I’ve never been particularly good at the social aspects of life, and having been schizophrenic for the last 20 years, I can’t recall a time where I’ve ever been fully in control of my emotions, or anything that goes on in my head, really. I did what was necessary of me to get through life to be seen as a “normal” person, and for quite a few years, I did very well. I excelled in college and law school, I had a great job that I loved, and I’d managed to hide being schizophrenic from coworkers and friends, thanks to medications and a great therapist. When I started playing video games in 2014, they became my escape from what had always felt like putting on a show for the world, or a fake life. I could come home and shut that me off and lose myself in a game. It was such a relief to have somewhere I didn’t have to perform, and somewhere fun at that.
Then I had a stroke.
In the time around my stroke, there’s a very distinct before and after. I clearly remember being outside and talking with my sister and then being on the ground thinking someone had shot me in the head. I don’t have any memory after that for what I’m told is about four weeks. What I recall most clearly though, is who I was before versus what I’m all too aware that I’m lacking now.
I was in and out of consciousness in those weeks, mostly out, and when I finally did regain full consciousness, I wished I hadn’t. Everything hurt and my head felt like it was in a vice. I could feel my heartbeat in my ears and paying attention to anything, for any length of time, had suddenly become as exhausting as marathon training had been in the past. However, having had my share of health problems – all of which contributed to me having a stroke at 36 – I fully believed that any physical impairments that resulted would be easily (relatively speaking) rehabilitated. Being Deaf, in the immediate days after waking up, the biggest frustration I had was my lack of coordination with fine hand movements that made it nearly impossible for me to communicate with people. While in the hospital the only real concern I had was getting my body back to where it had been before; training for a triathlon that was a couple months away. Games that required delicate actions like aiming and any kind of motion control (who knew my old Wii would come in handy?) were a prescribed part of my rehabilitation and they were a godsend in the recovery of my ability to sign as easily and fluidly as I had before, because they made what otherwise would have gotten quite boring and repetitive quite quickly, something that engaged me mentally as well. You’d be amazed at what a strong force boredom is as a roadblock to recovering from a stroke. The therapist that was working with me had me doing cognitive rehabilitation exercises along with the physical exercises, but it never crossed my mind that those were anything more than a technicality, and my struggles in that area were anything more than an effect of the drugs I was being given.
It never occurred to me that the cognitive impairments were impairments of any kind at all, and I certainly wasn’t prepared when I finally did have the realization that my brain, the thing I once considered my best attribute and the sole contributor to the success I’d had in my career, had been changed. I was in the hospital for several weeks and maintained my denial that the “slow” feeling hanging over me would last or would become a permanent feature of who I was.
Upon returning home, it hit me all at once, that there wasn’t much I could do for myself anymore. Not because I was physically unable, but because I couldn’t figure out how. I would try to shower and end up sitting there with the water on until it ran cold because not only could I not remember what I had and hadn’t washed already, I couldn’t recall what things I needed to use to get the job done. I would skip meals because I knew what I wanted to eat but I couldn’t remember what it was called or how to make it. When in the common areas of my condo building, I went from a nice, social neighbor, to one that desperately tried to avoid running into anyone because conversation was both exhausting and another area in which I was at a loss for what I was supposed to do. Somewhere along the way, it seemed, my filter for not simply saying whatever rude or random thing popped into my head had disappeared. Pair that with the fact that I was angry about all of this anyway, and soon I didn’t have to avoid my neighbors because they just didn’t talk to me anymore.
Another new “feature” of me that I had to learn to live with was my newfound inability to both understand and regulate my emotions, and understand other’s feelings. Everyone has their moments of ridiculousness when they’ve been upset or hurt by someone, but what separated most people from me was most adults have the self-awareness to eventually realize they’re being ridiculous. It wasn’t until months later that it was explained to me that the thing that allowed me my adult-like world view, the thing that tells you the earth isn’t revolving around you and not everything that happens in life is happening to you of because of you, had been irreparably damaged. So someone would disagree with me on something I felt strongly about and I would become inconsolable for hours because I couldn’t understand how they didn’t just see that I was right and their belief or random opinion was harming me personally, even though that was rarely true. Simply put, my world became very black and white and no happy medium or middle ground existed for me anymore.
What made this a particularly challenging thing for me was trying to get other people to understand. I’m still perfectly able to opine on philosophy, interpret Constitutional law, and express myself well and clearly in writing. It’s difficult for people to understand how that same person can also be unable to cope with even a minor disagreement or negative reaction. As my doctor explained it, my IQ was just as great as ever and had been mostly untouched by the stroke, but my EQ had, for all intents and purposes, been obliterated. These things all made it impossible for me to return to my previous life and when one learns that nearly every aspect of their life has been forced to change, recovery can easily become something of a “why should I even bother?” issue.
I am and have been much more fortunate than most in that my early career success allowed me to retire well before I was supposed to and that I live with my very large, pieced together by mostly non-blood relatives, family, and they were able to all work together to manage the 24/7 care I now needed. Without this, I have no doubt that I would either be dead or in an assisted living facility because I can’t hold a job anymore and I can’t do the necessary things one must in order to keep themselves alive. My family also serves as the necessary filter I need in order to be able to interact, in an albeit limited way, with the rest of the world.
