In the summer of 2011, Life Skills Village opened its doors with a mandate to revolutionize the neuro rehabilitation business. Our guiding principles emphasized helping people with brain injuries achieve a life of quality, purpose and fulfillment by regaining their independence. We began by treating them with dignity and providing opportunities to return to an independent lifestyle. Our transdisciplinary approach helped clients maintain focus on personal and social goals while guiding them successfully into the community. We adhered to evidence-based therapies and purposeful activities, so our clients could achieve positive functional outcomes. The Village environment allowed our clients to restore cognitive skills, self-regulate behaviors and improve overall independence in a supported, functional setting. Thanks to our talented clinical team, the many compassionate providers who partnered with us and our clients who worked so hard every day, we have more than a few success stories. On December 28th, we expect those success stories to multiply exponentially as Life Skills Village moves into a new, centrally-located and state-of-the-art 10,000 neuro rehab treatment center in Oak Park, Michigan.
The new Village vastly expands therapeutic opportunities for clients. Like our first Village, this will literally be a “community within the community,” a supported environment built to be both rehabilitative and social. But that’s where the similarities end. The cumulative experience and creativity of our therapists, administrators and clients have added up to a singularly unique treatment center that provides an unrivaled array of therapies and services to a much larger client population. From creating an inviting space that promotes socialization to organizing a micro-business incubator for clients to offering extracurricular social programs and therapies – the new Life Skills Village Treatment Center for TBI is designed to accelerate and intensify neuro rehab and recovery.
So what can Life Skills Village clients expect in January?
The outpatient community reintegration day program will function much as before – utilizing behaviorally-based therapies augmented by opportunities for clients to achieve their individual goals, develop and expand their knowledge base, hone their living skills and practice their social skills. Didactic sessions will continue to emphasize therapy for the client’s whole life: the mind, the body, social relationships and life in the community.
Concentrating on community reintegration, vocational development, socialization and reducing counterproductive behaviors, the new Village functions both individually for clients and collectively as a supported community. For example, a client with vocational goals may focus on reducing behaviors that prevent community integration, acquiring computer skills in the Library, practice customer service skills in the Village Market, receive psychological counseling and attend didactic sessions with other clients. Another client, with different vocational goals, might focus on developing a microbusiness in “Nine-to-Five,” the Village micro-business incubator and, afterwards, savor a lunch prepared by other clients in the Village Bistro or catch a movie in the client-run theater.
People with brain injuries who are not members of our day program are encouraged to spend a complimentary guest day at the Village to gauge their interest in our intensive neuro rehab program. They may also participate in individual therapies or other activities.
The Village will be open and available for clients to use both for treatment as a community within the community environment that includes:
The new Village will be open from 9am to 5pm for clients to attend individual therapies, events and even spend the day for respite. The outpatient day program will stay at the usual 12:30 - 4:30pm time. To accommodate the longer hours while continuing to provide respite and “mobile” therapy to clients, we have hired several new clinicians.
Beyond the day program, clients can participate in numerous extracurricular activities intended to reinforce existing therapies or function independently. These activities include:
Ready to see the new Life Skills Village for yourself? Schedule a tour today!
By Dr. Bryan Weinstein and Drew Bufalini
Your doctor might have the bedside manner of McDreamy from Grey’s Anatomy, an office papered with Ivy League degrees, X-Ray eyes and hearing so sensitive he can detect blood pressure changes…but unless you’re a good patient, there isn’t much he can do for you. Why? Because it takes both a good doctor anda good patient to make the doctor/patient relationship function to your benefit. For example, suppose a doctor prescribes an anti-depressant. The patient takes it as required until he begins feeling better…and then stops. By the time of his next appointment, he’s wondering why he feels depressed again. The doctor did his part, but the patient did not.
