The next emotional phase that I see people typically go through is denial. The patient says, "There's nothing wrong with me."
For example, they're in a motor vehicle accident, they're briefly seen in an emergency room, and they go home. Suddenly, they're having difficulties. They're forgetting things or burning food.
Family members may say, "you seem different." But the head-injured person says "No, there's nothing wrong with me."
Often the medical system unknowingly supports denial. Many doctors will say, "Go home, relax for two weeks, and everything will be better."
For some people, things don't get better. They wonder why they're doing some silly things. For example, why did they put their shoes in the refrigerator? Or why did they put the milk in the closet? They have these odd events and they keep rationalizing them away.
Denial can be very difficult for both family members and medical staff. For example, the head-injured person may say, "Yes, I can drive," but family members who have been with the person know that it would be dangerous. This can stir up huge arguments. The person in denial says there's nothing wrong, even when directly confronted by family members.
When someone is in denial, you must give consistent feedback that everything is not "okay." Generally, very direct feedback is necessary. However, some people get really angry when they're constantly being told "NO".
I often find that distraction, such as changing the topic of conversation, is better than getting into long-winded or violent arguments. For example, the head-injured person may want to drive when it's not safe to do so. Instead of arguing, it might be better to say, "Your doctor has not cleared you to drive" and move on with the conversation.
There are two types of denial. The first type of denial is an emotional one. Something has happened that is so terrible, or so frightening that they just don't want to deal with it.
The second type of denial comes from changes to the brain. The brain literally refuses to process certain types of information.
For example, there is one type of injury to the brain where the patient cannot receive visual information on the left side. Their vision is gone on the entire left side—but they don't know it. They may bump into walls, or, if driving a car, they may run into things. If drawing a picture, they may leave out half the drawing.
The brain doesn't like missing information, so it tends to fill in that information. You may be thinking that you don’t know anyone who has part of their vision missing. Think again! Did you know that part of your vision has a hole in it? Where the optic nerve comes through on the eyeball, there are no visual receptors.
The brain doesn’t like missing information and “fills in” that little hole. If you close your left eye, hold a pencil about one foot from the eye (down and to the right), the eraser will just disappear when you find this small hole. So, now you see how the brain can contribute to “denial.”
Denial is a very common problem, but eventually it breaks down. Head injury problems just don't go away. The same problems happen over and over and over again. This leads to the next phase, in which the person has a limited awareness of the head injury, beginning what I call the depression/anger phase.
* Editor's Note: This excerpt from Dr. Johnson's book has been adjusted to make shorter paragraphs. Certain words have been highlighted for emphasis. No wording has been changed. Dr. Glen Johnson, Clinical Neuropsychologist, wrote Traumatic Brain Injury Survival Guide. At the time of this writing, he is Clinical Director of the Neuro-Recovery Head Injury Program in Traverse City, Michigan. You can download a free pdf file of his book at http://www.tbiguide.com. |
Welcome to Our World
