15, I would be better. I believed it. I had to believe it.

And then that month came and went, and I’d barely improved at all.

That’s when I found out that if you don’t recover in a month, the next likely window of recovery is three months.

And if you miss that target, the next target is a year.

Two more months living with a vacuum pressurized brain? Possibly an entire year? I felt more hopeless than I could have ever imagined. Rationally, I knew things could be worse – I wasn’t dying, after all. But I felt like a shadow of my real self, and I wanted so desperately to be myself again and get back to my normal life.

My doctor had told me that it was normal to feel anxious or depressed after a concussion. But she also said that anxiety and depression exacerbate concussion symptoms and make it much harder for the brain to heal itself. The more depressed or anxious you get, the more concussed you feel, and the longer recovery takes. Of course, the worse the symptoms are and the longer they last, the more likely you are to be anxious or depressed. In other words, it’s a vicious cycle. And the only way to get better, faster, is to interrupt the cycle.

I knew I was trapped in that cycle. And the only thing I could think of that could possibly make me optimistic enough to break it was a game.

It was a strange idea, but I literally had nothing else to do (except watch television and go on very slow walks.) I’d never made a healthcare game before. But it seemed like the perfect opportunity to try out my alternate reality theories in a new context. I might not be able to read or write very much, but hopefully I could still be creative.

I knew right away it needed to be a multi-player game. I’d been having a lot of trouble explaining to my closest friends and family how truly anxious I was, and how depressed I felt, and how hard the recovery process was. I also felt awkward, and embarrassed, asking for help. I needed a way to help me say “I am having the hardest time of my life, and I really need you to help me.” But I also didn’t want to be a burden. I wanted to invite people to help me. Make it optional. Make it fun.

As with any alternate reality project, I needed to research the reality of the situation before I could re-invent it. So for a few days, I spent the limited amount of time I was able to work (about an hour a day at this point) learning about post-concussion syndrome online. From various medical journals and reports, I pieced together what experts agree are the three most important strategies for getting better and coping more effectively – not only from concussions, but any injury or chronic illness.

First: Stay optimistic, set goals, and focus on any positive progress you make. Second: Get support from friends and family. You can’t do it alone. And third: Learn to read your symptoms like a ‘temperature gauge’. How you feel tells you when to do more, do less, or take breaks, so you can gradually work your way up to more demanding activity.[i]

Of course, it immediately occurred to me that these three strategies sound exactly like what you do when you’re playing a good multi-player game. You have clear goals; you track your progress; you tackle increasingly difficult challenges, but only when you’re ready for them; and you’re connecting with people you like. The only thing missing from these recover strategies, really, was the meaning – the exciting story, the heroic purpose, the sense of being a part of something bigger.

So that’s where SuperBetter comes in.

SuperBetter is a superhero-themed game that turns getting better in multi-player 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.

Mission #1: Create your SuperBetter secret identity. You’re the hero of this adventure. And you can be anyone you want, from any story you love. So pick your favorite story – anything from James Bond to Gossip Girl, Twilight to Harry Potter, Batman to Buffy the Vampire Slayer. You’re about to borrow their superpowers and play the leading role yourself.


I chose Buffy the Vampire Slayer (the late 1990s television series) as my storyline. 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. Plus, it’s just plain fun take on a secret, heroic identity. If you can’t be yourself (due to your symptoms), why not be someone secret and awesome?

Mission #2: Recruit your allies. Every superhero has an inner circle of friends who help save the day. Pick the people you want to count on most, and invite them to play this game with you. Ask each one to play a specific part: Batman needs a Robin and an Alfred, while James Bond needs an M, a Q, and a Moneypenny. If you’re Bella, you’ll want at least an Edward, a Jacob and an Alice. Give each ally a specific mission, related to their character. Use your imagination – and feel free to ask for anything you need! When you’re saving the world, you can’t be shy about asking for help. Be sure to ask at least one ally to give you daily or weekly achievements – these are surprise accomplishments they bestow upon you based on your latest superheroic activities.


As Jane the Concussion Slayer, I recruited my twin sister Kelly as my “Watcher” (that’s Buffy’s mentor). 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. It was a huge relief to me when she accepted this role because I didn’t know how else to explain that every single day was really hard for me, and that I really needed daily contact, and not just checking in on the weekends, to get through it.