Whether you’re going to your primary care doctor for a minor problem or are seeing numerous physicians for a chronic illness or injury (like a #TBI or #chronicpain), being a good patient can mean the difference between sickness and health; between recovery and relapse; between living a fulfilling life and suffering a sedentary, painful existence. Getting the most from your physicians means more work for you as a patient, but it’s the best way to achieve a positive outcome from your time with the doctor. Here are a few tips you can use to maximize this time:
1. Be on time. You know how much you hate waiting to see the doctor? He doesn’t want to wait for you either. Doctors generally have a good reason for being late – checking your medical history, spending extra time with another patient or doing some last minute research. A late patient has a cascade effect on the rest of the doctor’s schedule for the day – causing him to be late for the rest of his appointments that day.
2. Be prepared.
· Bring any pertinent medical records, identification, paperwork and insurance information with you to the appointment.
· If you have a long list of symptoms or a number of problems to discuss, organize your thoughts on paper before your appointment.
· Always bring a list of your medications that includes dosage and frequency.
3. Be honest. Even if you think your problem is embarrassing. If you’re dishonest, the physician won’t know how to treat your real problem. Communication is paramount in doctor/patient relationships – your doctor can only work with the knowledge you provide about yourself.
4. Be nice to the staff! Nurses, assistants, receptionists, schedulers – even billers – are all there to help you. Treat them with courtesy and respect.
5. Be informed. The internet is filled with medical education website for the lay person. For example, sites like healthgrades.com rate and provide extensive background information on most doctors. WebMD.com covers conditions ad nauseum. This is not to say that you should self-diagnose…merely that the more you know about your doctor and your potential condition, the more informed you’ll be in the long run.
6. Unplug. Don’t take calls or respond to text messages while you’re with the doctor.
7. Take notes. No one has a perfect memory. Shore yours up against forgetting by writing down all of your physician’s recommendations and instructions. Bring a trusted friend to your appointment to jot down every salient point your doctor makes.
8. Be compliant with medications and treatment recommendations. If you can’t afford your medications, tests or treatments - tell your doctor. There are often programs to help people in these situations. Check out: www.lifeskillsvillage.com/resource-links.html for numerous options.
9. Don’t rely on a pill to cure all ills. Quitting smoking, exercising, eating a balanced diet – these can all improve your overall health. When your doctor recommends a lifestyle change, follow instructions and there may be fewer pills in your future.
10. Don’t be afraid to ask questions. There is no such thing as a stupid question when it comes to your health. If possible, bring a list of your questions and concerns to the appointment.
11. Know your rights. You are not at the mercy of your physician. Every patient has rights that can be exercised as needed:
· You have the right to "fire" your physicians. If you do not like the way your physicians treat you, if you do not trust them, or if you do not believe they are providing you with the best possible care, you can leave and find a new doctor.
· You have the right to be told about alternative courses of treatment, even if your health insurance may not cover them or you may not be able to afford them
· You have the right to refuse consent for any procedure or treatment. If you refuse consent, you may be asked to read and sign a form indicating that refusal.
· You have the right to leave the hospital or care facility against medical advice. You will be likely have to sign a waiver form indicating that you are doing so on your own free will and against the recommendations of your medical providers.
· You have the right to be treated with dignity and respect in all matters related to your health.
Of course, you could always show up twenty minutes late sans shower and demand to be seen immediately; call the receptionist a few choice names you picked up online; lie to your doctor about your symptoms; demand medication for a self-diagnosed condition; and then threaten him with legal action if he doesn’t cure you immediately. See how far that gets you.
Whether you’re a physician or a patient, please add your own tips to this list by adding a comment.
Dr. Robert Lamberts of Augusta, Georgia from blog: Musings of a Distractible Mind
By Dr. Bryan Weinstein and Drew Bufalini
Approximately 96% of people who live with a disability have an illness that is not visually discernable (2002 US Census Bureau). They do not use wheelchairs, canes, oxygen or any obvious assistive devices. For all intents and purposes, they appear healthy. Yet, they are far from it.
