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TBI,ABI,Brain Injury,PTSD

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  1. 1. A m a g a z i n e f or t h e br a i n i n j ury c om mun i t yIssue #1 April / May 2013Premiere Issue!In This Issue:Who’s Who in This Family Now?by Rosemary RawlinsMapping New Directionsin Caregivingby Janet M. CromerThe Slow Crawl ofBrain Injury Recoveryby David GrantBrain Injury and Grief:Fact or Fiction?by Janelle Breese BiagioniMake Your Life’s Story Betterwith Journalingby Barbara StahuraWhere is the Love?by Matthew and Cassondra BrownFamilies Caught in the Aftermathof PTSD: The InvisibleEmotional Woundsby Marilyn LashTBI and PTSD:Navigatingthe Perfect Stormby Marilyn LashHelping Childrenwith Brain InjuriesSucceed in Schoolby Janet TylerA Better Approachto Finding a Jobafter Brain Injuryby Dawn WestfallReading RoomBook Reviews
  2. 2. “Our goal is to provide the highest quality, individualized transitional Table of Contents A m a g a z i n e f or t h e br a i n i n j ury c om mun i t y and long term care for persons with acquired brain injury.” Welcome Nathan D. Zasler, MD from Lash & Associates Publishing/Training Founder, CEO & Medical Director Publisher’s Letter Tree of Life Services, Inc. by Marilyn Lash, MSW…………………………………......5 Issue #1 - April / May 2013 Mission Statement Editor’s Letter Brain Injury Journey - Hope, Help, Healing helps persons with brain by Barbara Stahura, CJF..………..................................5 injury, families, and providers successfully navigate challenges and live a full and satisfying life. We offer empowering personal stories, inter- views with experts, and clinical updates and research findings. Above Family Matters all, we provide a community to enhance hope and foster healing after Who’s Who in This Family Now? brain trauma or disease. by Rosemary Rawlins…………………………………........6 Publisher Lash & Associates Publishing/Training, Inc. Caregiver’s Compass 100 Boardwalk Drive, Ste. 150,Youngsville, NC 27596 Mapping New Directions in Caregiving Tel 919-556-0300 Fax 919-556-0900 by Janet M. Cromer, RN, MA, LMHC………………...8 E-mail: New Horizons President Marilyn Lash, MSW The Slow Crawl of Brain Injury Recovery CEO Bob Cluett by David Grant……………………………..…………10 Brain Injury Journey Editor-in-Chief Barbara Stahura Graphic Design Bill Herrin Stepping Stones Advertising Bob Cluett, Nick Vidal Brain Injury and Grief: Fact or Fiction? Subscriptions Nick Vidal by Janelle Breese Biagioni, RPC………………………...12 Editorial Inquiries Marilyn Lash Editorial Policy Telling Your Story Brain Injury Journey is published six issues per year. Lash & Associ- Make Your Life’s Story Better with Journaling ates Publishing/Training Inc. does not endorse, support, or recommend by Barbara Stahura, CJF……………………………..14 any specific method, facility, treatment, program, or group for persons with brain injury. Any inquiries or concerns about an individual’s health, treatment, and recovery cannot be addressed and should be discussed Veteran Voices with a health care practitioner. Where is the Love? Advertising rates by Matthew and Cassondra Brown...............................16 Please call 919-556-0300 for information on rates and distribution. Families Caught in the Aftermath of PTSD: Distribution and Subscription Brain Injury Journey is available electronically and in print. The Invisible Emotional Wounds Sign up for free online subscriptions or paid print annual $48 Chief Editor by Marilyn Lash, MSW…………………………………...18 subscription for six issues at: Nathan D. Zasler, MD Clinical Corner Letter to the Editor Policy TBI and PTSD: Navigating the Perfect Storm We welcome comments and feedback, but please limit letters to 300 by Marilyn Lash, MSW...………..………………......20 words. Published letters may be edited for spelling, grammar, and length. The writer must include name, address, email, and/or phone number for contact. Lash & Associates reserves the right to refuse let- Kids’ Club ters for publication, and submission does not guarantee publication due Helping Children with Brain Injuries Succeed in School to space limitations. Opinions in Letters to the Editor are solely those of by Janet Tyler, PhD.......................................................24 the author and do not represent Lash & Associates. Provider Points Brain Injury Journey©2013, is published six times a year by Lash & Associ- A Better Approach to Finding a Job after Brain Injury ates Publishing / Training. All rights reserved. No part of this publication by Dawn Westfall, MS, CCC-SLP…………………….26 may be reproduced in whole or in part in any way without the written permis- 1-888-886-5462 • Fax 804-346-1956 sion from the publisher. For reprint requests, please contact Bob Cluett, CEO, Reading Room & Resources via email at Back issues can also be ordered Administrative Offices Book Reviews.……………………..............................28 at 3721 Westerre Parkway, Suite B • Richmond, Virginia 23233 Resource Page & Advertisers........................................30 3
