Jane Connely

@healthebrainwithjane | contributor
I am a Neuro Occupational Therapist and founder of Heal The Brain With Jane

What Big Little Lies Got Wrong About Stroke Survivors

I am a big fat fan of “Big Little Lies” (BLL). I loved the original novel by Liane Moriarty; I gobbled it up in two days. I remember putting down the first couple of chapters and thinking “this is incredible.” I was working in the Palisades, a ritzy neighborhood of LA, at the time, as a nanny / assistant / tutor, I kept thinking this Moriarty woman is writing the story of the westside of LA. The complexity and nuance oozing out of each page made my heart explode with recognition and admiration. I went on to adore the show. I didn’t mind any liberties taken or the fact they always show the Big Sur bridge when it’s supposed to take place in Monterey (they are hours from one another!) I couldn’t have cared less that they changed some of the story, because the artistry, acting and what they envisaged was so good. I have been particularly impressed with the sensitivity with which they have addressed domestic violence. The show is full of nuance aesthetically. You could watch a scene, sound off, and get the gist of the dominant emotion through color and movement, but the shining star for me has always been the writing. Each word is carefully crafted, different strings of an intricately weaved tapestry. I couldn’t wait for them to describe the complexities that are so much a part of being alive with each new and fresh episode. I was enamored and one of their biggest, loudest fans, until very recently. I had the privilege of watching this particular episode by myself. It was early morning and my family had gone for a walk. I poured myself a cup of coffee and cozied up to watch my favorite show. Episode 5: Season 2. This episode is titled “Kill Me.” I did a thorough sweep of the internet to see if anyone has written about this topic yet. Several articles have been written about this episode, some of them critical, but not for the same reason. As a colossal fan, I went through several phases of grieving: shock, anger, disbelief, and then full on sadness after watching this scene. “Big Little Lies” is a safe haven for female voices and the underrepresented in general, so it stung to see an experience so near and dear to my heart rendered so poorly. Here is what happened. Spoiler Alert! Bonnie, played by the exquisite Zoe Kravitz, is sitting in a hospital room having psychedelic, perhaps omniscient, guilty dreams. In between flashes of herself drowning, she replays pushing a man down several stairs to his death and her mother abusing her as a small child. It all tumbles together like when you get stuck in the barrel of an indomitable wave. “Big Little Lies” does a wonderful job of expressing the expressionless, like how childhood trauma can leave a person feeling as out of control as they were as a child. Bonnie’s mother is in the hospital bed after a massive stroke. In order to connect a complicated race, abuse and murder-laden storyline, the writers did something unconscionable. I have been in the room of people who wake up in that post-stroke nightmarish haze. I will never forget the first time I experienced it. It was at UCLA hospital with a man post emergency craniotomy. I was still a student and my instructor walked in to help him out of bed or more accurately, his chair. He wasn’t allowed to lay down on account of not having a skull. I was mostly observing until he was fully sitting without assistance and I met his eyes. He was probably in his early 40s and he had the most clear green eyes, made even clearer by all the bruising and swelling surrounding them. He looked at me searchingly, and without thinking, I said, “This is the beginning of your journey, not the end. It will be OK.” It was like a reflex or like someone else said it, not me. I felt exposed in the silence that ensued. But he did something I did not expect — he squeezed my hand. Then he cried and then he sobbed. He tried with a mixture of signaling and muffled words to tell me, “just a couple days ago…” I think he was trying to explain that he was in an alternate reality and that he was a lawyer living in Santa Monica three days ago. I can’t remember if I pieced that together, or if he was able to communicate it. What I do remember is the pain and disbelief, likely fear, in that room. You could not breathe without contracting it, and my eyes began to sting as my throat closed. Incredibly, the emotion I remember most was what he expressed through his eyes — the will to live. Once he stopped crying and even as the tears poured out of him, there was this understanding that he was not going to take this lying down or even sitting up. The horror of his situation lurked there in disharmony with this acerbic desire to know what the hell was going on and what the future held. I went on to meet many people post brain surgery or stroke then emergency brain surgery. It is not a pleasant reality, but always memorable and at times unforgettable. When my own dear dad came to after his stroke and heart attack, I wasn’t with him. He came in and out of consciousness several times with varying degrees of awareness. He was so confused that when they finally allowed us to see him, after three days, only one person was allowed in at a time. We fudged this rule, and I was able to sit with my mom while Dad slept in the ICU. He woke up for a minute. He was really uncomfortable and his throat ached from the breathing tube and his chest hurt from the CPR. He was out of it, but he looked at my Mom and all he said was “I love you. I love you so much.” Then he repeated “Bridget?” He hadn’t recognized anybody in five days. Mom could barely croak out an “it’s me Pat, yes.” He just kept repeating over and over how much he loved her. As their child, I have seen them be loving before. I would say they are annoyingly loving at times, but these were anchoring final words — goodbye, thank you, acceptance — a kind of “I love you” that I had never seen. All of these experiences tumbled in my head while I watched Bonnie’s mother wake up for the first time. I was recently exposed to the word “ableist.” It is the assumption that a disabled life is not a life worth living. I get that it tied up a plot line to do with murder, but having your stroke survivor sit up in that magical moment of realizing you are alive only to say “kill me” horrified me. To then have the daughter ask, “Can we kill her? She would not want to live this way,” felt like getting the wind knocked out of me. What does “this way” mean? Obviously, some pains were made to understand stroke, because the survivor had the correct resting night splint on, but what other research was done? Did it matter or did this lesser plot just need to be tied up neatly? Stroke is a leading cause of disability in the United States. It leads to many different lives and ways of living. It happens to babies, children, teenagers, young mothers, athletes etc. It is not a death sentence, but a Lazarus style miracle that marks the rest of a full albeit different life. Since my dad almost died two years ago, he has begun a new phase of his life. He has held his eighteenth grandchild — my son Georgie — been to visit Hawaii with his Bridget, attended countless events for his grandchildren, and told me stories I never knew about young Pat. I never thought a survivor at 70 would walk, read, or think as well as he does. I could never have imagined it turning out this way. I would not have dared to dream it.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.

