Many people experience moments when they can’t come up with the exact word, or words, they want to express, and resort to the hackneyed phrase: “It’s on the tip of my tongue.” But for those suffering from a traumatic brain injury, this phrase extends beyond its timeworn use. Word finding, or word retrieval, is one of the most common cognitive difficulties in TBI survivors. The language center of the brain is located in the left hemisphere – the frontal and temporal lobes. Difficulty with word retrieval usually means the damage has occurred in the frontal lobe, the location of most TBIs.

What does this mean for individuals who have suffered a frontal lobe injury? Called dysnomia, or anomia, they tend to have difficulty naming objects, people, and places. They may know what the object is that they are looking at, but cannot identify it.  Sometimes the process is selective, say, to colors. For instance, individuals might know the difference between blue and pink, but cannot name them. In other cases, individuals might be able to identity an object through sound – the ringing of a bell – or touch – a needle – but not sight. Others might use the wrong word. For example, instead of saying, “Can you please pass the salt,” they might say, “Can you please pass the tire?” http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

Circumlocution, a strategy where you “talk around” the name of the object, person, or place you are attempting to identify, often helps. If you’re looking for your cell phone, and you want to ask your husband if he has seen it, you might say, “It’s portable and it rings.” That way he will know what you are talking about. Also, this might prompt you to remember the object. Reciting the alphabet is a strategy that triggers words for me, especially if I can’t recall someone’s name, which happens all the time, even if I just met the person five seconds earlier. So, if I’m trying to recall the name Nancy, I say the alphabet in my head until I get to N. You can also visualize the word written out on a chalkboard, or whiteboard, or even a pad of paper. Similar to circumlocution, if someone cues me by sounding out the beginning of a word I’m struggling to express, my brain synapses suddenly come to life. http://www.speech-therapy-on-video.com/wordfindingdifficulty.html

For writers with a TBI, difficulties with word retrieval interfere with crafting poetic sentences for our readers to chew on. I typically find myself staring at a sentence for several minutes, rubbing my forehead and biting on my pencil. It’s not unusual for me to spend hours working on one paragraph. I usually end up resorting to my pile of notebooks of quotes I’ve collected from some of my favorite authors. For instance, if I’ve used “walk” a hundred times in my manuscript to describe someone entering a room, I flip through the notebooks, scanning the pages for unique ways other authors describe this same action. Of course, I do not steal their phrases, but seeing alternative ways to express “walk” is similar to someone verbally cueing me: My brain lights up with all kinds of options to consider, and I feel as if I just won the lottery.

Give these exercises a try, and feel free to share what works for you.

(FYI: Including research, it took me five hours and twenty-eight minutes to write this bog post).

More than six years after an older driver ran into me, causing multiple injuries including post-traumatic stress disorder, I decided I wanted to write a memoir about the tragedy and its aftermath. I wrote (actually I typed) nearly everyday. Essentially, I dumped my brain onto the page, ignoring the logical left side as I typed fast and furious without thinking about the structure of my story. Six months later, I had 365 pages of facts muddled with emotion. Though I felt proud of myself for my accomplishment, a puddle of grief muddied the moment. I thought I was ready to write about the accident, but maybe I wasn’t. Maybe I hadn’t yet figured out how to navigate my PTSD speed bumps. As the months and years passed, I read the pages again and again, examined with a closer eye what I had written, pondered the subterranean meaning of each passage and turn of phrase. The combination of time, taking breaks from my story, and reuniting with it from the perspective of a maturing writer, helped me gain insight into my work. In essence, I had stepped outside of myself, outside of my PTSD, and looked at the endless pages from a different, non-PTSD angle.

I’m glad I stuck with writing because research shows that it helps heal PTSD, even brief periods of putting pen to paper. http://www.sciencedirect.com/science/article/pii/S0005796712001088

When we experience a trauma, physical and/or emotional, our brains work overtime to process it, interfering with our ability to be present for others, and ourselves. Writing our thoughts down helps to release the emotional burden, and helps us to organize, put our thoughts in order – clean up our metaphorical cluttered homes. Writing has been shown to benefit the immune system, and overall health. But a professor of psychology at the University of Texas in Austin, Dr. James Pennebaker, cautions: “Standing back every now and then and evaluating where you are in life is really important.” Speaking from experience, I agree.  https://www.utexas.edu/features/2005/writing/

So, where to start? Here are my ideas:

1) Journaling: Even if you jot down one sentence each day.

2) Carry a pad of paper with you at all times – when a disturbing thought crowds your brain, write it down.

3) In first person (from the perspective of “I”), write about an emotional, or traumatic, event that has kept you awake at night. Just write. Don’t think about who might see it – lock it in a safe deposit box if you have to. The rub: put it away for a month, or two, or three, and then go back to it.

4) Take the same piece you worked on in number three, and write it from a different point of view – second or third person – forcing yourself to step outside of your hypersensitive skin (I’ve engaged in this exercise – it opened a vault door I never knew existed).

Feel free to share how this exercises worked for you?