  3. 3. Letter from Lash & Associates From the Editor-in-Chief by Marilyn Lash by Barbara Stahura Call for our latest catalog, We are so proud to introduce the first issue of Brain Nearly 2 million people annually sustain a brain injury Injury Journey – Hope, Help, Healing. We spent a lot of in the United States, and more than 5 million live with time choosing our magazine’s title because we wanted it permanent disabilities related to brain injury. Fortunately, and we’ll get things in order! to reflect our philosophy as well as the needs, issues, and public awareness of brain injury is growing, and much concerns we hear every day. research is being devoted to Words matter, so we have prevention, treatment, and chosen them carefully. recovery. Yet despite all the tremendous advancements The 2013 Lash & Associates catalog is available by request, and our Brain Injury - We address being made, most do not all types of acquired brain entire selection is on our website 24/7 at Ad address this fact: Brain injury Call or check us out online today, and have a better tomorrow! Catauog l lt injuries with those due to begins and ends in the family. 2 0 internal causes such as brain 1 3 tumors, infections, or stroke as What happens to the family well as traumatic injuries due when so many aspects of to external forces of collisions, their lives have been turned Lash & Associates Publishing/Training Inc. 100 Boardwalk Drive, Suite 150, Youngsville, NC 27596 Tel: (919) 556-0300 Fax: (919) 556-0900 explosions, assaults, falls, or gunshots. upside down and they struggle to live their “new normal”? When many professionals in the field do not adequately 919-556-0300 Journey - Living with a brain injury is an ongoing Call us for a FREE catalog! Leading Source of Information on Brain Injury in Children, Adolescents, Adults and Veterans process or journey that is constantly changing, challenging, understand the changed dynamics and realities of living with brain injury, how can families bridge the gap between Lash & Asso and rewarding for everyone involved. There is no finish what is happening to them and what they need to know to ing/Tr ciates Publish ain Leading publishe r ing Inc. and concussi on brain injury, blast inju on in adults line with a tape to cross, cheering crowds, and a celebratory survive, or even thrive? and veterans ry . party. Rather it is getting up and facing each day with the conviction and purpose of rebuilding one’s life. We strive to fill at least some of that gap in the pages of this magazine. Our mission: Brain Injury Journey - Hope, Hope - This is what survivors, families, and caregivers Help, Healing helps persons with brain injury, families, Lash & Associates Publishing/Training Inc. 100 Boardwalk Drive, Suite 150, Youngsville, NC 27596 tell us is so important. Hope is what sustains them in their and providers successfully navigate challenges and live Hope . . . comes in many forms Tel: (919) 556-0300 Fax: (919) 556-0900 darkest periods. Hope is the vision that lights the darkness a full and satisfying life. We offer empowering personal and creates new possibilities for a better future. stories, interviews with experts, and clinical updates and Help - As the African proverb says, “It takes a village research findings. Above all, we provide a community to raise a child.” The same is true for brain injury. Help to enhance hope and foster healing after brain trauma or comes from many people and in many ways. The individual disease. Helping Brain Injury Victims Lash & Associates who survives a brain injury enters a community that is much larger than friends and family. It includes clinicians, Our writers reflect the brain injury community to whom this magazine is devoted: people with brain injury and their Families Nationwide. Publishing/Training Inc. 100 Boardwalk Drive, Suite 150 therapists, educators, advocates, providers, insurers, and who come from civilian and military backgrounds, family Youngsville, NC 27596 Tel: (919) 556-0300 many, many more. They share the goal of ensuring that caregivers and family members, and expert providers Fax: (919) 556-0900 treatment for brain injury is more than just survival. such as speech pathologists, therapists, educators, and Healing - There is no fixed timetable for recovery. The mental health professionals. We will do our best to cover a healing process after brain injury is much more than a spectrum of topics to provide helpful, valuable information neurological recovery. Healing is multidimensional. Yes, not often available anywhere else, presented in clear, 1-800-4LAW-MED it is physical, but it is also cognitive, emotional, social, familial, and spiritual. reader-friendly language. 