Some examples of these invisible disabilities include: #traumatic brain injuries, #fibromyalgia, #Crohn’s disease, #bipolar disorder, #chronic pain, #PTSD, chronic sleep disorders and many other painful, inveterate illnesses.
These chronic diseases, syndromes and as-yet undiagnosed, life-changing afflictions wear a mask of normalcy that belies the truth. People living with invisible disabilities suffer more than severe health problems – they must also deal with disbelief and misunderstanding from loved ones and the general public. “They are forced to battle for respect and understanding while mourning their loss of ability and freedom; often while others accuse them of being lazy or malingering.” (InvisibleDisabilities.org)
Nevertheless, the invisibly disabled are quite real and facing the world against the odds. What can we learn from these people who face their challenges and challengers head-on in an effort to live a meaningful and fulfilling life?
1. Disability and happiness are not mutually exclusive.
Disability cannot steal happiness. Only a negative attitude can do that. Of course, there is a grieving period for the “healthy self” that has been lost. But once acceptance is achieved (through therapy, medication, prayer, meditation or other means), happiness again becomes possible. Anyone can learn to find the joy in life that transcends disability. Or, for that matter, any other problem.
2. Communication is courage.
Suffering in silence has its place, but maintaining healthy relationships with friends and loved ones means honesty. While illness is a very personal experience, the people who care about you want to help. Turning their help away may give the briefest feeling of self-righteous independence…but accepting it or even asking for help doesn't make you any less independent. Communication facilitates a connection and an understanding between you, those who care about you and the community at large. We should all have the courage to communicate honestly – both to keep our loved ones close and our consciences clear.
3. Kindness is a two way street.
While helping others can certainly provide a boost to the ego and even a “helper’s high,” the ability to accept help yourself is both a lesson in humility and an inside look at how others may feel when you help them. Using this knowledge to adapt your behavior when helping others is true sympathetic kindness. Share your positive feelings and kindness with others and, more often than not, it will be reciprocated when you need it most.
4. Know yourself.
Anyone with a disability knows their limits – whether they can only stand for ten minutes per hour, eat a specific diet or must stay close to a restroom – living within these limits without allowing them to becomelimiting is an art. Understanding yourself gives you the opportunity to fine tune your life and play to your strengths while cultivating new ones.
5. Learn to at least tolerate, if not accept, other people.
People with invisible disabilities face discrimination every day – from their doctors, insurance companies, families, employers and even strangers who feel compelled to label them “healthy” without any real knowledge. They are forced to tolerate this discrimination even while being judged. If the invisibly disabled can tolerate those who discriminate against them, it’s because they’ve learned to practice what civil rights leaders have espoused for years: everyone deserves tolerance. Even the ignorant. Extending this practice can only have positive results in your life.
6. Be grateful for every moment – both the good and the bad.
Make the good times count and be thankful for them. Learn from the bad moments and leverage them to make yourself stronger. Beyond helping you have a higher level of positive emotions, practicing gratitude can also lead to lower blood pressure and a stronger immune system. (http://greatergood.berkeley.edu/expandinggratitude)
7. Inspiration Is Everywhere. Find Yours.
Author Jack London was once quoted as saying, “You can’t wait for inspiration. You have to go after it with a club.” Disabilities – visible and invisible – can make getting out of bed to face the day a daunting challenge. Inspiration may lead to purpose, which can motivate you for the rest of your life. Whether you’re inspired by the sunrise, the smell of breakfast or your children - finding these “little” inspirations can make a significant difference in your life.
8. Enjoy the Mysteries In Life.
Appreciating what you do not understand can seem difficult at first. But do you need to know the moon’s gravity to appreciate its fullness in a cloudless midnight sky? “This is the greatest damn thing about the universe. That we can know so much, recognize so much, dissect, do everything, and we can’t grasp it.” - Henry Miller (http://www.brainpickings.org/2013/03/21/henry-miller-meaning-of-life/)
9. Life Is Short and Capricious. Live Without Regrets.
There is no time like the present to correct mistakes, tell someone how you feel, forgive a grudge, open yourself up to a new relationship, act on a long withheld, positive impulse and the million other things you may consider doing. No one wants to look back at their lives and feel they missed an opportunity that could have been life-changing. Take a chance.
