The Need for Purpose after a Brain Injury – Part II

Brain Injury Blog by Jessica Felix Jager

May 17, 2011

Purpose in Life Changes after a Brain Injury – Part II

According to Dr. Frank Crane, “Nobody has things just as he would like them. The thing to do is to make a success with what material I have. It is a sheer waste of time and soul power to imagine what I would do if things were different. They are not different.” (Cook, 1993). After experiencing a traumatic event that causes one’s whole way of thinking, way of life and cognitive function to change, it is difficult to focus on anything outside of  “I wish I were the same as I used to be.” If a victim of a TBI remains fixated on this thought, the probability of progressing to the next level of recovery, or the next level of higher functioning will be very slim. However, on a positive note, if one changes his or her way of thinking, or the mindset of their fixation, the results could be empowering and allow them to succeed.

According to Robert Barker author of the Social Work Dictionary, cognitive theory is a group of concepts pertaining to the way individuals develop the intellectual capacity for receiving, processing, and acting on information. Cognitive concepts emphasize that behavior is determined by thinking and goal determination, rather than primarily resulting from instinctive drives or unconscious motivations (2003, p. 80). In other words, if one can change their way of thinking, the result will be a change of behavior. In The Essential Brain Injury Guide, by the Brain Injury Association of America, it is emphasized that due to frontal lobe damage that is often a result of a Brain Injury, the executive functions that drive initiative and motivation may become impaired which results in initiation problems. An initiation problem, as defined by the Brain Injury Association of America, is difficulty in engaging in activities unless prompted (2007).

In the initial stages of recovery one may need to use  written note cards or set alarms on a cell phone as a prompt to remember to go brush their teeth or to fix breakfast, for example. Eventually once those skills are mastered, different prompts such as using a planner may be used as reminders to attend specific doctor’s appointments and so on. These prompting methods have been found to be very effective in getting short term, specific goals/tasks met. But what about long term goals? What about the “big overall picture” that a survivor can work towards, a picture that is broken down into smaller goals until attained? Could it be possible that a sense of purpose could serve as a “prompt” for a TBI survivor that essentially causes him or her to engage in activities that aide in reaching or meeting that purpose? The need for purpose is just as strong and relevant for an individual that has survived a TBI as it is for the “average Joe”. Our basic developmental and emotional needs do not go away as a result of a TBI, in fact, in many cases these basic needs not only remain, but intensify, and often need to be re-addressed.

In 1954 Abraham Maslow and other humanistic professionals developed a view that today is known as The Hierarchy of Needs, which suggests that people’s needs occur in ascending order. One fulfills physiological needs first, followed by needs for safety, belonging, self-respect and self-worth, and finally self-actualization or achieving one’s full potential (Baker, 2003, p.195). This Hierarchy of Needs can be applied to all individuals including those that have suffered from a TBI. The difference is that the survivor may have to re-develop stages that were already developed prior to receiving the injury and may now also take longer in developing the other stages due to the nature of the injury. The fact still remains that as long as there is a hierarchy there will always be another level to reach, and as long as the person is alive, there will be the need for fulfillment.

To be continued next month…..

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