1-800-452-9633 For the person who is injured and the family alike, That is our philosophy, and that is the foundation for this coping with a brain injury, especially in the early days, can magazine. We hope you find the articles, information, and feel like the end of the world. You may feel isolated and Thomas Henson, Jr. alone, believing that no one else understands what you are Brain Injury Attorney insights valuable and helpful in your journeys, whether they and Advocate for over 20 Years be personal or professional. You are all valuable members of going through and all the challenges you face. But we do this very special community. understand because we have been there, and we can tell you it is not the end. The journey ahead is not easy, and 2501 Blue Ridge Road • Suite 390 • Raleigh, NC • 27607 • Please help us spread the word and encourage your you likely will be called upon to make many adjustments. THIS IS AN ADVERTISEMENT. Henson Fuerst Attorneys are licensed in NC, VA, GA, NY and DC, and will associate co-counsel in various jurisdictions to assist friends and associates to subscribe at http:// Know that we are here for you and will gratefully share with these claims. Clients not accepted in states where unauthorized by state bar rules. SERVICES MAY BE PERFORMED BY OTHERS IN THE FIRM. what we have learned to help you along the way.4 5
  4. 4. Family Matters Reaffirming: Telling each other we loved each other often. Staying flexible: Understanding that last minuteWho’s Who numerous, and some had not even revealed themselves yet. changes might happen, and that roles would continually shift and change as Hugh’s health This Family Now Our twin daughters, Anna and Mary, age 14 and once Life for families will be different and often difficult the center of our universe, were now left off to the side after one member sustains a brain injury. But in theby Rosemary Rawlins or enlisted as caregivers. “Can you stay with Dad while long run, some families may grow closer than they ever I go out to the store?” I’d ask. “Remember to be sure he dreamed possible. It happens without warning. keeps his helmet on.” They both did their best to help out, but I know it was hard—hard to see their father disabled, Ten months after his injury, Hugh earned his driver’s One person takes the hit, the hard to care for a parent who used to care for them, and license back, and one evening, he drove himself to thebullet, or the fall, while lovedones witness the wreckage. hard not to complain about it, because there were so many gym to work out. A while later, a fireman called the competing emotions. In truth, they lost both parents for a house to tell us that Hugh had suffered a seizure. MaryWhen traumatic brain injury period of time because I was focused solely on Hugh and and Anna swung into action. “I’ll come to the hospitalstrikes a family, everybody his treatment. with you, Mom,” Anna said.suffers. Children are forced to grow up fast after a parent has “It will be okay,” Mary said, rubbing my back, and Survivors emerge from a fog that slowly gives way a brain injury. Their needs will not come first and mayto bewildering awareness of limitations, deficits, and a not even seem important. But over time, the experience I knew it would, as long as we all had each way of living. Family members wait out the initial will have taught family members lessons about love,hours and days following the injury in cliffhanger mode, Rosemary Rawlins is the author of Learning commitment, patience, and overcoming adversity. Our by Accident, a memoir. You can learn morehanging onto any branch of hope within reach. family made it through the hardest first two years, and about Rosemary at: One family life ends, and another begins. looking back, here’s what helped us. Structure: Keeping the children on schedule for Depending upon which family member is injured— school and extracurricular activities so there was afather, mother, child, sister, or brother—roles flip, continuation of familiar past activities. This requiresresponsibilities shift, and stress mounts. Until the extent ofthe injury is known, and healing begins, remaining family family and friends to chip in with driving and other tasks. Ne uro Neuro Community Caremembers take on what added responsibilities they can, Support System: Relying on emotional support and The right support, at the right time • NCC recognizes the complex needs of those with brain injuries and the lifelong challenges they faceand learn to do without—without the counsel, connection, help from family, friends, church, teachers, therapists, andand comfort of someone