Why I Worked Through Cognitive Struggles after a TBI while earning a Master’s Degree
A 4-part story of adversity, courage, hope and success for one TBI survivor
Lisa had worked through the initial phases of a TBI patient, completed her bachelor’s degree, yet still wondered what she could do to fit in while struggling with on going cognitive challenges. She pushed herself through yet another degree program at the graduate level to learn and heal, but it still was not enough.
These obstacles and challenges associated with TBI survivors include many skills associated with execution functions of the brain. These skilled functions can be thought of as the command center of the brain that controls the cognitive processes such as decision-making, impulse control, attention, emotional regulation, and working memory.
Here is part three of her story.
Progress Takes Time
During my undergraduate work, I did a significant amount of research on mild to moderate traumatic brain injury and found there to be limited research regarding mental health and TBI survivors. The wonderful degree I had just earned would not be enough for me to be able to work with fellow survivors.
I do not know about other survivors’ experience with locating a mental health provider who understands and works with TBI survivors, but I ran into a number of therapists who wanted to throw a label on me (whether right or not) and use therapeutic approaches that did not work with my processing and cognitive impairments.
The therapists would say “I can’t help you”, give me a name of someone else to pawn me off on, and be done with it. When I began going to a brain injury support group, I realized there were more people like me out there with similar struggles.
Why not take my accident and turn it into something good to work with other people just like me? I sure did not understand “normal people” and “normal people” reaffirmed time and again that they had no interest in attempting to understand me. So, back to rehabilitation (school) I went.
Unfortunately, the “I can’t help you” therapist plea did not end or improve on the “Learning to Become One of Them” journey. I saw many TBI survivors not being provided with appropriate services and were given diagnoses just as inappropriate when I was doing my internship for my master’s program.
Three years later, I graduated and was blessed with the opportunity to become licensed as a therapist and began working within a private practice where I had the freedom to work with TBI survivors without negative backlash. This, while still working for the other employer (great benefits) and the associated disrespect (bad benefit) I had served for over three years at the time.
I had the misconception that after I graduated and made something out of myself that life would be better, and I would finally earn the respect of my peers. For some reason, this matters to me. If people do not respect me, they are surely not going to see me as someone they would want to work with in a therapeutic setting.
It seemed like my boss with the long-term employer lost respect for me when I earned a master’s degree, which was disappointing because I had a lot of respect for that boss who actually came to my undergraduate graduation and told me how proud they were of my accomplishment.
My self-esteem tanked once again, and I struggled with not feeling good enough. The judgments, cold-shoulders, and rejections were taking their toll on my well-being. What was wrong with me, I wondered?
My cognitive and processing functions began to regress and my mental health was struggling with my hearing the same tune as before, “I can’t help you” or “I am not a good fit for you”. Those feelings of being a freak or an alien returned, and I wondered again why people are so cruel, quick to judge, and slow to understand?
What I was doing was not working, so I began considering ways I could work on my self-esteem and insecurity issues without the willingness of a mental health professional to work with me.
Have any of you ever wanted to get help but could not get it?
Money is a huge factor, in addition to finding a therapist who is compatible with your emotional needs, finding a therapist with an available opening within a few weeks is another challenge, and by the time you actually get an appointment with a therapist, weeks have passed and the motivation to work on your issues has gone on vacation somewhere. Your motivation is on a beach somewhere, while your emotions are playing pinball in your brain.
Overstimulation? No. De-stimulation? Yes.
I went a year-and-a-half swimming uphill in a river of depression. Deaths and dear friendships lost were added weights to my load and I once again struggled with despair. I was driving my vocational-rehab counselor crazy……..
I needed to do something.
Until next time.
Dr. Lisa Ansell, Guest Blogger Lisa Marie Ansell, Ed.D., LPC, NCC, CBIS Licensed Professional Counselor National Certified Counselor Certified Brain Injury Specialist Adjunct Professor at a Private University
If you have anything to share please feel free to reach out to me at www.razcoaching.com or www. coachingacademics.com. michelle@razcoaching.com Or follow my www.Instagram.com/razcoaching. I do daily mini blogs with tips of inspiration and post almost every day. There’s something in there for you that can help you with your focus for the day.
