The Cognitive FX Blog

Journaling is one of the greatest therapeutic techniques available. Journaling is free, confidential, and convenient. It offers you the opportunity to be your own therapist. You might think journaling must be done sitting down and writing in a diary-type book. If that doesn’t sound appealing, you may be excited to learn there are numerous types of journaling. You can find a style of journaling that is fun and stress relieving at the same time. Journaling offers you a way to process something and let it go.

It can be incredibly helpful after a brain injury! After a brain injury, it can feel hard to express yourself and journaling is one way that can empower you to share yourself in a creative way.

Discover some of the different types of journals below. Try several. If you find one you love, stick with it. If one doesn’t necessarily click for you, don’t force yourself into it. Keep experimenting until you find one that gives you emotional expression, release, or relief.

Types of Journaling

Write it Out

• Daily life and experiences: This is the type of journal many typically think of when discussing journals. Write about your day chronologically. The entries don’t have to be exhaustive. Try writing a little bit each day. Just put a pen to paper and write for a specified length of time or for a certain number of pages.
• Quick journal: Write one sentence a day.
• One word essence journaling: Write one word to summarize the day.
• Question a day: Answer your own questions or be guided by prompts or predetermined topics. I loved my “Q&A a Day: 5 Years Journal” I purchased on Amazon. 
• Meditation or transition journal: After work, before you transition to home, write out all your thoughts to assist you in letting go of the stresses of the day and transition into a more relaxed state.

A Tool to Support You in Healing 

After you have received treatment, or are feeling better, and are no longer feeling like your concussed/traumatic brain injury (TBI) self, you may find yourself still holding back or saying the words “I can’t.”

It was a traumatic injury, sometimes the recovery can feel traumatic as well. You may have had many months while healing from your TBI where you struggled with various aspects of your life, including but not limited to, calling in sick to work because of headaches, forgetting important events, not remembering a word during an important presentation, inability to run on your treadmill due to dizziness, and feeling too tired to take care of your kids. Subsequently, you learned to set limitations for yourself. For this reason, once you’re feeling like yourself again, it can be a difficult transition to the new you.

Acceptance is the ultimate goal with regard to the stages of grief, your TBI or concussion, and the new you.

Acceptance is accepting who you are, where you are, how you are. This is it. This is YOU. The good, the bad, and the ugly. And you are truly amazing. Struggles and all. You are a survivor. No one can do it better than you!

Acceptance may mean distancing from people who don’t understand, give you ultimatums, enforce deadlines for healing, or get upset with you when you aren’t who you once were. You are worthy. You are deserving. You are brave and amazing. You are different than you were before your injury, but different can be good. 

Many believe the five stages of grief last weeks or months, but according to Elisabeth Kübler-Ross and David Kessler,  the stages of grief are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. As a reminder, we do not enter and leave each individual stage in a linear fashion. We may experience one, then another, and back again to the first one. Let each stage happen. Embrace it, learn from it, and then keep going.

What is bargaining? 

Bargaining is a stage in the grief process that is helpful when you feel powerless over circumstances, especially after a brain injury. Bargaining is an attempt to regain control. Bargaining is frequently done with God, or a higher power, that you feel has some control over the situation.

Bargaining is similar to negotiation. “I promise I’ll do this, or be this, if I can just go back in time—or have  five more minutes or have one more day.”

It’s interesting because you know all the bargaining in the world won’t help, but it doesn’t prevent you from trying, begging, “Please? I’ll do anything. I just want my brain back. I want me back! The way I was.” You want to go back in time—stop the accident from happening, put on protective gear, yield to that stop sign, put on your seatbelt. If only, if only, IF ONLY.

Depression, one of the five stages of grief, may be the most familiar, and frustrating, feeling experienced after a traumatic brain injury (TBI) or concussion. And it’s not a fun one. Depression is a feeling of loss, emptiness, sadness, loneliness, hopelessness, and/or confusion.

Depression as Part of the Five Stages of Grief

After a TBI, typically you’re told to rest for days, weeks, maybe even months. A forced withdrawal from society, family, friends, work, school, everything. Then, once the rest period is over, you still may not instantly go back to the activities you’ve done in the past.

You may find yourself getting lost driving to familiar places. You put food that belongs in the refrigerator in the pantry. You leave things in a very specific place to prevent losing them—only to forget where that place was! You read the same sentence seven times and still don’t understand what you read. You find yourself yelling at your spouse/children/friends for no apparent reason. You get a headache just walking across the room. The activities you used to enjoy may now cause you pain. You get dizzy running on your treadmill, and staring at your computer screen feels like torture. You may find yourself questioning your faith, your choices, your mindset, your abilities, questioning everything. Your TBI has changed your life. All of it.