they once relied on. doctors. • NCC provides cost effective, community based support for individuals with Community Care brain injuries, neurological, cognitive or physical challenges L LC In my case, my husband, Hugh, was hurt. On April 13, Surrogate Parents: Close family and friends stepping Brain Injury Support Services • NCC Case Managers and Life Skills Coaches act as a bridge and advocate on the2002, a car hit him as he rode his bicycle home from an in to give children needed attention and help when parents client’s behalf; exploring community resources, making referrals and providesafternoon workout. He was forty-six years old, athletic, are overwhelmed. ongoing trainingsmart, and seemingly invincible. To his children, he was Open Communication: Being honest and open with • NCC Case Managers work collaboratively with clients, caregivers and providers in“Huperman,” the dad who would always protect and each other’s feelings—venting, laughing, and crying developing goals; accessing services and providing advocacy so that needs are metdefend. He was the main breadwinner in our household. together as a family. • NCC Life Skills Coaches provide ongoing individualized skills training for persons with brain injury or other cognitive impairments in their own environments After two emergency brain surgeries in three days, Reasonable Expectations: Letting kids be kids.Hugh was in a coma. In the space of those first harrowing • NCC has considerable experience providing services and support to military Asking only age-appropriate caregiving help from personnel, veterans and their familiesdays, I became a single parent. Being in charge of his children, and only when absolutely necessary. 12520 Capital Blvd., Suite 401-139, Wake Forest, NC 27587medical care felt like a monumental task to handle alone,but I also had to communicate with his employer, pay our Using Our Strengths: Anna was great at helping in the kitchen. Mary liked to stay up late, so she helped out info@neuro.combills, and manage our insurance policies, my part-time when the night nurse was off duty. 919-210-5142 office 888-626-3681 faxjob, the house, and family. Hugh was sent home after thirty-three days wearing a Accepting: Acknowledging that life was different, buthelmet on his head (a chunk of his skull had been removed we’re all in this together. “What makes NCC unique is that our services are provided in the individual’sto relieve brain swelling). I held tight to the gait belt Encouragement: Bolstering each other’s spirits during home or community environment and are functionality based”strapped around his waist for balance. His deficits were hard times.6 7
  5. 5. Caregiver’s Compass non-caregivers? We are also vulnerable to traumatic chair, close your eyes, and bring your attention to stress from caring for a person who suffers, is in pain, your breath. Just breathe naturally, in and out a few or very disabled. There is even a form of severe mental times. Starting at the top of your head, slowly draw and physical exhaustion, known as compassion fatigue. your attention down the length of your body, front andMapping New Directions among the diagnoses studied. This condition leads to a depletion of resources and interferes with every dimension of life. back. Keep your mind open and non-judgmental. Just notice any spots that feel sore or tense. Notice anyin Caregiving For adult caregivers, our titles and roles change areas where worry or anger might be hiding out? Let as the journey progresses. In the beginning, most of What helps prevent some of the health hazards your breath flow easily. You might try inhaling into us start as a crisis manager juggling tough medical associated with caregiving? How can we replenish our a sore spot to soothe the area, and then exhaling a bitby Janet M. Cromer, strength, motivation, and empathy at each stage? decisions, family life, and even a job. Then, during of pain. Note any feelings you might want to exploreRN, MA, LMHC months or years of rehabilitation, we become a coach, later in your journal or a conversation with a friend. Realistic resilience skills Welcome to Caregivers maybe even a drill sergeant. A child becomes Dad’s Sit for as long as you like. Breathe, stretch, then smileCompass! Are you a caregiver teacher as he explains how to spell or play a computer No matter where you are along the continuum of and continue your day.for a family member who game. caregiving,has a brain injury? Although there is an We’ll delve Persons who have a severe brain injury might into seriousyou may feel alone, you are essential require complex medical care at home. That caregiver issues such asin good company on your ability that feels more like a nurse and physical therapist than ajourney. More than 65 million fortifies