denial/acceptance of a TBI

[jamiesgirl]

I was wondering whether people had trouble actually accepting that they'd had a TBI, or at least the severity of it? Did you go through a period of denial and if so, how long did that last?

My other half had his accident nearly 5 weeks ago now (I'll post the background again sorry, I want to do a signature but am not allowed? anyway...) He passed out and hit his head, which resulted in an acute subdural hematoma, 2 skull fractures and a frontal lobe contusion. He had one week of post traumatic amnesia but luckily he didn't need surgery, and was discharged home coming up to 3 weeks ago.

The main problems he is experiencing are hearing loss (which we now know to be permanent higher frequency loss) and permanent tinnitus; fatigue; vertigo and headaches. Slight memory issues and irritability when particularly tired, but no real cognitive issues I don't think.

BUT the big thing I've noticed, is that he seems to be having trouble actually accepting he's suffered a severe TBI. He'll say things like "there's nothing wrong with me other than being deaf now" or "if I had a head injury, I'd still be in hospital." To me, it's ironic - the very fact he's saying he hasn't got a head injury indicates he's got a head injury IYKWIM? He does know what injuries he's sustained, but it's like he's in denial.

Is this common? And I'm not sure how to deal with it. I don't want to agree with him, because he HAS had a TBI, but on the other hand I don't want to argue with him either. It's exasperating and upsetting.

[HeadStrong]

Hi Jamiesgirl,
Sorry to hear of your "other halfs" injury. Denial is common in TBI whether it's from the Health Care Professionals or the patients.....happens on both ends. The good news is he has you as his advocate, as many lack a supportive caregiver.

He is still early into his recovery and from what you posted, still fighting it. For the time being, you can help be his eyes and ears as far as the memory and other symptoms go, until he starts accepting it.

You are right not to argue with him, I know it is challenging (I know my family feels that way with me) but he is not reacting that way by choice. Do you have a professional you can talk to about your concerns?

Hang in there.

[Mark in Idaho]

jamiesgirl,

He is likely just being a guy. Ego, pride, machismo, what ever, feeds this attitude. Add some personality changes and you have a perfect storm of denial.

You need to download the TBI Survival Guide at www.tbiguide.com. Print it out and highlight those symptoms you recognize.

Why do you feel he needs to admit he had a TBI?

The only thing that matters are how he deals with his symptoms.

[greenfrog]

I guess jamiesgirl might feel that if he's not acknowledging his TBI, how is he going to take the necessary steps to promote his recovery? If he assumes he's fine but just has a mild headache and a couple of other minor physical symptoms, then he might do something dumb like seriously overexert himself (as I did two weeks into my recovery, thinking that I was over the worst of it, which I'm pretty sure prolonged my recovery).

Might be easier to hear this tactfully from a doctor though. Denial can be tough to penetrate, even for people without TBIs!

[Mark in Idaho]

greenfrog, Those ideas are obvious but I was interested in what her concerns were. She is very new to this forum and not necessarily up to speed. Many spouses have expectations and ideas based on wrong understandings. I see this frequently with newbies at my local brain injury support group. It is often easier to help 'after' understanding the perspective of the person and correcting any misconceptions.

[greenfrog]

Mark, I'm not sure what I wrote was "obvious" to the OP - if she's new to NT then I imagine she'll be interested in hearing more than one perspective. I certainly was, and very little of what I read early on was obvious or superfluous to me.

My concern is that "the only thing that matters are how he deals with his symptoms," while true as far as it goes, may be a bit simplistic. For me, understanding that I had had a brain injury ("getting it," in other words) was important - I only wish that this had been brought home to me earlier. My specialist is great but I wish he'd explained more clearly (and in no uncertain terms) what avoiding physical and mental exertion meant, why it was important, etc.

[Mark in Idaho]

I meant it was obvious to me. You were replying to my question/post.

It can be helpful to draw out existing information before opening the fire hose of new information.

But.....

[jamiesgirl]

Originally Posted by greenfrog

I guess jamiesgirl might feel that if he's not acknowledging his TBI, how is he going to take the necessary steps to promote his recovery?

This is partly it, yes. I want to help him take the steps towards recovery and for example, have been researching what would be best in terms of nutrition and vitamins. But he's not open to eating the right things or taking supplements - whereas I think if he accepted the severity of his TBI, he might be.

I also think long-term he would benefit from talking to other TBI survivors, whether it be on a forum like this or at a physical group - but atm he would totally dismiss that (cognitively he's more than able to use the internet and has been doing) because he doesn't think there's anything wrong, he wouldn't think he has anything in common.

But it's also about emotional recovery & that's why I posted really. I am assuming that you would go through stages after a TBI or other emotional trauma, much like the stages of grief? And therefore am assuming that denial is a normal stage? I don't want to rush him through it (perhaps my OP came across like that) I only want to support him through it...I was just interested from other people who may have been through it themselves, how long it lasted for - just so I can prepare myself really.

[Mark in Idaho]

The saying goes, "If you've seen one brain injury, you've seen one brain injury."

Every injury is different. It is best to identify the individual symptoms and treat, work around or accommodate them individual.

There are personality changes that can be temporary or long term. One common change is called rigidity of thought. This can manifest as stubbornness or difficult letting go of a single concept. The denial can be this rigidity of thought. Trying to push through it will be counterproductive. The stress of the conflict caused the brain to turn to fight or flight mode causing the rigidity to increase.

One of the problems with mTBI/PCS is the long term changes. He can continue to develop worse symptoms for 2 or 3 months. By then, it is easy to attribute them to something other than the mTBI.

A challenge he faces is even recognizing his symptoms. It is not necessarily denial but rather ignorance. If he has been self-directed and self-reliant prior to the injury, it is almost like he needs to fail miserably so that he stops to try to figure out what is going wrong.

So, the best you can do is study up on mTBI. The TBI Survival Guide is you best resource. Find it at www.tbiguide.com. You can download the 84 pages to print out. Then, when he has a struggle in front of you, you can excuse the behavior as a result of his brain injury. Maybe a " That is just your brain injury acting that way." or some other careful but appropriate comment.

Be ready to explain how you come to this conclusion. If he opens the door to reading the TBI Guide, make the most of the opportunity. Let him learn at his own speed. It can be quite humbling to accept the dysfunctions and changes to a person. As you commented, It can be like the grief process, just the initiating of the process can be delayed and full of conflict.

I assume he is driving. If not, or if he is but his driving is suspect, this can be an opening to some testing and therapy. A neuro rehab clinic should have the means to test his abilities. A follow up with his doctor may be able to start this process.

As you can see, there is no simple answer. Go slow. Get as much knowledge as you can.

My best to you.

[HeadStrong]

Here is an article that talks about TBI and "denial". It also states there are certain situations (such as if the person is in danger of the denial) when there must be some intervention. Other times, it is ok to ignore it.


http://main.uab.edu/tbi/show.asp?durki=48139


Here's another one. This is an older reference, but it's told from the perspective of a TBI survivor:
http://barbara-pytel.suite101.com/tb...ications-a3229