Excerpts

Physical recovery and healing is the first thing everyone focuses on after brain injury. You and your loved one have needed courage and determination to face the tasks of physical recovery.

Before you start this book, take some time to appreciate all that you and your loved one have done to get this far in recovery. The hours, days and months spent as your loved one regained physical skills gave you both important lessons in motivation, willpower, and clear results. You will use these valuable lessons again and again to support your continued healing and growth.

This stage, after your loved one has started to recover and heal physically, is when you both might be asking: What’s next? For most survivors and caregivers, what’s next is recovering psychologically. Psychological recovery involves four main areas of recovery: self-awareness (also called recovering the Psychological Self ), emotions, thinking, and behavior.

These four areas of recovery will become very important as you work at finding a place in your community where you feel valued and where you can contribute, whether this involves being a friend, an intimate companion, a worker, a teacher, or a learner. The four areas are reflected in this book. Chapters 1 and 2 help you understand the Psychological Self, the part of you that needs to recover after the loss and upheaval of brain injury. Chapter 3 shows you ways of understanding and guiding your emotional recovery. Chapters 4 and 5 give you methods and tools for thinking in new ways and changing behavior after brain injury.

Chapter summaries

What follows is a brief introduction to each chapter. Chapters 1 and 2

Since this is your book, you can start at any point in the book. However, it is a good idea to start with Chapter 1, “Looking at the Psychological Self,” because psychological recovery depends very much on being self-aware.

Like many things in life, becoming self-aware requires constant learning. When you were a child, you had a picture of yourself that you carried inside you. That picture looks very different now, at this stage of your life. You can’t yet know how you will see yourself next year or ten years from now. Your awareness of self will change with living and with your staying open to the lessons in life. Chapter 1 helps you picture your Psychological Self as it is now, understand it, and see what it does. Chapter 1 answers the question: Who am I, right now?

With awareness of the Psychological Self comes knowledge about how to get started on psychological recovery. Chapter 2, “Having Inner Conversations Again,” focuses on the second important step in becoming more self-aware: learning to have conversations with your Psychological Self.

The chapter also helps you understand denial, a main stopper to these conversations.

These first two chapters and the exercises they contain will help you understand that:

• Your relationship to yourself is central to all your psychological growth and healing.
• How you communicate within yourself affects how you communicate with others.
• Your Psychological Self manages your feelings, thoughts and actions.

Chapter 3

Each brain injury is unique. This uniqueness results from two facts: (1) all people are unique, and (2) the brain is so complex that even similar injuries can have different impacts.

It is also true that emotional recovery is predictable — most people have similar basic issues, or core issues, and go through the same five stages of recovery. Most people also take on trauma roles in hard times, sometimes acting as a victim, sometimes as a persecutor, and sometimes as a rescuer. Chapter 3, “Recovering Emotionally,” helps you make the predictability of emotional recovery work for you. It helps you identify where you are in emotional recovery and gives you tools that can heal. Chapter 3 will help you understand:

• your current core issues
• the five stages of emotional recovery
• your trauma roles

Chapters 4 and 5

Chapters 4 and 5 focus on two things that affect most survivors of brain injury and their caregivers: changes in thinking and behavior. These chapters will increase your understanding of the changes in thinking and behavior after brain injury and show you ways to help your loved one. In the process, you will probably find that you are changing your own ways of thinking and behaving, too.

Chapter 4, “Thinking in New Ways,” reflects the fact that living with someone who has a brain injury usually means living with changed thinking skills. Memory, attention, judgment, problem-solving, decision-making, and impulse control are all affected.

Chapter 4 will help you understand:

• what parts of the brain are usually affected by a brain injury
• what strategies and tools you can use for helping your loved one learn important thinking skills

Chapter 5, “Changing Behavior,” is the final chapter of the book. It focuses on changing behavior that has been affected by brain injury.

Placing this chapter last was done deliberately, so that you have the chance to work through the topics covered in the earlier chapters. By the time you have reached this chapter, you understand your Psychological Self better, you have started having inner conversations again, you know that emotional recovery happens in predictable stages, and you know that you can practice thinking skills that affect your behavior. You are now ready to tackle behavior change realistically.

Chapter 5 looks at what works when changing behavior and provides you with three models for changing behavior.

Each model shows a different way of working with your loved one or yourself to change behavior. This chapter will help you understand:

• stages in learning new behavior
• what models work best at certain stages
• ways of breaking down learning goals into small, manageable pieces