10. Forgive and Forget.
Rationale: see above.
11. Develop a Support Network.
Support groups exist for just about every disability imaginable. They provide a judgement-free zone for people with similar disabilities to share a cathartic vent session and learn new techniques to help overcome various issues. Whether you’re a mom with a special needs child or a college kid with an unruly puppy – the internet has more than a few places to find people in similar situations to share their knowledge, experience and compassion with you. These can become connections that last for a lifetime.
12. Saying “No” to Others Is Only as Difficult as You Make It.
People with disabilities become people pleasers because they already feel they are disappointing their loved ones by having a disability. This tendency can cause them to lose focus on their own needs and suffer disproportionately as a result. Consequently, simply deciding on an invitation can turn into an agony of self-delusion, second-guessing and misery. Or it can be as simple as knowing yourself and RSVPing one way or the other.
13. Never Stop Fighting.
Whether it’s for a correct diagnosis, a good cause or simply to get through the day without giving in to your pain or symptoms – the fight makes us stronger and teaches us how to keep winning our daily battles. Sometimes no matter how much we put into it, we still lose. This is the time to take pride in the fact that you made the effort and know that you’ll live to fight another day.
14. Adapt or Suffer the Consequences.
Everyone has heard Albert Einstein’s definition of insanity: doing the same thing over and over again and expecting different results. As your life changes for better or worse, you have the opportunity to redefine yourself as a person who can build on experiences by adapting and forming new, game-changing habits and a happier life. The alternative is, simply put, suffering and insanity.
15. Sometimes Hope Is All You Need.
When it feels like the deck of life is stacked against you, remember that tomorrow is always another day. With any luck, a better one. Hope can also translate into effort when you make the decision to turn your hope into reality. Start by opening your mind to the possibilities.
16. Laughter May Not Always be the Best Medicine…But It Sure Helps!
Maintaining a sense of humor in the face of any adversity…regardless of how idiosyncratic your sense of humor. Here’s a bit of silly to get you started: “My insurance company refused to pay for my newborn son’s circumcision. Their rationale? “Unable to locate member.” (http://www.rd.com/jokes/funny/medical-care/insurance-policy-joke/)
Another often quoted gem of Einstein’s says that “When we stop learning, we start dying.” Therefore, we must recognize all that the world and its wild diversity of people, culture, philosophy, technology and even politics has something to teach every one of us – whether we have a disability, invisible disability or are as healthy as a thoroughbred on race day.
Please note: this list was culled to limit the length of the blog. We encourage readers to share their own life lessons with a comment.
About the Authors:
Dr. Bryan Weinstein, D.O.
Dr. Weinstein received both his undergraduate, and Osteopathic Medical Degree at Michigan State University. He attended the residency programs of Detroit Psychiatric Institute and Wayne State University and received a mini fellowship in electroconvulsive therapy at Duke University. Dr. Weinstein owns two private psychiatric clinics and Life Skills Village, a behaviorally-based neuro rehab treatment center. Full Bio: http://www.lifeskillsvillage.com/clinical-team-bios.html
Drew has lived with several invisible disabilities for going on ten years. Before returning to work after a health-enforced hiatus, Drew ran the chronic pain support group at Crittenton Hospital in Rochester, MI. After several years of effort, education, trial and error, Drew joined Life Skills Village as a volunteer to build up his endurance. Almost four years later, he works full-time at LSV as the Chief Marketing Officer.