A Damaged Spirit, Cognitive Struggles and The Determination To Overcome
A 4-part story of adversity, courage, hope and success for one TBI survivor
Lisa, with a damaged spirit and facing many cognitive struggles, embraces her disabilities in the midst of healing with the will and determination to overcome her challenges.
This is part two of a four-part series of how one traumatic brain injury (TBI) survivor overcame obstacles to improve her quality of life when appropriate resources seemed out of reach. We learned how Lisa’s life changed after a terrible accident in Part I: Overcome Obstacles Instead of Being Overcome by Them. These obstacles and challenges associated with TBI survivors include many skills associated with execution functions of the brain. These skilled functions can be thought of as the command center of the brain that controls the cognitive processes such as decision-making, impulse control, attention, emotional regulation, and working memory.
Here is part two of her story.
Change Takes Time
Have you ever heard the term, “doing a geographical”? Many times, geographicals do not work but in my case, it saved my life; literally. Somehow, I was able to get a good job in another county. I got good references from people in the other community, I think mostly so I would leave. If people think they fooled me, they did not but I needed to go somewhere else to pick up the pieces before my pieces were so broken, they could not be repaired. The job did not work out even though I told the employer about the head injury and how it may take longer for me to get the information into my long-term memory, but once I got the information into my long-term memory, I was good.
The trainer grew so impatient with me, she snapped pencils in frustration.
I knew my time was done then.
So began my employment woes.
Headaches after the accident were brutal and constant. One day, after moving to the new community, I had the worst headache, my speech was worse than it had been since the accident (four years prior), and I thought I was having a stroke. To the Emergency Room I headed only to be diagnosed with a migraine and sent on my way. The clinic connected me with a kind patient navigator who turned out to understand my circumstances better than most, being a TBI survivor as well. This kind soul connected me with resources that assisted with getting services and referrals to people who deal with TBI.
I felt like the thunderstorms were heading east and finally, sunny weather was in my forecast.
The new community had their own ideas about my “strange” behavior and I again faced judgement and incorrect opinions. Employment opportunity labeled me “a liability” and spread the word through the county of my ineptness, which spread like a wildfire. There is nothing better in the world than being judged, tried, and convicted of being an indecent person by people who have no willingness to understand someone who is different, and in their opinions, insignificant. What if it had been them in the accident, how would they feel?
During my recovery, I have seen the kind side of people for the first encounter, then the (not so) subtle body language telling me to stay away from them. Talk about a self-esteem killer! It has been my experience that people push away what they do not understand, and rebuke what is different than their interpretation of normal. So, is their version of normal the norm for the rest of us? Why are they so special?
Just saying. Is anyone relating to any of this?
Aside from doctors and becoming a subject within a sample population for a research study to receive free treatment for my TBI in exchange for data for the researchers, I found another form of rehabilitation. Having been dealt more rejection after the accident than I had previously experienced in life, I found acceptance, in school.
Remember the words from the Junior Associate lawyer who pretty much told me I would not amount to much in life? If you do not, I did. Thinking I had nothing to lose, I applied to a university expecting to be laughed at (behind my back of course) but instead, I got accepted. Let me repeat the word, accepted.
Between the words of the Junior Associate lawyer and reading the word, accepted, I was motivated to prove all the doubters wrong.
School was tough. I did not retain the information within the reading assignments the first time, the second time, or even the fifth time. I had to reread the material repeatedly to comprehend enough to answer one question. I do not believe any of my professors knew how hard I had to work, they just commented on my being a good student.
While the rest of the world (it seemed) thought this “different, awkward, and strange” woman would not amount to much, I trusted God’s plan for my life, whatever that was, and each time I got a good grade, I felt accepted and more than my brain injury, I was learning how to process information, formulate sentences, and re-learn critical thinking skills.
I began to have belief in myself again.
Someone within the community who knew I was living out of my pick-up truck or a motel when I had money, told me about a job possibility they knew I had experience with. I was upfront and honest with the potential employer regarding my injury and after going through some hoops, I was offered a job and have been with the employer for nearly eight years.