“There is no greater agony than bearing an untold story inside you.”  Maya Angelou, I Know Why the Caged Bird Sings

Additional Resource:

http://healmyptsd.com/2014/08/writing-for-ptsd-healing.html

November 16, 2014. 5 pm Pacific Time (8 pm Eastern Time): Tune into “Another Fork in the Road,” hosted by Donna O’Donnell Figurski, and listen to Melissa share the transformative impact of her traumatic brain injury. Feel free to call in with questions or comments at (424) 243-9540.

http://www.blogtalkradio.com/braininjuryradio/2014/11/17/another-fork-in-the-road-melissa-cronin-author-chicken-soup-for-the-soul

Twenty-three states have legalized the use of cannabis for those who suffer from medical conditions like arthritis, migraines, AIDS, cancer, and psychiatric illnesses. Yes, even post-traumatic stress disorder makes the list, which means, if you are among the 7.7 million people who suffer from symptoms, you’re in luck. It appears that scientists agree cannabis may be just what you need to alleviate your anxiety related to PTSD. Researchers at NYU Langone Medical Center have found a connection between the human brain’s cannabinoid receptors, called CB1, and PTSD. These receptors are linked to an intricate internal engine of chemicals and neurological pathways called the endocannabinoid system, which affects our emotions, appetite, pain tolerance, and memory. Studies have been conducted on animals, showing that cannabis, together with naturally occurring chemicals in the body, stimulate CB1 receptors and interfere with memory.

Physicians at the NYU School of Medicine conducted brain scans on people with PTSD and found that they had lower levels of a certain endocannabinoid than those without PTSD. With this knowledge, not only can they better diagnose individuals with PTSD, they can treat them with a something that works, rather than antidepressants, which don’t always work. Studies have shown that those who take antidepressants continue to suffer from nightmares, flashbacks, night sweats, and poor sleep. But those who were administered a synthetic form of cannabis experienced significantly less intense nightmares, or no further nightmares at all. http://www.newswise.com/articles/brain-imaging-study-links-cannabinoid-receptors-to-post-traumatic-stress-disorder-findings-bring-first-pharmaceutical-treatment-for-ptsd-within-reach http://onlinelibrary.wiley.com/doi/10.1111/j.1755-5949.2008.00071.x/full

So, for those of you who are looking for an alternative to Paxil, Zoloft, Prozac, or any of the other alphabet soup of drugs on the market that claim to create a Zen-balance among the sea of moody chemicals sloshing around in your brain, science is on your side. And there’s good news for those living in Connecticut, Delaware, Maine, New Mexico, Oregon, Nevada, or Michigan – they allow the use of cannabis to help alleviate PTSD symptoms. Arizona recently authorized the use of cannabis use for PTSD – the provision goes into effect January 1, 2015. http://www.azcentral.com/story/news/arizona/politics/2014/07/09/medical-marijuana-can-treat-ptsd-arizona-official-decides/12418673/

Each state’s guidelines are different, but here’s the basic rub: You need to have documentation from a “certifying” physician who can attest that you suffer from “debilitating” symptoms that interfere with your ability to carry out “activities of daily living.” http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881

Born ten weeks premature, Jesse Cooper suffered a brain hemorrhage, and survived – with cerebral palsy. In 2005, at age seventeen, he died.

During the course of my twenty-year career as a pediatric and neonatal intensive care nurse, I cared for thousands of babies and children, many who had cerebral palsy. I provided the best care possible – heeded their cries, exercised their rigid limbs, and carefully fed them pureed foods so they wouldn’t choke. But it was impossible for me to know what it was like to be a mother of a child with cerebral palsy, or any of the ill children I cared for.

But actress Marianne Leone knows. In her memoir, Jesse, Leone writes with stark prose, sharing with us her “mask of red rage,” and her “fuck-you double slather of red lipstick,” as she, and her actor-husband Chris Cooper, work tirelessly to navigate the hairpin turns of their lives caring for a child with cerebral palsy (185, 189). She lures us along in their trek, from Jesse’s endless days in the neonatal intensive care unit, through their frustrating odyssey in search of physical, occupational, and speech therapists who would treat Jesse with dignity, and their fevered commitment to convince the school system within their community to integrate Jesse into classes with what Leone calls “able-bodied” students. Leone reminds us that “Jessie wasn’t a CP kid first, and a kid second (57).”

Jesse is more than a mere telling of the speed bumps Leone and her family encountered along the way. It is a story of perseverance, and idiosyncratic family coping mechanisms in the face of Sisyphean challenges. It hurtles the reader into a better awareness of what it means to be a quadriplegic, and non-verbal – which does not equate with being an “idiot (31).” Leone’s memoir is a must-read for families, health care professionals, teachers – all of us – who are on a quest to do what is right for our children, whether or not they are disabled.

Jesse speaks to the human condition – in this case, internal conflict – and the human being in us: Even long after the death of her son, Leone admits she’d rather “stay inside and be alone (248).” But she also knows, in order to still feel connected with her son, she must reach out and talk to other mothers with “babies like Jesse (248).”

Jesse himself tugs at the human being in us. His humor, non-judgmental approach to others, and endurance – he was an honor roll student, and windsurfed and wrote poetry – impels us to take a long, hard look at ourselves and ask, “Who am I? Am I aware of what is happening around me? How do I treat others? How do I want to be treated? What meaningful contributions am I making to others? What if I were a quadriplegic and non-verbal?”

In an autobiography Jesse wrote in sixth grade, he says:

“The most important lesson I can teach/is to see people for what they can do/ and not for what they cannot do (82).”