Cognitive Issues

Cognitive issues are often the first thing people think of when they think about TBI. After all, it’s your brain, right? And that’s the source of your cognition.

Project LEARNet, which is “A Resource for Teachers, Clinicians, Parents, and Students by the Brain Injury Association of New York State”, has some great tutorials on Cognitive and Academic Issues for students after TBI, as well as Self-Regulation/Executive Function Issues. Don’t let the focus on kids / students deter you – these are great resources for anyone who is seeking to better understand TBI. Check out the tutorials on Cognitive and Academic Issues here and Self-Regulation/Executive Function Issues here. They are downloadable PDFs that you can print and take with you – great stuff!

Cognitive Issues after Brain Injury can include:

34. Altered consciousness
35. Aura or weird reverie, trance
36. Trouble concentrating
37. Trouble making decisions easily
38. Trouble reading
39. Analytical skills suffer
40. Trouble telling what’s real or not
41. Being easily distracted
42. Being forgetful, can’t remember
43. Nightmares
44. Worrisome thoughts

13 thoughts on “Cognitive Issues”

  1. I would suggest that this be called Cognitive Issues rather than mental as we tend to associate mental with psychological.
    I would consider nightmares a physical issue or behavioral (along with worrisome thoughts)


  2. Is this the proper forum that we would use for adaptive strategies and skills we have learned thru the years …sharing in hopes others would find them useful????


  3. A friend with TBI and memory issues would forget where keys were, and had problems finding them. After my initial TBI I did the same thing with my keys as we did as nurses carrying the drug keys. We had one of the stretchy bands that you can easy get at a dollar store, with a key ring on one end, and the click lock type parachute clamp . I also used on climbing harnesses, or any sort of slip lock on a fairly long cord. I always wore mine around my neck as I did my stethoscope and put my keys on them, whether car, mailbox or house. One end can attach to a belt loop, or belt, or buttonhole if not the neck, and the other hods the keys. You always have them on you need them, and they are never accidentally left in the car or the home or car when you leave. I also keep a KEYS(the word) beside the door to put all keys on when I get in and it is the last place I go out so I know I have them on me, and never have to spend countless frustrated hours looking for them when I need them for something….This was a tip mentioned to me by my occupational worker at Carolina Living Services in NC when they found out I was a nurse, and was used to help me keep a little less stress, and a little more comfort in some and still some uneasy days. Hope someone else will find it useful!


  4. BB – BB wrote: Cognitive issues are often the first thing people think of when they think about TBI. After all, it’s your brain, right? And that’s the source of your cognition.

    BB – At one time I tended to think like you; today (2013) I don’t completely.

    In my experience, many people do not respond to or react to words like cognition and perception (although they are both good English words). I am not exactly sure why. Occasionally cognition and perception challenges are discussed at cerebral palsy and hemiparesis groups and prosopagnosia (face blindness) groups. Other words used to address aspects of this topic include executive function/executive dysfunction, working memory vs ~ glitchy working memory, etc. Personally, I do not understand exactly how movies like Awakenings (1990), Memento (2000), and Limitless (2011) can be made (for millions of dollars) yet it can be difficult for anyone to talk about having seen them or talk only about the emotional aspects of the movies. Best wishes. – Charles Thomas Wild (Paying attention vs inattention, processing, memory, etc.)


  5. I think you have a point. People don’t really think about cognition and perception. I think they can look at the whole person and just think they’re “broken” — without separating out the ways that people are affected. The whole issue of brain injury scares people so much, not many are actually able to think about it in any detail.

    Thanks for making this point.


  6. I have TBI and I am still struggling with this portion daily even 4 years after my accident. I remember trying to remember where I put my keys within the first year of my injury. I tried to think about where I put them and all I saw in my head was a blank white wall. The harder I tried the worse my head hurt in the spots that were injured. I sat on the bed and cried. My fiancé put a nail in the door frame and helped remind me to put the keys there as a habit every time I walked in the house. Now I put them on my handle of my purse or the kitchen counter. If I do not remember to put them in either of these spots I still struggle to find my keys. I still get pains in my head and brain fatigue if I overdue it…the hardest thing to deal with is struggling how I think and act which is so different than before my injury. I really hate the glitchy memory! I can do something and within 10 minutes I will have no memory of doing it at all.


  7. Yes, I can relate. Even 4 years after, we can still have a lot of issues. It took me years of constant work, to get where I am today, and I still have to keep at it. TBI is a huge reality check for me – it keeps me honest, like nothing else. I have ONE place I keep my keys — on a key holder in the kitchen, beside the door where I go in and out. As soon as I come in the house, the keys go on the holder. If I forget, or just think “I’ll remember to do it later,” I get panicked, not being able to always remember what I was doing when I first got home. The worst is when I am bringing things in from the car, and I put my keys in my coat pocket, and then forget to hang them up. A search high-and-low commences — and believe me, it’s never at a good time, because I am usually running late. Especially when I was so busy the day before that I forgot to hang up my keys. Always an adventure….


