TBI Recovery Narrative

Table Adapted from Nochi, 2000

This is the table that gave me so much trouble. It formed the primary trigger for the last depressive episode.

The table is based on one contained in an article describing the application of newly constructed self narrative as a means of adapting to TBI injury. These recovery narratives take different forms but each variation assists the victim in undertaking a positive response to his / her injured state.

My negative response to the recovery narrative article was not due to the narratives but was a reaction to the data contained in the table excerpted above. This table created a number of cognitive shocks. These shocks are described in the following sections.

Recovery Narrative – Shock of Injury Duration

The first shock was due to the fact the sample population has spent an average of 9.5 years in recovery. The longest recovery duration is 28 years. Given my present age, and this extended recovery period, I am forced to acknowledge I will likely deal with this injury for the rest of my life. This has been extremely difficult to accept.

Recovery Narrative – Shock of Similarity

The second shock came with the recognition of the similarity between my injuries and those of the sample population. The first lawyer to handle my file spoke with the insurer, and then relayed the insurer’s opinion that my injury was “unique,” that it was unlike anything they had previously encountered. Based on this opinion, the lawyer advised it was unlikely the insurer would accept my claim.

Yet, when I examine this table, I find that 100% of the sample experience short term memory (STM) issues. This is one of my major deficits.

Fully 50% of the sample experience problems with emotion. Again, this is one of my major deficits. Since the date of injury I have experienced a very flat emotional range  — so flat that an incidence of spontaneous laughter provoked a blog post. I encounter none of the emotional responses previously experienced either in relation to individuals, or objects, or processes. When I undertake a test for Autism Spectrum Disorder (ASD) the test indicates that I now exhibit the clinical signs of this illness. If I answer the same test battery based on how I would have responded prior to the injury then there is no evidence of ASD.

My period of unconsciousness is not known. My best estimate is a duration of between 30 seconds and one minute. The problem is that the duration of coma is not a reliable indicator of the injury impact. In the sample population described by the table, the male who experienced 8 weeks of coma has returned to work while the other individuals, with much shorter periods of coma, or no reported coma, remain engaged in recovery.

Recovery Narrative – Shock of Severity

Another key data point was the age of the individuals at the time of injury. If you subtract the recovery period in years from the current age of each of the victims, you find that the average age at time of injury was 28.4 years with a median age of 24 years. Age is a recognized factor in the severity of brain injury. I was 5 months shy of my 60th birthday at the time of the accident. This is more than twice the median age of the sample population. Given this fact, I am thankful my injuries were not more severe.

Recovery Narrative – Shock of Loss of Self

The key insight derived from this article, and the associated table, is the realization that my prior life strategy  (a compensation strategy, or learned behaviour )  does not address, and cannot resolve, the TBI deficits. The strategy may have worked to avoid bullies, and in helping to fit in with a group, but it does not facilitate recovery from TBI.  Insight into my injury, or my psyche, is of little practical benefit in dealing with the deficits.

I need to develop a new strategy, and adopt a new self image. Together these function as a coping mechanism helping me adapt to the injury. This calls for a “new” me. It also demands I place less emphasis on the strategies deployed by the “old” me. This realization has been very difficult to accept. I have no idea how to go about doing this and the thought of abandoning 60 years of accumulated life experience is extremely daunting.

Update 21/06/14 17:12:59

I revisited this table prior to seeing Dr D and realized that it contains another critical data point. Subtracting the post injury recovery period from the age in years gives the age at time of injury. The median age at date of accident for the table sample is 24 years. My age at date of accident was 59 years.

Age is a known factor in the severity of brain injury. I was over twice the age of the other individuals in this study.