Traumatic Brain Injury: How It Hits Survivors the Hardest…in our weakest spots

By John Hatten, Rehabilitation Counselor, TBI Survivor

First things first: I should explain that I know, the hard way, about this subject.

A long time ago (1973!), I had a Traumatic Brain Injury in a construction accident. Very few people survived such an injury then: I walked in uncharted territory. So unlike so many of the brain injury experts, I’ve “been there, done that, and took notes”. I should also say that it’s taken me 43 years (I still find that number hard to believe) to get where I am now. I still go through many of the same issues as you.

In future postings, we (I really want and need your feedback) will discuss all sorts of issues around Traumatic Brain Injury, or TBI. For today, I’d like to start off with a little bit about how TBI seems to aim for our weak points. Some people don’t believe that it really does, that this feeling is “all in our heads” (I choose to leave that hot topic for another time).

I have found that my TBI really has aimed for my weaknesses. I was always a bit absent-minded (I didn’t focus as well on my environment as I did on whatever was going on in my head). I continue to have significant problems with this. I have made strides with overcoming or working around my other cognitive or thinking issues, but this ‘absent-mindedness’ seems to be slower to recover.

I was a TBI Case Manager for some years out of a TBI Model System (a wonderful job) and so I talked with many hundreds of people with TBI. I heard this complaint a lot: it seemed that their TBIs also “hit them in their weak spots”. Let’s talk about why.

When anyone learns anything, it’s implanted in their neurons (brain cells). Not only do we learn the fact (or whatever) that we’re focused on, but we learn a bunch of other stuff that “fits around” that fact. For instance, if you recall the way a teacher taught a class one day, that goes along with the class material into your memory. Every time your teacher uses that approach, it makes that particular pathway to the next neuron fatter and thus stronger and faster (so you know it better). If you were later with friends and that subject came up and you told your friends what your teacher taught you, that is stored in a separate set of neurons and also gets stronger with repetition. So the better you know something, the more places in the brain it can be retrieved from and the stronger the memory.

The brain is like a freeway, with cars (thoughts) running back and forth all over. Our TBI brains are more like a freeway under construction: traffic can slow down to a crawl or even stop. Then we have to find another way to get where we want to go, and this is hard to do, unless we have several “favorite routes” that we have used. Then we can get to where we want even when lots of roads are closed. So we have problems with unfamiliar stuff because we have fewer options. People without TBIs have the same thing going, but their car is not as beat up and can glide easily to their destination. If we with TBI haven’t been on that road in some time, it’ll be harder for us to get there.

So we aren’t crazy: our brains do play favorites with our memories, and the better we are at something, the better that skill or ability survives our TBI and we can use it. 

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