Before we go any further, I am posting an overview of the predominant cognitive and psychological deficits I experience. I include it here for two reasons. First, any victories I post mean little if you don’t know the tendency or deficiency I am contending with. Second, this exercise allows me to gauge my progress. I’ve developed compensatory strategies and systems for some losses, while others remain just as glaring and insurmountable as the day I left rehab. Here is an excerpt from a note I posted on Facebook in 2007, back when I opted for using all lowercase letters because of poor motor skills. Current status is noted after each section. Let’s see how I do!
Concept Formation: – this is one of the cognitive problems i have that i can’t really improve with willpower or determination. i just have difficulty explaining things at times. sometimes i do alright but i often feel that mental “block” that gets in the way. sometimes writing things out first helps. of course, i can’t always take that kind of time so i usually do the best i can off the top of my head and hope it makes sense.
UPDATE: Still an area of difficulty but I don’t write things down as much anymore. Instead I punch them into my iPhone. If I’m trying to explain something to a customer at the bike shop, I present the information in whichever order it comes to mind, which isn’t always logical. There seems to be a lag between what I think and what I say so that I skip parts in conversation.
Multitasking/Multithinking: -this is another cognitive issue that i just have to learn to live with. my main coping strategy is to just avoid situations where the ability to multitask is needed. that’s why i don’t do much group stuff, and prefer to hang out one-on-one. sometimes i’ll decide to attend a group event anyways and what i find is i get tired rather quickly. my brain is workin’ that much harder to process everything (multitask) and it fatigues easily. so what often happens at larger gatherings is that i have to tap out early.
-in three-way conversation, i mentioned that i have trouble following two trains of thought while forming responses. this varies depending on who i’m talking with, but in most cases i end up listening mostly without contributing. i’m okay with it usually, but sometimes i get annoyed at being a wallflower and make my exit. again there’s nothing i can do to really improve things in this particular area so i basically have to put up with it and not get too annoyed.
UPDATE: This issue is still very much at large. I can’t say I’m compensating or coping with this any better than I did four years ago. Friends may argue I’m much better now, but just reading this section makes me tense. I may tolerate it more, but I’m still just tolerating it. The few times I’ve enjoyed group outings, alcohol was involved. Perhaps I just need to relax more.
Catastrophizing: -this one is a combination pyschological/cognitive issue, so there are things i can do to minimize the impact this has. over-reacting to things is psychological in that i exaggerate the implications of some small inconvenience. if i calm down and actually think about things in a logical manner, i see that it’s not the end of the world as i initially felt. i can minimize this by making a habit of not reacting instinctively, recognizing the fact that my instinct is a little overly sensitive for the time-being.
-where the cognitive issue comes in with this is that when unexpected problems arise, the problem-solving and re-assessing required at that point places more strain on my brain. i’m often more upset about my brain having to do additional work, than i am about the problem itself. so there are small things i can do to improve what i can, but some of it is out my hands.
UPDATE: The intensity this used to have has ebbed in the past four years, but I still recognize the knee-jerk reaction that takes place internally now. At the bike shop, when nothing I do silences the noisy rear derailleur, my frustration can get the better of me. This results in me muttering grumpily and, sometimes passing the job off to Tim.
Stimulus Overload: -this is another issue that doesn’t really improve with repeated exposure. i can’t will myself into not getting overwhelmed in a busy environment. i tend to avoid events that are busy, but when i’m in this kind of situation i basically just tough it out. i can really concentrate and try to be more interactive, but conversation over loud music while looking out for stray frisbees is not as fun for me as it sounds. it just slowly empties the fuel gauge until i need a nap immediately.
UPDATE: Yeah, that’s still pretty much the case. I suppose my endurance has improved overall, for I’ve been up past midnight far too often recently, but a higher level of concentration and focus is definitely needed in highly stimulating environments. This is especially true when I’m tired. I really need to go to bed earlier.
Anticipatory Anxiety: – this one is more of a psychological issue – basically an aspect of post-trauma syndrome. this is quite common for anyone who experiences a traumatic event and is related to the catastrophizing i mentioned earlier. i can try to control this a little bit. instead of trying to anticipate problems and avoiding them, i try to be a little more spontaneous and not worry so much. this isn’t as easy as it sounds because with all my spinal/neck issues, there are many legitimate concerns that need to be considered.
UPDATE: I’m rather proud of the ground I’ve gained in this area, especially in terms of travel, where this was strongest. From extended camping, to road-tripping, to flying overseas, I’ve successfully traveled quite beyond my comfort zone and had a blast doing it. I still have the initial apprehensions and moments of panic, but now I plow through them just to spite my insecurity. Increasingly, I’ve come to taunt my anticipatory anxiety, defying it to hold me down. In addition, my spinal issues, with regular strength training, are much less intrusive than they once were.
Concept of Time/Memory: –with my haywire sense of time, and my shoddy memory, i try to make up for both by writing things down. i have a wall calendar i write my appointments on. i write down odd jobs that need to get done, and any other significant changes to the usual weekly routine. i also minimize the difficulties by maintaining fairly empty days. i take note of a couple things i want/need to do each day and that’s about it. that leaves time for any naps or rehab-exercising i need in a day too. if there aren’t too many things to remember, i do fine without writing it down. otherwise i have to write stuff down AND remember to look at the list.
UPDATE: This one has become more refined over the years. I’m better at remembering things now, but I am unable to place them in any sort of time frame. Today I was asking Tim if there was anything happening with work this Friday because I remembered us talking about a shift change or something. He reminded me that he would be in and out of the shop on Friday – last Friday. I take note of important information, but then I forget it when I need to recall it, or remember it when I don’t need to. I know, weird.
Overall, I’d say there is marked improvement, yet still room to develop.