Brave New Who?

Hello all,

No, nothing to do with Doctor Who’s regeneration. This month I thought we’d cover bereavement. Not the kind of bereavement people usually talk about – after a death of a loved one. I mean the kind a brain injury brings.

The following is drawn from my experience, counselling clients with ABI and stroke.

Similar to the grieving process we all go through after a death, people finding themselves with a life-changing brain condition go through their own. This process has its own stages / periods. N.B: Theses stages / periods have no particular order.

• Denial
• Anger
• Loss of Focus / Identity
• Depression
• Reflection & Self Awareness
• Acceptance & Adaptation

Let’s look at these in turn.

(Denial)

This can be either a willful or unconscious non-recognition that a brain injury has happened. This is different to a client not perceiving the difficulties they are having; some clients know they’ve for example, suffered a stroke but remain unaware of the true extent of adaptation they need.

However, sometimes the shock of a life-changing event and the initial fears that go with it are all too much. It seems easier to go with the idea that nothing’s wrong, or that others are making things up, or exaggerating.

When it’s obvious that short-term memory problems and/or “simple jobs” are no longer being done “properly”, both the brain injured person and those close to them can find it helpful at first to pin problems on another health condition. Or age.

(Anger)

Even before a brain injury, some people have short tempers. After a brain injury those tempers can change either way – become even shorter, or if not stay the same, become harder to tell. Some people hardly ever get angry. Some are good at hiding it.

As part of bereavement, anger is often aimed at the cause of the injury, the world for not understanding, life in general or God for what’s happened. Or the patient / client can target their anger towards themselves.

N.B: Anger can alternate with guilt, for example when a person labels themselves as a “burden”. (I like to balance this with a further note: That a good number of people also find comfort in being needed by others.)

One good thing about anger is that, in the right place, time and company, it can be a great motivatior.

(Loss of Focus / Identity)

The crux of the matter. The immense yearning to again be that person who was. Because all that’s left is, for this time being, a nobody. For one client it was like the voice saying: “I don’t know who I am anymore,” was coming from a faceless shadow, not the person himself.

(Depression)

No kidding, this is a difficult period to move on from. Because of the change in neurology, medications may be necessary to help. Being actively listened to and listening to one’s self can also help. Keeping as active as possible is important too, even when not feeling motivated.

For more on motivation and ABI, click here.

(Reflection & Self Awareness)

In Western society we are quick to confuse who we are with what we do; we identify ourselves with our job. Meeting a stranger the question most asked and answered is: “What is it you do?”

Reflection and growing aware of the person who the person was who appled for that job before they had it, asking: “How much of that person is still here?” and paying attention that remaining person is very much part of the brain injury journey. Especially for the patient / client themselves.

(Acceptance & Adaptation)

This is not the end result of the process. The process goes round and around like a wheel moving forward.

Recently, I also used this metaphor: Bereavement is like two feet walking – an emotional foot, and a managing foot. Some days emotion take over, some days practicalities can be done.

Living with a brain injury yourself, or indeed getting to know someone all over again can be rewarding too. Some people consider themselves a nicer, or stronger, or more confident person than they were before. Some discover talents that had never shown themselves before.

I’m going to end this month with a song.  It’s not about brain injury. But the words kinda fit. Alicia Keys: Brand New Me Skip the ad’.

Take care.

Sean