The job schedule worked with my academic studies and eventually, I was able to move into my own apartment after seven months of living in my truck or in a motel. I still get people who judge me and think they have the right to draw erroneous conclusions as to why I am the way I am, but I really don’t care anymore as I trust my abilities and know my job. If I cannot do my job due to having a tough day with overstimulation, I have an agreement with my boss that I will call and take the day off.
There have not been many days I have had to call off work for overstimulation reasons. But the words of people who have tarnished my reputation have created a disrespect of me within the employment that no matter how much I recover, to them, I am just the pain in the butt who shows up for work and does her job.
Gossip kills not only a reputation, but it also does damage to a spirit.
As I sign-off for this post, I am going to share with you that this “awkward” and “different” TBI survivor graduated with honors and received a bachelor’s degree five years after the accident without using accommodations.
My determination wanted to do the work without crutches; I needed to prove to myself that I could do it.
Walking across the stage to shake the hand of the university’s president with one hand and grasp my diploma holder with the other hand did so much for my self-esteem and belief of becoming more than my brain injury.
To the doubters, it almost felt like I was giving them the bird, though I knew there may be nothing I can do to prove them wrong in their own minds. But to myself, I found a part of me that I did not know existed before the accident. Maybe there was a blessing in disguise within a terrible experience.
Until next time. Lisa Marie Ansell, Guest Blogger
If you have anything to share please feel free to reach out to me at www.razcoaching.com or www. coachingacademics.com. michelle@razcoaching.com Or follow my www.Instagram.com/razcoaching. I do daily mini blogs with tips of inspiration and post almost every day. There’s something in there for you that can help you with your focus for the day.
Listen to Ross, a college student with ADHD, talk with Academic and Career Coach Michelle Raz of Raz Coaching about his Challenges with ADHD as a college student.
In this episode Ross and Michelle dig deep into his journey through figuring out what works for him to be a successful college student managing ADHD on his own. You will learn the words of advice Ross got to get through the boring and mundane work and how he had to look within himself to find solutions to his problems. The support source he has received enables him to face his failures and feeling of shame. Hear what it took to get him on a positive academic path.
A key takeaway for him and pivotal question he began to ask himself when procrastination and low motivation set in was:
“Where has this procrastination led me in the past and did I like that?”
Learn where this journey has taken him
Hear where he is now academically
This is a great episode for parents of ADHD college students and motivational for ANY current or future college student.
Please forward and share with someone you feel needs to hear Ross’ story.
If you want more podcasts, blogs, videos on life with ADHD visit Michelle’s website at www.razcoaching.com or www. coachingacademics.com. or email her at michelle@razcoaching.com. Also, you can follow her at www.Instagram.com/razcoaching. She has many mini blogs with tips of inspiration. There’s something in one of her outlets there for you that can help you with your ADHD struggles and challenges. She even has an App on her website to ask questions. “Ask Raz!”.
Overcome Obstacles Instead of Being Overcome by Them
A 4-part story of adversity, courage, hope and success for one TBI survivor
This is one of a four-part series of how one traumatic brain injury (TBI) survivor overcame obstacles to improve her quality of life when appropriate resources seemed out of reach. These obstacles and challenges associated with TBI survivors include many skills associated with execution functions of the brain. These skilled functions can be thought of as the command center of the brain that controls the cognitive processes such as decision-making, impulse control, attention, emotional regulation, and working memory.
Here is the first part of her story.
Healing is a continual process, but for this TBI Survivor, I made a choice to overcome obstacles instead of being overcome by them. Do not get me wrong, there have been, and still are some tough days, but with determination and a willingness to change, anything is possible.
What Happened…
Over eleven years ago, my life drastically changed on a fall day as I was driving to Steamboat Springs, Colorado in a snowstorm for a class. We all know how Colorado weather can be; sunny one minute, a few miles down the road and a few minutes later, a complete whiteout has greeted you with full force. As I was making the final turn toward the West Summit of Rabbit Ears Pass, I noticed a vehicle fish-tailing on their side of the road and decided to pull as far right on the shoulder as I could hoping the car would pass, I could make a sarcastic comment about their driving, then be back on the way to class.
I did not make it to class but, I did survive a head-on collision with the side of the other driver’s vehicle. Not only was life as I knew it changed but my ambitions for my career were crushed as well.
What changed?