and caregiver trauma, wife as she gives tube feedings, suctions a tracheotomy,Americans care for a family sustains body, compassion and moves her husband’s weak legs through a range ofmember at home. Many of mind, and fatigue, and motion exercises.them care for a person who has one of the many types spirit. I call mental healthof acquired brain injury. The crisis may have begun Brain injury can contribute to problems that affect it “realistic concerns.with a traumatic brain injury, blast injury, hypoxic memory, mood, cognition, and behavior. This means resilience.” Prevention is thebrain injury, stroke, tumor, or infection. The causes are that caregivers often become counselors, behavior Resiliency best medicine.different, but some consequences are universal. In an coaches, and emergency responders. Fortunately, there has been So, we will offerinstant, a family member is plunged into the wilderness is now effective treatment available for conditions such defined as explanationsof intensive care units, rehabilitation hospitals, as depression or post-traumatic stress disorder (PTSD). the ability to along withneurology appointments, and then the community. However, both military and civilian families can feel cope well with proven at a loss to understand and help a son or spouse whose high levels techniques to All of a sudden you are officially declared a of ongoing, minimize the personality and behavior have changed dramatically.caregiver without a compass, job description, or worst kinds Recovery requires a combination of good treatment, disruptivetraining manual. This uncharted territory comes with change. of stress. We time, and effort.a mountain of responsibilities, a foreign language, and Resiliency will show youunfathomable scores. Not to mention insurance limits. By the time you have been a caregiver for a few allows us to new ways toYou are assigned to be the guide and coordinator. No years, you probably summarize your role as “The bounce back, reverse the stresswonder you call out, “Help! I’m lost in here! Where’s CEO of Our World.” You might take pride in your adapt to changes, and move forward. The realistic part response, manage troubling emotions, and approachmy road map?” valuable contributions, even as you worry about finding comes in because resilience requires us to recognize responsibilities more confidently. vocational training for your wife or a supportive place and acknowledge changes and losses, and embraceWho is a brain injury caregiver? The topics that caregivers sometimes consider for your daughter to live as you get older. what is real now. We don’t pretend, or deny our Caregivers are a diverse and dynamic group. We feelings. We push past the edges of our comfort zone to “taboo,” yet dive into with each other, will also find There is one important title that every family a voice in Caregivers Compass. Topics such as theeach bring a unique life story and personality to the enter new territory, even if we feel anxious or insecure. caregiver learns and earns: Fighter and Advocate! We caregiver’s sexuality, anger, and need for an identityrole. We are spouses, partners, parents, siblings, That bravery allows us to use active coping strategies should be awarded trophies for the advanced skills beyond caregiving deserve exploration.children, and close friends. We might not even think of and creativity to solve problems, learn new skills, and and commitment that empower us to partner with theourselves as caregivers because helping someone we care for ourselves and others. survivor to live a full and meaningful life every day. We There are many routes to becoming a resilientlove comes naturally as a parent or husband. Others grow, and promote growth in others. We start support Two key categories of resilience in particular have and masterful caregiver. Join us to forge a strong andprefer the term “care partner” when they collaborate groups to share our experiences. We get involved and been shown to reduce the risk of health problems and inventive community sharing our journey.with, assist, and support the survivor. tell our stories to change the healthcare system. We compassion fatigue—stress resilience and emotional Children are often the overlooked or hidden rally for legislative changes, educational reforms, resilience. You have probably heard the standard advice Janet Cromer, RN, MA, LMHC is a psychiatric RNcaregivers. A survey by the National Alliance for resources, and disability rights. to prioritize time for yourself, set boundaries, and put and the author of Professor Cromer Learns to Read:Caregiving estimates that at least 1.3 million children your own oxygen mask on first. Tried and true advice. A Couple’s New Life after Brain Injury. Janet speaks On one hand, we are strong, powerful and