Nicole Ondatje

Back to Brain Injury Basics

I returned to work part-time just shy of 17 months after my traumatic brain injury, and I recently increased to full-time hours in a new position within my company. Gone are the days of long walks around the local reservoir, extended meditation sessions and regular journaling! I’m now spending much of my day in front of a computer screen, engaged in two-way conversations over the phone and learning the ropes of a brand new role. As my brain symptoms have amplified and my energy levels and stimulation tolerance have decreased, I’ve had to sacrifice a few of my favorite leisurely activities, let go of some personal responsibilities and go back to the basics of supporting my sub-optimal brain. Below are some strategies for “better brained” self-care, what I consider “the basics,” that I’m using to support my brain after going back to work. 1. Set up a supportive work enviro nment. I use Iris software on my work computer to reduce blue light exposure, and luckily, I work from a home office where I can keep the overhead lights down low and completely avoid CFL bulbs and fluorescent lighting. If you work in an office or another public place with harmful bright lights, you can purchase blue light blocking glasses. As much as possible, I schedule 45-minute meetings rather than 60 minutes so I have short breaks in between calls to recoup, grab a snack or water, or take a bio-break, and to write down notes from the previous meeting. I keep a healthy supply of sticky notes for reminders, and I use OneNote to write everything down during/after meetings since I’m more likely to forget the details post-brain injury. I have turned off all pop-up notifications from email and instant messenger to avoid bombarding my brain with little distractions. I use Himalayan salt lamps to generate positive ions, and I diffuse Doterra’s “Balance” essential oil blend to create a calm workspace. Most importantly, I block off time in my calendar to take regular mini-breaks from work, time to get fresh air, walk the dogs, boost my heart rate, sit for a couple of quiet minutes, do breathing exercises, or have a cup of soothing tea. 2. Ask for help. Near the end of my medical leave, I was able to run more errands and take my daughter to her dance classes. Now that I’ve gone back to work, I’ve had to ask my husband to take these family responsibilities back from me again. I’m also enlisting the help of my 8-year-old daughter with more household chores like vacuuming, washing dishes, folding laundry, making her own school lunches and feeding the dogs. 3. Accept less than perfect. If you’ve ever seen the inside of an 8-year-old’s dresser drawers, you know where I’m going with this. The bottom line is that I need help, and every little bit counts. 4. Say no and set boundaries. With work responsibilities, I’m no longer able to spend a day or two resting and recovering from an overstimulating event or series of events that will cause a spike in symptoms that linger. This means I have to pass on my kid’s all-day break dancing battles, evening time social events, volunteering in the classroom, and serving on FARE’s (Food Allergy Research and Education) Support Group Leadership Council. This also means instead of binge-watching “Breaking Bad” after my daughter goes to bed, I listen to an audiobook or stretch and roll or do some light reading before bedtime. 5. Re-prioritize. My daughter’s elementary school teaches this technique for organizing a to-do list: determine what tasks you must do as a top priority and determine what tasks you may do (or just want to do) as a lower priority. There are many days I only get to the “must do’s” (and even some days I can’t even tackle that list!) So I keep a small notebook with my various pending projects in different categories, such as creative projects like designing a family photo album, housework projects like cleaning the fridge, and a list of books that I want to listen to or read. For me, writing these “may do’s” down in an organized fashion helps prevent my brain from ruminating on them when I can’t seem to find the time for them. 6. Simplify. With lower energy levels and a reduced capacity for multitasking, I’ve had to find ways to simplify daily life and break down lengthy or complex tasks into simpler steps. If I try to prepare more than one dish at time in the kitchen, I will inevitably miss an important ingredient or burn something. So I make crock pot meals often or cut veggies and measure out spices for dinner in the morning. Instead of spending a whole day or two cleaning my entire house on a pre-determined schedule, I clean in batches and only after it’s unbearably dirty. I might clean the bathrooms one week and the floors the week after, or vacuum the main floor on one day and the upstairs floor the following day. I have also found it helpful to declutter our house as much as possible so I can find things easily and my brain has fewer junk items to process (ever heard of the KonMari method and Marie Kondo?) 7. Eat well. When I first went back to work, I found myself constantly raiding the pantry for crunchy snacks, usually something that would spike my blood sugar and cortisol. Now I make sure I have healthy brain-supporting snacks like olives, nuts and seeds, coconut milk yogurt, fermented beets and avocados on hand. On the weekends, I make paleo/keto muffins or bread so I have something quick to grab during the week. I also divide chopped veggies for breakfast smoothies into mason jars to save time and energy during busy weekday mornings. 