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Rebuilding a Personality After Brain Injury
Brian Stokert, MA
Speaking at the San Diego Brain Injury Foundation’s
general meeting on September 11, Brian
Stockert, M.A., a counselor in the Acquired Brain Injury (ABI) Program at Mesa
College, in San Diego, described how the program helps to “rebuild a
personality after brain injury.” Brian is a marriage and family counselor who
specializes in special education.
Brian Stockert, MA with survivor David Hoapili and
Behavioral Optometrist,
Dr. Brenda Anderson
The Mesa College ABI program is one of the very few
post-acute, post-secondary programs for adult survivors of brain injury. Brian
emphasized that the free ABI program is a support to psychotherapy, not a
substitute for it.
Most rehabilitation programs focus on a medical
model---the pathology of brain injury. The Mesa College program approaches
recovery from a holistic perspective. It is based on a foundation that all
people must have to feel that they have an identity and self-worth. This
“psychosocial rehabilitation” is also crucial to recovery.
Brian first discussed the elements of thinking and
coping. Our thinking and emotions aren’t separate; they are an interconnected
loop. The two basic emotions are love and fear. People’s coping strategies
differ, depending on whether they are coming more from love or from fear.
A related aspect of the program is the building blocks of
recovery. First, in order to learn anything else, we must learn how to pay
attention. Then the program focuses on concentration, then understanding, then
memory. After these are worked on, the program focuses on organization, problem
solving, and task completion.
Throughout this course, there is attention to the
strategies we use to control our emotions. Learning how to do self-monitoring is
an essential part of this. To reach our goals, we have to monitor our thinking
every step of the way. Learning how to use coping skills helps to chase away
negative emotions and fear, which can cloud our thinking.
The ABI program helps us to learn more about who
we are now and to build on that, rather than focusing on who
we used to be. It is a journey of discovering ourselves again. Who we are is
rooted in who we were in the past, who we are now, and what we want to be in the
future. Knowing our values and our vision
gives us insight into our inner selves and how we relate to others.
Brian explained that our senses of ourselves can be
compared to a house. The foundation of the house is your basic values. The
walls, which are the support structures, are your skills. The roof, which is
your shelter or security, is whether you matter or whether you belong. When you
have a brain injury, it is like a house that has been in an earthquake. The
foundation, walls, and roof of the house are cracked.
The first step is to deal with the grief of the loss. The
next step is to take a good look at the house to see what is left and what needs
work. Looking at the foundation (the values), we ask, “What matters now?”
Looking at the walls, we ask, “What skills do I have now?” Looking at the
roof, we ask, “Who am I?” and “How do I matter or belong?”
One important thing to notice is that when you are
rebuilding a house, you don’t start with the walls; you start with the
foundation. Focusing on the walls, your skills, won’t help until you have
dealt with the foundation. To do this, it is necessary to look inward, not just
outward. This is difficult for some survivors, but it is important. The old
person, like the original house, didn’t go away, but it changed. When you have
gone through this step, you have a firmer foundation. Then you can work on
acquiring new skills. You can take the best of the old you and the best of the
new you and build on them. You can put on a new roof by creating a new sense of
who you are and how you matter and where you belong. This is where your vision
comes in.
Brian said that it can take eighteen months to two years
or longer to work on identity issues and create a new, integrated self-concept.
Another aspect of brain injury that the Mesa College ABI
Program addresses is that individuals with injury to the right hemisphere and
right frontal part of the brain may be unable to recognize the results of their
injuries. They don’t know what they
don’t know. This is called “ansognosia,”
and it is not the same as denial, although it frequently is mistaken for denial.
In order to be able to learn about yourself, you need to
be able to look at your self realistically. You need to be able to evaluate your
performance, strengths, and challenges.
For more
information about this program, call Brian Stockert at 619/584-6983.
Mesa College,
Acquired Brain Injury Program
San Diego, California
The Mesa College ABI program conducts neuropsychological
testing to help students identify their functional problems, their strengths,
and their challenges, in order to plan their programs most effectively. Injuries
to the pre-frontal cortex of the brain also can impair social, interpersonal
behavior. Injuries to the parietal lobes can cause problems with perceptual,
sensory abilities. Injuries to other parts of the brain can impair linguistic
ability. Different survivors have different types of impairment.
ABI Program counselors help students to increase their
life skills, as well as their academic and work skills. They help teach them
sensitivity to environmental and interpersonal cues. They provide group
counseling with peers regarding goals and behaviors. Classes cover cognitive
retraining, personal development, coping strategies, awareness, communication,
academic skills, creativity, and vocational exploration. The aim of the program
is to provide students with the tools they need to succeed in important areas of
daily life, including interpersonal relationships, work, school, and the
community. Many members of the San Diego
Brain Injury Foundation credit the Mesa College ABI program as being one of the
most important factors in their recovery.
The program is sponsored by the San Diego Community
College District. Instructors include speech and language pathologists,
rehabilitation counselors, recreation therapists, counselors, and
paraprofessional support staff. The Spring and Fall semesters are 18 weeks, and
the Summer session is 8 weeks.
For more
information about this program, call Brian Stockert at 619/584-6983.
