Join Brainline.org | 9 Things NOT to Say to Someone with a Brain Injury

Written by Marie Rowland, PhD, EmpowermentAlly
www.brainhealthconsulting.com

Click here: Download Dr. Marie Rowland's article:

Brain injury is confusing to people who don’t have one. It’s natural to want to say something, to voice an opinion or offer advice, even when we don’t understand.

And when you care for a loved one with a brain injury, it’s easy to get burnt out and say things out of frustration.

Here are a few things you might find yourself saying that are probably not helpful:

1. You seem fine to me.

The invisible signs of a brain injury — memory and concentration problems, fatigue, insomnia, chronic pain, depression, or anxiety — these are sometimes more difficult to live with than visible disabilities. Research shows that having just a scar on the head can help a person with a brain injury feel validated and better understood. Your loved one may look normal, but shrugging off the invisible signs of brain injury is belittling. Consider this: a memory problem can be much more disabling than a limp.

2. Maybe you’re just not trying hard enough (you’re lazy).

Lazy is not the same as apathy (lack of interest, motivation, or emotion). Apathy is a disorder and common after a brain injury. Apathy can often get in the way of rehabilitation and recovery, so it’s important to recognize and treat it. Certain prescription drugs have been shown to reduce apathy. Setting very specific goals might also help.

Do beware of problems that mimic apathy. Depression, fatigue, and chronic pain are common after a brain injury, and can look like (or be combined with) apathy. Side effects of some prescription drugs can also look like apathy. Try to discover the root of the problem, so that you can help advocate for proper treatment.

3. You’re such a grump!

Irritability is one of the most common signs of a brain injury. Irritability could be the direct result of the brain injury, or a side effect of depression, anxiety, chronic pain, sleep disorders, or fatigue. Think of it as a biological grumpiness — it’s not as if your loved one can get some air and come back in a better mood. It can come and go without reason.

It’s hard to live with someone who is grumpy, moody, or angry all the time. Certain prescription drugs, supplements, changes in diet, or therapy that focuses on adjustment and coping skills can all help to reduce irritability.

4. How many times do I have to tell you?

It’s frustrating to repeat yourself over and over, but almost everyone who has a brain injury will experience some memory problems. Instead of pointing out a deficit, try finding a solution. Make the task easier. Create a routine. Install a memo board in the kitchen. Also, remember that language isn’t always verbal. “I’ve already told you this” comes through loud and clear just by facial expression.

5. Do you have any idea how much I do for you?

Your loved one probably knows how much you do, and feels incredibly guilty about it. It’s also possible that your loved one has no clue, and may never understand. This can be due to problems with awareness, memory, or apathy — all of which can be a direct result of a brain injury. You do need to unload your burden on someone, just let that someone be a good friend or a counselor.

6. Your problem is all the medications you take.

Prescription drugs can cause all kinds of side effects such as sluggishness, insomnia, memory problems, mania, sexual dysfunction, or weight gain — just to name a few. Someone with a brain injury is especially sensitive to these effects. But, if you blame everything on the effects of drugs, two things could happen. One, you might be encouraging your loved one to stop taking an important drug prematurely. Two, you might be overlooking a genuine sign of brain injury.

It’s a good idea to regularly review prescription drugs with a doctor. Don’t be afraid to ask about alternatives that might reduce side effects. At some point in recovery, it might very well be the right time to taper off a drug. But, you won’t know this without regular follow-up.

7. Let me do that for you.

Independence and control are two of the most important things lost after a brain injury. Yes, it may be easier to do things for your loved one. Yes, it may be less frustrating. But, encouraging your loved one to do things on their own will help promote self-esteem, confidence, and quality of living. It can also help the brain recover faster.

Do make sure that the task isn’t one that might put your loved one at genuine risk — such as driving too soon or managing medication when there are significant memory problems.

8. Try to think positively.

That’s easier said than done for many people, and even harder for someone with a brain injury. Repetitive negative thinking is called rumination, and it can be common after a brain injury. Rumination is usually related to depression or anxiety, and so treating those problems may help break the negative thinking cycle.

Furthermore, if you tell someone to stop thinking about a certain negative thought, that thought will just be pushed further towards the front of the mind (literally, to the prefrontal cortex). Instead, find a task that is especially enjoyable for your loved one. It will help to distract from negative thinking, and release chemicals that promote more positive thoughts.

9. You’re lucky to be alive.

This sounds like positive thinking, looking on the bright side of things. But be careful. A person with a brain injury is six times more likely to have suicidal thoughts than someone without a brain injury. Some may not feel very lucky to be alive. Instead of calling it “luck,” talk about how strong, persistent, or heroic the person is for getting through their ordeal. Tell them that they’re awesome.

On Self-Esteem | 10 Ways to Feel Better About Yourself

NEW YORK CITY:  In a March 31, 2011 article on Emotional Fitness, Psychology Today states, "Everyday, you have another chance to make things better. Some days are better than others. On those days that go less well, we usually end up being hard on ourselves."