After a traumatic brain injury or concussion, relationships can become strained. Communication can be difficult. Let’s be honest, thinking can be difficult. Sorting out your feelings and sharing them in a healthy way may feel impossible. After a TBI, the areas of your brain that affect processing, language, and word retrieval, can be affected. It takes extra energy and effort to communicate after a TBI. It may feel overwhelming or exhausting.

The good news is it is possible to have healthy communication after a brain injury. It may take more effort and practice, but it is a real possibility.

My memory struggles didn’t make communicating more difficult, but it did require me to come up with some simple tools to remember how to communicate effectively. 

Anger is a stage in the grief process. Many times when we experience loss, or trauma, we experience anger, irritability, frustration, or even frequent annoyance. Anger is a healthy emotion, one we don’t necessarily like, but it’s not wrong to feel angry. Experiencing anger doesn’t say anything negative about us. We feel like just about anything could be the “straw that breaks the camel's back”.

Anger is a common emotion most of us are familiar with, prior to injury. We frequently pretend we have control over it. After the injury, we recognize we may not be able to control it.

Why do we have anger?

Anger can cause us to do, or say, things we don’t mean, we later regret, and can’t take back. Anger isn’t the problem, it’s what we do with those feelings that matters. Anger can cause us problems, but anger is also beneficial. 

What is Denial?

Denial is a stage in the grief process. Many times it just doesn’t feel real. We may believe we’re imagining the pain or trauma we’re currently experiencing. It’s a bad dream, a nightmare. We’re in shock and we’re anxious to wake up and go back to our normal reality.

If you have had a recent brain injury and are unsure how to deal with the symptoms and changes you are experiencing, then this post is for you! To begin with, we encourage you to find a doctor and work with them throughout your recovery. Finding the right doctor to be on your team is very important to a successful recovery. 

Typically, you will follow the return to play protocol, starting with rest and self-care. Then you can use the following suggestions to help you adjust to the changes after a concussion or TBI. I wish I had a list things to do to support me in my mntal health when I experienced my TBI. 

Grief and loss are a part of life, but they are the least talked about part of life. Have you ever wondered why that is? It is because grief is HARD. Going through it is difficult. We seem to feel if we avoid talking about it, we will avoid feeling grief entirely. Wrong.

Maybe you have heard of the Stages of Grief, and maybe you haven’t. Either way, you are experiencing grief, due to a recent brain injury, concussion, TBI, or trauma. Learning about the stages of grief gives validation and understanding. But, know that there is no wrong way to grieve. There is only your way. Grief is unique. 

You may experience all of the stages, or you may not. In what order, for what length of time, or how severe it will be is unpredictable. Stages may last minutes, or months. Not knowing is the irritating part!

Elisabeth Kübler-Ross and David Kessler developed the Five Stages of Grief as a framework to deal with death, dying, and loss of a loved one. More information can be found at grief.com. I believe these stages apply to all loss, including brain injury.

Everyone’s experience is different. Anyone experiencing a concussion or TBI has a different story, different outlook on life, and different symptoms, their experience of EPIC Treatment is going to be different as well. With that said, here’s my experience. I was injured 17 years before I received treatment, and you can read more about how I got my injury in another post here if you are interested. Hopefully, my story validates some of your experience, gives hope, and provides direction.

To begin with, I was surprised my schedule wasn’t more packed with activities. I questioned if this would work. I received over 25 hours of treatment during the week when I was expecting a 40 hour week. By the end of the week, I appreciated that I didn’t have a 40-hour schedule because I don’t think my brain could have handled it.

Day One:

I walked into the office on Monday morning. I was handed the check-in questionnaire. I filled out the Post Concussion Symptom Scale (PCSS) check-in and check-out questionnaire each day of treatment. CFX uses the questionnaires to monitor symptoms throughout the week, and is used as a measurement in their research. 

As I sat down to complete the simple form, I started to cry. I’m not against crying, but it takes a lot to push me to tears. I wasn’t sure what was going on. I called my husband. He said a quick “Focus, give it your best, and I love you.” Then I met Porter. Porter is one of the Patient Care Coordinators and I really felt support from him while I was at Cognitive FX. I didn’t have any idea what to expect. I was nervous. He gave me a tour, and we got started.

*Sometimes you might also have an fNCI on your first day. I got my first scan done before I started treatment for my brain injury. 

I was in an auto accident on January 2, 2001. I received a severe TBI, broke my back, pelvis, jaw, ribs, and pretty much every bone in my body. I was grateful to be alive, but after a few years I had accepted the fact that I was going to be deficient for the rest of my life.