In the course of living our lives, we develop innate trust in our interpretation of personal sense data. We maintain unreserved confidence in our ability to correctly interpret the minutiae of our experience. This development is guided by family, by social relations, by our cultural milieu, and through formal learning. We call this learned capacity “maturation” and accept it as a mark of adulthood.

Given that this self-confidence is developed over an extended period of years, it is unlikely to be immediately surrendered based on the fact of a brain injury. Age at time of injury may have a profound impact on our response, with younger persons being presumed more able to initiate a positive adaption.

It was not until almost a year after my injury that I began to develop doubts in regard to my own functioning. When diagnosed with mTBI, I refused at first to believe in the fact of the injury. I thought the injury impossible; there had been no head strike.

It was through continual encounter with my various deficits that I came to accept the fact of the injury. Only now, four years after the injury, have I come to understand some of the false assumptions I made.

The first false assumption concerned an absolute belief in rehabilitation. I was determined to make a full recovery and was prepared to make whatever effort proved necessary. I refused to acknowledge that a complete return to a pre-injured state was an unlikely outcome.

The second false assumption deals with the process of rehabilitation. I spent two years attending to the needs of a parent with Parkinson’s Disease. My mother would stabilize at a certain level of function, there would be a crisis, and she would re-stabilize at a new, lower level of function. This new level would hold for a period of months. Then – another crisis. This was immediately followed by a further decrease in function and renewed stabilization at a new, lower level of capability.

Mum’s last years followed this stair step pattern of decline. Having experienced this, I arrived at the unexamined assumption that recovery from brain injury would follow a reverse stair step pattern. I would achieve a level of function and stabilize. This would be followed by some improvement that would result in a step up in cognitive performance with stabilization at this new, higher level of function. Like a submarine slowly climbing from the bottom of the ocean, I would, through the application of time and effort, eventually arrive at the sun washed surface and once again be “normal.”

This incorrect understanding of the injury suspended me on a psychological yo-yo. Any evidence of improvement was a sign that I had jumped up a step. A day, or week later, when this improvement was found illusory, I plunged once again into the dark depths of a new despair. I would fight my way back toward the surface only to find myself once again sinking toward the depths. This was a very difficult period. It was made more difficult by the fact that I did not understand what I was doing to myself, the degree to which I was the primary cause of my psychological distress.