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Brain injury recovery: emotional stages

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Rehabilitation

Brain injury recovery: emotional stages

A brain injury can disrupt almost every aspect of life, leading to emotional turmoil that also impacts on the whole family. 

A sense of shock and loss are common after a traumatic brain injury or similar type of brain disorder. The person with the injury may see lost friendships, independence, abilities, career and opportunities. Family members and partners can also experience loss - some say it is like losing a loved one but being unable to say goodbye, due to personality changes.

 

Grief can have a serious impact upon a person's recovery but there is no guaranteed way of dealing with grief - people mourn in their own personal way and eventually begin to move on. It can be helpful to understand some of the emotional stages that can occur after a brain injury:

 

  • Denial (this isn't happening to me!)
  • Anger (why is this happening to me?)
  • Bargaining (I promise I'll be a better person if...)
  • Depression (I don't care anymore)
  • Acceptance (I'm ready for whatever comes).

 

Kübler-Ross originally applied these stages to any form of catastrophic loss - a person may not experience them in this order, or may not experience certain stages at all.

 

Denial

Often the first reaction to loss, denial acts as a buffer to protect against being overwhelmed by strong emotions such as anxiety and fear. Without a period of denial, the shock of acquiring a brain injury could prove too much for some to endure. Time is usually one of the best remedies. A good approach for working through denial involves providing a supportive environment for the person to experience difficulties and learn about their new limitations. Examples of possible denial include:

  • I'll definitely be back to work soon
  • I will have a 100% recovery
  • I'll walk again even if the doctors say it's impossible.

 

Anger

Anger can come in many forms but is often focused on blaming others for the loss, or the injustice of the situation. Some brain injuries will increase the chances of angry outbursts. In other circumstances, some may express their anger as a reaction to how their life has changed and may direct such frustration towards people who are the closest to them. Acknowledge their anger but avoid agreeing with what they are saying if it reinforces their negative thoughts. 

 

Bargaining

Bargaining can be a sign that extent of the injury is being realized, but not accepted as yet. A person who believes in God may make a silent promise to be a better person or go to church every week in return for a full recovery. More recognizable signs come in the form of less drastic comments such as, "I'd give anything to have my life back." Acknowledge how the person feels and give positive suggestions and encouragement about the present and near future. 

 

Despair

Despair is a difficult stage as acceptance of the brain injury's effects occurs. Encouragement may be rejected with comments like "What's the use?" Families and friends can feel helpless as they watch the person sink into deeper depression and some friendships may be lost. There is the danger of clinical depression and suicidal thoughts developing - get professional help as soon as possible. 

 

Encouragement is important but may not be enough. Focus on truths:

  • You are alive against the odds
  • You will continue to improve for a number of years
  • You still have your intellect
  • You have a supportive family
  • You have an opportunity to rebuild your life for the better.

 

The added danger of the despair stage is that if it continues for too long, there is a risk of the person developing clinical depression or contemplating suicide. At any hint of this happening, professional help should be sought.

 

Things that could help in this stage are:

  • Joining a support group
  • Keeping a diary of progress
  • Writing a poem or finding one that holds personal meaning
  • Seeking professional support.

 

Acceptance

Acceptance of the loss occurs, and there is preparation for the future. The person has come to terms with the brain injury, and sees the ways life is both different and the same. There is often a greater sense of control of events and the future.

 

Everyone will work through these stages in their own and in their own time. People who adopt a positive approach to adversity usually recover faster, as do those with a humorous approach to life and talk openly about how they are feeling with others. A support group, both for the person with the traumatic brain injury and the family members, can help a lot with working through these emotional stages. 

 

References and further information

 

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