Here are some tools to avoid doing so.

1. Keep going.
Don't let life's changes throw you off track, but remember that most extenuating circumstances are temporary. Gain more clarity by staying the course and channeling your energy in a positive direction.

2. Trust yourself.
Believe in your inner resources, no matter what, and you'll grow from the experience. I believe that the answers usually lie within and you are probably smart enough to figure out what you need to do. Give yourself a little time and have patience.

3. Be friends with life. 
Remember that the world is not out to get you and it does not punish you. You do that to yourself. Learning to focus on other opportunities or in another direction can give you some perspective.

4. Watch your thoughts.
Your thinking will never be 100 percent positive. You must learn to dismiss the negative thoughts and stay open to other ideas that will help you move in a positive direction. Start recognizing negative thoughts and use your mind to quell them.

5. Summon the strength you have inside.
Learn to access and direct your strengths to the highest good for all concerned. Believe that your strength and intelligence can help you deal with anything. Remember that you have survived worse.

6. Learn to love yourself. 
You do not have to be who you are today, and your life is not scripted. Changing how you feel about yourself means creating a strategy, gathering some new tools, and making yourself into the person you want to be. A good way to start is to stop doing things that hurt.

7. Don't want too much. 
Desire can be a powerful motivating tool, but wanting something too much can be very painful and very expensive, so don't live beyond your means or covet the unattainable. Seek your desire, but keep your integrity.

8. Don't get insulted.
It is wise to be dispassionate about critical comments. Human's will always bump heads, but consider the source, and if it's the other person's issue, ignore it. Learn to respond instead of react, and don't show your ire.

9. Recognize that disappointment is part of life. 
Even the most successful people have to deal with disappointment, but they've learned how to use it to get to the next level of life. The trick is to process your feelings, then take some kind of action.

10. Deal with your fears.
Overcoming fear makes you stronger, and being a little scared can make you better. You want to have butterflies; you just want them flying in formation. It helps to understand and admit your fears. Then you can kick them to the curb.

Feel good about yourself, no matter what life brings. 

Know that each time you wake up, you have another chance to make things better. Don't waste it.

Simple Self-Esteem Boosts That Improve Emotional Strength

NEW YORK CITY:  When our self-esteem is poor we are likely to experience greater drops in motivation after a failure, and to demonstrate less persistence toward the task at hand.

Lower self-esteem even makes us more vulnerable to anxiety and stress. Studies found that when our self-esteem is low we release more cortisol into our bloodstream when we experience stress and it circulates in our systems for longer compared to people whose self-esteem is high.

Those whose self-esteem was boosted displayed significantly less anxiety those who did not receive a self-esteem boost. Rest assured, no electrical shock was then administered -- but the participants did believe they were about to get zapped.

So, if boosting our self-esteem can improve our emotional immune systems, how can we give ourselves this extra fortification when our self-esteem is at a low?

One of the most effective self-esteem boosters is self-affirmations. In contrast to positive affirmations (which are general positive statements such as, "I am worthy of great love and success!" and which we might or might not actually believe), self-affirmation reflect personal qualities we know we possess.

From Clinical psychologist Guy Winch's Huffington Post article.

Strength Building Self-Statements 

1. What’s the worst that can happen? And based on my experience, and NOT on my emotions, how likely is that to happen? 

2. Feelings are sometimes painful, but are time-limited. 

3. It will get easier each time I practice. 

4. My success is measured by taking skillful action, not by whether I was anxious when I did it. 

5. I’m not going to let a lapse get in my way. I’m going to continue making progress towards my goal. 

6. Feeling I can’t do it is NOT the same as not being able to do it. Stick to the plan. 

7. Good job—I’m staying in the situation, even though it’s hard. 

8. I’m going to make it. 

9. It’s a sign of strength to ask for help in an effective way. 

10. Knowing when to ask for coaching is a skill in itself. 

11. I am a unique person, and I have unique reactions. Only I can determine how I SHOULD feel in any given situation. 

12. My feelings are not right or wrong, they just simply ARE. 

13. A feeling of certainty is not the same as the truth. 

14. My painful emotions happen for a reason and are an important source of information and direction for me. 

15. Urges are a natural part of emotions and of being human. Having an urge (even a strong urge) does not mean that I have to DO anything at all.

Brain Injury Association | No Two Brain Injuries Are the Same

"Since anyone can sustain a brain injury at any time, it is important for everyone to have access to comprehensive rehabilitation and ongoing disease management. Doing so eases medical complications, permanent disability, family dysfunction, job loss, homelessness, impoverishment, medical indigence, suicide and involvement with the criminal or juvenile justice system. Access to early, comprehensive treatment for brain injury also alleviates the burden of long term care that is transferred to tax payers at the federal state and local levels."

Dr. Brent Masel, National Medical Director

for the Brain Injury Association of America