8. Sleep well. I have read volumes and volumes about sleeping well and how to beat the insomnia monster that has been haunting me for 13 years. The American Sleep Association recommends good sleep hygiene tips for behaviors that promote healthy sleep. I was recently able to completely wean off of all prescribed sleeping medications, and my top effective sleep hacks have been to: Practice good sleep hygiene. Train my brain to associate bed with sleep – no more reading in bed, no more lounging in bed at any time of day or night, no meditating in bed, and certainly no working on my to-do lists in bed. Use sleep restriction therapy to train my brain to consolidate sleep in fewer hours in bed based on my average total sleep time and my sleep efficiency score from the prior week. For more information, check out “End the Insomnia Struggle: A Step-by-Step Guide to Help You Get to Sleep and Stay Asleep” by Drs. Colleen Ehrnstrom and Alisha Brosse. Take steps to increase my sleep drive – unless my brain is extremely exhausted, I avoid naps. I’m usually fighting the urge to nod off between 8:45 and 9:15 p.m., but if I get in bed early, I will surely toss and turn that night. If I can stretch myself to get in bed at 9:45 or 10 p.m., I usually sleep more soundly. I’ve also learned that getting more intense exercise during the day or even in the evening helps improve my sleep drive so I sleep more soundly. Time and dose my supplements and medications appropriately for sleep – it took me quite some time to discern that my thyroid medication dose taken at 6 a.m. was contributing to insomnia, and I have finally adjusted the dose low enough to manage thyroid symptoms without affecting sleep. I also switched to a thyroid medication I tolerate better, and I don’t drink any caffeine within three hours of my morning thyroid dose in order to avoid an unpleasant spike in cortisol and anxiety. I have to take all adrenal stimulating and brain-boosting supplements early in the morning, and then take adrenal and brain calming supplements in the afternoon and evening. I’ve also started taking melatonin 90 minutes before bedtime rather than immediately before. Finally, I’ve learned that the following supplements can be stimulating for some people so are best avoided after noon: vitamins A, B (specifically B5, B6, B12), C, D and K. 9. Exercise. Experts recommend getting 150 minutes per week of moderate exercise to lower your risk for cardiovascular disease and dementia. After going back to work and feeling more tired, it’s been challenging to fit exercise into my day and also make it a priority when I’d rather be resting. On days when I’m feeling a bit more energetic, I will meet a friend for warm power yoga or take hip hop dance class with my daughter after work hours. I find I am far more motivated to work out with a partner than alone. On medium energy days, I will do a Pilates or Tracy Anderson exercise video in my basement. On low energy days, I will take the dogs for a leisurely walk around the neighborhood and maybe do some light stretching or rolling. When I’m really pressed for time, I squeeze in 5-7 minutes of quick cardio-boosting exercises like jumping on the mini-trampoline (though I was not able to do any bouncing in my early brain injury days), squats, push-ups or the 7-minute scientific workout. I also try to get extra movement in my day by parking farther away and walking my daughter to school each day, and I aim for at least one day a week of myofascial release techniques such as yin yoga, eldoa or rolling. 10. Rest and de-stress. Back to work means back to resting on the couch more often, more audiobooks and more evening time alone. While I’m not able to meditate as often or for as long as I did while on medical leave, I absolutely have to keep up with a semi-formal meditation practice to calm my nervous system and get rid of daily stress. I save the longer meditation sessions for weekend mornings and make sure I still adhere to a twice-daily (morning and mid-afternoon) schedule for short 10-30 minute meditation sessions during the week. On days when I am really pressed for time, I will at least sit for 5-10 minutes and take mindful breaths, or 2x breaths (breathe in for 2 counts then out for 4 counts, breathe in for 3 then out for 6, breathe in for 4 then out for 8), or 4-7-8 breathing, or even just some mindful listening to the sounds in my environment. Aside from meditation, there are multiple other ways to stimulate your vagus nerve and activate your parasympathetic nervous system such as singing, gargling, cold showers and using a soft ball (like a deflated soccer ball) to roll your stomach. Dr. Izabella Wentz, author and thyroid expert, recommends scheduling four hours of personal management time each week when you only do something you feel like doing and nothing that you “have” to do. I’ve been working on scheduling two hours at a time to read, knit, journal, or snuggle with my family and watch a funny movie. 11. Connect with friends. Positive social relationships not only help us feel happy, supported and connected, but they also boost cognitive performance and lower our risk for dementia. After going back to work full-time, I’ve discovered I no longer have the energy to invest in friendships that are mostly one-sided. If I’m going to put effort into creating meaningful social connections, I want to find friends who are physically and emotionally available, who are interested in supporting their health in the same way I am, and who have positive energy vibes. While I don’t have as much time and energy to invest in friendships after a busy work week, I know how important it is to my brain health, well-being and overall happiness, so I make time to schedule some social time every now and then. I find that brunch dates work best for my brain since I have more energy in the mornings. 12. Practice gratitude. Whenever life feels challenging, I have to remind myself of all the blessings, big and small, that surround me. Most evenings over the dinner table, we discuss as a family what we appreciated most during our day, and I often fall asleep at night while running through a list of things I am grateful for in my head. 13. Let go of guilt. It certainly doesn’t serve me to waste energy feeling guilty about spending more time on the couch after work hours or doing fewer chores or even missing some family outings. My brain requires more tender, loving care, and that’s just the way it is. 14. Remember that this too shall pass. My husband reminds me that I was overwhelmed and exhausted when I went back to work part-time, spending additional hours on the couch again or time alone in my room listening to audiobooks rather than engaging with my family. Over time, I was able to train my brain and build up resilience in the midst of a busy schedule and heavier workload. I may be struggling with full-time hours now, but my brain is becoming more resilient and healing every day. Soon enough, I’ll be able to say with confidence that I am able to work full-time, despite my brain injury!