I recruited my husband as my “Willow" (that’s the smarty-pants best friend who’s also a computer geek) His mission was to do all of the score-keeping and record-keeping for me, read me interesting articles, and in general to help me with anything I wanted to do on the computer without getting a headache. And 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 better when someone else gives them to you – that’s why it’s important to have a friend or family member bestow them upon you, instead of making them up yourself. 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 email 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 post-concussion ways to drown my sorrows. Honestly, both of those felt like epic struggles at the time – so fiero well-deserved!) We figured that by the time we’d gone through a four or five seasons, I would be fully recovered!

Mission #3: Find the bad guys. To win this battle, you need to know what you’re up against. Pay attention all day to anything that makes you feel worse, and put it on your bad guys list. Some days, you’ll be able to battle the bad guys longer – some days not so long. But most importantly: every time you do battle, you’ll want to make a great escape. That means getting away from the bad guy before he knocks you flat.

You can always add more bad guys to your list as you discover them – and if you vanquish one forever, you can take it off and claim the permanent victory.


My list of bad guys at the start of the game focused on things I kept trying to sneak in even though I knew they made me feel worse: reading and responding to email; running or doing any kind of vigorous exercise; playing Peggle; and 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 – something is harder than it should be, or I can’t do something 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 into helping 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% decaf with just a splash of caffeine, working my way up to half and half, and eventually full caffeine when my brain was finally ready to be stimulated again. Take that, bad guy! I totally pwned caffeine!

Mission #4: Identify your power-ups. Good thing you’ve got superpowers. Maybe they’re not your typical superpowers – but you definitely have fun or important things you can do for yourself at a moment’s notice to feel better. Make a list, and be ready to call on them whenever the bad guys are getting the better of you. In fact, try to collect as many power-ups as you can every day!


For my concussion recovery, I focused my fun power-ups 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 sitting by the window and listening to a podcast. And the biggest superpower I discovered had to do with my sense of smell: I really got into smelling different perfumes. I would go to a perfume counter, spray samples of a dozen perfumes on cards, and 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 fun things I could without hurting my brain at all. And eventually, once my vertigo was improved, I was able to add long walks up San Francisco hills with my husband to my power-up list.

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.

Of course, I had serious power-ups too: the most important of which was a big handful of walnuts, every single day, to get Omega-3s for my brain. I felt like I was really helping when I did it.

Mission #5: Create your superhero to-do list. Not every mission is possible, but it doesn’t hurt to dream big. Make a list of goals for yourself, ranging from things you’re 100% positive you can do right now to things you might not have been able to do even in your wildest dreams before you got sick or hurt. Everything on your list should be something that would make you feel awesome and show off your strengths. Every day, try to make progress toward crossing one of these superhero to-dos off your list. Be sure to get your allies’ help and advice.


This final idea – the “super hero to-do list” was inspired by a question I 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?”[ii] 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 a "perfect" recovery. But it also can make it less scary to fail – because there's 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’s still possible to do. It increases real hope of success of enjoying life more, no matter what else happens 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 awesome anyway.) The biggest superhero to-do on my list was, of course, to finish my book. So far, I have 82K words written out of 100K. FIERO!

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

As you play, be sure to do follow these three rules:

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

2. 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.

3. 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 really 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. I would score at least one great escape, grab at least one power-up, rack up some points, and unlock an achievement every day, no matter how bad I felt otherwise. Doing these things didn’t require being cured; they 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 only say that for me, the fog of misery lifted first, and then soon after, the fog of symptoms started to lift as well. Within a two weeks of playing Jane the Concussion Slayer, my symptoms were improved by 80%, and I was up to working as many as four hours a day. And within a month of starting to play, I felt almost completely recovered. In fact, as I’m sitting here writing this now, it has only been five weeks since I invented the game, and I am myself again.

