The Journey is the Destination David J. Scarisbrick, Ph.D. Director of Neuropsychology Progressive...

The Journey is the Destination

David J. Scarisbrick, Ph.D.Director of Neuropsychology

Progressive Health of Pennsylvania

Brain Injury: The Family’s JourneyBrain Injury Alliance of New Jersey

October 18, 2014

General “Guiding Principles”

You MUST plan for both the short-game and the long-

game.

General “Guiding Principles”

It is a LONG-GAME

General “Guiding Principles”

ALL Plans are subject to change.

General “Guiding Principles”

TTT- Things Take Time

General “Guiding Principles”

The labels “Mild-Moderate-Severe” are related to the effects of the initial insult

and not necessarily mapped onto the long-term sequelae.

General “Guiding Principles”

The neurological system is a dynamic NOT static

system

General “Guiding Principles”

One must be wary of inadvertently creating

problems (iatrogenic). Some individuals will begin to steal or lie to get their

perceived “needs” met.

General “Guiding Principles”

Individuals may “Grow Into” a deficit

General “Guiding Principles”

Be aware of “control” issues and always try to respect

and give as much control as possible.

General “Guiding Principles”

“Windows of Opportunity” open and close at various and unpredictable times

during one’s life

General “Guiding Principles”

Whose GOALS are they anyway?

General “Guiding Principles”

Topic of Hope

Acute Stages: Family and therapist are viewed as sources of hope. They are helping me do something

Long-term Stages: Family and therapist are viewed as trying to “stop me” from doing something.

General “Guiding Principles”

This ain’t for sissies

General Overview of the Brain and Organization

Brain and Spinal Cord are continuous

“Lower” areas of the brain (e.g. brain tem) serve more basic

automatic functions

General Overview of the Brain and Organization

Evolution is not wasteful. Newer brain regions are added onto existing ones

“Newer” regions often control “lower” areas through inhibition

“Higher” functions may be lateralized to a greater extant to one side of the brain (e.g. language, emotions, facial processing)

Long-term Cognitive and Emotional Problem

Awareness

“We don’t see things are they are, we see them as we are.”

Anais Nin

Long-term Cognitive and Emotional Problem

Anger-Episodic Dyscontrol-Frustration

Long-term Cognitive and Emotional Problem

Depression- Disorders of Mood

Long-term Cognitive and Emotional Problem

Disinhibition-Impulsivity

Long-term Cognitive and Emotional Problem

Memory

Long-term Cognitive and Emotional Problem

Initiation (Motivation)

Long-term Cognitive and Emotional Problem

Aging and Health

General ConclusionsGive control when possibleBe Specific in your feedbackCheck for mutual understandingDisengage when anger arisesRe-engage when anger subsidesBe positive and find humor when possibleLook for “Windows of Openness”Try and set goals that are meaningful to

allLook for positives to reinforce

Questions?