“You have to find ways to understand that there are things of joy in life… I might not feel it at first because I’m in a moment of crisis, but the moment I do these things it helps the brain calm down.”

The Power of Fun

Recovery from brain injury demands focus, dedication and incredible resilience. But a life well lived needs laughter, joy, the company of others and, sometimes, being just plain silly or playing with a pet.

Doug Dolan, COO of Recovery in the Pines, a substance abuse and mental health recovery program in Prescott, Arizona, believes using fun as part of the recovery process is essential.

There’s a lot of overlap between the brain injury and substance misuse recovery demographics. Substance misuse often leads to brain injury, either from accidents that happen while inebriated, changes to the physical brain from long-term use or apoxia from overdose.

Much like brain injury survivors, people recovering from substance misuse often find themselves tangled in a web of physical, emotional and systemic hurdles to overcome, all at the same time. Their bodies may be permanently disabled, or their cognitive and emotional states may be radically changed.

All of which makes just the idea of fun seem impossible.

“It’s going to be tough to feel like really fun,” Doug said. “You have somebody going through a crisis, and it’s not typically just the substance abuse or related issues. You almost always have other factors like strained relationships, strained jobs or lost employment. Usually, there’s some impact on finances, there could be legal things.”

But this, Dolan says, is when fun is most important.

“You have to find ways to understand that there are things of joy in life,” Dolan said. “And I might not feel it at first because I’m in a moment of crisis, but the moment I do these things it helps the brain calm down.”

The type of fun, however, matters. Dolan’s program focuses on healthy and normal dopamine production, which is precisely the opposite impact of modern technology, which generally overstimulates the brain and can engender addictive patterning.

“What we try to stay away from is those things that will overstimulate individuals,” Dolan said.

That’s why many recovery programs focus on various physical activities, especially those involving groups. Dolan named a slew of activities he uses to help people on their recovery journey. They include going to the gym, hiking in the forest, swimming, fishing or engaging in team sports like flag football.

“It’s healthy for an individual to get up and move,” Doug said. “Men in particular appreciate feeling like, ‘Hey, my body is coming back into shape,’ which also then helps other aspects of the brain heal.”

Physical activities tend to be even more beneficial when they’re done in groups. They help combat the specific kind of internal, psychic isolation so many brain injury survivors can fall into long after their initial physical recovery is complete.

“You may be showing up at jobs; you may be showing up with your family,” Dolan said. “But you’ll just get the sense you’re not as open, you’re not communicating as much anymore.”

More than creating social ties, group activities help physically heal the brain and regulate the body.

“These activities we’re talking about are social bonding activities,” Dolan said. “It’s about plugging back in with people; it’s about connecting with people in healthy ways. So that just really helps us with serotonin levels, oxytocin levels, healthy dopamine production, things of that nature.”

Though many survivors may have permanent injuries or disabilities that don’t enable participation in group sports, that doesn’t mean they can’t still benefit from being outdoors or spending time with people.

After all, group activities don’t have to be physically intensive to help healing and be fun. Dolan’s clients, just like BIAAZ’s social groups, will do things like go bowling or go to a movie.

And most of these activities are either low-cost or free. Resource facilitation groups like BIAAZ often sponsor, host or facilitate social groups, so no one has to miss out on a good time.

In January of 2021, Moriarty’s stroke left him partially paralyzed and with serious cognitive recovery to do. He’d always loved games, especially chess, but quickly realized it would take some work to get back to playing them

“When I first got out of the hospital, I couldn’t really play chess even though I could before,” Moriarty said. “I felt like I was kind of drifting around.”

Still, that didn’t stop him from trying. Over the next several weeks and months, he began to play again, bit by bit.

He even found a way to gamify his physical rehabilitation. While working to regain mobility on his left side, Moriarty would throw a juggling ball into the air with his right hand and try to catch it with his left hand, which he couldn’t open very well 100 times.