resilient. nationally on family and professional caregiverin the U.S. between the ages of 8-18 care for a sick ordisabled sibling, parent, or grandparent. Many care for On the other hand, we can become exhausted and However, Caregiver’s Compass will supplement issues including stress resilience, traumatic stress, overwhelmed. Did you know that caregivers have what you already know with innovative approaches to compassion renewal, seasons of caregiving,a brother or sister while parents work, or help a parentlearn to read again. Brain injury is well represented higher rates of chronic disease and depression than make your own. For instance, here is a practice, called and creativity and healing. a body scan, to try right now. Sit comfortably in your See more at www.janetcromer.com8 9
  6. 6. New Horizons challenges with my memory. We can add to the list a Life as a survivor of brain injury is vastly different couple of new-found speech impediments: stuttering than I ever expected. Challenges I never considered in and aphasia. my old life can overwhelm me. Akin to learning to drive a new car, I am slowly learning how to navigate through In the days after my cycling accident, I saw doctors Yes, on the outside, I “looked” normal. But under theThe Slow Crawl of Brain of many specialties. The orthopedic doctor let me know hood, it was becoming very clear that something was life with my new limitations.Injury Recovery that my broken arm would heal, that I would be in a wrong. Another trip to the neurologist revealed a new, But there is good news. By being respectful of my cast for a couple of months, and feel a bit of pain for six multi-facetted diagnosis. Grateful that my body was new limitations, and surrounding myself with peopleby David Grant months. Right on cue, at the six month mark, my arm mending, and still confused over some of my newest who love me, who care about me, and who want me as pain stopped. challenges, I was told I have a very clear-cut case of well as I can be, I am building a new life. Yes, much of So much of life happens post-concussive syndrome. At this same time, several it is more difficult. But much of it is surprisingly morebetween those moments of But recovery from a brain injury cannot be defined months after my accident, I was also diagnosed with wondrous. I have slowed down to a pace I never hadnormalcy. The sun rises, the by an end-date circled hopefully on a calendar, though post-traumatic stress disorder. before and now take time to see, feel, and experiencesun sets, many of us go to I thought this at first. As my broken body began its my world with deeper appreciation than I ever thoughtwork, care for our children, slow crawl toward wellness, as my bones knitted, and By nature, I am hard-wired to be a problem solver, possible. as my bruises faded from black to yellow and then an overcomer. Whenever a life event comes to pass, thespend time with those we And for that, I am profoundly grateful.cherish, and never give much to memories, the extent of how my brain injury was optimist in me tries to pull whatever positive I can fromthought to the fact that life affecting my life became clearer. the experience and move on. David A. Grant is a writer based in New Hampshire and the author of Metamorphosis, Surviving Braincan change dramatically in the My journey to my “new normal” may or may not But with a brain injury, there is no end-game. Thereblink of an eye. Injury. A survivor of a harrowing cycling accident in be typical. is no magical date on some future calendar page that 2010, David openly shares his experience, strength, and And so it was for me in Brain injuries is circled in red, perhaps with a smiley face, that I hope as a brain injury survivor. Recently recognized byNovember 2010. On a cold, are like await. I have learned over the last couple of years that the Brain Injury Association of America, David’sblustery day here in New snowflakes— recovery from brain injury is lifelong. I have learned book offers real-world insight into life as a brainEngland, my life was forever no two are that the brain recovers in its own time, sometimes at injury survivor.changed. Local police estimate alike. In the glacial speed. And if I try to hurry the process, I am left www.metamorphosisbook.comthe speed of the teenage driver days after my disheartened and 30-40 mph who broadsided injury, I hadme while I was cycling. In a CAT scan, an EEG, and Unique and Innovative Programstwo ticks of a clock, my lifeunexpectedly and abruptly other tests for Adults with Brain Injurieschanged course. I was thrown to see if my and Their Familiesfrom my trusty bike into the cognitive abilities were Locations in Huntersville and Asheville, NCstrange new world of traumaticbrain injury. compromised. Day Program I