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16th May 2024
Chronic Migraines & Control's Assist Mode
[Global Accessibility Awareness Day 2024]

This is an article that I began writing in 2021, and it's... a little different from what I've written about in the past. For some time now, I wanted to take some time to return to Control's Assist Mode. The creation of which was, in many ways, a game-changer. It allowed players to change the experience to fit them, making the barrier to access and enjoy the adventure easier. This is an article about how the game became a whole different and more positive experience when the mode was brought in. 

This is also an article about my stupid brain. 


The Original Control

In 2019, when I wrote my original review for Control, I spoke about its sometimes intense difficulty level and how the developers compared the game to the notoriously ruthless Dark Souls. It made a kind of sense; Jesse was in a new world filled with threats, and the only way to overcome them was to become more powerful. It's a story about challenges and overcoming overwhelming odds, and you can feel it when you play. Throughout the marketing, whenever the challenge was mentioned, the difficulty level always came with a sense of pride.

In the review, I talked about how Remedy delivered on their promise of providing players with a challenge but how it was tricky to say for certain how an adaptative controller or similar peripherals would work with a game's action-heavy, fast-paced sequences. At the time, I was thinking about player mobility, the speed at which you have to react to enemies. I don't have any mobility issues, but I have friends who play on adaptive controllers. Thinking back to the review, it was really the only issue that I had with the game, but it very quickly attracted some "git gud" trolling. 

It was something that I was somewhat expecting; at the time, Remedy had positioned itself in defending the challenge and difficulty levels. A small minority of gamers would later use it as a bar of entry or bragging rights, similar to Dark Souls or Cuphead. Admittedly, I don't see how the studio could have acted differently with the game they had at the time; even with feedback from previews, their course was set. I kept the part in my review, shrugged off those comments, and had conversations with people who had peripheral controllers and wanted to learn more about the game. While I was already interested in accessibility, particularly in games, Control brought everything into a new perspective.

After the base game was released in August 2019, Remedy celebrated the launch of The Foundation, the first of two paid DLC story packs for Control. Playing, I considered my old feelings about the challenge level, checking in with myself about which parts I was enjoying, which parts I would change, and how I might communicate techniques to players looking for a walkthrough. That's when something happened. Late into the DLC, a certain boss battle kept tripping me up, forcing me to return to a checkpoint. There was something more than that, though. Playing through that particular boss fight, I felt... odd. 


The Odd

It began earlier in mid-2018, and it was the general feeling of something... not being quite right. You know that weird sensation when you're spooked, or something brushes you, and your back tenses up? It was kind of like that, but constant. Sometimes, this was followed by neck pains, which I just put down to sleeping weirdly. Then, sometimes, I had back pains, which I thought was due to not sitting properly while working. Slowly I started getting headaches, and those sucked too. This happened slowly over about eleven months, so it was easy to explain that it was just over needing a new pillow or temporary stress creeping in. That year, I was still looking for full-time work, helped with three house moves, and lost an immediate family member, so, of course, it had to be stress, right? I would take painkillers, and sometimes it would fade, and sometimes just sleep helped. It was annoying, but I never considered it was more than that. 

Things would slowly increase. I would excitedly book coffee meet-ups (one of which was with Vida) or dinner and bail that morning after an incredibly rough night. Control was released the autumn that things were increasing. While I had a lot of fun playing it, I would play before bed and end that night having to have painkillers to fight off muscle tension or creeping headache or whatever my body had decided to do when I decided I was just stressing about a boss fight. Looking back, I don't know how much of that was unconsciously feeding into my review. 

Playing the DLC pack created a weird logbook of sorts. By then, things had progressed, and I had started taking more note of it. While I would get mild pain for some earlier challenges in the main game, I would feel much worse whenever I attempted The Foundation's boss fight, and it took hours spread over several days for me to get the right combination to take them down. After, I got to the next checkpoint, I saved, took 800mg of Ibuprofen, and went to bed thinking about the fight. I was mentally SO RELIEVED but physically not doing well. Looking back, three things came into play during that fight; sharp sounds, flashing lights, and physical stress. I could handle two with the current option settings, but the stress? That one was harder. 