  8. Howdy BB! People do not want to deal with the ins and outs of a brain injury. Your blog does a great job of covering the subtle but critical points in all this. I’ve recently been trying to reveal my past with this and I have been met with very few if any body who is willing to go, really go there with me. You have touched on this in prior posts. Laymen and specialists alike are invested in confirming what they already know. And if you do not fit into any area of their “schema” a ten cent word meaning “prior knowledge” then you are set aside at best or told you have character issues at worse. If someone has worked with you for decades addressing a problem (in my case one that was not totally off) and a different picture emerges, of course there where be reluctance to look at new information or over-looked information. Not to mention, the unrelated natural tendency to look at a TBI or series of “mild” TBI’s due to a discomfort of dealing with an intimidating problem for its complexity. As if major depression or schizophrenia were not scary enough subjects for people to think about. There should be book called “how to deal with the things themselves, not only the affects” The effect of one who has multiple concussions etc amounts to something broken. The doctor or family member can say look it’s broken but who cares enough or is strong enough to ask “how did it break”. In my experience, the best candidate to probe the details in a broken man’s life is the trauma therapist. But a TBI treatment is not in their arsenal. The Wizard of Oz had something to offer the three who accompanied Dorothy but found himself in great distress when he had no answer for Dorothy. Fortunately, he faced that as difficult as it was, and Dorothy had advocates who were not going to let The Wizard off the hook. People with brain injuries are as frustrated as those who treat them. Many years into the recovery, the TBI survivor may have a developed empathy and identification with the frustration that despite their situation or initial meltdown of frustrated misunderstanding, they may be more concerned with others than themselves. And it is because the survivor has felt the same frustration and is often times, disconnected from certain feelings or ego, and investment-free so they accept the frustration and walk away not wanting to pain another. It is not a lack of self-esteem or self-confidence, but a lack of confidence in anyone understanding his/her plight. It took me so long to figure out the course of my life was altered most by a physical problem and not a psychiatric one or a psychological one. Like most problems, I was able to see it when I got far enough away from the problem. That is I was not in the whirlwind of symptoms and not being told weekly that my problem was such and such. There was no way that I could have figured it out earlier because denial was high and self-awareness of deficits, very low. A TBI survivor may even think punishing himself is right. In early stages of awareness, the survivor may co-conspire to ruin self due to many of the reasons professionals might tend to. The survivor with distorted cognition may sense but not consciously process how another despises them or wants to dismiss them. The PTSD and TBI join in the destroying of the survivor. It appears to be a self-esteem problem, but it is not that simple. In fact, in the life o a TBI survivor, nothing is simple anymore except the recognition that they themselves are broken. Everybody loses. Little by little, thanks to people like you, football leagues and individual sufferers are taking in more than just the broken person.
    Do we hear about pro football players in trouble with their spouses or the law due to this idea that a sports star believes they are above the law or because there brain is misfiring. Or some other combination of reasons. The statistics that many football players who enter the league are ex-cons to begin with does not say anything about the validity of TBI affecting personality, no more than ones history of depression does. TBI injuries can not be ignored nor should the risks inherent in contact sports be. TBI can masquerade as many things. A broken bone does mean one’s knee is not mangled. An x-ray may say yes a broken elbow but miss a badly sprained knee. But a player may miss a career due to the knee and weeks to the bone. A person with verifiable pasts of severe abuse may resume life to happily marry and raise a family and have a great career, but a brain that has been jolted twenty times may leave a person without family or career. But you look fine to me. Man up!


  9. Thank you for writing this, Luka. It all sounds very familiar. I honestly don’t know how trauma therapists don’t “get” the trauma of TBI. I think they look for trauma only in the incidents that caused the injury, not in the ongoing trauma we experience each and every day, due to personality changes that distance us from ourselves and our former place in the world. That is traumatizing, and to ignore it seems… well, negligent.

    Or just ignorant.

    So much gets lost along the way, and I have a hard time believing that we are in the 21st century, and caregivers and healthcare people still do not believe that brain injury recovery is possible… let alone understand the mechanics of it. There ARE people who understand and know how to fix things, but why doesn’t anyone listen?

    I think — as I heard a very wise many say in a YouTube video — that it has to do with Belief Systems. You must BELIEVE that the brain can be retrained and modified. You must BELIEVE that the human system can be altered by intention. It’s not about science — it’s a form of religious belief, that keeps people locked away. Because they cannot for the life of them believe that such great things are possible — or that these kinds of great things happen every single day, without our even realizing it. They are locked into their own limited view of what is possible — and probable — and so everyone around them suffers as a result.

    People who don’t *really* believe in the brain’s ability to change, should not be therapists, in my opinion. Of course, then there would be maybe 15 therapists in the world 😉

    I have a very dim view of how people think and behave (as you may have already observed). I also have a very dim view of the “experts” and organizations that are put in charge of managing the lot of us. Not too big to fail — too big to succeed. The turning point for me was when I realized that I could have this dim view, and also ignore it and get on with my own life. Other people may be headed for the cliff, thanks to their unwillingness to think for themselves, but there are many of us who think on our own, who have our own ways of doing things, and will succeed, no matter what.

    The thing that bogs us down, is when we try to fit in with a world that doesn’t have room for us. There are lots of other opportunities to fit in elsewhere. We just have to known when to cut our losses and find our own path — and our own happiness. Regardless of what others say/think/do.

    As for myself, I’m determined to have a good day, whatever comes. It’s possible. Definitely possible.

    Liked by 1 person

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