passed all Residential Program I did not then know the my early Therapeutic Horseback Ridingscope of “America’s silent tests with Community Support for Veteransepidemic” in today’s society, high honors Caregiver Support Groupsblissfully unaware that more and wasthan 1.7 million Americans a congratulatedyear sustain a TBI. by many within the Recovery from a brain professionalinjury is like nothing I have communityever experienced. If you for dodging aare a survivor, you already bullet.know this. If you are a familymember or a caregiver, you But allknow this as well. But to was not well. Most all of my symptoms, those cues 14645 Black Farms Road Huntersville, NC 28078live life as a brain-injury survivor, there are no past that let me know I had sustained a TBI, came slowly, in 704-992-1424 office 704-992-1423 faxexperiences I can draw upon that have helped me many cases weeks after my injury. Word-finding issues this new and uncharted life territory. were among my first challenges. Then came significant10 11
  7. 7. Stepping Stones these individuals and their families. As stated, the process is Loss associated with brain injury can be physical and/ chaotic. Add to it that the loss is the “death-like” experience or cognitive, but there may also be additional losses in of a person no longer resembling who he or she was prior to relationships, lifestyle, employment, and in the person’s being injured, and the crazy-making is exacerbated. sense of self. Each loss requires reflection, expression, andBrain Injury and Grief: through all five stages and in the order given, or they were Interference with Grief After Brain Injury acknowledgment before healing and acceptance of a newFact or Fiction? grieving wrong. Let me tell you: the only wrong way to life can take place. grieve is to not grieve. Prior to Kübler-Ross’ death in In my work I have 2004, she explained the model was not meant to be a list of Janelle Breese, RPC,by Janelle Breese Biagioni, RPC discovered several reasons that “absolutes” that one had to do in any specific order to heal, interfere with the grief journey is an author, speaker, and Grief is most often but that it was a list of potential grief responses a person counselor with expertise in following a brain injury. Theyassociated with death. While it may experience. I have come to learn, both personally are: grief, loss, life transitions,is true that the death of a loved and professionally, that the list of responses is far more and brain injury. Sheone (family member, friend, or expansive. Dr. Alan Wolfelt’s Companioning Model 1) Society’s incomplete resides with her familypet) and, at times, the death of identifies potential grief responses as shock, numbness, list of loss and an unrealistic in Victoria, BC. She ispeople we do not know (Sandy disbelief, disorganization, confusion, searching, anxiety, timeline to grieve and mourn. the author of A ChangeHook Elementary shooting) panic, fear, physiological changes, explosive emotions, of Mind: One Family’s Society accepts the need towill catapult us into the grief guilt and regret, loss, emptiness, sadness, relief and Journey through Brain grieve and publicly mourn thejourney, death is not the only release, and finally, reconciliation and healing. Injury and the upcoming physical death of a loved one,cause of grief. Although death but there is little understanding book, Life Losses: Healingis an important reason, there are other losses in life that we The grief journey is complex. It is a process and not for a Broken Heart. Visit of the need to grieve thealso need to grieve. These too are life-changing and will an event. It is not time specific, nor is it orderly and and “death of a personality”solicit the same grief responses as death does. predictable. Moreover, the process is fraught with “crazy- follow her blog at when the person is alive. The making” stuff. It is a lonely path. It feels like nobody www.janellebreese.blogspot. Society has slowly recognized significant life events as person may have physical understands what you are going through. That is true. com She can bealso being a source of sorrow and cause for grief. Events and/or cognitive limitations; No one can truly understand how another person feels; contacted at however, those individuals andsuch as divorce and separation, transitional losses (moving however, those who have walked this journey never forget Janelle@lifelosses. their family living with suchto a new community or job loss), and developmental what they felt or experienced. They can be a tremendous comlosses (children leaving home) are also ways in which we profound change are often left source of strength and courage to you.experience feelings of sadness, depression, hopelessness, reeling in unfair comments like, “It could