How Are We All Doing?

Hello, everyone.

It’s no fun being in the house all day, every day. Only the delivery person and occassional neighbour provide face-to-face human contact.  If exercising in the outside world for thirty minutes is possible, its around the same place – no change of scenery.

I’ve been doing a shorthand version of the SMART technique this past month in lockdown. I’ve been what I call “SAG-ing”: Setting myself a Small Achievable Goal once a day.

Online Wordsearch

The other day I went online with the goal of setting someone a wordsearch to do. I went to a site called “The Word Search”. (As they say, it is what it says on the tin.) The site’s “maker” page helped me.

I gave my wordsearch a title, added a small description of my design’s topic, and listed 30 words for my friend to look for. There was no need to grid the letters myself; the website did it for me.

Then it was my turn to complete the wordsearch made for me. It was good fun seeing who could do whose quicker.

What Else?

Whatever you think of, let it be something do-able, requiring just enough effort to give yourself a sense of success. Here’s a link to a fellow brain injury survivor with her own tips for how to cope. Her name is Anne Johnston. (Approx. 9 minutes)

I will say that Anne refers to going to the gym’ and the online workouts that people are streaming. Not everyone is so nimble and co-ordinated to be able to do that. But I agree with her, it is important to physically exercise as much as possible.

Mods and rockers fight, Brighton 1964

Chairobics

No, not quite as in the picture. (This is part of Stanley Cohen’s study into how newspapers etc create “moral panics” by the media – the mods and rockers at Brighton, to be exact.)

No. Click here for some exercises for wheelchair users. By the groovy electropop beats and rythmn it’s a proper 1980s workout. It certainly looks dated. But it’s still worthy of a look.

Quick Update

Just to let you all know before signing off, I’m in the middle of an online course on e-counselling. Fingers crossed, I will soon feel fully competent at telephone and email counselling if not video. Obviously, I’ll let you know when.

Bye for now. And please stay safe!

Sean

Keeping Things Together

IMPORTANT:

Until further notice, I am not taking new clients. I am continuing to counsel and mentor current clients. Current sessions are by telephone. Normal service will resume as soon as possible.

This may come as a surprise to some. All the anxiety and fear that is being passed around right now, you’d think this is the time when people will want counselling more than ever.

The thing is, it’s my responsibility to take care of myself as well you. I need to be “fit for purpose”. For the time being, I don’t feel it would be ethical of me to invite more work than I can manage right now. I hope you understand. As I say, normal service will resume as soon as possible.

Meantime, I can still provide help and support via this here blog. If anyone out there wants to comment, share your experiences, please do.

Sorry to write this off the cuff. There’s a lot I’ve had to get my head around in the last fortnight. And I’ve had to do it fast. Haven’t we all?

In the coming days and weeks we’re all going to cope as best we can. For those whose immune systems are less effective, it’s going to be harder. The advice to stay indoors should be taken seriously.

A lot of people are learning what it is living life in isolation. We are all having to take extra care of our wellbeing. Keeping active, keeping a sense of routine and purpose is more important than ever. Anything that takes your mind off things will help keep us calm.

Here are a few links back to some helpful posts I’ve given you before:-

pacingMaintaining achievable goals & a rouine: SMART pacing

Art Therapy

Being creative: Expressive Art & Brain Injury

Journal keeping: Writing Therapy (Part One)

Writing Therapy

Writing stories: Writing Therapy (Part Two)

Take good care, all of you.

Sean

 

More Than One Way

HAPPY NEW YEAR!

Hoping you all managed through the festive season. Now that we’re out and on the other side, I thought we’d take a look at a slightly different option when seeking help. Or wanting to help a client with A.B.I. / T.B.I.

Cognitive Analytic Therapy (C.A.T)

What It Is

illustration-im-lost-hiker-no-direction-frits-ahlefeldt

C.A.T. is a type of therapy based on Cognitive Behaviour Therapy and Psycho-analytic Therapy.

Typically, therapy is given with a collaborative, person-centred style. New names / labels are found to describe difficult patterns of events, stages in process and emotions and behaviours that link them.