I can’t say for sure I got faster any better than I would have without playing the game – although I suspect it helped a great deal. But I can say for sure that I suffered a great deal less during the recovery as a direct result of the game. I was miserable one day, and then the next day I wasn't; and I was never that miserable again as long as I was playing the game. Before I started playing, I felt like no one understood what I was going through. But when my allies joined the game, I felt like they really got it, and I never felt quite so lost in the fog again.

In many cases of post-concussion syndrome, anti-anxiety medication or anti-depressants are prescribed. I personally wanted to avoid taking new medications unless it was absolutely necessary. The game gave me an alternative, a way to try to treat the anxiety and depression without drugs. If it hadn’t helped, I would have been open to medication, without a doubt. But it did help – enormously.

SuperBetter, of course, isn’t meant to replace conventional medical advice. It’s meant to augment good advice, and to help make it easier to take.

Why I'm sharing all of this now:
After posting my initial videos and then later declaring my victory over the concussion in a Twitter post, I received dozens of requests to post all of the rules and missions, so that other people could game their own injuries and illness, everything from chronic back pain and social anxiety to lung disorders, migraines, the side effects of quitting smoking, and even their teenager’s mononucleosis.

I would suggest using the hashtag #SuperBetter for players to tag their own videos, blog posts and Twitter updates, in case you want to find each other online. But I don't think it's necessary to play "in public" unless you want to. It's really good to play mostly just with your closest friends and family, which I did for the most part.

Right now, I don't have plans to build a web application, or develop an automated scoring system, or even setting up a social network for playing the game. A game doesn’t have to be a computer program. It can be like Chess, or Hide and Seek, a set of rules that one player can pass on to another. I would like to make a website eventually with the missions beautifully laid out with awesome, inspiring visuals and such. So hopefully, the official SuperBetter site is coming soon. (But first, I have to finish my superhero to do, my book!)

One more thing I'd like to add: An alternate reality game can be as simple as a good idea, a fresh way of looking at a problem.

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 ourselves to deal with that reality better. 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 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 just may be the toughest challenge we’ve ever had to face. And that’s how we get superbetter, thanks to a good game.

UPDATE: I celebrate the one-year anniversary of my concussion, with video!


Here are a couple of videos from the early design phase of this project. As you can see, I was struggling a bit to think and speak clearly -- but I'm happy to say I'm pretty much fully recovered now.

Why I'm making a concussion recovery game

Designing the first mission

[i] The British Journal of Psychiatry (2003) 183: 276-278 Post-concussion syndrome: clarity amid the controversy? NIGEL S. KING, ClinPsyD


Nina Simon said...

Congratulations, and thank you for sharing. I'm glad you didn't have to get into the late season Buffy experience (die again, come back to life, evil twin) to win.

As an athletic person, I live in fear/denial of debilitating illness or injury. Watching my husband recover from a torn ACL/knee surgery this summer with grace and patience, I thought, "I could never do that." Your process makes me feel more confident that I could deal with that situation.

TS said...

Lovely thinking. Especially like the notion that this is a game you make your own and for yourself with your own private group of allies.

And glad you're recovered.

IneffaBelle said...

This is super awesome Jane! I might just have to start playing... It never occurred to me to try and turn my recovery into a game before, but it sounds like it just might be exactly what I need to do to get myself where I want to be. Thank you!

M. Huw Evans said...

This is really great stuff, Jane! Have you considered writing it up for publication in a medical journal? I think it could work very well for a lot of hospitalized patients. I can also see patients who might otherwise have trouble buying in to a super hero themed game giving it an honest go if it's presented to them by their physicians as an important part of their recovery plans. And once the idea has been distributed to the medical community, I would be surprised if you don't find an opportunity to actually see it tested in that holy grail of clinical research: the randomized controlled trial.

Jane said...

Nina -- not running was one of the hardest parts of it actually, taking away daily endorphins from a runner is like going cold turkey on any addictive substance. brutal... but yeah, you would totally and creatively find the strength to deal with it for sure. recovery 2.0 ^)^

ilorien I think we will try to collect some other case studies, get a dozen or so others report on efforts to see if it even has any positive impact on anyone other than me ^_^ and then yes I would like to see if any more clinical settings would be interested in trying, I think with kids/teens especially, but also not to undercut its usefulness for adults ^_^ especially geeky or playful adults ^_^ thanks for the suggestions and and advice on proceeding is definitely welcome!

