Denial and Acceptance: A Traumatic Brain Injury Diagnosis

A traumatic brain injury (TBI) or catastrophic accident changes lives forever. An individual with a traumatic brain injury diagnosis goes from being a productive member of society to having a life of uncertainty. A TBI can have physical, cognitive, social and emotional symptoms. These symptoms can range from mild to moderate or severe. With each level of injury comes varying levels of symptoms. It can be difficult to know what symptoms or problems an individual will have. Traumatic brain injuries can be a mystery and it takes time to identify how an individual’s life will change.

Many individuals in the early stages of recovery feel a sense of daydream. Is this real?  S/he might think, “This cannot be happening to me.” S/he may have trouble remembering details of what happened the day of the injury or days after the injury. The lack of memories could lead an individual to feel uneasy or scared. As an individual begins the recovery process s/he experiences many different emotions and behaviors. Denial and acceptance become very important aspects to successful recovery.

Denial is an unconscious form of coping. In some cases, a little denial can be a good thing. Being in denial for a short period can be a healthy coping mechanism, giving you time to adjust to a painful situation. It can be a valuable tool in the short term after injury. However, denial has a dark side. Being in denial for too long could prevent you from effectively dealing with issues that require action[1]. Once an individual begins to talk about her or his injury, it is easier to begin to accept the diagnosis and the realization that life will be different.

An individual going through the process of recovery may struggle with acceptance. A lack of awareness of the injury or limitations can be a potential obstacle to successful rehabilitation following a TBI. Research has shown the first level of awareness is recognizing the injuries themselves; that is the particular physical, cognitive, social and emotional. The acceptance of physical disabilities is often achieved more readily than the social and emotional problems. Second, the acceptance that the injury will have a negative effect on independent living, work, driving and everyday activities. Lastly, the ability to accept one’s future goals may change from his or her pre-injury goals.

Family members, caregivers or significant others also go through the process of denial and acceptance. The members of the support system are often fatigued and have increased stress which leads to varying levels of denial and decreased awareness. Some are in denial that their loved one will make a full recovery; some realize that the disabilities are permanent and others are afraid to disclose problems with behaviors due to repercussions. The support system are the people that are providing care to the individual daily and have to deal with anger and frustration[2].

It is often appropriate and necessary that an injured individual is admitted to a residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries. At NeuLife, in Mount Dora, Florida, a 27-Point Client Care Plan will be developed with the input of the individual and his or her family to achieve the best possible outcome for this client.

Family training and education, cognitive support services and psychology services are important for the client and family to consider participating in, in addition to physical, occupational, recreational and speech therapies. Cognitive behavioral therapy is a form of treatment that focuses on examining the relationship between thoughts, feelings and behaviors for both the client and family.

Education and training, as part of a holistic approach to recovery has proven to be very beneficial to a client and family. The importance of being able to communicate needs and wants is a key area of the recovery process. These services allow the client and family to practice and develop skills necessary for a positive recovery experience regarding the client’s goals and plans to achieve those goals. These sessions can be arranged on an individual basis or involve the client’s family.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period”—the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.