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Wednesday, August 20, 2014

The roles of confidence and faith in recovering after a TBI

The items in the list below are the results of a brain-storming session I indulged in prior to writing this post.

Confidence and Executive function
Confidence and Motivation
Confidence and Focus
Confidence and Rebalancing Left and Right brain responsibilities
Confidence and sequential thinking
Confidence and Event-Memory

Over a lifetime of learning, each of us continually builds upon a personal model that represents our understanding of reality, or "how things work." A brain injury, by changing the way our own minds work, can make our previous mental models obsolete, and can result in a crisis of confidence that can be more disabling to us functionally, than it is to our actual capability to recover.

A few moments ago I had an epiphany in which I realized that confidence enables a person who appears to be functional after a brain injury to be able to work effectively without succumbing to sudden overwhelming mental exhaustion as we doubt and test and retest the basic assumptions that form our personal models of reality.

Confidence is not just an attitude. It is intimately connected with the years of experience of successes and failures that went into building the personal mental models with which we understand the world around us. When a brain injury disrupts our personal balance between left and right-brain thinking, there will naturally be a crisis of confidence during the transition. If sequential language-oriented management of our mental model has been compromised, and is in the process of being replaced by a more visually oriented management process, we may recognize why we previously thought the way we did, but if we can no longer test the and verify the trustworthiness of our thought processes as quickly as we once could, we loose confidence over our entire sense of reality. Every premise must be re-tested, and in some cases, new and possibly even better reality models may result, potentially improving us. However, if we do not understand the role of confidence and the need to risk trusting our new perspectives as we chose to trust our previous perspectives when we were younger, our confidence may never be restored, and we may forever be caught in a preparatory mode of rediscovering our personal sense of reality. At some point, there must be a transition from questioning everything, to trusting our own judgment once again, even if our "new" judgment does not have the benefit of years of trials. We must start over in learning to trust ourselves. Yet, having already navigated this challenge in the past, it should not be as difficult, if we choose to believe in ourselves as we once believed.

When I speak of "functional recovery," I am speaking of how we recover our functional capabilities, as opposed to how we may have hoped to recover old abilities via physical healing. Functional recovery involves accepting that some of our losses were permanent, and won't be coming back. Functional recovery means finding new ways to solve old problems. It also introduces the hope that our more experienced minds may come up with superior ways to do things, which may help us turn some of our losses into gains. I firmly believe that last point should become the basis of our hope for the future, that we should not hope to be "nearly as good" as we were before, but that we should see the changes we are being forced to make as an opportunity to build a better foundation for a more efficient and more useful model of reality.

Tuesday, August 19, 2014

Perseveration - Persistent Repetition After Brain Injury

I stumbled across this video a few minutes ago. As with "flooding," I had never heard this term before I saw it used in a video by the Northern Brain Injury Association of British Columbia. The description of perseveration brings to mind my own difficulties with what I have called distraction "loops," several incidents of which, I have written prior posts. My distraction loops are due to a combination of mental fatigue and multi-step tasks in which a component step in the task interrupts my "big picture" of what I'm doing, causing me to either finish the subtask and then, having forgotten the reason for the subtask, causes me to wander on aimlessly, or in the other common scenario, realizing I have lost my sense of what I'm doing, I go to my notes, and start the same task over, eventually coming to the distracting task, and repeating it, often loosing hours before some external distraction finally causes me to stop acting in a half-awake mode, and enables me to stop and focus.

I fear I have not described this ongoing difficulty well. I may revisit this post when I find a way to describe the experience of "distraction loops" better.