Rik Panganiban said...

Wow, this is super inspiring and thought-provoking.

Where I work at Global Kids we've been developing programs for our urban teens to be creating their own games using various online tools. I realize that we sometimes get caught in the trap of wanting to use the latest digital tool to help empower our kids.

But you speak so well about the power of simply constructing the game design as a way of reframing a problem, in your case a very personal one, and finding ways to be heroic in confronting it.

I would love to see how we could translate this perspective to how we help our kids confront their own life situations, as well as problems in their community and the larger world that they are concerned about.

Thanks so much for sharing this.

Allen Varney said...

SuperBetter would be a natural activity for nursing homes and geriatric recovery situations. The challenge would be introducing the game into the environment; I suspect many patients would take to the idea with enthusiasm, if only for novelty's sake.

Congratulations on your recovery!

Matt Forbeck said...

That's an absolutely awesome story, Jane. There's probably a "Life's a Game" book in there somewhere. Congratulations on your recovery, and thanks for sharing how it came about.

Jane said...

Matt -- lol -- you're right!! there IS a book in here somewhere. It's called Reality is Broken -- why games make us happy and how they can change the world -- and it should be out in Fall 2010 from Penguin Press. ^_^ (that's the book I was lamenting working on in this blog post ^_^)

Chris Havranek said...

Great to here you've recovered! From what you wrote it sounded like you were having one of the hardest times of your life and I'm sure all this work you put into recovery helped enormously. This could easily add a chapter or two into your book...pfft forget chapters, you could write a book or two on this last month of your life!

Joe McCarthy said...

Jane: you are truly an inspiration, even in the midst of misery. I am delighted that SuperBetter was instrumental in your recovery, and am sure that it will help many others cope with their life challenges.

I like the way you broadened the playing field - "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" - and would invite you to broaden it even further.

I read an article in the Wall Street Journal the day you posted this entry on The Long Slog: Out of Work, Out of Hope, in which the reporter observes some trends in chronic unemployment that seem similar to those of post-concussion syndrome and other health-related chronic conditions you noted in your post: "As challenging as it is for anyone to find a good job in this economy, it can be even harder for people out of work a long time. Skills atrophy. Demoralization sets in and can become permanent. Some potential employers shy away ... The probability that a laid-off worker will find a job grows smaller the longer people have been out of work"

More than anyone else, you have changed my perspective on games and life - primarily through seeing their multifaceted [potential] interconnections. Other commenters have noted the prospects and pathways for SuperBetter to have broader impact for people with health problems ... I'm hoping that this gameful approach to life's challenges can also have broader impact to those with employment problems.

Thanks for sharing your inspiring ups and downs, and I'm very glad that you are on the mend!


caislas said...

Hi Jane,

It is nice to read that you are happy back again. I saw your videos before this post, and gave me food for the though.

I couldn’t write you earlier, and perhaps now my thoughts are not relevant anymore, however I would like to share them to you.

Overcome of problems is an art that millions of people do every day. We are lucky we are healthy, we have energy, and basically we are not missing anything. We are fighting for our dreams and to make this world a good place. However we are minority in this privilege situation.

Hence I was thinking that the fact to be in the situation that you were, it gave you the opportunity to explore a new world. Actually you knew it was temporal, hence it was sure that you will get out of there, just that this time you were not the puppet- master. Life was at charged.

The challenge came when you start to stop to be sure that you will get out of there ASAP. Part of the positive thinking, I assume, is to enjoy the present whatever it is.

Life is a huge game, it is up to us if we want to look at it in this way. Full of surprises and each one plays in its own way. I think the main secret weapon is: keep it positive, believe in yourself and your dreams.

You reach your goal within your own personality, as you have reach other goals earlier. It helps that you have positive connections on your past too. The interesting part is what this experience let you, what did you discover in it, and how can you empathize with others in similar conditions. Each person is a world that makes it SO rich, but we are all connected too ;)

Keep enjoying your path!

Anonymous said...

Most impressive, it is very cheering to see you continue your positive impact on the world.

Anonymous said...

