I’ve been thinking a lot lately about concussion/tbi making you “dumber” – slower, etc. When I had my neuropsychological exam, it became painfully clear that my processing speed was slower than expected. And it really bummed me out for quite some time. Plus, once I was aware that this was happening, it seemed like I couldn’t do anything without being painfully aware that it was taking me a little longer to process things than I (and others) expected it to. For some reason, everybody just expected that I’d be able to respond immediately to their questions or comments or conversation starters. But it just wasn’t happening.
After thinking about this from a bunch of different angles, I had a bit of a revelation this morning. It was something I’ve thought about before (and maybe I’ve written about it before – I can’t remember), but this morning it really made a whole lot of sense:
It’s not that I’m necessarily slower or dumber than I “should” be — or than I used to be. The thing is, after my TBI(s), I became so much more sensitive to a lot of different stimuli, and my brain has to work harder to sort through a larger amount of input, than before. It’s like the injury/-ies put holes in the filters that are usually there, allowing in a whole lot more input and information — sensory, like light and sound and (sometimes) smells and touch/feeling — and all that has to be factored in. It’s like my brain has to work harder to shut those things out, and since concussion/TBI has a way of activating your sympathetic nervous system fight-flight activity, you’re even more alert to all the stimuli around you…. constantly scanning and checking things out and sensing for danger, where it may or may not exist.
I’m sure I’m not the only one who has this.Maybe someone else can confirm/affirm this for me?
Think about it – say you give someone a deck of cards to shuffle and sort. Then you give someone else two decks to shuffle and sort, while they’re having a conversation with someone and an important piece of news is playing on the t.v. behind them. If the two people race to get done with their shuffling and sorting, the person with the two decks of cards are is going to take longer — because they have more to sort through, in the first place. And they have these other distractions going on around them.
That’s what it’s like after concussion/TBI – so of course I’m going to seem “slower” than others — when in fact, my brain is actually working harder, and perhaps even more efficiently than others, because it has so damned much stuff to sort through.
I think this can also explain why folks after TBI have the same IQ level as before, only now their processing speed is slower. I’d like to challenge the idea that processing speed is actually slower, in fact. Because regular measures probably don’t factor in the distractions and added sensitivities that have to be filtered and processed. Heck, if you look at the sum total of all the activity, it could be that post-TBI, your processing speed actually increases — but your brain is so busy trying to sort things out and re-categorize them and figure out what it all means (all over again) and re-learn the old past familiar things… not to mention battle against the rising dismay that things “don’t work like they should” and the wondering “what the hell is wrong with me?!” … that the end result and net effect looks like you’re stupid and slow and not keeping up.
That’s my theory, anyway. Although it’s almost purely anecdotal, it’s consistent with my experience, so I’ll have to go with that.
It’s ironic, isn’t it, that we go through these things that actually make us stronger and more active, but people who don’t understand and don’t share our experience (including researchers and doctors and therapists and other certified experts), will label us as “weaker” and “less active” and “stupid”… all because they just don’t get it, and they can’t see why they should change their opinions.
I’m not sure what it will take to change this, but for the time being I feel pretty good in my own changing understanding, and it’s giving me some relief from that nagging sense of being stupid and slow and (excuse the expression) retarded.
Anyway, it’s a beautiful day, it’s Memorial Day — so, here’s a big THANK YOU to all who have served, and are serving, and to all who have paid the ultimate price out of love and service and duty. I probably wouldn’t be sitting on my back porch watching the dragonflies making their rounds this morning, if you didn’t do what you do. So, again, thank you.
But enough of the talk. It’s time to get into my day and enjoy myself with friends and family. Here’s hoping you can too.
Broken Brain - Brilliant Mind 
Yes, I can concur that in my case, several layers of filters were knocked out. It was, and still at times continues to be tough to go into restaurants or anywhere with a crowd comfortably. I struggled with why at first but after much study, I believe it is due to the fact that the filters that would get you through prior to the injury have been disabled and you just have too much info to process. Listening and talking filters both are affected, I’ve found myself saying things that previously would have been swallowed before.
