Grief and Loss
06 Jan 2012 2 Comments
A traumatic brain injury is a blow or jolt to the head or a penetrating head injury that disrupts the
function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long-term problems with independent function.
The loss of self is often the real tragedy of traumatic brain injury. It is seldom addressed by the medical profession yet it is a loss so profound that many never recover from it. Brain injury strips away a lifetime of learning, of personal identity, and personal power. The loss is a soul shattering experience, intense and intimate. It is so intimate that society as a whole averts its eyes and closes its ears to the pain and despair of such a naked soul. It is a soul bedeviled by infantile demons, the very stuff from which neurosis and psychoses is made.
Grief over the loss of self is something every brain-injured person goes through. However, grieving often is not recognized for what it is because the resulting distractions, anger, fatigue, and other signs can be masked by or confused with the symptoms of post concussive syndrome or post traumatic stress disorder. Also, lack of insight, which may make you unable to correctly evaluate the impact the symptoms are having on your life, is a typical aftereffect of mild traumatic brain injury. Unfortunately, the recognition of grief as a possible cause of post injury behavior has eluded many physicians and mental health workers, as well as MTBI survivors themselves. Many doctors tend to attribute symptoms of grief following an MTBI to the physical consequences of the injury.
I chose to interview a 51-year-old man named, Steve, who suffered a TBI 17 years ago as a result of a car crash. At the time of the accident, this
man was 34 years old, married with 2 daughters, ages 12 and 13, had a home in the country, and was enrolled in school for blueprint reading to help his father run his business. Everything was great. Loneliness was not an issue.
One evening in August, Steve and a friend were driving rather fast on a dirt road to have dinner with Steve’s family. They were riding in a Dodge Daytona with tops off. Steve had no seat-belt on, but his friend did. Steve lost control of the car and was thrown out, landing on the ground unconscious. From there he was transported to a nearby hospital and then airlifted to North Memorial Medical Center with swelling in the brain and life support started.
His mother had not wanted the life support as she considered his life was over and predicted a poor outcome if he should survive. His oldest daughter would cry and plead over him to wake up, telling him how much she loved him. Almost as if she could will it to happen. His wife encouraged the life support and stated she would never leave. His father blamed him for the accident and dealt with the grief by listening to Steve’s voice on an answering machine.
Steve’s coma lasted about three months, after which he traveled to a few different hospitals for various long-term therapies. During this time his wife, after being named his guardian did leave him and all that they had achieved during his 16 year marriage had been taken. He lost his family, home, and his sense of self. Because of one night that he will never remember, he lost it all, except for his life, and even that wasn’t familiar anymore.
Steve’s biggest struggle was the loss of self. He has stated that if he hadn’t changed so much his family wouldn’t have left. He struggles with attempting to get people to listen to him and respond to him as a normal person. Because he has speech impairment people will talk down to him and sometimes ignore him. But at the same time, people who have known him will criticize him for not having a job without realizing that a lot of his disabilities are invisible. He struggles with fatigue, memory loss, double vision and right-sided weakness. He sometimes has no control of his right arm, especially when he is fatigued. He’s attempted to return to college but had to stop because of visual disturbances. He cannot read a line all the way to the end. Peripheral vision is affected. All these things contribute to the loss of self, depression and loneliness.
He had tremendous difficulty letting go of the past, even after 17 years, and would drive out to his old house many times.
He would attempt to physically help people with things like moving, cleaning, etc., which would frustrate his mother, anger his father, and illicit pity from others. He was left without friends, a family that was too busy to give him the time he needed, and no one who really understood what he was going through.
In attempts to combat his loneliness he has traveled to the Philippines, and did eventually marry a young woman there. They have a child together who, because of poor maternal care, was born prematurely and suffers from autism. His current family is now in the States and Steve has devoted his life to his 3-year old daughter, who is doing well with the attention he has given her. His TBI has allowed him to work with her in some of the same ways he has been helped. He is now too busy to feel lonely. He still mourns the loss of his children, who are now grown with children of their own, but he feels he has a second chance and is grateful for that.
Never forget that life doesn’t follow the plans we make just because we make them. We have to allow for change, prepare for it, and seek positive results from it. We have to understand that tragedy, sadness and unexpected challenge may wreak havoc at any time, and leave us facing hard work to recover a life.
Every year, hundreds of thousands of people are diagnosed with closed head-injuries. Many more go undiagnosed. And the frequency of the injury is rising.
Because closed head brain injury often reveals few, if any, signs of injury, survivors and those around them-family, friends and co-workers may doubt the validity of the injury. This increases the risk that survivors will not receive proper treatment and adds to the devastating life disruption that head trauma delivers. Often the survivor must relearn the easiest tasks and devise new strategies to execute daily responsibilities.
Doubt and misunderstanding complicate the recovery, making it even more difficult for the survivor to accept, address and attack the challenges. When doubts and misunderstandings come from close family and friends, a crushing burden is added to the recovery process.
I definitely see grief, loss of self, and depression as enormous issues for people who have suffered a head injury. After speaking with Steve, and hearing the amount of losses suffered because of his injury: his family, his home, and very personally, his loss of self, it’s obvious that his losses are similar to what the professionals have stated as grief and loss in their journals, as well as those stated in personal stories of people who have suffered a brain injury, and the families that help care for the victims of those suffering from brain injury. Steve, as well as others who have suffered this type of injury experience, denial, grief, depression, and the struggle to regain a sense of self.
Without a doubt, the research supports the interview.
Diane Roberts Stoler, EdD & Barbara Albers Hill Coping with Mild Traumatic Brain Injury 1998
Kara L. Swanson I’ll Carry the Fork 1999
Brain Injury Association of America http://www.biusa.org
Brain Injury Resource Center www.headinjury.com