Congratulations, Jane! Your recovery and how you went about it are amazing. I'm going to pass this blog on to some friends with chronic health problems. Plus, I'm bookmarking it for myself. You just never know what might happen. Thank you.

Bez said...

I am in pretty much the same boat as you are!

I got my head jammed in some tube train doors. Not a big deal, you might think, but my head "pinballed" back and forth between the two rubberized door edges, bruising my brain fairly evenly all over.

I don't think I'm as symptomatic as you - I was dizzy for a week or two, and the fog hasn't really lifted yet. I'm not blanking on remembering things, but I do take longer than normal to recall, and my focus is shot. Occasional short headaches and nausea, too. And panic attacks. Oh God the panic attacks. They're the worst, robbing you of sleep.

First 3 weeks or so, I rested (tried going to work, but it left me feeling completely drained, and that triggered panic attacks). I had to get used to the idea that work would have to do without me, and as much as they said "that's fine", I felt guilty for not being there to help on crunch work for our game, and paranoid that everyone thought I was skiving off.

That only got me more worked up, so I asked special permission from the doctor to go into work, but to ease in the hours, so that I could atleast be in there part of the time. Because of crunch, work wanted 50 hours a week from us, and I just about pulled it of by coming in weekends for a bit. Hoping it doesn't exacerbate things.

I'm sort of hoping I'm not being flippant about not resting. Being a head case is no fun. Then again, I'm giving myself panic attacks not working, so what can you do?

David Sahlin said...

So glad to hear you're better now, Jane.

SuperBetter is an amazing idea, I'm really curious to see how effective it is for other cases.


Barry Joseph said...

Jane, I had no idea you were injured, so imagine my being upset to learn of it, relieved by your recovery, and inspired by how you took it on - all at the same time. Yours is a mind and a personality we don't want the world to be with out. Thank you for taking the time to document it and looking forward to the book.

BunchberryFern said...

Wow. You are super-cool. And have plonked an Alka-Seltzer into my mind.

Thank you.

Em said...

Thanks for this inspiring and personally vulnerable post, Jane. Hope you continue on the mend!

NekoHime said...

Oh wow, Jane, you are made of awesomeness. To be creative and make a game when you are struggling in a recovery process - how inspiring is that?!

I'm really glad you slayed concussion in the end! Congrats! :)

Mikael Hjort said...

This was a truly inspiring read - I'm very glad you are feeling better, and thank you so much for sharing your experiences with us.
Can't wait for the book!
Take care.

Alan Jack said...

Wow, this touched on so many issues for me ...

For one, I've just recovered from depression and anxiety problems, and I've always wondered how gameplay might perhaps have some parallels with the healing process. This was something I'd put off studying for just now, so its really wonderful to see someone else coming up with ideas for it! Brilliant.

Its also inspiring to read talk of reality gaming again - I've been out of the design loop for a bit while I sort things out in my life, and getting back in, I was swamped and bogged down in computer games. Must remember that the principles applicable to digital games, to board games, and even to subconscious games in life, are all interchangable - or should be, at least.

Finally, this post strengthens my belief that, more than in traditional static media, game designers and those working in interactive media need a deep understanding of psychology. I developed a small obsession with it over the past year, and am considering looking into post-graduate education.

The book is on my Amazon wish-list already! Looking forward to it.

liv said...

Thanks for this wonderful and detailed article about the game-play and game-development.I like to play game but I never thought how whole process of gameplay.I get to know some unknown stuff about the gaming here.

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Joe Edelman said...

OMG, this whole blog post and story is heartbreaking and sweet and cute and endearing and strong and beautiful. It's SO you, Jane--I mean, I'm sure lots of people turn their recovery into a game, but an urban superhero game? But it's also so universal, so reach into the hardest most vulnerable, often most isolated places, and reach out of that with a metaphor and a plan. A sad thing, a triumph, a not-all-thereness, a vulnerability, resonance with others, a seed for a movement. A seed for a movement.

Prettiest Boy on the Planet said...

What a lovely little idea!

As a long-time sufferer of Clnical Depression, OCD, and Social Anxiety Disorder, I couldn't help but envision how SuperBetter might be adapted to aid in the treatment of anxiety and mood disorders. I feel the potential to assist others in pain here is incredible.