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BB – In TBI your ‘filters’ get damaged – so in that sense you are on target – most people only very subliminally attend to all the data around them (this is also why people with TBI have attention deficits – even the slightest bit of activity can distract). So yes, you may be juggling more information in a conscious way. So part of ‘self-improvement’ is re-learning how to filter better. This is another benefit of a mediation practice. When you learn how to slow down or stop ‘monkey mind’ (the chatter and noise in your life, the multitude of random thoughts and inputs) you can apply it more to day to day living. How to concentrate on what a person says and not be distracted by other little things.
Also in TBI the ability to manage data is often injured – the multi-tasking aspect. This goes hand in hand with filtering. When we talk to people or interact in a situation we are doing many things – listening, thinking of a response to the immediate statement, reading body language, monitoring our emotional response etc. When these things are filtered well and integrated well we can paint a cohesive picture and still process. But when we must selectively attend to one thing we can listen, or observe, or think but not all three at once. This slows down the ability to respond.
When established circuits are damaged the brain will attempt to use other circuits – but those circuits may be more ’roundabout’ or overloaded or simply not as well designed to the task (visual assessment for example). The brain works on patterns, when access to certain patterns is destroyed, the brain becomes slower – pattern recognition is a speed tool. For example they used to believe that pilots should retire when they get older – but they recently found that even though their speed of processing is slower (minutely) their knowledge base is bigger – they are more competent and EFFICIENT. It took years to get your brain to a certain level of efficiency – I believe that with repeated efforts over a number of years you can achieve efficiency again – it will still ‘feel’ different because it is different circuits but it will continue to improve.
Leastways that’s my thought on this. Meantime – use a digital tape recorder and record all important conversations. It makes a WORLD of a difference. And don’t answer anything till you listen to the tape.
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When, like you, my inadequate filters allow a bombardment of auditory, visual, tactile etc. stimuli to flood/torment/torture my brain after I’ve simply walked through a crowded, noisy mall, driving my head into a Perfect Neurological Storm, I have found some methods for coping and reducing my tension! I have successfully applied some of the Navy SEALS training techniques for overcoming overwhelming cognitive/neurological challenges! When I notice that my amygdala is sending out fight, flight and fear neurotransmitted signals, I interrupt and change my internal conversation from one of fear/panic to that of relaxed coping! You and I have already dabbled with breathing techniques and that’s just what the SEALS are trained to do when they are subjected to unbearable conditions! The SEAL candidates are instructed (from what I saw on “H-2” special) to start taking in deep calming breaths and then a judicious amount of rational “self talk”, like “I’ve seen this situation before and I made it through it in one piece”!. They are instructed to continue the two practices as their “executive brain functions” regain control. That’s a poor description of what they do, but I hope you get the idea!
Putting our problems into perspective you might want to take a quick look at this video of a young boy: I saw a clip this morning of a returning Vet being greeted by his young son with CP. The father apparently had not seen the boy walk before: http://abcnews.go.com/GMA/video/boy-takes-steps-soldier-fathers-return-16442766
Enjoy your day!
Alex
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Oh yes – “saying things that previously would have been swallowed before” — I am working with my NP about that right now. They don’t seem to think it’s that big of a deal — that everybody says things they later regret. But so many times I have found myself saying exactly what I did not want to say. I knew I shouldn’t. I tried to stop it… but as you say, there was so much else to manage, that the filters failed me and I ended up really alienating or offending people I never wanted to alienate or offend.
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Thanks m –
That makes total sense, thanks – adding onto and confirming what I’ve been thinking. Noise, noise, noise… how to tell the meaningful sounds from the noise…?
That rebuilding of “roads” in the mind — in roundabout ways — can be arduous work, and it can really take it out of me. Must remember to rest, so I can beef things up again. I tend to forget that I’m still (re)learning a lot, and I overlook the amount of effort it takes, and the amount of rest I require to rebuild.
Fortunately, I had this long weekend to catch up on my sleep… I’m still a looong way from being “all there” but it’s progress.