have been worse.” Stop by andand sorrow. To heal from these experiences and to move I mentioned earlier that the only wrong way to grieveforward in life, we must grieve and mourn. is not to grieve. In addition to that, it is important to There is no timeline to grieve and mourn. Unfortunately, remember that grieving is not the end to the means. It is share yours. Furthermore, with the advancement of technology and society operates on the thought that people need only only the beginning! I say this because grieving is about “three days bereavement leave” and/or that in a few monthsmedicine, people tend to live longer; however, many arecompromised with chronic illness, such as diabetes or heart how we feel on the inside due to what has happened in everything and everyone will be back to normal. It doesn’t our life. If one is allowed to truly feel—to grieve, this work that way for both physical and non-physical deaths.disease. While these are often manageable, it is not unusual will lead to mourning. Mourning is the process of takingto experience some level of loss as a result. It could be that Remember this: It isn’t time that heals all, but rather what those feelings from the inside to the outside. It is giving we do with the time that heals us.people are no longer able to work in the same capacity, or expression to how we feel. This may be done in a varietythey may have a substantial change in lifestyle, or the way of ways, such as funerals, talking, writing, art, and music. 2) There are layers and layers of loss experienced bythey view themselves in society becomes grossly skewed, Wolfelt describes it like this: “Mourning is grief gone survivors of brain injury and by each person connected toand therefore they begin to grieve. Then we have what I public.” The only way to move through or reconcile and them.identify as extraordinary grief resulting from a disease mourn feelings of grief is to find a safe and comfortablesuch as Alzheimer’s or a catastrophic injury such as a brain The layers of loss following a brain injury and the way to express those feelings. This applies to all types ofinjury. This kind of grief is profound. People must grieve uniqueness in the realm of grieving are overwhelming for loss, including those associated with brain injury.who they were, and the family also grieves the person who many. To adequately grieve these layers of loss, it requiresis no longer there, albeit physically present. Sadly, I think Understanding the grief journey and its connection with those involved to explore and determine the primary andsociety as a whole is only beginning to understand how secondary losses of the brain injury and how this impacts Come blog with us about brain injury! Interesting, informative brain injury is important for survivors, family members, daily postings by survivors, families, caregivers and even theprofound this type of grief is. friends, and professionals alike. It’s important because if them. This applies to both the survivor and to their loved staff of Lash & Associates. You’ll laugh; you’ll cry; you’ll want you do not acknowledge the losses that arise from having ones. Once the layers are identified, then people can begin to tell your own story and this is the place to tell it! Post yourThe Complexities of Grief to work through their feelings. a brain injury, it will be difficult—if not impossible—to comments on our blog articles and share your experience. In 1969, Dr. Elisabeth Kübler-Ross published a move forward in life. This is true for people who are Reflect on the life losses that you have experienced, It’s easy to join this blog, so come on...give us your two cents!revolutionary model of grief in her book On Death and living with the outcome of a brain injury, and it is true including brain injury. Do you feel that you were able toDying. These five stages, commonly referred to as DABDA, for those in relationships with them, including spouses, fully acknowledge the grief that resulted from your loss?are denial, anger, bargaining, depression, and acceptance. children, family, and friends. And it is especially true for Do you feel that others understood or supported you in Lash & Associates Publishing/Training Inc. 100 Boardwalk Drive, Suite 150, Youngsville, NC 27596 Tel: (919) 556-0300 Fax: (919) 556-0900The flaw was not in her model. It was in society’s the professionals involved because it is our responsibility grieving (feeling) and mourning (giving expression to those w w w. l a p u b l i s h i n g . c o m / b l o g www.lapublishing.cominterpretation of it. It was believed that people had to go to help facilitate the process of grieving and mourning for feelings) following loss? Leading Source of Information on Brain Injury in Children, Adolescents, Adults and Veterans12 13