I’m discovering I’m not the only one having trouble speaking and writing after a brain injury, even months after the injury, and even though everyone says, “But you seem just fine to me!”
So, in an effort to offer you some of what I’ve learned lately, I’m going to insert here what I posted in an e-mail group earlier. Have questions? Ask and I’ll respond in the comments below.
This is what I’ve found out at TIRR: Outside of addressing those weaknesses or deficits apparent in a neuropsychological eval and maybe an OT eval, there doesn’t seem to be a regular treatment plan for improving writing and social skills outside of practice, practice, practice. A vocational program (in Texas we have DARS, http://www.dars.state.tx.us/) may help you more than a traditional therapy facility, but my impression from my case manager is that it will still direct you toward practicing, and not toward any specific exercise.
*How* you practice, of course, will count. For instance, my OT work and neuropsych eval verified my issues with distractability and fatigue, which in turn affect my writing and speaking. The approach is to (very) slowly increase my tolerance for distractions, while also respecting that for at least now I need to operate at a different pace than I was trying to operate . . . I need to work more slowly and thoroughly. When I can do that, I can more often be satisfied with my work and not feel so frustrated and make as many mistakes (it’s kind of easy to spiral downward, making more mistakes and then getting more frustrated, and then making more mistakes).
Little, indirect things make a difference in my comfort level and performance, like finding quiet places to work and talk, eliminating or minimizing auditory and visual distractions, and taking more frequent breaks to avoid fatigue. Once I feel comfortable, then I can challenge myself incrementally. It is key that I do not set myself up for failure, but for success!
I guess the big thing that I’ve learned from TIRR is that by trying to meet others’ (including my doctors’) expectations, and by insisting that if I just worked HARDER I would overcome my weaknesses, I spent a lot of time tired and frustrating, and I alternated between wanting to shut down and wanting to do everything I did before, just as well if not better. I’m much kinder to myself, and dedicated to operating at a very simple pace. I guess an analogy is working out. The best way to achieve overall fitness isn’t to lift very heavy weights a few times and leave the gym exhausted and broken, but lift lighter weights more frequently, improving your physical fitness over time.
Scheduling downtime is really important, too. When I challenge myself–say, in a social situation like church–I set a time limit and then make sure I have scheduled time in my day to chill out, stare at the wall, whatever. It lets me recuperate and not feel fried, while still benefiting from that kind of “exercise.”
Added 9 Nov 2007:
Relaxation and meditation skills (imagery, deep breathing) can help you work through an overwhelming or fatiguing situation (driving can still be very stressful for me). Reducing distractions–I’ve taken to wearing ear plugs a lot–help keep me focused, and might help you, too. Planning the minutiae of my day–even if I’m just at home–also help me direct my energy and keep me on track without feeling fried or pushing myself toward a point where I don’t complete my task to my satisfaction. Finally, if you aren’t organized already, do so. Your brain is trying to reorganize itself after your injury; the best favor you can do for yourself is organize your environment so you can really think.
Edited 9 Nov 2007.