Thanks again
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yes – good point – I think that is why rest is so critical. Young babies are very sensitive to every stimulus – the sharp tang of lemon, a breeze in the air, the play of light, the texture of a soft stuffed animal, a heartbeat – its all overwhelming at times and as they organize, filter, understand, tag and categorize they get better at managing their world. We give them time to do this, plenty of rest and enough experience and input data to keep them stimulated but not overwrought (or they cry….) We give them plenty of support and acceptance in the process to. Over time they develop the capacity to address the filters. This is why different cultures may notice different things – a kid brought up by the sea might be more attuned to wind and temperature whereas a kid in the city might pay attention to sound or proximity of others. I think that rehabs should think about these things.
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Thanks Alex –
I’ll take a look at the video when I’m back from my picnic with friends.
I think you’re really onto the same “track” as I am with the Navy SEALS — I think there are a lot of combat-related response techniques that can be of great help to TBI folks. Can you share where you got the info about the SEALS – was it a show on t.v.? YouTube? I’d really like to watch it and see how they handle things.
TBI-related stress, in my opinion, can be very similar to combat stress — even though the actual comparisons fall far short, in our minds and in our personal experiences, TBI can blow them way out of proportion and result in us feeling profoundly threatened, which triggers major fear and/or other coping mechanisms that are more appropriate for actual life-and-death situations.
From where I’m sitting, there needs to be a “two pronged” approach — 1. learning how to physically calm yourself down in the face of perceived danger, and 2. learning how to recognize the *real* nature of the circumstances. I’m presently working on #1. My neuropsych is working on #2, but until I get #1 under control, all the rational thinking in the world is going to be derailed by my biochemical reactions, which have absolutely nothing to do with reality, at times. It’s just this wave of emotion that I get pulled under.
I’ve heard people talk about handling stressful life situations as “skillful surfers” and it always bugged the crap out of me — it sounded so pat. But in a way, they’re onto something. Maybe I need to pay closer attention and hear what they’re really talking about. 😉
Have a great day!
BB
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Yes, rehabs and also NPs. If they could explain “the rest business” to us in those terms, it would make total sense. And we might not be as resistant to sleeping.
Maybe…
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@alex – there are different kinds of yoga techniques that the military uses to teach them how to learn ‘relaxation’ in times of high stress. I think there is something of value here but one has recognize that not all situations are high stress too – sometimes after TBI we see stress when it isn’t there. I wonder if the techniques will be effective in those circumstances and/or if they are repressing stress. But in general I think you are right – the military is now incorporating mind/body approaches both preventation and as treatment. Makes sense since tbi and ptsd are all about mind/body.
Some good articles…
http://www.nytimes.com/2012/04/15/education/edlife/upward-facing-soldier.html?_r=1&ref=yoga
http://www.indianexpress.com/news/us-army-turns-to-yoga-for-making-soldiers-combat-ready/758996/2
there is also yoga nidra which is used for sleep http://www.yogawonders.com/yoga-nidra.php
http://chronicle.augusta.com/news/metro/2012-04-25/yoga-used-therapy-fort-gordon-soldiers-brain-injuries
http://warriorsatease.com/category/news-press/
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Thanks m – this is a great collection of resources. Much appreciated.
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Hi BB, In answer to your question, it was an History channel program: “The Brain”. David Eagleman was amongst those describing the evolution of the brain as akin to an apartment building, one that begins with the brainstem (where I have had much in the way of brain damage) and later developing into the pre-frontal cortex etc. The Navy SEALs section followed them through their training and how many candidates couldn’t make it past the underwater torturous training. I looked at the History Chanel lineup/schedule and didn’t see any upcoming “The Brain” programming. Maybe on Hulu.com? Keep your “inner rational talk” flowing when over-stimulated, as I am trying to do and hopefully it might assist you! Feel free to write to my email if I can ever offer you some support or insight!
Best of luck,
Alex
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Thanks Alex – I googled “history channel the brain navy seals” and I found a bunch of videos. There are some segments that look like they might be that part. Thanks for the heads-up!
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Your filtering theory is correct. ALL The scientists and healthcare professionals will not totally understand unless they have experienced it. It’s hard to even imagine how difficult it is for the brain to work so hard after injury. I try to compare it to a 5000 piece jigsaw puzzle. Imagine walking out the door all put together one day, dropping the puzzle and picking up 4500 pieces. Over the next few years you attempt to piece the puzzle together, one day and one piece at a time. How do you think we can piece an entire puzzle together with only 4500 pieces of a 5000 piece puzzle? I guess our brains are doing a pretty good job for most of us survivors!
