Thursday, December 9, 2010

After a Traumatic Brain Injury: Stages of Healing


In general, after a Traumatic Brain Injury a few stages of healing happen.  Most of them are driven by our inner person.  The first stage is unconscious denial.  Here is when, in my opinion, everybody notices something wrong with us, but we don’t notice it.  As an example, in the early stages of my injury, others would tell me that I was acting very different, and that I would forget simple instructions, that I just simply could not put things together, that I could see or talk normally or that I could not balance well.  Even though they mentioned to me how I was behaving, I did not see it and I did not take it serious. All through this stage, there were some doubts in my mind, and I kind of saw all they were mentioning as a blur, I could not see it clearly.
The second stage is what I will call the shocking truth.  Here is when after going to extensive clinical testing we start to accept the presence of an injury or that there is something different.  Here is when I first really saw that I was having cognitive problems.  It was at this stage that I became extremely frustrated because I saw I could not remember simple things, not even a three line story or a list of five words.  At this stage I became irritated when others would point out deficiencies.  Keep in mind that here there is a shock but yet there is no acceptance.
I will call the next stage the race against a ghost.  Most of us have a clear memory of how we were and at this point we could see the deficiencies.  We could see how annoying is not been able to balance ourselves, remember things, not understanding what we read, basically not been proficient at anything.  As rehabilitation happens, we maintain a focus on trying to be who we were.  I had put a lot of energy in attempting to be who I was.  I was trying to rush thru everything so I could get back to work.  There was still no acceptance of the severity of the problem at hand.  I was taking it as if it was a flu or cold.  Everything I did I tried to remember how I had done prior to the injury and I would fail.  Instead of learning new ways I was trying to perform as if nothing had happened.
The fourth stage is sadness, grief, and anger.  Sadness and grief will happen all through the healing process.  As a result of us witnessing our new acquired problems and our inability to perform how we used too, we start grieving and asking ourselves many questions.  I would ask myself: Why me? Will I ever get to be how I was?  How long is going to take? Do others see me different? What am I going to do now?  At this point we all have been seen by many clinicians and at least one of them has mentioned that it could be a behavioral problem, PTSD or depression.  We know is not mental, but by them mentioning that, it raises more questions inside us like: Am I going crazy?  Those doubts should never be put on our heads as it makes all this process harder to deal with.
The next stage is acceptance.  After dealing with the sadness, grief and anger, we then have to see things as they are.  Nobody can change the past. We have to deal with the card that life played us.  At this point we see the severity of the injury and we realize that denial just makes it worse.  Here is when we are trying to make the best of our new found reality.  We start to put all efforts in our rehabilitation and try to work with a better outlook in life. The real healing and rehabilitation starts at this stage.  Here we try to gain our independence back, we learn how to set attainable goals that would minimize frustration, and we start learning about our condition.  After a brain injury acceptance is what gives us clarity of what is it that we are dealing with.  We start owning our injury at this stage.  We try to make the best out of it, the only downside during this stage is that ownership of the injury has not really happened yet. 
The last stage is healing through ownership.  At this stage is when we take control of our condition and we know exactly what our impairments are.  We try to find what works best to balance the losses.  We find new ways to cope and do things.  We see that attainable goals bring a sense of accomplishment and success.  We see ourselves as tools to help others and help them in their healing journey.  In this stage is when most of us have a new found purpose in life, which normally involves helping others.



Disclaimer:  This article is based on my experience.  I am not a clinician and I am not pretending to be one.



  1. You know I think most people feel like you. The lose and the NEW SELF. But I never did.(that I remember anyways) I always excepted my situation and worked on my physical problems. I overcame them with a lot of hard work and my deficites, like I said, I just excepted. I figure if people don't like them, it is their loss not mine. I never had a BIG career that I had to learn alot of mental things to get back to. Or like I've always said, " God was protecting me and didn't let me think that I couldn't do something. I just DID IT! Maybe not the way someone without a BI would do it. But it got done.

  2. I always knew something was very wrong with me from the start. I spent a lot of energy trying to hide it from others and act like not much was wrong. No way was I even remotely convincing, but it took me a while to realize this.

    When I did, I dropped the charade and could relax a little and start to accept myself. I also started to use all the energy I was putting into trying to hide my deficits into healing.

    Somewhere along the line, I gave up the notion of trying to get back to the "old me." Only then, I could accept the new me.

  3. Recovery, be it brain or physical injury, has stages. What you shared made these stages clearer for people trying to understand how these stages go. This is especially for people whose family member or friend is suffering from it. Looking from the outside, it might be easy for other people to pity recovering patients, and they would even think that what they're doing help the situation when in fact, it doesn't. Understanding them and knowing how to help these people recover are the best ways families and friends can do for their recovering loved ones. Thank you for shining light into this topic. And I hope you are well on your own journey to recovery.
    Alejandra @ US Health Works