Boizy

Starting Over After a Traumatic Brain Injury

I look in the mirror and I don’t recognize the person staring back at me.  I don’t recognize this person anymore.  Life has changed so much over the last year and a half, I feel like I am living in the Twilight Zone. It is amazing how you can take things for granted. I remember teaching my students that one second could change things forever, and here I am now. I am living proof. I was already dealing with erythromelalgia and Raynaud’s phenomenon. Those diseases were taking a toll on my body, but I was determined not to let them control me.  Then I sustained a devastating brain injury at work and my life changed forever.  Now I have to use speech to text technology. I can no longer read because I have lost partial vision in my left eye. I started having seizures, which caused me to lose my driver’s license. Besides the constant pain, I have had to deal with PTSD, major depressive disorder and anxiety.  To add to this, I have had to deal with people questioning my injury because they cannot see it.  The isolation has been devastating and I learned quickly that people I thought were friends really weren’t. After my brain injury, my other two diseases progressed rapidly and my body started to deteriorate. Now I am waiting to see a specialist to determine whether or not I have another autoimmune disease. I could be angry and I could just give up. It would be easy, so easy. In the beginning, I wanted to. I didn’t care anymore. It is very easy to become consumed in your sickness and pain. Sometimes you just want to close yourself off and not try anymore.  I am here to tell you not to do that to yourself. There is a reason why you are here. No matter what you are going through, you have an important purpose. I am determined to use my story to help others find strength in themselves to carry on. I had the opportunity to speak with a very renowned neurosurgeon, Charles H. Tator.  He told me that I would find my strength in helping others and in volunteering, even if I could never teach again. He gave me hope. This man has worked with important people like Sidney Crosby.  If he believed in me that much, I needed to believe in myself. After speaking with him, I remembered one of my favorite quotes, “The two most important days in your life are the day you are born and the day you find out why.” I am asking you to never give up hope and never give up on yourself.