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True, true. The idea that folks who mean to help and are supposedly qualified to help, don’t quite get it, is a bit disconcerting. But there it is. Where did all those other puzzle pieces get to…? 😉
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The remainder missing 500 pieces either disintegrate or jam together so the puzzle can not be completely solved. Everything needs to move around the jam or possibly they never will be found…they just don’t exist. This idea is based upon the level of functioning prior to and after injury depending on what happens to the missing pieces. I can see we are all trying to figure out the mystery of brain injury…probably more then the scientists because we are living the life.
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Sounds right-on to me — disintegrated or jammed together. When you bend metal and then un-bend it, it never really goes back to its original shape. It will always have a bit of a wave or a crinkle to it – that’s how I conceptualize my brain, sometimes.
Yes, living life… those of us who are dealing with this directly have a LOT more motivation to figure this out. Sometimes we do, sometimes not so much. As long as we just keep going — in the right direction(s) of course 😉
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BELOW: “vanilla” my term referring to those with so-called “neurotypical” brains
— — — —
This is such an IMPORTANT thread. RIGHT ON! – every single one of you. (My experience too – personally and professionally.)
I’ve been putting off commenting because I could write an entire BOOK responding to the points in the comments alone. I’m not sure how to put things briefly — or how to manage my own frustration that I have helpful information I do not have TIME to share in any fashion that will make sense without sounding “airy-fairy!” I’ll give it my best shot in the time I have.
I LOVE the jigsaw puzzle analogy [BISR June 1 comment above] — but I want to remind us all that EVEN if all of the pieces were available (or 99% of them), we would still have to put the puzzle back together WHILE we keep life going at a pace framed with expectations that all the pieces are already together!
THAT unconscious expectation creates more stress, more time required to manage effectively, and is a magnet for more “well-meaning” censure from the vanillas, who have (as BB articulates so well) MUCH less to process.
WE are always in a state of “cognitive bootstrapping” in more than a few functional processes. THEY have much more systematized — on “autopilot” — than we do. Until we can retrain our habits, WE must process in bits and bytes, THEY can process “chunks” — which really extends the limits of short term memory ( 7 +/- 2) in ways not available to many of US.
Studying “attentional spectrum disorders” full-time for almost 25 years now, I CAN second your instincts – our struggles ARE exacerbated by what you are suspecting – and your proposed solutions DO work to mitigate the damage (for brain-based reasons, some documented with approved studies, some “only” anecdotal):
• stress control methods (including Yoga, Mindfulness, meditation, etc.),
• reframing methods (NEURO-linguistic ADD coaching techniques, meridian approaches like EFT Tapping, etc. — as well as Cognitive Behavior Therapy (but NOT from an ADD/TBI/EFD clue-free CBT practitioner – which is MOST of them, as I’m sure you’ve learned)
• restoration & consolidation methods (including diet & sleep habits – although comorbid and resulting sleep disorders make sleep less amenable to WILL than the neurotypical population believes, understands or considers)
The bottom line is TIME: when everything takes longer to do, we run out of time faster and sooner than those with vanilla brains. How to best prioritize where we spend our time? What can we DROP to put some foundational elements in place? (omigod, DECISIONS are so pre-frontal cortex intensive — stressful!).
The decision-making process is especially stressful when we suspect – quite often correctly – that there is nothing much we CAN drop. Figure in the impact of short-term memory deficits and the limitations of brain-resources for ANY human being, and sometimes Scarlett O’Hara’s idea is best: think about it tomorrow — what looks like denial, procrastination, suppression or repression to those who don’t understand all the parameters of the problem.
And BOY, they can’t wait to tell us all about it, regardless of what it does to our stress levels. The result: second guessing & rumination. MORE stress. And so it goes.
Despite what the vanillas intone we have to affirm for ourselves and for each other that a teensy bit of progress is still progress: a job worth doing is worth doing BADLY, too!
