I met Pam four years after her accident. Pam suffered damage to her frontal lobes, an area of the brain primarily involved in behavioral control. As a result, she became impulsive, irritable, angry and impatient. These emotional problems were compounded by cognitive problems, commonly associated with brain injury. She was never able to return to work.
Until I met her, she had never been appropriately assessed or treated for her brain injury.
I am always amazed by the vast number of individuals that I meet who “fall through the cracks” and never get the support they so desperately need.
By the time I met Pam, she had lost almost everything she had worked so hard to build. She was extremely anxious, depressed and suicidal. She was, in fact, living in a shelter, isolated from her family and friends whom she gradually alienated.
“After my injury I was obsessed with wanting to get back to teaching- to my old life… I still get furious when I remember how cruel people treated me after so many years…”
I realized that something was not “right”, but I couldn’t quite figure it out and I did not want to discuss “it” with anyone. I was constantly in pain, overly tired, confused and really frustrated…. No one was listening to me”.
While she willingly acknowledges physical problems as a result of her injury (i.e., fatigue, pain), she is not ready to admit that she discovered any cognitive shortcomings (i.e., memory, attention). A cognitive injury like memory does not hurt like a broken arm. Pam’s diminished self-awareness was hindering her progress and halting her recovery. Most individuals have this kind of problem when they first have an accident. There are also many unique factors that inhibit an individual’s level of awareness.
Pam was isolating herself from her co-workers, friends and family and falling slowly into a deep hole. I have seen people take this path too many times.
Deficits in awareness are incredibly frustrating for brain injured individuals and their families. Pam’s lack of awareness causes her to deny that she had any difficulties that influenced her ability to do her daily tasks. So when her family was trying to help her solve problems that she denied, she became very angry.
“My family was treating me as if I was an infant…like I am stupid, lazy, crazy and can’t do things on my own. For 40 years I had been very capable of managing my own life…. Everyone really irritated me…I started to delete everything that was causing me frustration. …I retreated…
…People around me were accusing me of forgetting things that I just said… I kept my words to myself. I retreated into my own safe place, where no one would criticize me or be ashamed of me…
Gradually, my phone stopped ringing. Eventually I even stopped visiting my family. I felt my dad was embarrassed of how I was turning out. My family was putting too much pressure on me. I felt like I wasn’t treated as a person anymore, only a “problem”…. I was forced to isolate myself from everyone”…
Pam, like other individuals with brain injuries, thought that she was in total control, until her experience demonstrated otherwise.
“I insisted on driving myself to the grocery store I had been going to for practically every day over the last 20 years. I often got confused and could not remember the way there … Sometimes I made it to the store, but couldn’t remember why I went out or what I needed to get? Sometimes I got distracted by the different labels on the packages in the store…Eventually, I learned to tag along when I knew someone was going shopping”…
It is only when she joined a support group that things really change. The group is critical in increasing her self-awareness of her deficits. Group really helps Pam to let go of her old goals and to come to the realization that she will not be able to teach.
“The group really helped me. Connecting to others that had similar things helped me. I saw their challenges, hope and growth. This really made me want to change and move forward too and this more than anything kept me going”.
So this is the story of Pam- A true survivor. There are so many similar stories that have to be told…. Unlike the popular TV show, her struggles do not end with a prize. While she still has a long road ahead of her, she has made profound progress.