Well, I went from being a semi-respected member of the community to the town joke.
Memory, balance, speech, processing, and cognitive issues made me different; insignificant in the minds of many who, instead of trying to understand the abrupt challenges in my life, people chose to judge and diagnose me to be someone I was not. I lost friends, family members had no idea how to deal with me or communicate with me so, it was just easier for them to write me off as a “freak”. People I called friends called me, “different, odd, awkward, and consistently inconsistent”. Great on the self-esteem, I tell you (sarcastically speaking).
There were limited resources within the community I lived and the husband at the time, scared the crap out of me when he drove me to and from doctor appointments and surgeries. It took me over a year to get behind the wheel again.The marriage did not survive, but my mild traumatic brain injury was not the only reason.
Do you know what it is like to walk into the store or post office and see people whisper into one another’s ear while looking at you from the corner of their eye? Nah, they were definitely not talking about me, and they were so secretive, I had not noticed. Right…
I apparently hired a lawyer to represent my best interests but I don’t recall signing the paperwork, but when it was all said and done, I was hurt in the accident so they could benefit from my pain and suffering. On one of the few encounters I remember with the lawyer’s Junior Associate (my mood swings and emotional dysregulation were too much for the real lawyer), it was mentioned that I should lose my home, be broke, and accept that I would never have worth-while employment for the rest of my life.
I guess if I had bought into what they were selling, they would have gotten more of my settlement, and they got most of it. That was just enough motivation for me to realize I did not want to be the person they decided I was going to be. Boy, did I make a few sharks angry. Who cares about what their words did to my self-esteem?
Oh yeah, being different means being insignificant, right? Wrong!
One afternoon a year-and-a-half after my accident, I sat at my kitchen table in despair, crying, and thought I could not live the way I had being living anymore. I was afraid to drive, the help I was getting was minimal, and the then husband was about as available as a live operator in a computer-operated call center. I was ready to give up and had grown resigned to the idea of my disappointing new life, trying to find acceptance of my circumstances even though I struggled to accept the new me.
It was tough because I could still remember how I use to be, I just did not know how to reach that person. We had been permanently disconnected. I sat at that kitchen table and surrendered and prayed. Something had to give. Does anyone reading this understand where I am coming from or what I am talking about?
Within my next post, I will share about healing; Lisa style.
Until next time……
Lisa Marie Ansell, Guest Blogger
If you have anything to share please feel free to reach out to me at www.razcoaching.com or www. coachingacademics.com. michelle@razcoaching.com Or follow my www.Instagram.com/razcoaching. I do daily mini blogs with tips of inspiration. I post almost every day. There’s something in there for you that can help you with your focus for the day.
Are some kids dealing with Autism misdiagnosed with ADHD?
Yes, absolutely! There are overlapping conditions between the two. Read on to read the full comparison by The Diagnostic and Statistical Manual of Mental Disorders (DSM–5)
How are these two disorders similar?
Many of the symptoms associated with Autism Spectrum Disorder are confused for ADHD, such as difficulty in settling down or focusing on something, ability to pay attention, impulsivity and social awkwardness. These are the executive functioning skills: time management, organization, self-reflection, emotional regulation, and focus.
Yes, Autism and ADHD can look a lot similar as children with either has difficulty focusing. They have issues communicating; they might struggle with their schoolwork and so on. Although the two conditions share a lot of common symptoms, the two are very different conditions. Autism is a kind of developmental disorder that can impact language skills, social interactions, behavior and learning ability. ADHD affects the way the brain develops and grows. It is also possible at times that someone on the Autism spectrum is dealing with both, which would be called a comorbid condition.
So, how can we differentiate between the two conditions?
Look at the checklists below and compare and observe the behavior. All those dealing with autism struggle to focus on things that they dislike. For instance, if they don’t like to study, they cannot focus on reading for comprehension. When they asked to read, they might fixate on things they like, such as watching a cartoon or playing their favorite game. Students dealing with ADHD lose interest in the initial phase and they try to avoid things asked to focus on. They can look similar. The difference will be the severity in the autistic person and the other traits listed below.
You can also look at the way the person learns to communicate.