*Reducing* the stress of second-guessing and rumination is FOUNDATIONAL — to avoid being hijacked by our amygdalas (the “fight, flight or freeze” neuro-regulator that has the authority to pull resources from the cognitive parts of the brain – effectively shutting down thinking). None avoid rumination very well in isolation, so most of us look for agreement to quiet our internal discussions — *especially* the vanillas. (Why do you think they try so hard to get us to change how we approach life to affirm the way THEY do it!?)
Understanding and acceptance of “what’s so” is the ONLY way out – but it needs to BEGIN with the highest functioning and filter down, NOT the other way around (no healthy parent expects their kids to be able to take care of the needs of the grown-ups, right?)
Our lives would be SO much easier to manage if those at the top of the functional pyramid would START the process of understanding by acquiring information, and STOP “learning about fire with OUR hands,” making US wrong for our reaction to our burns!!
But hey – they’re too busy for brain-based education, right? (Unlike us — we sit around eating bon-bons all day, I guess.) According to most of them (given the way they speak to us), WE need to understand *their* frustrations, straighten up and fly right! After all, *they* are the only ones who pick up the pieces when we drop the box — or so they seem to believe, as they knock it out of our hands AGAIN.
BB’s thoughts about “processing speed” are SO well articulated and IMHO/experience, absolutely correct. See also the Juggling posts on my blog (TaskMaster series, start with “Taking Your Functional Temperature”) – use the search box.
Madelyn Griffith-Haynie, CMC, SCAC, MCC
– cofounder of the ADD Coaching field –
(blogging at ADDandSoMuchMore and ADDerWorld – dot com!)
“It takes a village to educate a world!”
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Holy smokes – this is going to take me a while to digest and respond to. But I like what I hear. More later — after I get some sleep.
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I totally relate! Shoulders to the wheel 24/7 can’t be done, is lousy for our functioning overall to try, and never gives us what we think it will anyway (just ask the manics!). Sleep tight.
xx,
mgh
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Well, this is absolutely brilliant, and I thank you for taking the time to put it all into words. The pieces about decision-making being so stressful, and having to just put up with doing the job less well than one would hope — tradeoffs and reducing stress… It’s remarkable, how tolerant I am becoming of what I used to consider “mediocrity”. It’s a double-edged sword, because the line of work I’m in has a very low tolerance for mediocrity, but what the hell am I supposed to do…? Keep trying to hack down the proverbial oak with my little penknife? Seriously. I’ve learned to exchange excellence for progress, where it’s expedient. I don’t much care for the experience, but what’s the alternative? Doing nothing? That will never work.
I could also really relate to your description of “vanillas” needing us to do things the way they do. It just doesn’t work for folks like us, yet you’d think we’d flayed their favorite pet alive, when we don’t comply with their standard issue approaches. I’m having a particularly tough time, these days, with my boss who is intensely invested in creating stress and strain all around them, for the sake of keeping us minions “alert”. Please. They cannot see how counter-productive it is, how rapidly you reach a place of diminishing returns, not to mention how much it undermines their very purpose. Brain-based reasoning is clearly not the darling of the business world I inhabit. It’s just so lame, it’s astonishing. But it’s the world where I make my living each day, so some coping mechanisms are in order.
Sleep helps. And remembering that a lot of people (those in charge and otherwise influential in our lives) are really sleep-walking their way through things, and they’re pretty overwhelmed, too. And a lot of them have never had the benefit of having to deal with “non-standard” conditions, so their repertoir is pretty limited. Ah well, soon time for work.
Thanks again for your excellent words.
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Welcome to the life of an ADDer – you describe my experience of life for ALL of my life, as well as the experience of those I work with & support (what biz pundits call “my target market.”)
It sucks big-time but, as you imply, we really have no alternative but to figure out how to work outside the vanilla frame — unless, of course, we think life might be better lived homeless. Stressing over the fact that we must work harder to accommodate vanilla “shoulds” that make no sense (for anyone, really, but especially not for US) only makes it difficult to impossible to do much of anything – brain-based.
THEY will never get it, but we MUST. Resilience is a factor of bandwidth. THEY have more to play with than we do. Structure works well for everyone, but those of us with Executive Functioning struggles NEED it. Structure primes expectation – which is proven to improve cognitive functioning. Nobody’s brain does WELL without priming – but it is *deadly* to attempt to live in “crisis mode” (another definition of “no structure”) without reserves of bandwidth.
