The Importance of Maintaining Positivity and Hope After Brain Injury

On April 24, 2009, BrainLine had the opportunity to sit down with Dr. Kreutzer and Dr. Stejskal to talk about their work with people with traumatic brain injury and their families.

Helping people be hopeful is often a great challenge early on after injury. Sometimes I think it's the most important thing that we do. And I would say that I've been working in the field for a really long time, and I find I still look forward to going to work every day and I just find it really rewarding because I've been so impressed by people who have been in a lot of pain but who have worked really, really hard to turn things around. And I've found many people to be very courageous and very creative and very caring, and I've just been so impressed by how much people have recovered after their injuries that I would say that working with those kinds of folks has inspired me to continue to work in the field and to dedicate my life toward helping people achieve better outcomes. I think one question that people often ask me is, "I received some information or some feedback "about what I'm going to be able to do now after my injury." And I'll tell you that after a brain injury, family members, couples, individuals, they see a lot of doctors, and the ones that they remember are the doctors that told them what they couldn't do and talk a lot about how not only were they able to get out of the wheelchair, they don't use a walker anymore and they walk when they were told that they wouldn't be able to do that. Or they were told that they wouldn't live and if they did they'd be a vegetable, and they're a productive member of society. So I would say that if someone has put limitations on your life and said that you can't do something, that may be true and it may not be true, but don't let those limitations stop you from your recovery and achieving what it is you think you can achieve. Learning how to be positive is not an easy thing to do. But, like patience or stress management, it's a skill. It requires me and you and everybody else when you begin to say something negative to yourself in your mind to stop yourself from saying that negative thing and to say something different. People that tend to be pessimistic tend to say negative things to themselves in their minds about what's achievable, what will happen or what will never happen, and so first I'd start with some self-examination about what you're saying to yourself on a daily basis. As professionals, we're really bad at moving pretty quickly to acceptance and making big changes, and that is not something that happens overnight. Learning to be more positive, learning to accept what has happened and what changes have occurred, that's probably a lifelong process. Does that mean that you won't move toward acceptance over time and it won't get better? Absolutely not. That will be a process. But it's something that is hard won, people have to fight for, and I think that's where the patience and persistence comes in because learning these new skills is not an easy thing but definitely a possible thing. We envision often the first few meetings with the person who's been injured saying, "How can I live like this?" And I've actually used this as a question for group discussions as well as discussions with students. Imagine that a person with a brain injury that had a very terrible injury walks into your office and says, "How can I live like this?" And it's a really hard question to answer. It's a hard question to hear. And it's been an issue because I've talked with groups of people who have had brain injuries and said, "What if somebody came into this room today "and said that to you?" There's a series of answers that will partly work for that question. One is to acknowledge that having a brain injury is very, very difficult. It's very important to acknowledge that person's feelings of being overwhelmed. People say they feel frustrated. Those are all normal feelings that people have when they have a catastrophic injury. So acknowledge the person's feelings. The second is, and Taryn talked a bit about stories or about examples of people that she's worked with and examples of people that I've worked with who have had a very, very difficult time early on, people who were told they'd never walk, they'd never work, they'd never have a family, they'd never get married. We've seen those people ten years later. And sharing the stories of people who have been successful can help people see hope. What it may really come down to in answering that question in a positive way is to ask the person to try to get beyond their feelings of frustration, their feelings of hopelessness and just trust me as their therapist. I have worked with other people who have been in similar situations, and I'm going to work very hard with them over the next year, two years or three years. However long it's going to take, I am going to help them make their life better and please trust me for now, we're going to find a way out of this. And trying is way better than not trying.
Posted on BrainLine May 27, 2009.
Produced by Victoria Tilney McDonough and Brian King.