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Brain injuries call for resilience

LAYTON — The man who fell from the scaffolding and the woman who suffered a stroke both discovered they're no longer who they were. His angry outbursts are over the top — he calls it "on my mind and out my mouth." She gave up her career because she could no longer remember even the simplest orders from her customers.

Their ability to move forward from the brain injury they each suffered will depend on their ability to be resilient. That means finding ways to function competently under stress and the ability to recover from trauma and adversity. It also means identifying help and making the most of it.

Sam Goldstein, Ph.D., of the Neurology, Learning and Behavior Center at the University of Utah, told their stories during his keynote address at the annual Brain Injury Association of Utah family and professionals at the Davis Conference Center in Layton Friday. He said those two people suffer an effect that's not uncommon with brain injury: "You know who you are and who everyone else is, but you are not able to do the things your life experience has taught you."

Coping —even thriving —requires a new set of life skills, and the first one is resilience. With brain injuries, many people don't lose any intellect, but they lose cognitive efficiency and that is a greater challenge to overcome than a lowered IQ.

"When you talk about the mind, you are not talking about the brain. You are talking about a great, amazing process in which cells come together and create awareness. You can't change your brain, but you can change your mind."

Surrounded by new weaknesses, people with brain injury need to find their strengths and build on them.

Goldstein said people are born with certain traits: The drive to help, the drive to master skills, degrees of altruism, self-discipline or at least the ability to read some social cues, a need for social connections. Brain injury frequently has devastating impact on those things. People become isolated, they lose their ability to read social cues. Sometimes they lose control of emotions, becoming more moody or irritable.

Fortunately, the brain is malleable and responsive, fueled by life experiences. It is "constantly changing and adjusting throughout life." The trick is figuring out how to help the injured brain respond. But no two people heal the same way or use their minds the same way. And no two brain injuries are the same, either.

"Success in adult life comes from harnessing whatever assets you have," Goldstein said. People who have been injured need to find a sense of self and normalcy and sometimes they have to create it, because traumatic brain injury steals both.

Research has shown that people who really flourish have three positive thoughts for every negative one. Predictors of a resilient child include an easy temperament, consistent family relationships, competent caregivers, development of self-esteem and emotional security, he said. The same is true to be a resilient brain-injury survivor.

After brain injury, "they need to recognize the boundaries of their control and focus energy on those areas, acting proactively," he said. That includes figuring how to solve problems and make decisions. "There's more than one way to get there and they may need a new one," he said, adding one must be flexible and willing to explore new ways to do things. The belief that you can still contribute and make a positive difference in the world is also a "powerful force" in recovery.

But the most powerful tool is one person helping another, so he tells people he counsels to find (new) "islands of competency and strength that define their identify" and use them to help others and to deal effectively with mistakes and failures.

Wellbeing, he concluded, hinges on competence, confidence, connections, character and caring.