Full Bio: http://www.lifeskillsvillage.com/marketing--admin-bios.html
By Dr. Bryan Weinstein and Drew Bufalini
Every day, each of us participates in dozens of seemingly minor social interactions: from buying our morning coffee to casually passing someone in the hallway. For most of us, these become automatic. For someone recovering from neuro trauma, there is nothing minor about utilizing social skills in any level of communication. At Life Skills Village, we believe in helping our patients redevelop their social skills via education, rehearsal, reintegration and discovering an altruistic purpose in their lives. This purpose can do so much more than provide meaning in our patients’ lives – it promotes the neuroplasticity so critical for true rehabilitation.
Neuro trauma or otherwise, altruism makes people happier even than spending money on themselves.“Giving to charity activates brain regions associated with pleasure, social connection, and trust. Scientists also believe that altruism may trigger the release of endorphins in the brain, giving us a ‘helper’s high.’” Perhaps most important for people with neuro trauma: altruism promotes social connections. “When we give to others, they feel closer to us, and we also feel closer to them. ‘Being kind and generous leads you to perceive others more positively and more charitably,’ writes psychologist Sonja Lyubomirsky in her book The How of Happiness, and this ‘fosters a heightened sense of interdependence and cooperation in your social community.’”
Obviously, this is important for all of us as social beings. But for someone with neuro trauma, these social interactions actually promote neuroplasticity, which is the essentially the brain optimizing itself as a result of behavioral change or to accommodate an injury.
Being altruistic doesn’t require a big dollar donation or a massive dedication of time and energy. In fact, altruism can be integrated into those “seemingly minor” social interactions mentioned earlier. Below are 47 socially positive, altruistic actions that can be used for developing social skills and uncovering a meaningful purpose in life.5 Integrate several of these into your daily routine and it won’t be long before you notice positive differences in your own life - neuro trauma or otherwise.
1. Hold the door open for the person behind you.
2. Donate your old clothes to a charity or directly to someone in need. (www.salvationarmyusa.org)
3. Inspire others online. (Start a blog or simply post an inspirational meme on your Facebook page.)
4. Replace what you’ve used. (Example: If you finish off the pot of coffee at work, brew another for those who will want coffee after you. This goes double for toilet paper!)
5. Shop at your local charity thrift store, where the profits support your community’s at-risk populations.
6. Pay for the person in line behind you when you get your morning coffee.
7. Donate old glasses to your local Lenscrafters (www.lenscrafters.com/lc-us/find-a-store) or the OneSight program (www.onesight.org)
8. Create a care package and send it to a soldier overseas.
9. Instead of asking for birthday gifts, ask friends to donate in your name to a charity.
(www.birthdaycharity.com can give you some ideas)
10. Add some change to an expired parking meter so that person’s car isn’t ticketed.
11. Offer your seat on the bus or subway to someone else when there are none left.
12. Hug a friend. Let them know how important they are to you.
13. Give or loan out books to friends, charities or prison organizations.
14. Use www.freecycle.org to donate/recycle items you otherwise might throw away.
15. Send an unexpected, complimentary card or email to a friend, saying how much you value them.
16. Donate items to the Humane Society from their online wish list.
(http://www.animalhumanesociety.org/donate/donate-our-wish-list) or donate in person. If you have an hour or two a week to spare, ask about volunteering.
17. When you’re ordering take-out or fast food, order an extra meal and give it to a homeless person.
18. Take your neighbor’s trash cans back up to their house after the garbage has been collected.
19. Shovel someone else’s driveway when it snows. (Or mow their lawn in summer.)
20. Let someone else ahead of you in line.
21. Smile at someone who looks like they could use one. Smiles are contagious and can instantly change someone’s bad mood to good – especially when they’re unexpected.
22. Help the elderly or disabled with their groceries, other shopping or even cleaning.
23. Tip generously and unexpectedly. Servers depend on tips and good ones are always appreciated. Tip someone unaccustomed to tips (such as your bagger at the grocery store) a dollar or two.
24. Be an equal opportunity listener. Address the shyest person in a group and give them a chance to be heard. Chances are, they’ve been waiting for this moment for a while.
