Scene 03 - Sarah's Introduction

***************************Sarah’s Introduction**************************************

For Sarah there was no warning.

Not really,
I had just dropped my daughters at Little Angles Daycare,
I was going through a green light - it had just turned green -
and Boom.

There was no warning.

****************************************************************************************************         

The first sentence of this story segment contains a common experience concerning TBI - there was no warning.  I’ve already written about this in a previous post, so I won’t elaborate on it again here except as a reminder of the consistency of an unexpected event begining a journey of recovery from brain injury.


Instead, I will use this entry to speak about the character of Sarah and the woman I used as a model for her - I will use the name “Jessica” for this woman.

To quickly describe “Jessica”, she was a bubble pumped full infectious joy to the paint that her skin was stretched thin by it, and sometimes an unintended criticism or sharp word would cause her to burst into painful self-hate and depression.  When my relationship with the Crumley House began, “Jessica’s” condition was such that she had lost her short term memory and would forget what she had been told only hours or minutes earlier - though with regular, repeated exposure people, activities, and schedules would be recognized.  Her memory did seem to be improving by the time I ended my work with the Crumley House, but she still tended to rely on her difficulties with memory as an excuse if she got in trouble with any staff at the center (I will write more on this in a future entry).

Being relatively new in her recovery process, “Jessica” was in the process of adjusting to her new world.  As I worked with the Crumley House, I witnessed what I felt were several transformations  of “Jessica’s” personality - from a new survivor excited by the privilege of living again after her accident, to an angry victim of the world, to a woman settling into her new reality of recovery.  This is clearly an oversimplification of “Jessica’s” process, but I present this journey in these three stages because I recognize my own healing journey mirroring that path - and I would hypothesize that this are common stages for survivors of TBI (if you know of any good resources to support or contest this hypothesis, PLEASE LEAVE A NOTE in the comments below - thank you).

With these observations in mind, I created the character of Sarah.

In the timeline of Who Am I, Again?, Sarah is still at the stage of being excited to have survived (as discussed above), but is coming to the difficult realization of her new, different abilities - moving into the second stage of the healing journey outlined above.  Sarah embodies the urge to “put on a happy face” and quote inspirational slogans while trying to ignore the pain caused by the new circumstances of recovery. 

Looking back on my experience, I feel that in my experience this hope was a chosen naiveté supported and encouraged by healing professionals - especially in early recovery - because of the positive effects on my mood and with the belief that a positive outlook has positive effects on the healing process (again, I believe there is research support this, but would like suggestions of where to find citations - COMMENTS BELOW).  I remember reciting words and inspirational stories with such a consistent rhythmic and verbal structure that it was as if I was reading a script - having a background in theatre and an inclination for storytelling most certainly influenced my recitation, but I have observed similar tendencies in other TBI survivors, including but not limited to “Jessica”.  I term it a “chosen naiveté” because although an awareness of my situation was beginning to dawn on me, I used these scripted outlooks as an escape from the frightening and uncertain reality of recovery.  Furthermore, I feel the healthcare professionals that encouraged this outlook didn’t intend to create a “false hope”, but to acknowledge that there was hope - as previously discussed (earlier posting), the speed of recovery differs greatly for any individual, so hope should never be fully abandoned.  Granted, there is a danger in becoming lost in the ideals of what might be and not acknowledging what is - if a recovering person focuses only on what they will do, it is possible to forget to complete the necessary steps to attain that future - but there can be a balance between present reality and future potential. 

Sarah has this hope - this focus on the future.  Simultaneously, however, she displays the dangers of attempting to ignore the pain that exists behind a hopeful facade.  More will be written on both aspects of Sarah in future postings, but these opposing drives - the hope of recovery and the hidden depression - create a dark conundrum that exists in many people recovering from TBI.  Keeping the hopeful ideal of recovery at the forefront of a survivor’s public persona seems to provide relief to those close to the survivor - personal relationships as well as healthcare providers - and it is comforting for a survivor to provide comfort to those close, but the dark rumblings of inner depression are hard to hide.  This creates a quandary for caregivers - how to support a positive outlook while not ignoring what could become a dangerous depression if negative feelings are allowed to fester.

How does a caring, supporting person find this balance?  There is no easy answer, but having raised this question I feel compelled to state my opinion: the best way to support a survivor through this conundrum is by simply being there and listening - not as a professional or someone ready to intervene, but as a friend and companion.  That is not to suggest that work with a psychiatrist and/or rehabilitation clinician shouldn’t be employed to help - these are trained and studied professionals who understand the process of recovery and how to assist and protect a recovering person - but as a non-professional trying to help a recovering friend, simply listening allows the survivor to work things out for him or herself.  This empowers the survivor - so much of recovery is about doing what the doctors tell you to do that by having someone simply listen, a survivor is better able to recognize the ability and responsibility of self-direction.

Now, I recognize that listening is not always an easy process - especially in early recovery - as narratives may lack a clear temporal plot line or consistent logic, but I encourage allowing the story told by the survivor to take its own path - a listener should not try to insert coherency into the survivors narrative.  If a listener feels a need for clarification, questions may be asked, but don’t use questions lead the speaker - let the survivor reach conclusions following his or her own path.  Furthermore, and this may be the most difficult and counter-intuitive part, if the speaker reveals that he or she is considering potentially self-destructive behavior, the listener should not attempt to step in and remedy the situation - instead listen and let the survivor complete his or her narrative and, when the situation allows, quietly inform a professional of any fears.

That is my opinion on how a loved one can best help the conflict that arises between appearing hopeful and feeling depressed.  Please note, while I have done a fair bit of research and I draw from personal experience for this opinion, I am not a trained professional and I welcome any thoughts concerning this matter (COMMENTS BELOW).

As explained above, Sarah is the personification of this conflict in Who Am I, Again?.  In the performance Sarah’s body is always in her chair - unable to escape this conflict - but, despite her motivational responses being somewhat contrived, in her deepest self she recognizes there is hope.  It is finding hope amid this amalgamation of emotions that keeps a survivor driven to heal.

I expect that this topic of internal conflict will be explored more in future writings, but until that time, please leave your thoughts and suggested readings in the comments below.  Thank you for reading.  Chat soon.