Fundamentals for Living Better After Brain Injury Taryn Stejskal and Jeffrey Kreutzer, The National Resource Center for Traumatic Brain Injury, Virginia Commonwealth Model Systems of Care Page 1 of 2

Survivors and family members often face a host of unfamiliar problems. In this uncharted territory, people have a hard time knowing how to manage new, everyday challenges. New challenges may include managing stress, judging success and failure, setting priorities, asking for help, being patient, learning from mistakes, and developing short-term goals. After brain injury, there is little doubt that emotional and physical healing can take a long time.

You may have heard about the importance of “attitude” when facing life challenges. Abraham Lincoln said, “Always bear in mind that your own resolution to succeed is more important than any other one thing.” Carlos Casteneda said, “The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.”

We have talked to a number of survivors and family members about success and failure. Our discussions have helped identify goals that can help people be more successful and feel better about themselves and their lives.

• Learn to manage stress more effectively. Everyone faces stress at some point in their lives. Find and master stress management techniques that work best for you. Listen to music, take a walk, see a movie, exercise, talk with someone you like, read a book, or practice yoga and meditation. One of the keys to effective stress management is taking small breaks and finding enjoyment in your everyday life.
• Define success in your own terms. Everyone has the right to decide how to be successful and whether or not they are meeting their standards. No matter what your present situation, you can be caring, enjoy relationships, learn new things, help others, improve yourself, explore new ideas or hobbies you never had time to pursue, and live a meaningful life. Often times, survivors and family members get stuck comparing their standards for success to the way they were before the injury. Changes in your life make it important that you also change your definition of success.
• Set priorities and focus your energy to succeed. Often families get bogged down by trying to do too many tasks at once. Make a to-do list, number the items by priority, and work on the highest priorities first. Take time to recognize the difference between what you have to do and what you want to do. In addition, as other family members to do the same. Are there tasks that your family can work on together? Finally, take time to plan for the unexpected. Consider what sorts of unexpected events might keep you from achieving success.
• Learn how and when to ask for help. Many survivors and family members do not want to ask others for help because they are afraid they will be seen as a burden or be turned down. It is important to recognize that everyone needs at least a little bit of help sometimes, and most people enjoy helping others. Do not let pride get in the way of asking for the help you need. Seek help early on, before your problem becomes a crisis. And do not forget about the importance of helping others as well. People you have helped in the past will probably want to return the favor. Do not forget to let the people who have helped you know that you are happy to return the favor in the future.
• Learn the art of patience. Patience is a skill, not a type of personality with which you were born. If you are not already, you can learn to be a more patient person. Patience is important, but not always easy to muster. Patience is a much needed skill because the road to healing is long with many bumps and turns. Count to ten, take slow deep breaths, take a break, or focus on accomplishments or improvements. Happier endings come with patience and persistence over time.
• Learn from your mistakes. If you learn from a mistake, it is not actually a mistake, it becomes a life lesson. No one can do everything perfectly, especially the first time. Life lessons were created to teach us about how to be a better person. Think of your mistakes as lessons that create the opportunity to learn and make your future brighter.

• Avoid being hard on yourself. After injury, many family members and survivors are hard on themselves, especially if they are not able to do things the way they were able to before. An injury makes many aspects of your life harder. Healing both physically and emotionally is a big enough task. Why make it more difficult by being hard on yourself? Instead of getting angry with yourself, do your best to be kind and compassionate toward yourself. It will make things easier for everyone.
• Be as concerned about yourself as you are about others. Be careful about spending your time worrying about and helping everyone else. Try to take care of yourself first. When you are on an airplane, do you know why you are supposed to put your oxygen mask on before you help others? The answer is that if you do not take care of yourself first, you will not be any good when it comes to helping someone else. Decide what your limits are. Once you have set your limits, say no to the things beyond your limitations. Try to take out time for yourself each day, even if it is just 15 minutes.
• Create manageable short-term goals. Brain injury often requires that you put some of your goals on hold. To avoid being overwhelmed and afraid about all the things you have to do to get better, focus on the most important things you need to accomplish today and tomorrow. Often people do not want to set small goals because they think they are lowering their standards. You can still hold on to your long-term goals, but you are going to need to take smaller steps to get there. Smaller goals will allow you to measure your success and accomplishments each day. Finally, when you are healing after brain injury, making it through everyday is an accomplishment. In order to succeed, be sure to set reasonable expectations.
• Develop and maintain support systems. Everyone does better when they are able to receive understanding and support from others. Maybe your old friends do not visit or call as much as they used to. Do not be afraid to call them or reach out to make new friends. Of the common challenges families face, most people report that feelings of loneliness and isolation are very upsetting. You and your family may be different from who you were before your injury. Caring, helping, and reaching out to other people is a good way to make progress and avoid feeling alone. If you feel like your old friends do not understand you, join a brain injury support group or seek out others that have had similar experiences who will better understand you now.

From the National Resource Center for Traumatic Brain Injury, Virginia Commonwealth Model Systems of Care. Reprinted with permission. www.neuro.pmr.vcu.edu.

Jeffrey Kreutzer, PhD, Jeffrey S. Kreutzer, PhD, ABPP, is the Rosa Schwarz Cifu Professor of Physical Medicine and Rehabilitation at Virginia Commonwealth University (VCU), Medical College of Virginia Campus. There, he is also a professor of Neurosurgery and Psychiatry. Dr. Kreutzer serves as Director of Virginia's federally designated Traumatic Brain Injury Model System and coordinates VCU Health System outpatient services for families and persons with brain injury. For the last two decades, he has been active in implementing empirically based vocational rehabilitation, psychological support, cognitive rehabilitation, and family support programs. Dr. Kreutzer has co-authored nearly 150 peer-reviewed publications, most in the area of traumatic brain injury and rehabilitation. Co-Editor-in-Chief of the international journals Brain Injury and Neurorehabilitation, he has also published a dozen books focused on topics including vocational rehabilitation, community integration, behavior management, and cognitive rehabilitation. Currently, he serves as Editor-in-Chief of the soon to be published by Springer, New York, Encyclopedia of Clinical Neuropsychology.
 

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