How to Clean Up Stinking Thinking and Cope Better

Lee Livingston and Jeff Kreutzer, The National Resource Center for Traumatic Brain Injury, Virginia Commonwealth Model Systems of Care
How to Clean Up Stinking Thinking and Cope Better

After brain injury, people often find themselves having a hard time feeling hopeful. Feelings of sadness and nervousness are common. Thinking positively about the future can be challenging.

Following injury, a person or family member may find the following statements familiar:

  • “I will always have problems and will never be the same again.”
  • “This is so unfair. The driver that hit me was reckless and didn’t even get hurt.”
  • “My friends don’t return my phone calls. Nobody likes me anymore.”
  • “I’ll never be able to get or hold down a job with a brain injury.”
  • “The brain injury happened three years ago. He ought to be doing better by now.”

Are you concerned about how you or a family member with brain injury is coping? You may be wondering how you can tell if emotions are getting in the way. To help you better understand common symptoms of depression or anxiety, read the list of words in the “Are Emotions Getting in My Way?” questionnaire below. Check off the phrases that describe you or someone you know with brain injury.

QUESTIONNAIRE: Are Emotions Getting in My Way?

  • Feeling down, blue, hopeless, or tense
  • Can’t stop thinking about problems
  • Crying spells
  • Low energy
  • Irritability or restlessness
  • Appetite increase or decrease
  • Feeling guilty or worthless
  • Avoiding others
  • Getting frustrated easily
  • Not enjoying things
  • Difficulty falling or staying asleep, or sleeping too much
  • Difficulty making decisions, concentrating, or remembering things

Think about the items you checked and the ones you did not. The more items you checked off, the more unhappy you or a loved one may be.

These types of statements are warning signs of Stinking Thinking. Several examples of Stinking Thinking you may recognize are:

  • All-or-None Thinking (or Black or White Thinking). Thinking about things as extremes — either all good or all bad.
  • Over-generalizing. Using words like “always” and “never.”
  • Mental Filtering. Looking only at the negatives while ignoring the positives.
  • Labeling. Putting negative labels on yourself, others, or things in your life.
  • Jumping to Conclusions. Believing you know the facts without proof.
  • Emotional Reasoning. Thinking your emotions are facts or reality.
  • Should Statements. Using statements with the words “should,” “ought to,” or “have to.”

When thoughts are twisted by negative emotions, Stinking Thinking is the result. Survivors of brain injury and their family or friends may think they can’t win at life or they are a victim of life when twisted thoughts take hold. With mounting difficulties related to living with brain injury, Stinking Thinking can become a habit that is hard to break.

Stinking Thinking often leads people to feel sad, worried, and hopeless. To feel better, try to “freshen up” your thinking. Here are a number of ideas that survivors and their families find helpful to change negative thoughts after brain injury:

  • Remember, life is not painted black or white. Much of life takes place in the gray areas. Most things in life are not all good or all bad, but somewhere in between.
  • Misery is optional. Feeling miserable keeps you stuck in the past. The past is something no one can change. Focus on changing the things you can and accepting what you have no control over.
  • Emotions are not facts. Just because you feel a certain way, does not make it true. Notice when emotions are getting the best of your thoughts and check out the facts first.
  • The future is not set in stone. You cannot be certain about what tomorrow will bring. Try to avoid making negative assumptions about the future.
  • View “mistakes” as life lessons. Life is full of opportunities to learn new skills, make new friends, and try new activities. Learn from mistakes and do better next time.
  • Avoid seeking perfection. Instead, pay attention to progress made after injury. Remember, recovery from brain injury is a life-long journey for survivors and their families and friends.
  • Practice new ways of thinking to help you feel more positive during the process of recovering from brain injury.

If you or someone in your family is having trouble with negative emotions, individual or family counseling may help. Psychologists at Virginia Commonwealth University (VCU) MedicalCenter in Neuropsychology and Rehabilitation Psychology Services provide therapy to persons with brain injury and their family members as part of standard care and research. In addition, researchers at VCU are looking at the best ways to identify coping and adjustment problems after brain injury. Another study at VCU is available for persons with brain injury and their families to treat common post-injury problems. Individuals with brain injury and their family members are encouraged to call for more information about research VCU has to offer.

Posted on BrainLine July 25, 2008.

his column was written by Lee Livingston and Jeff Kreutzer from the VCU TBI Model System Program. For more information about outpatient rehabilitation services and VCU research programs, please contact Jenny Marwitz by phone at 804-828-3704, toll free at 1-866-296-6904, or by email at

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

Comments (4)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Thinking about positives, and building on positive building blocks, it is very hard at times, however eventually things get better. There will be "good" days and "not so good" days, and I have been trying to concentrate on the Blessings that I have been re-discovering (a lot on my "good" days and a lot on the days I don't feel like getting out and about), I try not to over do it, however it happens, and takes longer to recover before I feel like getting out and about again. On my days of reflection (often times on my recovery days I try not to bring myself down the dark path of thinking to much about certain things) Accepting things and finding the positives, this is a Realistic Expectation for 2018 that is on my list.

My prayers are for Positive thoughts and Compassion,


Angela in Colorado

It truly gets easier when one stays on the path of recovery. Surround yourself with friends that you can talk to, if you have any don't want to hear about it, maybe those are people that you should see less of. There are great people out there that want to have you around just as you are, even though you are working through issues. All of us are working through issues in our lives.

Good article. Every time I realize I'm doing the stinking thinking, I try to force myself to think about my blessings, the good things in my life however small they may be. It helps most of the time.

It’s a true statement, or conclusion that your life will never be the same after a TBI, but you should embrace it, as difficult as that is, as an opportunity to alter the path that life was taking you down, for the better or at least make some improvements in the activities you are currently involved in.