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And Just Like That My Lindamood-Bell Reading Rehab Is Over

Final Lindamood-Bell Progress Report for Visualizing and VerbalizingIt’s surreal. It seemed like the whole summer stretched ahead of me, five nights a week spent in intensively retraining my brain to read with comprehension, two nights recovering my energy before once again being immersed in Visualizing and Verbalizing the Lindamood-Bell way. I met and worked with six, seven different clinicians. Suddenly, tonight, it’s over. After not seeing her for awhile, the clinician I began my training with, I ended with. It was a full circle moment! At the end of my last hour, I received my final progress report from my Lindamood-Bell Australia consultant (also the Associate Director of the Double Bay resource centre) and a lovely send-off, complete with a signed certificate that they’ll mail me.

Way back in June, the Lindamood-Bell Minnesota centre, who had assessed me initially, told me: “We can restore your book reading.” It felt untrue. I asked:

“When you say I’ll be able to read a book like I used to (before my brain injury), do you mean a book at the level of an Agatha Christie? A PD James? Neuroscience article? And/or philosophy of mind textbook?”

They answered:

“In creating your recommendations for instruction, the goal I had in mind was your ability to read and process literature at the level of your potential, and at the level that would support research and continued learning for your writing. Especially with the full recommendation of 120 hours, I picture your ability to access all of the examples you provided in your original question. Our instruction may start at a lower level, but over the daily and weekly sessions, you’ll see an increase in the amount of language (text) you are processing as well as the complexity.”

That’s exactly what they did, except the Associate Director of the Double Bay, Australia resource centre knew I could afford only 80 hours of instruction; she set goals for me to achieve what I asked within that ambitious timeframe. I remained skeptical even while meeting all the goals on time as I progressed through the summer. But I didn’t just cross my fingers and wait for them to prove their assertion. I worked with the ADD Centre to ensure my brain biofeedback training would complement my reading comprehension retraining. My brain trainer told me what was most important was for my weekly brain biofeedback to ground me. I also used my Mind Alive audiovisual entrainment device a couple of hours before each nightly session to entrain my brainwaves into SMR and Beta frequencies, the ones that show a relaxing effect in people with brain injury and enhance the thinking brainwaves (beta frequencies of around 18Hz). I replenished my brain with glucose aka ice cream during the five-minute break between hour one and hour two of the reading retraining, as well as afterwards. Brain cells use glucose for energy; this past summer was steamingly hot, so ice cream was a must. I parked my brain more and more during my two days off. Other things got a little behind. My priority was reading. My energy needed to go all to reading. This was a last-ditch shot at getting my reading comprehension back; it was a rather expensive debt-exploding shot, too.

Lindamood-Bell Minnesota also said: “Since our vision for instruction will include increasing the volume of information you are processing, our goal is to decrease your fatigue, by systematically and consistently reinforcing independence with visualization for increasing lengths of language. Just like any foundational skill (ex: learning a new language, learning a new instrument) practice and continuous exercising of the skill, makes it more automatic. Instruction will stimulate and strengthen this process for you, but practice outside of sessions and beyond instruction, will also be key. You may still need to take breaks, but I anticipate the length of breaks and the frequency of breaks will diminish as you, on a daily basis, start reteaching your brain this visualization process.”

That is exactly what happened. When I began back in July, a sentence seemed super long to visualize and reading a whole paragraph all at once seemed impossible. As of tonight, I can read — that is, visualize and verbalize, denote and comprehend — four pages of a book, one page at a time in sequence, with less fatigue than when I was visualizing and verbalizing a sentence way back in July.

Even as I experienced progress, I remained concerned about being able to practice daily on my own. I worried about all this effort and money I really didn’t have wasted if I was unable to practice and lost any gains I made. People with brain injury have both motivation and initiation deficits. If someone tells me to read a page, and I’m able to do it, I will. But that kind of responsiveness is not the same as me being able to motivate myself to read a page and to initiate the action of reading a page. Too many health care professionals equate the two as being the same. They’re not. Responsiveness is not motivation. Responsiveness is not self-initiation.

I use a variety of technologies to initiate me. But nothing beats a fellow human being. When we speak, my neurodoc is now asking me to give me the main idea and a couple of pictures from my novel reading and my philosophy reading. My mother has bought the novel I’m reading, The Lions of Al-Rassan, and we discuss the plot, the characters, the action every so often. Accountability is so important.

But so is reward.

I was out and about with my CNIB orientation and mobility trainer and found myself near Soma Chocolate. I needed more of their kick-the-brain-awake hot chocolate; as I picked some up, I spied their chocolate covered dried cherries. Ooohhh. The perfect reward. One chocolate-covered cherry per page of novel read or per two paragraphs of philosophy read. That’s how I managed to read four paragraphs of philosophy this past weekend, not sweat through only two paragraphs and call it a day. I rewarded myself with two chocolate-covered cherries — soooo good — but the better reward was unexpected.

https://twitter.com/ShireenJ/status/1038471243559837698

I connected what I read with what came before. I saw the big picture unfolding. I comprehended how each of the writer’s points connected. I saw his philosophical argument beginning to unfold.

Holy s—!!!

I have not been able to do that before, seeing the big picture like a carpet unrolling, showing me its beautiful, intricate pattern. It wasn’t just that I comprehended it, I saw it. This is what visualizing means. Create imagery, and you’ll remember and understand.

For the first time this weekend, I felt confident that I will continue to progress on my own.

https://twitter.com/ShireenJ/status/1038504783852781569

Lindamood-Bell Australia told me I have partial proficiency in the application part of instruction because I need prompting with my higher-order thinking questions — yeah, I find it tough to ask myself these kinds of questions, a definite side effect of my brain injury — and to be more precise in my main idea. I’d achieved succinctness in my main ideas with Lindamood-Bell texts, but it’s not so easy with The Lions of Al-Rassan or Philosophy of Mind texts! They also noted that with the novel and philosophy, it takes some discussion between me and the clinician to make my images clear. I find creating imagery for concrete details far, far easier than for thoughts, flashbacks, concepts, abstract ideas, which are abundant in my application text. They did note that even neurotypicals need to pause when reading philosophy, reflect, go back, review vocabulary. It is not light reading for anybody.

I am absolutely amazed and stoked that I can finally — FINALLY — acquire and retain new vocabulary using Visualizing and Verbalizing!!!

They said that they don’t know what my reading will look like in the future. Will I be able to read a chapter and not be exhausted? They do know that, given how I have responded, I will continue to respond (as long as I practice). But is there a ceiling? They don’t know what the ceiling is or if my brain injury means there’s a limit to how much I can respond. The challenge for me will be how much language I can process as well as my reading speed. It takes longer to read when I have to break up a page into paragraphs and need hours to recover afterwards, like with my philosophy text. This limits me, there’s no doubt, because I still cannot keep up with others who can consume pages and/or chapters of a textbook or novel at one sitting, something I need to do if I take a course again. Maybe if I’d been able to afford 120 hours, I could have progressed to reading a whole chapter under their guidance before being out on my own . . .

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I will be re-evaluated in a week. But whatever the results, I know experientially, and my health care professionals have observed, I have improved dramatically. I have regained in eight weeks what I was unable to in 18 years using standard medical care or electrophysiological care for brain injury.