The prospects seem (to me) particularly exciting for Social Anxiety Disorder. Here is a condition which leaves many individuals isolated and with perilously few allies to count on for support. Unable or too afraid to seek help, they almost always attempt to solve their problems entirely on their own, only heightening their distress. The safe atmosphere a playful-minded game like SuperBetter provides could make it much easier for the socially anxious to seek help and achieve goals, empowering those who previously felt completely alone.

If it's quite alright with you, I would very much like to informally run a few games of SuperBetter within a community of Social Anxiety sufferers I know of. I think it could help a goodly number of folks, and I would gladly share the results of the experiment with you after completing some games.

Glad to hear that you've made a full recovery!

Jane said...

PBoP (love your handle), yes please by all means do run any and all informal games, experiments, and please get in touch with me to let me know how it goes! (via

Magee said...

What a great idea for dealing with a serious issue. My father had a massive stroke a year ago and during his recovery he had to deal with the same kinds of issues, trouble with concentration and focusing, aphasia but most significantly, depression. Having a background in neuroscience I knew that he needed to keep his brain active in order for it to re-wire and heal. Once depression set in that became a challenging task.
I also have a background in game design and my father was really hooked on RTS games before the stroke. I thought that some kind of gameplay that would keep him active and engaged would be a positive step towards healing. It was difficult to find anything that really focused on the core issue of optimism for his recovery. Most of the game play research is around regaining lost motor functions from a stroke. Obviously there is a lot of room for therapeutic games to be developed.
It was really inspiring to see you not only have the meta-cognition to recognize the issues you were having but actually design a game that helped you through the process.

satyre said...

First off, congratulations on your recovery. Those symptoms clearly were messing with the wrong lady.

I'd like to develop something using the Super Better framework for newly-diagnosed diabetics and would be deeply honoured if you'd take a look at it when it's done.

Can't wait for the book! :)

No Fee Refinance said...

Wow thanks for the info very informative and helpful. Thanks again

Topher Polack said...

Thanks for sharing this! I'm in my second week of recovery from a concussion. Your "SuperBetter" post helped put it into perspective.

I met a neuropsycologist last night and she described a concussion like restarting your computer. So while thisis be a challenging time for me, I know my computer/brain can have some random processes running in the background. Having this time to disconnect is a good thing.

Thanks again for sharing your experience.

Robin M said...

I'm not a gamer, but I commend you for your innovation in the face of adversity. I am hoping that more people like you continue to look for solutions to help solve problems for the better good. Thank you.

Sidder said...

SuperBetter is an amazing idea, I'm really curious to see how effective it is for other cases.

Unknown said...

Wow, this is super inspiring and thought-provoking.

Where I work at Global Kids we've been developing programs for our urban teens to be creating their own games using various online tools. I realize that we sometimes get caught in the trap of wanting to use the latest digital tool to help empower our kids.

But you speak so well about the power of simply constructing the game design as a way of reframing a problem, in your case a very personal one, and finding ways to be heroic in confronting it.

I would love to see how we could translate this perspective to how we help our kids confront their own life situations, as well as problems in their community and the larger world that they are concerned about.

Thanks so much for sharing this.

Unknown said...

Hi Jane, this is an awesome piece of advice. It really takes the patient out of the victim view and turns him into an in-control, self empowered super hero!!

Thanks a lot!

Joshua said...

Hello! Again, very inspirational!

Your tale of gameplay in recovery has reverberating effects on my own long-standing work in health and life-management. I will fully incorporate these Tomes of Knowledge into my base! Thank you.

Along these lines, here is a tale about using gameplay as one of my Power-ups during a bout of addiction recovery:

(non-monetized link)

Watching Evoke unfold with great joy as well. Thank you!

Agent Joshua Z.

Samuel Zoranovich said...

This is astounding. I'm deeply inspired to redesign how I've been thinking about my chiropractic practice once I finish school. I'll be reading everything of yours I can get my hands on!

Lilleke said...

This is so cool idea!

I am glad You are better :)

I will hack my way through graduation work with this! :)

I really think there should be some SuperBetter site. I feel shy posting my progress to YouTube and I don't use Twitter, but I would track my progress at SuperBetter site.