This means that problems can be looked at more in depth. Patterns can be drawn out and joined up in relation with different areas of life; whole situations can be mapped out.

The number of sessions spent with a therapist is limited.

How it Can be Applied to Acquired Brain Injury

I’ve done a little diagram of my own. I think many of you will recognise the re-occuring cycle.

CAT Diagram

This is how I have seen it with different clients over the years. But it can never be a case of “one size fits all”. With help, the best person to draw the process you go through is YOU.

Here’s the thing:-

  • Once expressed and put on paper, the process is not reliant on memory. How a situation is now can be seen and read.
  • Attention can be focussed more easily and areas identified that need tweaking. (For example, with support, the above “Former Self / Current Self” box can be gone into more in depth. A list of former, helpful skills that are still current might be revealed.)
  • A sense of direction could also become clear. (E.g: A still present, helpful skill could be discussed to see how it might be used to effect another box – maybe even re-write what’s in it.)

I shan’t go on. You’ve got the picture.

Research

Some of you out there might like further research on this subject. Here’s a very interesting online publication I came across. (Click the title.) It’s a paper by Caroline Rice-Varian. It’s called:

“The Effectiveness of Standard Cognitive Analytic Therapy (CAT) with people with mild and moderate acquired brain injury (ABI): an outcome evaluation”.

Referrence: Rice-Varian, C., 2011. The Effectiveness of Standard Cognitive Analytic Therapy (CAT) with people with mild and moderate acquired brain injury (ABI): an outcome evaluation.. Reformulation, Summer, pp.49-54.

Signing Off

Thanks for reading. Your questions, requests and comments throughout 2020 will be appreciated as always .

And now, in true “Monty Python” style, here’s something completely different: A cartoon called “The Cat Came Back”. (Approx. 8 minutes.)

Enjoy!

Brave New Who?

Bereavement

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.

Bereavement02

  • 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

Someone Walks into a Bank – Brain Injury, Modern Technology and Isolation

This month I’d like to highlight isolation. To help, I’ve the story of Mike. Mike is not a real person, but he is inspired by several real people – people living with the social effects of brain injury as well as cognitive.

What is Isolation?

The state of being separated from someone and/or something else. A “something” might be our community, which means being separated from lots of people. “Community” also implies, by its own definition, that those lots of people are helpful to each other.

So isolation can also mean ending up without help.

Chains of Isolation
  • Invisible cognitive problems
  • Communication difficulties
  • Emotional difficulties
  • Poor access to work
  • Reduced daily living skills
  • Relationship strains
  • Feeling sidelined
Modern Life

On the theme of computers and social skills, here‘s a “Little Britain” sketch I thought you might like before reading about “Mike”. Enjoy!

(Mike’s Story)

One Saturday morning, Mike decided to visit his bank. He had to cancel a direct debit. Not feeling confident, he had it in his head that a staff member would help from across the counter or in one of the side offices.

A reminder on his mobile three hours before the bank closed prompted him why he needed to get up in good time. (Being a Saturday Mike’s bank closed early.)

He arrived at the bank and stood in line to be seen. As he waited, a member of staff approached him. She had an ipad in one hand and a cheerful greeting for him. Before he could answer she asked if Mike banked on line. She told him that if he did, he need not have made the journey into town.

Mike felt awkward. He heard himself say: “I’m not interested. I’m just here to cancel a direct debit. Sorry.”Bank2

She carried on regardless. Mike tried to concentrate, but panic rose and her words began to wash over his mind. Anger began to take over from panic. The level of his voice matched the level of his emotion. “Stop!” Embarrassed he apologised. He tried humouring her. “I’m a dinosaur. I don’t get on with technology. I prefer to speak face to face with someone.”

Eventually, Mike felt telling her he had a brain injury was the lesser of evils. He coped better when not having to think about PIN and customer reference numbers, and yet another password. Telling her was his only way out of this situation. He did not like doing it; he worried who else might be listening.