25. Volunteer at your community garden and get to know your neighbors.
26. Ask your minister/priest/rabbi/imam to pray for someone in need.
27. Sweat for a cause by volunteering or participating in a charity walk/run.
28. Celebrate someone else’s courage – someone is always fighting a bigger battle than you. Call, write, post online or offer a toast in person.
29. Utilize social media to promote a non-profit to friends and as a tool to meet new friends online. If yousign an online petition that means something to you, pass it along to friends who may share your opinion.
30. Acknowledge the inspiration you get from someone else when you create something original. Do this in person or post “shout outs” on social media.
31. Express your gratitude when someone makes even the smallest difference in your day and/or life. Saying “thank you” never goes out of style.
32. Buy coffee and bagels and drop them off at your local fire house. Firemen are on call 24-hours a day for several days at a time and, since they generally cook for themselves, always appreciate something fresh.
33. Thank a member of the Armed Services, a policeman or fireman for their selfless service. Be sure togive them a good firm handshake. No one appreciates a firm handshake like a soldier.(6)
34. Buy 10 lottery tickets and give them away to random people on the street, wishing them good luck as you do.
35. Hide notes of encouragement for people where they will find them.
36. Visit someone who is homebound or ill. Offer to help any way you can – even a short conversation can brighten their day.
37. Take the time and show some interest in the lives of the people you encounter every day – from the clerk at the dry cleaner to your barista.
38. Forgive a debt that someone owes you.
39. Grow your hair long and donate the ponytail to Locks of Love.
40. Bring your co-workers a special treat like homemade brownies.
41. Read a book to a sick child at your local Children’s Hospital.
42. Help someone lose weight by becoming their exercise buddy.
43. Be nice to the telemarketer calling you during dinner. Remember: everyone has to make a living.
44. Return a shopping cart for someone at the grocery store. This benefits the person you’re doing it for as well as the store employee wrangling carts.
45. Visit a website where your clicks translate into money for a good cause – and you don’t have to pay a dime. For a list of these sites, visit: www.nicethingstodo.net/freeclicksites.html
46. Acknowledge the hard work of parents of special needs children by complimenting them on their efforts.
47. Donate old sports equipment to urban kid’s and veteran’s organizations.
(www.fitnessforcharity.org,www.pickupplease.org, or www.bbbs.org (Big Brothers Big Sisters of America).
In neuro rehab – as in life – every act has significance. Taking altruistic action has countless benefits, but especially to those with neuro trauma. Even a little fulfillment can lead to exponential enjoyment of life and the improved function that can come with heightened neuroplasticity.
A list like this is never exhaustive. Please add your own ideas by leaving a comment.
by Dr. Bryan Weinstein, D.O. and Drew Bufalini
Some define it as simply “feeling good.” Others describe happiness as being an infinitely more complex, scientifically quantifiable emotion; an equation that includes pleasure, engagement and meaning experienced in both the short and long term. Still others, like Mahatma Ghandi, describe happiness as a state of being where, “What you think, what you say and what you do are in harmony.”
Happiness can stem from our own actions and sense of purpose. It may be a seed planted by someone else’s generosity or come from achieving goals or even from viewing a work of art. Happiness can be elusive and enigmatic for some people, while others seem to know just how and where to find it. Ultimately, happiness is subjective. Finding happiness is up to each of us as individuals.
But what if you’ve sustained a traumatic brain injury? Is attaining the most basic definition of happiness possible? Is happiness achievable when you’re no longer the same person you were before your injury?
I believe that the same rules for finding happiness apply to all of us – brain injury or otherwise. Each of us has the capacity within. To find it, we must make a practice of positive actions and decisions that will allow our inner happiness to rise. We must practice happiness on a daily basis to find ourselves happy in the future…and be able to look back on happy memories. What are the positives actions and decisions we must undertake to reach a state of inner-Eden?