After months of my cognitive impairments not improving at all and my therapists throwing in the towel and telling me all of this was me now, my step-mom, who is a psychiatrist and avid video game fan, had the thought to use the games I played anyway as therapy to see if they could help me regain any part of what I’d lost. And while how much they truly help is debatable (I’m not any better at solving problems today than I was an hour after waking up from my stroke) games have made it bearable and something that I actually want to keep trying at.
Puzzlers, like The Witness and The Talos Principle, as much as I loathe them, help me tremendously. Problem solving, something I’d once excelled at, had become nearly impossible. I just can’t seem to work out how to get from point A to point B in even the most mundane everyday problems, so while practicing in games hasn’t helped that improve at all, what it has done is allow me to be less frustrated and angry by it. Learning to cope with failure in something where there are really no repercussions has allowed me to be less impacted by any minor repercussions I face in failing to successfully do something in my daily life.
Teamwork games such as Splatoon 2 and Fortnite allow me to work on my ability to work with and understand other people and work on a mutual goal rather than simply doing what I want, because in games like these, that’s really the only way you’re going to succeed. The bonus of these two games in particular is that they don’t come with that super serious, cocky player that’s going to trash talk someone for not doing well, as many do in other MMO games. The cartoonish appearance has a way of removing the air of seriousness and making the end game of success seem a little less important.
Relationships and all the things necessary to build and maintain them are not things that have ever come naturally to me. Being schizophrenic has caused me to keep people at a distance and on the occasion I do let someone get to know me, I have a hard time trusting them. Add to that my post-stroke limited world view and most of the time I feel like the world’s worst friend because I never feel like I know the right questions to ask or how to show proper interest in them and their interests, particularly if it’s an interest I find boring, so I just don’t try to befriend people because that seems easier than trying and failing. Games like Dragon Age Inquisition and the Mass Effect series, that allow you to build the kind of relationships you want with your companions give me a safe place to work on saying the right thing, showing interest in people, and knowing when to do what when interacting with a person. I often challenge myself to play these games with the dialogue tone indicators turned off, as I then have to work out for myself what is the sarcastic or snarky thing to say and what is the nice, friendly option. Simply reading the word choice does nothing to help me, so I have to learn from each interaction. Did I make Cassandra angry because I sided with Varric? Did I intentionally side with Varric? If so, why and now what can I do to get back in Cassandra’s good graces? Managing companions’ expectations of me in a playthrough of Fallout 4 is painfully difficult but tremendously helpful, because it forces me to set aside my own selfish worldview, consider theirs, and behave accordingly. This is not a function that most people in real life are willing to serve, being something of a crash test dummy for me to unknowingly insult or hurt because I can’t find the right thing to say, so this sort of practice is essential if I’m ever going to be able to maintain relationships with people outside of my family.
The most recent game I’ve added to my rehabilitation queue is turn-based RPG, Divinity: Original Sin. This game manages to infuriate and fascinate me all at once and I can’t overstate the importance of every aspect of a game like this in my effort to regain some of what my stroke took. I chose to play on “explorer” difficulty but limit my number of save and quick save files to one. That way every choice carries tremendous weight and every action requires careful thought and planning. Having put a few hours into this game, it feels like my capstone course in rehabilitation. As in life, decisions made in conversation, as well as speech choices, come with permanent consequences. In the above image, I was attempting to join a guild and my more rational and duty driven companion thought it a waste of time. I made choices that weren’t in line with hers, which lead to a game of rock, paper, scissors, the outcome of which equally determined by chance and skill point distribution I’d decided on previously, unaware that my choices in that area would have such an impact. I lost the game of rock, paper, scissors, and therefore the argument, and so my one and only chance to join this guild disappeared. In another instance I had to kill a woman because my companion and I disagreed on her use of sorcery and I lost that argument as well.
This game seems to take the different aspects from a dozen other games I play for rehab purposes and combines them into a world where I can work out numerous problems, plan and strategize to win fights, consider dialogue options, manage my party, and solve minor puzzles, and it lets me take my time doing so. Divinity has been difficult for me to play because no other game has made me so very aware of all the things I now struggle with which I used to take for granted. But this game also gives me as much time as I need to figure things out, which is a welcome break from the instant decisions and quick reflexes most games I play require.
I can say with complete certainty that video games are the only things that have made rehabilitation bearable. They’ve allowed me to still enjoy my life that was forcibly changed and severely limited because of a stroke. They’ve also given me a purpose outside of using them for rehab, allowing me to feel like I have some semblance of a job in writing up accessibility reviews when I can no longer the job I had and loved before my stroke. And even if I keep plugging away at different games and genres and fail to improve or regain anything, the time I spend on games is teaching me to be ok with failure and for me, there’s not anything more important in my recovery than accepting that I’m not always going to win and get what I want.