“Initially, out of a 100 times I threw it, I would have zero catches,” he said. “After two weeks, I was able to throw it and catch it 100 times out of a hundred.”

Folding games into Moriarty’s therapy seemed like a natural choice to Mattie Cummins, his counselor and the founder of Cerebrations.

“Kevin voiced his love of games and puzzles during my first meeting with him,” Cummins said. “Not only are games a crucial part of his rehabilitation process but also are critical in building his confidence to get back to work and life after brain injury.”

For the next two years, continuing to today, Moriarty volunteered to teach both adults and kids how to play chess and run several game nights.

“Not only does Kevin love games, but he also loves working with kids,” Cummins said. “Finding a creative volunteer position where he gets to do the two things he loves was really important, and its so much fun for our team to watch him on this journey of working after brain injury.”

The fun of playing a game keeps people motivated to play it, increasing the overall benefits.

“The more fun it is, the more likely it is that you’ll continue to do it,” Moriarty says. “And I literally think you can physically benefit just more than enjoying it.”

Moriarty also played specific board games to target areas of his mental recovery. When doctors told him his executive function was adversely impacted by his stroke, he learned that meant his ability to engage in deductive reasoning.

“So there are some games that are really good at that, so I did those too,” he said.

He played X  Minus 1, Code 777, and sodoku, among others.

“It helps develop those areas,” Moriarty said.

And, Moriarty acknowledges, it’s also a great way to connect with others.

“I like to come up with the strategy; I like the interaction with other people,” Moriarty says. “I usually tell a bunch of bad jokes. It’s really a matter of connecting with other people.”

He also sees games as a fun and beneficial mental challenge that fosters healing. He calls this his “tiger poop theory.”

“When you’re playing chess, your brain doesn’t know that it’s just a game and it’s not important if you win or lose,” Moriarty explained. “I think your brain thinks that you’re being chased by a tiger and so it thinks, ‘Uh-oh, we have a problem, so we better figure out how to solve this or we’ll become tiger poop.”

So, the brain rises to the challenge, eventually healing and improving.

It’s not a bad theory, and Moriarty only needs to look in the mirror to see proof of it.

“Used to be I lost a lot of games, now I win pretty much every game,” he said.

Playing games also gives Moriarity what he calls an “objective measurement of his improvement.”

“Pretty much every game I play is a challenge initially,” he said. “And now I’m pretty good at grasping how to play pretty quickly, versus when I started, I didn’t really get it.”

That certainly isn’t the case today. Moriarty’s son comes over every Sunday to play games. Though he tends towards strategy games, Moriarty is just as likely to play other kinds of games, too, like Poetry for Neanderthals or Instructures. He’s even developing his own game prototype.

Still, Dolan says rediscovering what’s fun is a natural part of the recovery process. One way is to think of a hobby or interest a person engaged in when they were younger, even if only casually.

Cummins agrees that prior interests can be the key to unlocking future fun in a survivor’s life.

“After a brain injury, people find their footing faster in this ‘new normal’ by incorporating the parts of their life that the person already knows, loves and enjoys,” she said.

There’s also always trying new things to see what works.

“It is about going out and putting themselves out there and trying new things,” he said. “That always helps to give somebody that kind of sense of purpose, and that sense of fun.”

No one questions that the road to recovery after serious brain injury is long and grueling in a myriad of ways. But that doesn’t mean there can’t be at least some fun along the way. It can also be a vital part of any survivor’s new normal.

ABOUT BRAIN INJURY ASSOCIATION OF ARIZONA

The Brain Injury Association of Arizona (BIAAZ) is the only statewide nonprofit organization dedicated to improving the lives of adults and children with all types of brain injuries through prevention, advocacy, awareness and education. BIAAZ also houses the Arizona Brain Health Resource Center, a collection of educational information and neuro-specific resources for brain injury survivors, caregivers, family members and professionals.

What began in 1983 as a grassroots effort has grown into a strong statewide presence, providing valuable life-long resources and community support for individuals with all types of brain trauma at no charge.