Brain Health

How Much Does Social Isolation Slow Down Recovery from Brain Injury? PTSD?

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I had a thought (I know, so odd): how much does social isolation, systemic inaccessibility, and opprobrium from family, friends, lawyers, health care professionals, etc. slow down recovery from brain injury and/or PTSD?

We’ve read of studies* showing positive effects on the heart of socially cohesive neighbourhoods, lifelong negative effects on children of lack of bonding as infants; we’ve heard of cancer charities successfully supporting patients through programs that are social in nature or AA working through people talking with people regularly, dependably. So we know social is critical to our we’ll being (although in how we shape our society and relationships, it doesn’t seem we believe it).

People with brain injury are marked by high rates of divorce (80% my diagnosing physician told me), high rates of unemployment, loss of friendships (no idea if 100%, but I’m sure it’s pretty close), ostracization by family members, and marginalization into day programs since the medical profession is seemingly not interested in healing brains. My father used to say to me that surgery is a failure of medicine. I’ll add that day programs are a huge failure of medicine.

One big message of the Book of Job is how unimpressed God is with friends who blame a suffering person for their unexpected woes and abandons them. Yet every one with a brain injury experiences this. I wonder: how much does that blame and abandonment retard their recovery?

When we know human beings are social animals and we know social cohesion enhances health and we know being a part of communities increases life spans and quality of life and we know social isolation destroys mental health (which is why sidelining concussed teens into darkened rooms by themselves for days is one of the stupidest pieces of medical advice I’ve ever heard), it stands to reason that people with brain injury would recover slower or not at all when you add to damaged neurons and shredded blood vessels friends leaving like rats from a leaking ship, family members pouring opprobrium onto persons’ already injured heads, spouses hightailing for the hills, health care professionals patting persons on their injured heads instead of doggedly pursuing treatments, and lawyers and insurance companies using personal epithets in their fight to deny legitimate claims.

Social workers will try and get a new social life going for their clients, but it’s a path littered with disappointments when the injury itself prevents regular kinds of social activity and many people don’t want to accommodate the sufferer. How much do those disappointments serve as brakes on recovery?

Yet resilience is a partial antidote.

Amazing resilience can allow a person with brain injury to progress in this society where answering emails and phone calls is considered too much effort, never mind staying in regular touch with a hurting person they once called friend.

But if you’re a friend who understands that friendship is much more than an annual catch-up, perhaps send the friend you care about a Brain-O-Gram and then make a commitment to enhance your own life by talking/texting/tweeting your friend at least weekly. Just a thought.

*Sorry, I don’t have links. If I had the energy, I’d go searching for them for you. But simply being able to write is an accomplishment these days. Sigh. 

Brain Health

We Humans are Social; We are Not Meant to Abandon our Sick and Injured

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This is not an easy post to write — I don’t even know if I want to write it. Deep breath. Here goes (assuming autocorrect doesn’t stop me in my tracks!).

Personality re-creation (shifting) is a neurophysiological process that is shaped by psychology, as I see it. Emotionally, it gets a little hairy. Think adolescence times 1,000,000.

I suppose when your brain’s emotional centre and/or networks are damaged — and really how much do we know about how emotion works — and it begins to heal and memories are reconnecting to the emotions that would have happened if they’d been working at the time and if those memories are of abandonment, by one friend after another, of the person you were and the injured personality you became, you’re probably going to get hysterical.

Hysteria: “general state of extreme fear and panic — freaking out.”

That would pretty much describe my state this past weekend. Add in a soupçon of personality shifting back and forth for several hours, and I pretty much had a spectacularly bad 48 hours. I highly doubt it’s over. I have rarely been so acutely conscious of how critical social is to me as a member of the species Homo sapiens sapiens. It sucks to be human. I’d rather be a jaguar at times like this.

But we human beings are not jaguars.* We’re lions in our prides or elephants in our herds. We become not normal when left to be by ourselves, especially in times of crisis, disability, ill health. Even hermits need one connection to another. I know a doctor who is the one and only friend of a man and sees him regularly but not too frequently. That man is mentally ill, afraid of people, yet even he needs a friend.

We see the Africans who’d rather contract Ebola than not hug and touch their dead loved ones as abnormal. But they are the normal ones, doing what even elephants understand is necessary to recover fully and well from the grief of losing an integral part of our social identity. We are the abnormal ones who so fear our social biology that we have memorials not funerals, don’t want to “interfere” then wonder why people suicide, so fear suffering we forsake the quiet joys of being with another as they walk a difficult path.

So I am on my path today with fewer people and now mostly professionals than when I was smashed onto it back in 2000. It really wasn’t until 2001 when I began to recognize that I was not on my 37-year long path from birth to just before my brain injury, but on an entirely new one. Confusing, incomprehensible, and one I thought I could navigate on my own because I had a plan even though the people who professed to love me the most were the first of my friends and family to leave me or say, figuratively speaking, hey, you’re on your own, we don’t want to hear you whine about your nonexistent so-called brain injury.

I’ve been thinking about this — some days, I think being pure intellect sans emotions has its advantages. I think not being able to feel that abandonment at the time was one of the few brain injury blessings. But I’m feeling it now, and, oh joy, re-living it too as I start on another new path feeling alone. This time I know how the walking will go. As Cliff Taylor told me when I was interviewing him for my book Lifeliner, if he and Judy had known what life would be like with her living on artificial feeding at home, they would never have had the courage to do it. It’s the knowing that makes setting out again on a path of healing frightening unlike back in 2001. This path is a branch off the brain-injury-healing path, called “get yourself a new personality and try to stay sane path.”

Some people can see or hear or sense the intensity of my sadness; others just see the calm exterior. Some health care professionals would see my grief at me dying back in 2000, an experience I share with too many with brain injury, and label it depression so that they wouldn’t have to deal with something so highly complex to treat and emotionally devastating to witness. When I’m calm, I’m aware that at any moment, I can break down but I cannot feel the sadness or be able to identify exactly what I’m feeling until someone labels it for me. (When the label is wrong, I can sense that it is because it doesn’t resonate deep within me.) I guess this is what psychodynamic therapy is for, to learn to feel and identify emotions when they’re at normal levels, not freak out levels.

But unless there is one person in my life who may not know about this personality shifting but is willing to learn, is willing to stick with me, can be trusted to hear and help with the worst aspects of it, then the freak outs will continue, for this is one change I cannot cope with and guide myself through alone.

* See Google search for articles on human sociality.