Accept Your Limitations and Embrace Your Boundaries.
Struggling against your limitations takes a vast amount of energy. When you are aware of your deficits, your therapist can help you develop strategies to work around them. This will help you begin to move forward in your life. If you aren’t able to drive- ask a friend, relative or transportation service to chauffeur you. Don’t lament your ability to drive. Rather, embrace the opportunity to socialize with whomever is driving you. Remember, it is up to you to make the best of every situation.
Set Realistic Goals – Then Break Them Down to Bite-size Goals.
Someone who decides to scale Mount Everest doesn’t catch the first plane to Nepal and start climbing. They train first and master the variety of skills and equipment required to make the 29, 029 foot ascent. The same is true with our goals in daily life. If returning to work after being injured is your goal, performing your former duties might make scaling Mount Everest seem less challenging! Instead, consider starting small at a sheltered workshop or in supported employment. Use a job coach to help you break down your goal into many smaller ones: explore your career options, developing your resume, rehearse your interview skills, purchase professional attire and secure transportation when you start interviewing.
Change Your Perspective.
We all have days where we feel like the world is against us or that we can’t do anything right. You can choose to accept and understand the situation by changing your perspective. Taking a different view of an issue or “putting yourself in someone else’s shoes” can make the difference between frustration and better understanding.
Find Insight From Your Failures and Celebrate Your Victories.
When we fall, there is always a reason. It is important to understand why we fell…but it’s more critical to get back up. Rise and pat yourself on the back. But before taking that next step, figure out why you fell in the first place. This knowledge will prove priceless for your progress.
Learn to Smile in the Face of Adversity – and Everywhere Else Too.
Helen Keller wrote, “Character cannot be developed in ease and quiet. Only through experiences of trial and suffering can the soul be strengthened, vision cleared, ambition inspired and success achieved.” While you may have already experienced your fair share of adversity, Life is never done with us. You canchoose to welcome adversity as a challenge for you to overcome.
Keep a Journal or Blog of Your Thoughts.
Writing in a journal or blog gives us the opportunity to streamline our thoughts. When what we think and feel is in black and white before us, it becomes easier to stand back and analyze our decisions and thought processes. Journaling allows us to stumble into catharsis, into witnessing a revelation in our own lives.
Seek Out New Experiences.
Living by a daily routine is important – especially with a brain injury. But sometimes routine becomes so automatic that we miss the myriad of experiences life has to offer. Seeking out new experiences can be as simple as trying a new kind of food or going to a play instead of a movie. The idea is to do something - anything positive - that is different and even potentially outside your comfort zone. Our lives and personal histories are constructs of our experiences…and you never know when you might discover something new that makes you happy.
Extravert or introvert, we are all social beings. When we are around others who are like us, we catch a glimpse of both ourselves and life’s possibilities for us. Being around other people with brain injuries will also give you a sense of belonging. What’s more: studies show that people who socialize regularly experience less stress, illness and even live longer lives!
Be grateful…and Express it!
Pretend every day is Thanksgiving and acknowledge everyone in your life who has made a positive difference. You can do this in person or your journal. Cultivating an attitude of gratitude cannot only make you a happier person, but it has distinct physical and psychological benefits too. In Dr. Sonja Lyubomirsky’s The How Of Happiness, she explains, “Gratitude boosts happiness by promoting positive life experiences, increasing self-esteem, encouraging caring acts and moral behavior, detering negative feelings and emotions AND helps us strengthen our relationships.”
Don’t Sweat the Small Stuff.
Stress is at the root of practically all anxiety and, very often, illness. Although it is easier said than done, it is counterproductive to stress out or get emotional about aspects of life we cannot change. Eating healthfully, exercising and getting a solid 8-hours of sleep every night also go a long way to helping us reach a state of serenity.
Forgive and Forget.
