Dr. H gave me a homework assignment that involves making note of my activities, and identifying my mood during the activity. I was to schedule activities from each of the four categories found in the initial post here.
On Thursday May 12th, I saw Dr. D and we discussed the homework assignment. Dr. D mentioned that the homework appeared to be a variation of Behaviour Activation Therapy (I may have miss-remembered her statement, Wikipedia provides an entry for Behaviour Activation here).
According to Wikipedia, Behaviour Activation is targeted toward the treatment of depression. In the beginning of May I experienced problems with walking and entered a very down mood. This is described in a May 10th post as follows:
Recent attempt to break in new shoes left me with heal blisters. The sub-text was that I was no longer competent even to walk. I became down, Had great difficulty in motivating myself.
I basically dropped off the map and did little more than sleep. While this event was triggered by walk difficulties, I suspect the ongoing battle with the insurer played a significant role. I am not a lawyer but I am attempting to litigate my own case as I cannot afford counsel. I am very aware of being out of my depth. I have made submissions but have no true understanding of the process, and zero feedback. At the same time, I am coming close to exhausting my retirement savings. I feel like I am being punished but I do not understand why. I did nothing apart from drive to work and was rear-ended by a speeding motorist. The other driver is completely at fault yet he is held harmless and indemnified by the state. I am left to deal with the injury and all the financial and emotional consequences.
There is the injury, and then there is my response to that injury. I am faced with the task of making the best of a difficult situation. I am conscious that some elements of my response result in negative effects. One example is my difficulty in sleeping. Sleep problems are associated with brain injury but I may be making things worse. When I first learned of the injury, I did not at first believe the diagnosis as I had no awareness of closed wound head injury. When I retired for the night, I reviewed all my daily activity in an attempt to pinpoint aspects of the injury, the errors I may have committed, and alternate behaviours to employ. I still perform this review and this results in my becoming alert when I should be falling asleep.
The homework appears intended to address these types of situations. As I began homework preparations, I realized this blog constitutes a record of my activities and serves to document my emotional response to those activities. In essence, I have been doing my homework assignment since May 2013.
Starting last Thursday, I have been working on this homework project. The following is the result.
1.0 Negative Mood Impacts
- 1.1 Imposed time constraints
- In January I had great difficulty due to multiple time commitments and bad weather avoidance
- In May I face weather limits plus conflicting time demands (TAQ, homework, CR Group, health card renewal, car repair)
- Fear of legal documents with 30 day response window
- 1.2 Multiple simultaneous demands
- Easily overwhelmed
- Need to slow everything down
- Resort to 5-2-5 breathing technique, blog entries, and walks to restore order
- 1.3 Physical handling and sorting of papers or objects
- Easily confused by duplicates
- Problem increases when doc lacks an assigned “home”
- Problem increases when no taxonomy in place
- Problem increases with volume of documents
- Problem increases with physical dispersal of documents in space
- Problem increases when performed for long period of time (unless highly repetitive rote work when it is done forever without stopping until suddenly it is 6 hours later and meal time was 3 hours ago)
- 1.4 Being physically tired
- Poor decision making toward end of a long walk day
- Greater sensitivity to traffic noise toward end of a long walk
- Lowered frustration threshold with fatigue
- 1.5 Being cognitively fatigued
- Same issues as above when cognitively fatigued
- Increased error rate (wide range of error conditions)
- Physically clumsy – drop things, make mess
- Unable to see error when performed (mistake is made but I do not “see” it until days, weeks, or months later)
- 1.6 Conflict
- Conflict with insurer
- Conflict with Dr. X
- Want to shy away and go wash dishes, or walk
2.0 Positive Mood Impacts
- 2.1 Performing rote work
- Sorting rocks for herb garden
- Chopping vegetables (more than required for meal prep)
- Chopping ice in parking lot (unnecessary work)
- Repetitive computer based tasks (make lists, organize files, perform pointless routine)
- Repetitive real world tasks like file folder labelling
- Repetitive real world task such as document sorting (provided all docs have a storage location)
- Endless dish washing
- Endless clothes washing
- 2.2 Going for a walk
- Positive sense of relief
- Gain insight into situation
- Mind pops up thoughts, solutions, unbidden
- Able to reimpose cognitive order
- 2.3 Blog posting
- Positive sense of awareness / insight into injury, or my behaviour. Insight aspect is critical.