At its most manageable, I would feel on edge and with a headache; I'd take some painkillers and spend a long time finding a good position to fall asleep. At its worst, painkillers wouldn't touch it. I would get a sharp stabbing pain behind my eye. It could be so sharp that I would spend the night throwing up from the pain, with my anxiety running on high. The first time it happened was actually in the early hours of my birthday, a case of perfect timing. The Foundation DLC was released a month later. Soon after that, I saw a doctor. 


Chronic Migraines

Fortunately, it ended up being nothing too serious despite the slightly alarming symptoms. Considering some of the genetics my Nan potentially could have given me, passing along chronic migraines at this point at least felt like coming off light. On my first trip to the doctors in early 2020, they suggested Migraleve. Those worked, but a couple of months later, it became clear that I also needed a preventative alongside. After an unsuccessful trial with Sumatriptan and anti-nausea meds, I ended up with Propranolol as a preventative  (a Twitter post suggested checking my blood pressure), with Migraleve for the episodes that try to break through. 

Chronic migraines are weird. Typically, they have three stages: prodrome, migraine and postdrome. The middle section is the one that most people know about, the other two are a little stranger. Prodrome is like a silent alarm going off inside your head; you feel like something is wrong, but it is accompanied by small indications like fatigue, mood changes or difficulties in concentration. It will be obvious in retrospect, but at the time, you're just grouchy and sleepy, and reading the same page repeatedly. This is when you should take tablets. This is also when it doesn't occur to you to take tablets. Postdrome is like a migraine hangover; you feel like you get hit over the head with a truck full of Monday, which can last for hours or days. You can throw things at the pain part, but there's not a lot to do with the rest apart from playing Ticket to Ride on your laptop or hanging out with a cat. When you're feeling brave, you may read a book on a back-lit ereader. 

Migraines are also frustratingly triggered by a lot of things, some of which are just ridiculous. They can be triggered by stress, anxiety, depression, sharp sounds (such as screeching car brakes or the ringing effect in movies), flashing or strobing lights, strong smells (heavily perfumed or unpleasant odours), caffeinated drinks, your menstrual cycle, a lack of exercise, and tiredness. All fairly normal so far, right? They can also be triggered by light on one side of your face, certain foods, temperature or the weather. So, you better start avoiding that... weather, I guess?

There are different categories for migraines, but for chronic migraines, you need to have it at least fifteen days per month, with at least eight of those days having migraine symptoms, and measured over a three-month period. It's also a grey area on whether it counts as a disability. I've had them for six years, diagnosed for four years. Whether they count as a disability depends on the doctor I'm talking to. It's also something that is commonly incorrectly self-diagnosed. Headaches can be overwhelming and deeply unpleasant, but migraines are specific to a sharp pain behind the eye. They, unfortunately, also can't be treated with the same medication you can throw at a headache. (That 800mg Ibfropfen often didn't work.)

By late 2020, I had prescriptions for my chronic migraines, but it wasn't a complete fix. I would still get them, but at least I knew how to approach them. However, Control had still highlighted a barrier for me, like yellow paint on a climbable ledge. There was one thing, though... I wasn't the only one.


Introducing the Assist Mode

As the game gained momentum, the Control community became increasingly interested in the ability to rebalance the difficulty level.

On August 27th 2020, Remedy announced the Assist Mode as part of their anniversary update, which also saw more Control Points, soft checkpoints, tweaks to the launch abilities, and the new arcade cabinet. The Assist Mode wouldn't mean anything to those who wanted the original challenge, but it was an absolute game-changer for those concerned about whether they could play it or enjoy it.

For some people, it was about making the game easier and playing at the pace they create. For others, it wasn't about preference or skill but being physically able. It's heartbreaking to feel isolated or excluded from something that you were so excited about because your body just nopes out on you. There's a lot of that in everyday life, but in entertainment, where things are specifically created as a form of escapism, the industry must keep pushing. Adding those settings isn't easy, and it takes effort, time and money, but for those who need it, it can mean absolutely everything. 

