Learning to Live with the Cycle of Response

(continued from Life and Living After Brain Injury)

Realize the brain has suffered a physical injury. Suppose, however, that injury had been a sprained ankle or a broken arm. Doctors and nurses would immobilize the injury and give specific instructions to let it rest while the body healed itself. Well, how do you immobilize your brain? Don't worry about it; the brain will begin to power down on its own, and mental fatigue will set in. It is important that someone recognize when this is happening. That someone can be the brain injury victim, or it can be a family member or caregiver.

The brain is saying, "It's time to take a walk or listen to music or take a nap, anything other than think." The brain injury victim can follow the advice of the brain, or not. It’s best to learn early on that the brain will win this argument. You can continue trying to perform while your brain powers down and you will observe firsthand that your performance gets worse and worse. You will then fly through the steps of confusion and frustration.

Instead of backing away from a stressful situation, you are forging full speed ahead, and other parts of your brain will help by pumping out chemicals like adrenaline and cortisol to give you added strength to mess things up. Those "fight or flight" chemicals have a purpose. They provide power that allows you to stand and fight or to quickly exit the situation. You, however, have chosen to ignore your brain and proceed with chemical power instead of brain power. It doesn't work that way, but you'll try it, and you'll try it hundreds of times.

Your injured brain, however, is sitting in the time-out corner, and it may be perfectly happy to sit there for the remainder of the day. You cannot coax it out of the corner, nor can you force it out. Our grandson learned early on about dealing with his older, teenage sister. On more than one occasion we witnessed him face her head on and say, "You're not the boss of me."

Neither you nor I are the boss of our brains, either. We are certainly grateful they don't go on strike because of the millions of autonomic responses they perform each minute of our lives like breathing and pumping our heart. Brains also perform executive functions, and most of those functions require input from us. And that is where the problem begins to manifest itself.

Decisions must be made. Here's a simple question for you: would you like a cup of coffee? Your brain begins working based on information you have previously stored in your memory. Do you like coffee? Do you like coffee at this time of day? Do you like coffee at the current weather temperature? Does your schedule allow you to have a cup of coffee at this particular time? Of course there is a follow-up question: how do you like your coffee? Black? Cream or creamer? Sweetened? Sweetened with what? Memories are flying through the brain so you can make decisions and drink a cup of coffee.

What if, however, your brain is in the time-out corner when the question is asked? You might do what Beth did and sweeten your coffee with salt. She was able to retrieve a few memories about coffee but not all that she needed. Recognizing she needed help, she handed the cup to me and asked, "Does this taste funny to you?"

Continued on Page 3 - Living with the Cycle of Response

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