The lady accompanied him to a desk and another member of staff. And even though that member of staff tried to help, her computer would not allow her to authorise the cancellation. In the end, Mike was led into a cubicle with a phone and given a number to ring.

Eventually Mike and the voice at the other end cancelled the direct debit. It had taken the voice several ways to answer Mike’s one last question, but the voice did not mind. The voice belonged to a human whose relative had had a stroke.

Mike was grateful but eager to get home. He felt drained and in no hurry to talk to anyone else that day.

As the “Little Britain” sketch shows, you don’t need to have a brain injury to be frustrated with modern technology. But for those with ABI, the problems can double.

Take care for now.

Sean

 

Action for Brain Injury Week 2019

Hello, everyone.

20th -26th May 2019 is “Action for Brain Injury Week”. Activities aimed at raising public awareness of the effects of brain injury, and the dangers, will be held. Headway is the force behind it, and its branches will be holding Hats for Headway up, down and sideways across the UK. Find out more by clicking the poster.hats-for-headway-poster-2019

As this year’s theme spotlights fatigue, I may as well throw my hat into the proverbial ring and talk about fatigue in this month’s post. My neurologist once said to me: “Sean, you can do most of what people can do. It’s just that what they do on one Mars bar, you can do on two.” So here’s an example of how fatigue gets to me – what takes me from over-tiredness to being on top of things again.

This week I’ve taken a few days off from my day job. (I know we’ve just had Easter, but hey, I was doing Easter type things.) The day job often tires me out. There are times I return home and doze on the sofa before I’ve the energy to do anything else.

The house being a bit of a mess despite help, I’ve chosen to use the time to get a few outstanding chores done. To help myself, I’ve written a “to-do” list with reminders on my mobile for each day.

Today’s To-Do

7am to 8am = Emails; letters; catch up on yesterday’s journal (1 hour reminder)

8:29am 8:31am = Med’s (Daily 1 minute reminder)

9:30am to 10:50am = Trip to shops etc. (3 hour reminder)

11am to 11:15am = Make important phone (15 minute reminder)

11:15am to 11:30am = Coffee & Kit Kat (1 minute reminder)

11:35am to 12:35pm = Filing (10 minute reminder)

12:40pm to 1pm = Lunch (10 minute reminder)

1pm to 3pm = Blog (10 minute reminder)

3pm to 3:20pm = Break (10 minute reminder)

3:50pm to 5:30pm = Blog (10 minute reminder)Snoozing brain

5:40pm to  6pm = Snooze / read (15 minute reminder)

6:10pm to 6:30pm = Get ready for evening out with friends (1 minute reminder)

Thinking Behind It

Knowing what I’m like, I factored in some safeguards to help keep my cool, not get wound up if Life, if not my self did not keep to my time-plan. Let’s face it, the real world is filled with delays and “unforeseen circumstances”.

Note my reminders to myself. I’m not as good at waking up as I once was. My mobile actually bleeped my need to be at my computer at 6am – 1 hour before hand; I’d set myself a 1 hour “window” to psyche myself up to the reality of getting out of bed.

Be gentle with yourself when doing your own list.

I also planned breaks at times close to my daily routine at work. This has put me in a business-like frame of mind. (Parent ego state, to reference last month’s post.) Pacing is a must.

Here’s a presentation I Googled you might find helpful: “There is Nothing Lazy About Someone with A Brain Injury” by Adasm Anicich.

What Happened

I got up at 7:30, so already I was behind what I’d intended. Thankfully, a letter I needed to compose was a virtual repetition of what I’d written a year ago. I just needed to change the date and a couple of other things and print off an updated version. After the usual showering and breakfast toutine, I left home half an hour later than planned.

But what I needed to do took less time than I thought. And my return bus stood waiting for a driver at the stop. (Good luck happens too.)

My point is: Be SOFTLY regimental.

Today I got all I needed to do at my computer. When I made my phone call I did not get an answer, even though I tried twice. I got through a big bit of my filing and I’ve completed this post to you on time, on the 15th of May. I’m happy.

Until next month, take care.