- Blog is more positive than TAQ. Real present day benefit vs a theoretical future benefit
- 2.4 Shopping
- Positive sense of being in control of events (I make final decision to buy, not to buy)
- Positive sense of minor challenges I can manage (i.e. cost comparison, collecting data via web, collating data in a document)
3.0 Activities Avoided
- 3.1 IT related activities
- I screw up
- Inadvertently destroyed 1 PC and 2 portable hard drives. Lost several GB of data
- Messed up laptop and unable to diagnose issue
- High error rate and the many problems arising from it
- Difficulty working with W and his tech environment
- Difficulty in programming due required exactitude and subtle forms of error. Extremely frustrating whereas used to be a pleasurable recreational activity
- 3.2 Mechanical Activity
- Avoid car battery repair due low trust in capabilities
- Avoid household repair due low trust in capabilities
- 3.3 TAQ Activity
- No positive feedback
- Aware of my lack of knowledge of law (also Civil Code vs Common law issues)
- Ongoing for five years with no resolution in sight
- Of no ultimate benefit – At the end of the day I will still be injured
- 3.4 Financial Activity
- Screwed up RRSP, lost $20,000
- Errors problematic with significant impact
- Errors not observed (missed payments despite monitor system in place. Create email reminder)
- 3.5 Noisy or crowded locations
- Learned behaviour. Was much worse previously. I am improved but remain wary of trigger locations.
4.0 Activities of Which I am Wary
- 4.1 Shopping Payments
- Forget change, forget purchase (multiple occasions – broccoli, produce depot, farmers market)
- 4.2 Social Interaction
- Not immediately understanding of interaction (peer support group, many other situations)
- Concentrating on something else
- Frustration outburst (post office repeatedly despite attempting to control)
- Sense of being out of sync ( banter with the ON post office mgr, the Canada Food groups comment)
- Being misunderstood
- Creating problems inadvertently (inappropriate comment, the national newsletter, CONCERNA project, volunteer work, Green non-profit)
- Unable to react (volunteer work)
- Dr Spock quality. Too logical, too direct, no social lubrication (volunteer work, W setting, Green non-profit)
- Reduced emotional content, emotional intelligence (ex girlfriend, Green non-profit, volunteer work) Appears to resolve with long term interaction i.e. Dr H and Dr D
- Sense of being taken advantage of (Green non-profit, some sales settings [keybd purchase])
- Sense of being dismissed due to being slow or incompetent, or mental defective [herb book transfer, ex girlfriend, police encounter]
- Sense of social disconnect or awkwardness not present prior to injury
- Cause unintended hurt or pain to others
- 4.3 Giving in and accepting injured state
- Abandoning the fight
- Acceptance of injustice on part of SAAQ and Dr X
- Injustice to other mTBI victims
- Conflict with my prior socialization
- 4.4 Going to Cinema
- Unable to follow plot
- Disturbed by sound effects
- Has been consistent for several years now (I will go to a movie to test my response. First noted with 2012 release of Dark Knight Rises. Same problem with Spectre in 2015
5.0 Activities I Enjoy
- 5.1 Intellectual insight
- Being able to generate insight and understanding of injury and self
- Being able to fight my way to a basic grasp of neuroscience
- Likely an aspect of early socialization
- 5.2 Playing in the kitchen
- Ad hoc meal construction
- Turning odds and sods into a very good meal
- Using up foods before they turn bad
- Appear to be returning to adventure cooking mode
- Enjoy dish cleaning endlessly
- 5.3 Contact with natural environment
- Peace and quiet of forest
- Challenge of going out in bad weather and managing the environment
- Route finding in the city
99.0 Random Mood Alteration
- Go to sleep at night feeling great and positive and wake feeling negative and down
- Have experience of same but in reverse. No known explanation for change