I have had no choice – ever, really – but to develop systems to work AROUND what’s not working (once I figured out – close enough – what wasn’t working & what I could recruit to create work-arounds).
Systems (keyed to structure) work beautifully until lack of planning in someone else’s life creates a crisis in mine – which can only be boundaried to a certain extent. RESERVES are essential – which bottom-line to time and money.
Only the wealthy can buy time – the time of others. The rest of us exchange time for money, for the most part, and time is finite. When it takes, as Hallowell says, “twice as long for half as much,” it is tempting to forgo self-care necessities in service of accountability expectations – our own and others.
It never works – it is an emergency measure that *seems* to work in emergency situations, but we must guard against generalizing. Crises-coping doesn’t generalize.
Bottom line reframe: “mediocrity” is a vanilla judgment that keeps everyone small. The Pareto Principle (80/20) is a vanilla attempt to change the paradigm around the foolish goal of doing everything equally well – which means expecting yourself (or others) to be equally brilliant in ALL things and to prioritize alike. We aren’t – we don’t – we can’t. None of us.
A job worth doing IS worth doing “badly” – and sometimes a total waste of the minutes of our finite lives to do some jobs at all, much less “well.” We must accept REALITY, not “mediocrity.”
Watch my blog for an upcoming post: I am writing an article to explain a method of real-time prioritization I suggest to clients: playing the “least & quickest” game: “What’s the least I can do to get this done, and what’s the quickest way to get it off my plate?”
Use it on EVERYTHING for one solid week (putting on your underwear, eating, etc. included) — pay attention to what you do and what you think. Track it.
There will be areas where you simply REFUSE to do the assignment to play the game (women with their kids, men with their sex lives, most often – the rest are individual-specific.)
Bottom line question & the point of the exercise & this comment: “Where do you think you GET the time to spend on those areas if you do everything to that ‘best ability’ standard?” It is not POSSIBLE. Not now, not EVER in the history of human beings. The attempt ONLY creates stress, which shuts down cognition and decimates effectiveness.
REFRAME the game. It helps.
xx,
mgh
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Hey BB – at the bottom of Part 2 in the Brain-Based Processing Series on my main blog [Processing Efficiency is all about Juggling] is a big ole link here. I’m positioning THIS article as Part 3 of that series.
I explain why I’m sending them over here by link at the bottom of Part 2 rather than “reblogging” (reblog widget formatting’s wonky) – but you make SO many good points so much more effectively in “first-person” than I could ever explain without this example, that it didn’t make sense to attempt to do anything BUT send anyone following that series here.
ADDers aren’t great with follow-through (and more than a few struggle with reading, so may not get all the way to the bottom). SO, in a day or two I’ll post a short “article” with a look more in keeping with that of the developing series, then repeating the link to HERE as the Part 3 post – so, with a teensy bit of follow-through karma, you may see pings from either.
(MY Part 3 article will repeat YOUR title so don’t let it throw you — you’re NOT suddenly in some strange Ping Twilight Zone when you get a pingback from “I’m not necessarily slower – I just have more to think about”)
I am treating my blog more like a website – content stays and builds on itself – with internal page links. EVEN when I get ADDCoach.com back up, I have no plans to relocate ADDandSoMuchMore.com as long as WordPress and Co. behave themselves and the .com platform remains relatively stable and speedy.
PLEASE LET ME KNOW if you ever decide to take this blog down (or decide to move elsewhere), with a bit of lead time so I can figure out what I need to do to keep you in the series (or explain a brief absense).
THANKS!
Madelyn Griffith-Haynie, CMC, SCAC, MCC
– cofounder of the ADD Coaching field –
(blogging at ADDandSoMuchMore and ADDerWorld – dot com!)
“It takes a village to educate a world!”
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Thanks for the info Madelyn – I have been thinking about how to better present information so people can access it. I keep meaning to put a little “table of contents” at the top of my posts, but I just get going, and…
I don’t plan to ever take this blog down. I love WordPress and I trust them implicitly. They’re just good people. So even if I back off on adding new content, I will probably never take down the whole blog.
So, no need to make contingency plans 🙂
Have a great day and thanks for your work.
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