Brain Injury Publications

"Survivor Perspective" by Mark Murrell

"Counseling & Brain Injury" by Allison B. Ford, Ph.D, LPC

"Cognitive Rehabilitation" by Dr. Lynda Johnson

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Survivor Perspective

My 25-Year Sabbatical
By Mark Murrell

I've spent the last 25 years of my life recuperating from a closed head injury. These years have been full of chaos and confusion, but I have learned to hang on with patience, persistence, and prayer.

My December 1982 single-car accident definitely changed my life and the lives of my family. Suddenly it seemed that none of the old rules applied.

I once likened myself to a science fiction explorer in an alien world because I felt I had been plummeted into a strange new world. Early on, I felt I was in a prison or a medium security hospital until I finally accepted the fact that the blasé phrase "auto accident victim" was for me. It was a single car accident and boy was I ashamed. This caused me to hate myself and it is a hatred that never has left entirely.

If I had not had friends, family and doctors who counseled me through many days of rage and misunderstanding, I can't even begin to say how I would have redeveloped.

Luckily, I did have those contacts. In the midst of such chaos, and confusion, there were some hidden blessings - like the attention and therapies I received in this office (NC Neuropsychiatry) - as a part of ongoing patient care.

You see, I'm not fully recovered; my closed head injury is not over. I am a "survivor," yet my life is forever changed.

I think the phrase "forever changed" has always struck fear into my heart. My accident was a scarce six months after I graduated college. In short, I felt the whole rug was pulled out from under me and I have been playing catch-up ever since. "Forever changed" only begins to scratch the surface. Nonetheless, lots of surfaces must be scratched when dealing with recovery from a closed head injury.

One of the first qualities I knew I must develop in my new life is patience. Now I've never been big on this quality, but nothing teaches it better (or ore harshly) than closed head injury. Don't thing that you are a failure if you can't master this one right away. I've been trying for the past 25 years and still have plenty of learning to do.

Persistence is another success strategy. Always tell yourself you are getting better. This can radiate outward to family and friends and can surround you with a buoyancy from loved ones.

Then there is prayer, the one I always full out when the other things don't work. Recovery from a closed head injury has taught me the need of prayer and its function. I stay tuned into spiritual concerns where I'm talking to an entity that knows my whole storey. I've been shown repeatedly how I can reach the limits of earthly powers, but I'm always ready to turn my overworked cares and concerns over to God.

In short, the three qualities - patience, persistence, and prayer have helped me the most in reconstructing my life after a closed head injury.

Editors note: Thank you Mark, for sharing your experience and amazing insight -NCN

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Counseling & Brain Injury

The Importance of Psychological Counseling in Brain Injury Treatment and Recovery
By Allison B. Ford, Ph.D, LPC

Brain injury, whether severe, moderate, or mild, can affect all levels of a person's functioning. For this reason, recovery is a complex process, and treatment for optimal recovery should address all components. This may include a combination of medication, cognitive remediation, and physical/ occupational/recreational/speech therapies. One essential treatment component is supportive counseling and psychotherapy, both for the individual and family.

Comprehensive psychological counseling addresses multiple aspects of the individual's life changes, in order to facilitate development of a more stable, productive and self sustaining lifestyle. The following is a list of some of the primary components to address in individual, family, and group therapy:

Changes in mood, thought patterns and behavior

• Expressing emotions about the injury including sadness, anxiety, fears, and anger; reducing intense moods
• Effective ways to interrupt the repetitive nature of intrusive thoughts, including negative, paranoid and suicidal thoughts
• Coping with distress related to the trauma, including: flashbacks, nightmares, severe anxiety, avoidance of triggers to emotional distress, social isolation, and sleep disturbance
• Understanding what happened, recalling the events without intense emotions, if memory loss learning what happened
• Letting go of self or other blame and gaining acceptance of injury, relinquishing the why's and what if's (why did this happen to me, what if I had done)

Managing the physiological effects of the injury

• Managing acute and chronic pain including headaches and migraines
• Coping with any permanent changes as a result of the injury, including physical, emotional and cognitive conditions
• Stabilization on medication and dealing with medication side effects
• Understanding the impact of injury on cognition and learning compensation strategies

Changes in social interactions and relationships

• Addressing patient's social isolation through physical activity, productive use of time and fulfilling leisure interactions
• Building or rebuilding healthy relationships
• Decreasing potential for social conflict due to decreased empathy for others or misinterpreting others' behavior.
• Self-awareness of disinhibited behavior verbal outbursts, socially inappropriate behavior (touching, sexual jokes, and missing social cues).
• Participation in support groups with others who have been injured. Learning how to share your story without self pity and helping others adjust to an injury and major life changes.

Involvement of the family in treatment

• The patient's spouse, significant other, and minor aged children need to be an integral part of treatment. They are the providers of information clarification and support. Initially they need explanations about what is happening to their loved one and what they can expect in treatment.
• Depending on the severity of the injury, the spouse may have become the primary bread winner and care taker of the patient as a result of the injury. Many spouses have mixed emotions about the patient worries about stability, anger about mood changes, resentment for losses, etc.
• Coping with sexual dysfunction and changes in the marital relationship
• Often, mood swings or periods of rage may be directed toward spouse, increasing potential for conflict
• Locating additional support for family members through local support organizations and networks (such as NC BIA).

Emotional impact of the loss of work, potential transition to return to work

• Financial worries due to lost income
• Impact of job loss on self worth and pride
• Addressing fears associated with return to work. For example, fears related to interactions with coworkers or fear of safety issues (could injury happen again?) and visual reminders of the injury, if the injury occurred at work.
• Completing comprehensive career assessments and helping establish on the job training or coaching.
• Working alternatives volunteering, helping other patients, support groups
• With comprehensive treatment, including psychological counseling to address these life changes after the injury, a survivor is more likely to regain a greater level of independence, esteem, and emotional functioning.

To inquire further about psychological supports for survivors or family members, please contact: Dr. Melissa Butler, PhD, 919-933-2000 ext. 124.

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