Your Changed Brain
- Understanding Insight
- How do I Know if My Brain has Changed?
- Getting Help
You will probably know that your brain injury is never going to be exactly the same as someone else’s.
The cause of your brain injury might be categorised in a group with other people, for example, you may have a stroke, a traumatic brain injury, or encephalitis, and then your ‘type’ will be further subcategorised.
You probably won’t feel any connection to this diagnosis, but, if you do, then it is likely to be because you have retained ‘insight.’
Insight is important because it tells your clinicians and specialists how to help you understand what has happened to you.
Insight helps us turn intellectual information into inner understanding and awareness so that we can make all the thinking connections which help us know how to get better.
Insight helps us feel these connections because we notice when we ‘realise’ the implications and effects of our own brain injury.
Your brain injury may have been recent, or you may have been struggling for a long time. Each of you will have had varying amounts of expert help, or perhaps very little input at all.
Whatever happened to you, the person who can help you the most is you.
If you are fortunate, and have support from neurological experts, you may recognise that you are still struggling to understand why you need to create new strategies, or to connect with what they are telling you.
Rather than it being you who doesn’t understand, it might be tough because your brain may still remember what you could do before, and this can make you think you don’t need lists and other aids to manage your everyday life.
You may understand what is being asked of you, but be unable to connect with why. Does this sound familiar?
Perhaps your family are trying to help you this way, and you can’t understand what they see. You may feel undermined and capable – even when you notice you make mistakes.
Perhaps, even though you notice the things you struggle with, you might not remember for long enough to be able to benefit from the experience.
Insight is what happens when you realise what people are telling you and why. Insight is what helps you to make the connection, and understand why people are making suggestions.
If you think other people don’t understand you, if you think they aren’t listening or they have the wrong end of the stick, please pause and think about whether or not these types of events might be happening because your brain is no longer able to support you the way it once did.
If my brain is injured does this mean I will now have problems that are invisible to me?
Is it possible that people will see my challenges differently to the way I can see them?
The answer to both questions is yes.
It is very possible that you won’t be able to see how your brain injury creates problems for you.
It is very likely other people will be able to ‘see’ or notice where you are struggling more than you can.
How do you know if your brain has changed?
Ask yourself if you can remember how your brain worked before it was injured.
If you know that you brain worked differently before, but don’t know what these differences are, then you may have problems with ‘insight’ which is a skill managed by the executive systems at the front of your brain.
Many people with frontal lobe injuries will struggle to describe the details of what is different.
Answer all numbered and A,B questions with a yes’ or ‘no.’
1. Do you have this difficulty?
2. Do you remember how your brain used to work and how thinking used to feel?
How can you know?
Think about the last task you did that either took a lot longer than usual or you know you struggled to complete, or perhaps abandoned because you became tired or frustrated. Perhaps something distracted you?
What did you think about it afterwards?
3. Were you able to describe the details of the problem to yourself or to someone else?
Did you recognise the problem immediately, or did you wander off and to try and do something else without giving it any further thought?
4. Are you finding it hard to think of an example?
Think about breaking down the details so that you can see in your minds eye exactly what went wrong and why.
5. Are you finding this difficult or perhaps have a vague awareness of things going wrong but can’t specify what these are?
A. Do you know which thinking and functioning skills were supporting you or were absent, and know why something went wrong?
B. Can you easily describe why you struggled or couldn’t do something?
If you are noticing anything from thinking about these questions, write down your thoughts so you can remember to think about them again later.
Can you describe what your thinking used to feel like and compare this to how it feels now?
If you don’t understand these questions, are having difficult relating to them, or can’t recall a useful example to use to help you answer the questions, then this has nothing to do with who you are.
However, it has everything to do with how your injury has damaged the structures in your brain; structures which used to help you think and do everything in familiar ways without having to think about it.
6. Do you think the brain injury has changed how you are able to do things?
7. Do you think it is the brain injury that is causing your problems?
Numbered questions – answer Yes
If you answered yes to all or most of the numbered questions you may have problems with insight.
If you answered yes to A and B, you have probably retained good insight.
If you struggled with some or all or the questions this indicates brain injury and problems with thinking and executive functioning.
Each person will recognise and know about their brain injury differently.
Perhaps your family or friends have been telling you to speak to someone or have been encouraging you to get help and you haven’t understood why. The answers you gave to the questions on the previous page will help you recognise, for yourself, if you need help.
There can be a shortage of available specialist services or long waiting lists to get help from a neurological expert.
If you haven’t been referred for help, but believe from reading ‘Your Changed Brain’ and answering the questions that you need help, take someone with you who can describe your challenges to your doctor. Ask for a referral.
Even where there are excellent services near you, you may still need to wait to see someone.
It is a good idea to take care of providing yourself with a nutritionally rich diet while you are waiting.
If you have tried to get help, had limited help, your insurance doesn’t cover you, or you can’t afford private help, always try again; get someone else to support you and check the details.
There are tools and strategies you can use/do to help yourself.