I'm lucky in that my chronic migraines has warning signs and prescription drugs that I can throw at them. I could still storm through Control, even if it was with some difficulty. In replays, I've used the Assist Mode to lower the barrier of entry, and it's made the experience so much more engaging for me. 


Gaining Control

As I haven't written an article about this before, and the topic is so extensive, I decided to write it from my perspective, but there are so many ways that improving accessibility makes a game stronger. I looked around to see how people talked about the update.

One name that immediately jumped out was Steve Saylor, who, as well as being a powerhouse, already did a video on Control's update. While the game had been in his backlog of titles to play, he talks about why it had suddenly jumped to the top, saying, "I wanted to see what Remedy was doing and could that change the experience for me. After playing with it for a bit, I actually also started to ask myself the question should all games have Assist Modes?" 

While the ten-minute analysis is inspired by Remedy's move to add the new mode, he looks back at previous adventures and the importance of the ability to put control in the player's hands. Crediting Celeste with the first use of an Assist Mode, he praises how much of an impact it has on players who want to tailor their experience, describing it as a "world of difference". 

As he talks, he shows the message welcoming players to try the mode. "Celeste is intended to be a challenging and rewarding experience. If the default game proves inaccessible to you, we hope that you can still find that experience with Assist Mode." Throughout the video, those words stayed with me, and it wasn't until a little later that I figured out why. As Steve touches on later, there's still a stigma attached to playing on the easiest setting or suggestions being considered cheats. Bringing in accessibility options doesn't change the game, but it does change how a player experiences that game, and with more studios incorporating them, it changes the discussion. 

Steve's video is more in-depth and highly recommended, but the more I looked around the discourse taking place about the update, the more I realised how well-received the mode was. 

On the Control subreddit, OctoMistic100 also asks a similar question, if Assist Mode is the future of gaming? "I am not a try-harder, I mostly play games for the scenery, the story and the gameplay, but not for the challenge," they write. "Surely I am not alone, and surely many players enjoy challenging sequences and feel accomplishment when they finally beat a boss. Personally, I usually quit when a sequence is too difficult and frustrating, not without bitterness because I cannot enjoy the rest of the game (which I paid for). Most games I know have some fixed difficulty levels, and because of unbalancing, the easy modes usually are just too easy, but I can be stuck somewhere on normal modes. And too many of them prevent to change the difficulty mid-game! That's why I think Remedy did a fantastic job with the Assist options, the devs made the game exactly as difficult as they wanted, but I can enjoy the full story even though I suck at aiming and dodging. I really hope more studios will be inspired by this mode."

That one thread alone has 48 comments and 83 votes up, and it's just one of several praising the Assist Mode on the subreddit. Another interesting thing is how people were responding to spam or bullying. As with my review, the thread had attracted trolls who tried to mock people using the options, but they were instantly shut down and told they were gatekeeping by community members. People were also more open to talking about their own disabilities, the sections that they struggled with or had rage-quit, with others were offering advice on which options they recommended for certain scenes. 

"I don't know if Remedy looks at Reddit at all, but I seriously wanted to thank them" describes kpres14 on the same thread. "I don't have time to play many games these days and used to only play RPGs where I didn't have to really aim. I don't have time to "git good" and don't want to be constantly frustrated trying to play. I love stories and art."


The End?

When writing this piece, I was tempted to dive into some of the analytics that were posted via the Control website or in Vida's IDGA GAconf talk and how it shows the strong interest in Assist Modes going forward. I planned to bring up how, after the update in August 2020, 64% of players turned on Assist Mode once and continued with it, and only 18% have no playtime with Assist Mode, and I would go deeper with it. But I'm going to stop there, because the data is useful, it shows demand, and how players were tailoring their experience. However, even as a data nerd, it's not all about the numbers. I'll get to that down the line. Somedays, it's just about the human stories.

-- CONSOLE & PC GAMES --

Formerly "Vanguard"

The Crossfire Series

The Control Series

The Quantum Break Series

The Alan Wake Series

The Max Payne Series

-- MOBILE GAMES --

-- LIVE ACTION SERIES --

Icons by the incredible, Evil-Owl-Loki.

Beyond the shadow you settle for, there is a miracle illuminated.