Although in both conditions, children struggle to communicate with others, those dealing with Autism are generally highly focused in their own world. They struggle to put words to their thoughts and fail to express their feelings. They also find it difficult to make eye contact with someone. On the other hand, a child dealing with ADHD can talk non-stop and can be very social. They can be talkative and challenging to stop them once they stop.
While an autism child loves to repeated events, those dealing with ADHD like to move onto the next interest. A child coping with Autism might like the consistent routine of things, whereas those with ADHD do not like to do the same thing over and over again. They like to explore new things often.
While these are samples that help differentiate between ADHD and Autism, there are many more characteristics considered before a diagnosis could occur.
The first and most important thing to do is to visit the doctor. Let the expert decide what your child is going through if you suspect either condition. To diagnose ADHD, doctors generally look at the behavioral pattern of the child over time, for instance – not following the instructions, being forgetful, not listening to parents, fidgeting and so on. They ask for feedback from parents and teachers and draw a conclusion based on their observation and symptoms. The feedback for Autism is much more complicated. Look below at the full DSM5 criteria the professional use to determine if it is ADHD or Autism.
Here are the full Diagnostic Criteria for Autism Spectrum Disorder from the www.cdc.gov site
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Specify current severity:
Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper- or hyperreactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Specify current severity:
Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level
DSM-5 Criteria for ADHD
People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development:
Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
Often has trouble holding attention on tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
Often has trouble organizing tasks and activities.
Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted
Is often forgetful in daily activities.
Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is expected.
Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
Often unable to play or take part in leisure activities quietly.
Is often “on the go” acting as if “driven by a motor”.
Often talks excessively.
Often blurts out an answer before a question has been completed.
Often has trouble waiting their turn.
Often interrupts or intrudes on others (e.g., butts into conversations or games)
The accurate diagnosis of the condition starts when you start talking to the doctor about behavior, what he/she dislikes, what they struggle with. Apart from the symptoms and behavioral patterns, some more tools and tests are conducted to understand what the client is dealing with.
Fortunately, there are many resources available today to help distinguish the two conditions and behavioral plan options to help live the most productive and fulfilled life.
If you have anything to share please feel free to reach out to me at www.razcoaching.com or www. coachingacademics.com. michelle@razcoaching.com Or follow my www.Instagram.com/razcoaching. I do daily mini blogs with tips of inspiration. I post almost every day. There’s something in there for you that can help you with your focus for the day.
Welcome to the ADHD strategist where we come together to talk about living with ADHD. We are here to discuss the challenges and applying strategies that we face living with the disorder in ourselves or our family and how to stay in control with our lives. I
Online schooling can be great because you can work at your own pace but it can also be difficult when you’re needing extra support or you’re needing to make sure that you’re getting things done for accountability. I have three questions today that I’ve been asked recently that I want to share with you and I hope that I’ll help you and your experience with this online schooling.
1. Do I need to enforce where my student studies?
2. My student takes forever to do their work, is there something I can do to help them be faster?
3. My student gets frustrated so easily and gives up before he/she can get help, what can I do?
If you have more questions and you are still stuck and you can’t find the answers on my website with some of the articles I’ve written, try my Ask Raz! app on my website where I answer relevant ADHD and executive function questions. Thanks for listening today. www.razcoaching.com or Instagram.com/razcoaching where I offer daily motivation tips advice and humor.
Welcome to the ADHD strategist where we come together to talk about living with ADHD. We are here to discuss the challenges and applying strategies that we face living with the disorder in ourselves or our family and how to stay in control with our lives. I
Online schooling can be great because you can work at your own pace but it can also be difficult when you’re needing extra support or you’re needing to make sure that you’re getting things done for accountability. I have three questions today that I’ve been asked recently that I want to share with you and I hope that I’ll help you and your experience with this online schooling.
1. Do I need to enforce where my student studies?
2. My student takes forever to do their work, is there something I can do to help them be faster?
3. My student gets frustrated so easily and gives up before he/she can get help, what can I do?
If you have more questions and you are still stuck and you can’t find the answers on my website with some of the articles I’ve written, try my Ask Raz! app on my website where I answer relevant ADHD and executive function questions. Thanks for listening today. www.razcoaching.com or Instagram.com/razcoaching where I offer daily motivation tips advice and humor.
