The Road to Recovery

Even though the psychological and cognitive issues of a TBI client are many and difficult, there are predictable and identifiable stages during the recovery process. These stages were developed by Karen Lloyd, PhD at the Center for Comprehensive Services, Inc., in Carbondale, Illinois. The following is an outline of those stages:

Awareness of Problems

A. Minimal awareness of changes in self. Theme "I'm sick."

1. Issue of Disability ­ sees self as sick; the doctor is in charge; may deny severity of problems because they are temporary; waits to "get well"
2. Issue of life-style ­ sees changes as temporary; assumes ALL previous activities will be resumed later; not participating in previous activities is a relief
3. Issue of relationships - sees self as legitimately needing & wanting help; change in relationships seen as temporary

B. Increased awareness of change. Theme "Make me better"

1. Issue of disability ­ starts to ask questions; notices that cannot do things like before injury; wants doctor to do something; blames the doctor
2. Issue of life-style ­ misses former life-style; feels left out and left behind; tries to make contact with representatives of former life-style
3. Issue of relationships ­ "What's wrong with you?" ­ blames others for problems; senses changes in relationships with others may be more than temporary; blames others: "How can you do this when you know I'm sick?"

Understanding of Problems

A. Minimal understanding of changes in self and circumstances. Theme "It's not fair"

1. Issue of disability ­ sees self a disabled rather than sick ­ beginning of understanding may not "get well" in the usual sense of recovering from illness or physical injury; feels frustrated regarding the length of time necessary to "recover" and the difficulty of the work involved
2. Issue of life-style ­ perceives that life is going on as usual for others; feels left out, abandoned, and resents this
3. Issue of relationships ­ sees role as changed and previous responsibilities, authority & freedom are reduced; sees self as "patient" and as relatively helpless; feels frustration & anger over loss of previous role functions (which changes the nature of all previous relationships)

B. Increased understanding of changes in self and circumstances. Theme: "Why me?"

1. Issue of disability ­ sees disability as significant * possibly some aspects as permanent; anger &/or depression result; When answering their own "Why me?' question, those who answer "I don't deserve it" get angry ; those who answer "I must deserve it" get depressed; begin to move past anger & depression, which are inevitable at some point & are not necessarily destructive if the person can "move on"
2. Issue of life-style ­ wants old life-style desperately & when can't withdraws with anger & sadness; avoids or minimizes exploration of a new life-style (due to pain at loss of old life style)
3. Issue of relationships ­ feels new kind of alienation toward previously significant others (coupled with jealousy over lack of changes in others' lives); feels unconscious anger that others escaped disability (Why me and not you?"; may reject others

Accepting Problems

A. Minimal acceptance of changes in self and circumstances. Theme: "I'll show you that you're wrong about me --- I'll beat the odds"

1. Issue of disability ­ sees self as disabled & begins to accept the need for therapy; begins to see that responsibility in therapy is shared between self and therapist; wants a guarantee: "If I do this in therapy, I expect to get _________ in return"
2. Issue of life-style ­ begins to explore new options; begins to be less self-conscious of disabilities in public; is willing to show off new or relearned skills
3. Issue of relationships ­ pushes limits of relationships: "I'll get what I want by trying harder"; challenges relationships; they end or they get better by developing new ways

Accepting Problems and Challenges

A. Increased acceptance of changes in self and circumstances. Theme: "I'm disabled and I'm a worthwhile person"

1. Issue of disability ­ "My disabilities are a fact; I have to work with them and sometimes work around them" "Limits in one area need not limit me in another; some things I give up, some I modify and I'll start some new things"
2. Issue of life-style ­ "The past was good, but it's the pasts; the future can be good, too, even if it is different from what I once anticipated"; "Everyone's life-style changes; maybe mine has changed more quickly, but everyone needs to learn to adjust"
3. Issue of relationships ­ "My relationships have changed; some have ended because of the changes in both of us: "There is pain in relationships that change or end, but new relationships give me strength" "Sometimes it's easier to be with new friends than old ones; it still hurts when I can't meet someone's expectations, and people who previously knew me often expect what I can't deliver

Disclaimer: The information posted on this web site is not medical advice and should not be taken as medical advice. Information posted on this web site is for information purposes only. To obtain medical advice, please consult with your physician or schedule an appointment where a complete, detailed history of your specific case may be obtained.