Plus, a special SuperBetter site would gather all of the people who do this together! I am sure that many people You, Jane, know, would start playing and this idea could spread like fire through hay!

BTW: I like EVOKE! (although maybe I liked SuperStruct bit more, because the problems presented in SuperStruct are problems that I have given more thought to.)

Thank You for Your ideas!


Kelly said...

I am so impressed and amazed by your game, Jane. As you've already noted -- this can be applied to a lot of situations. I'd love to see this sort of thinking applied in women's shelters. I think it could be revolutionary. I hope this idea takes you far because it's one of the most positive clever means of mental recovery I've seen in a long, long time. Good luck with this and I can not WAIT for your book!

David Wang said...

I saw your TED video and thought that your research was inspiring. The fact that you've gone forward to show how your theories have effected your own personal life is a great testament to the effectiveness of gaming in real world situations. I hope your recovery continues to go well and you continue to keep changing the world. POWER UP!

Amanda Ford said...

Clearly your great attitued was the real key to your recovery.

Thanks for sharing your story.

It's amazing how something as small as an open cupboard door can lead to such a profound experience.

Marie-Lynn said...

Years ago, I was on my way to see my grandmother who was about to pass away, and I was crushed between two cars. Luckily I walked away but my pain grew until I was not able to think or do anything anymore. I lost my ability to develop Web applications... I couldn't figure out why my mathematical brain didn't work anymore. Feeling like a failure sucks. It took a long time for me to find a way out of despair and manage the pain. Volunteering and doing crafts helped me. I have maintained employment for 10 months and found that the best way to keep pain at bay is to build. I am currently developing a social games as an e-commerce platform, and another one based on your concepts of social games that change the world. I have won one idea contest so far (for another idea) and doing this creates the positive interactions that help my body heal. I am most sad for the few years that I have lost and vow to use my time to the fullest to affect as much change in the world as I can humanly accomplish.

Sarah Williams said...

you took a very optimistic view of overcoming accidental injury. Superbetter was cool enough to follow as a guide on curing shock. I really admire your attitude and the way you look things, like seeing your self stuck on the cycle and interrupting it, could make a change and just made you better.

Social Phobia said...

Hi Jane,

I am sitting here in my dialysis treatment session in London, England and I must say that you have totally inspired and blown me away on so many levels!

I have been willing myself to get better and not taken much action, this whole new SuperWell game plan is a whole new, fun way of looking at things.

I can relate to you in regards to the feelings of anxiety and depression too, I didn't have concussion but social phobia and depression.

Thanks for being you


Unknown said...

Hi Jane,

I played this game without knowing it. Last year I had an emergency resection of my intestine and without knowing of SuperBetter the game emerged out of my sheer desperation to understand what was happening to me. Anyhoo, I explain it all in a blog post. I hope it supports your research.

Unknown said...

Hi Jane,

I played this game without knowing it. Last year I had an emergency resection of my intestine and without knowing of SuperBetter the game emerged out of my sheer desperation to understand what was happening to me. Anyhoo, I explain it all in a blog post. I hope it supports your research.

Johnssius said...

Makes my head hurt to even think about to be a month without reading, writing or working. And I don't have as much imagination as you have, so it would have been like been in prison.

self improvement seeker said...

This is a super idea. We humans are so goal oriented so if you can turn your adversity into a game that you can play at and eventually win, it restructures your perspective so easily. And perspective is most of the battle I think. I really do believe we learn the most through the difficult times in life and I'm so grateful to get this technique so that I now have it in my arsenal to handle adversity that I'm sure will come to be in the future. Thank you!!!

Sikaal Vrenssen said...

Turning your recovery into a game is a wonderful NLP technique:). I work with EFT, Emotional Freedom Techniques, where you tap on release points of the body to lighten the load. Perhaps that is something to look into next time.
Natural Depression Therapy Brisbane and Sunshine Coast

Rachel Lancaster said...

After seeing your post, my eyes were opened to how the actions I had taken while in the hospital recovering were shockingly similar to your game "SuperBetter".

But playing the game just made me anxious lol