Developing Mental Flexibility After a Traumatic Brain Injury

Have you ever heard the saying “perfect is the enemy of the good?” This truism is never truer than when recovering from a brain injury. Unsurprisingly, many people who have a stroke, concussion, or traumatic brain injury describe themselves as “type A” personalities. Shocker, I know. However, perfectionism can be a huge barrier to progress. At first, the perfectionist personality trait really helps the recovery process. These survivors attack their exercises with a superhuman zeal. They can keep this up for several weeks, ignoring everything else in their lives and focusing completely on their recovery. This is like the honeymoon phase of therapy. Every session is exciting and you are healing rapidly in those first few months. Visible healing is always nice and it starts this great momentum, but then it slows. Sessions become more arduous as your limiting beliefs start to take hold and you get into your disability process as well as your healing process. What this means to a perfectionist is “it has been a year and I thought I would be better by now.” Does this sound familiar? A disability process is a lifelong journey of discovering limitations and deciphering when to challenge or accept these limits. Working hard, becoming very focused on your goals and attacking challenges in your life is not perfectionism. I think these things tend to get conflated, but true perfectionism often results in procrastination and paralysis. The perfectionist discards the process mindset in exchange for a results mindset that does not fit with the disability experience. It doesn’t mean you don’t try hard. It means you try hard as hell without immediate results. The perfectionist in rehabilitation often burns bright in the beginning and then flames out fairly quickly, as a result of these four bad habits: Intense focus on the time frame of their healing. Inability to integrate former and current self. Lack of mental flexibility Lack of self-compassion Putting a timeframe on your recovery and measuring your progress daily is akin to watching water transform from room temperature to boiling. Your focus does not make it boil faster. Let your doctor and therapist worry about arbitrary degrees for insurance reimbursement. You do not have to immerse yourself in the weeds. You have enough to worry about and it is more than a little frustrating to watch the needle move five degrees forward and ten degrees back. Recovery is not linear and time is a linear measurement. Integrating your former and current self is a topic worthy of a lengthy novel, but for the sake of my attention span and yours, I will get to the point. I am not a fan of the “new normal.” It isn’t about forgetting who you were before your accident, but embracing yourself more fully and integrating some of the challenges and benefits of your current situation. Yes, benefits; you can learn the value of your life, who your friends are and rise above the BS of poor priorities. The disability experience has long shadows, but it sheds light too. Mental flexibility is key to enjoying the life you almost lost and progressing into the life you want. However, it can be very hard to achieve. Sometimes as a result of the part of your brain that was injured and sometimes as a result of clinging to what your recovery “should be,” it can seem impossible. Maybe you thought if you worked single-mindedly on this one task it would become easier, but thousands of new barriers emerged. Tackle those barriers; make that other task a long term goal. Step back and have the mental flexibility to allow yourself to be both challenged and a challenger at the same time. Self-compassion does not mean you are indulgent, lazy or destined to be swallowed by your couch. It is not self-pity and it doesn’t lead to self-loathing. It is the voice of your best friend, your kindest aunt and your truest teacher. It is the voice that says “Today was hard and I struggled, but that does not mean I am bad or that it won’t get better.” A little bit of self-compassion goes a long way toward achieving your goals. Instead of punishing yourself and feeding that mean little monster on your shoulder, give yourself a break. You do not have to be perfect to be happy. We know this, but truly accepting this into your mind and heart is a process. I want to encourage you to imagine what happiness would look like, today, despite anything you perceive as flawed. Imagine that you are whole and content with all the baggage, the hurt and the broken pieces. Finally, lean into this fundamental truth:: You are imperfect and still worthy of healing and a good life.