Like avoiding stress, forgiveness can be a monumental task – but it is, quite literally, good for both your heart and overall health. Forgiveness can give you a lower heart rate, blood pressure and reduce your stress level. A study published in the Personality and Social Psychology Bulletin, found that “Forgiveness not only restores positive thoughts, feelings and behaviors toward the offending party (in other words, forgiveness restores the relationship to its previous positive state), but the benefits of forgiveness spill over to positive behaviors toward others outside of the relationship.”
Feed Your Head.
These days, there is a diet for just about everything. Because we now understand so much more about the nutritional content of food and their direct benefits to our bodies, zeroing in on a diet that can benefit your brain is simple. According to Dr. Phillipa Norman, including the following foods in our diet can provide energy, help cognition, learning and more:
· Purple grapes
· Brown rice
· Flax seeds
· Sesame (seeds, oil, butter, etc.)
· Sweet potatoes
According to the National Academy of Sports Medicine, exercise promotes personal happiness in several ways. “Regular exercise releases endorphins and catecholamines, which are the “feel good” chemicals released by the brain. Regular exercise also increases production of dopamine, a neurotransmitter that improves mood and decreases feeling of depression. Exercise also helps happiness by increasing self-esteem and feelings of accomplishment.”
Don’t Just Show Your Compassion, Act On It.
Compassion is showing sympathy for the suffering or misfortune of others. But there is an enormous difference between feeling compassion and acting on it. In the long run, the benefits of acting on your feelings go far beyond the immediate effect of helping you lead a happier life. When you act on compassion, you improve someone else’s life and, therefore, all of our lives.
Laugh…So the World Will Laugh with You.
A list of the physical and psychological benefits to laughter probably runs longer than a complete encyclopedia of knock-knock jokes. Here are a handful: Laughter relaxes your entire body and relieves physical tension and stress. Laughter can improve your resistance to disease. It triggers the release of endorphins that promote a sense of well-being and even temporarily relieves pain! Perhaps most importantly, laughter strengthens our social bonds with others and enhances our own sense of resilience.
Know your purpose.
When you know why you’ve been given the gift of survival, you’ll know where to focus the majority of your energy. Yours might be to help others, make art or music, be a good son or daughter or do any number of things! Ultimately, knowing your purpose allows you to live a more satisfying life.
Add to this list! You make your own happiness!
Seriously. Add to this list. There should be room in every happy life to grow, to be creative and share that creativity with the world. Whether it’s a pearl of wisdom or a one-sentence manifesto – make your mark with a comment.
In reality, happiness requires more than a few suggestions from a blog. It takes practice. Whoever said “Happiness is a journey, not a destination,” knew that the longer you travel, the easier it gets. The same is true of practicing happiness. The more accustomed you become to practicing happiness, the more happiness will seem as natural as smiling on a warm, spring morning.
25 TIPS FOR SUCCESSFULLY RETURNING TO WORK AFTER A
By Dr. Bryan Weinstein, D.O. and Drew Bufalini
Many people define themselves by what they do for a living. I am a physician, writer, construction worker, therapist etc. While this may not be the most psychologically healthy approach to self-identification, it is a fact of life. When an individual sustains a traumatic brain injury or other health-related, extended absence from work - time may not heal all wounds.
In fact, over 50% of people with a traumatic brain injury can’t return to work within one year of being injured and 20% with a “mild” TBI remain unemployed or are only sporadically employed. For others with a disability or who have been injured on the job, only 70% are capable of returning to work within one year. Injuries, illnesses and how individuals respond to them vary greatly – therefore, the following behavioral tips are designed to make returning to work an easier proposition. (While these tips are meant for people with a traumatic brain injury, they just as easily apply to anyone returning to work after an extended, health-related absence.)
1. Start part-time to build your endurance.
Going from zero to forty hours a week can be extremely taxing for anyone – let alone someone with a brain injury or other health issue. Rather than exhausting yourself and exacerbating your injury, start working a few hours a day and scale up your hours as your health permits.
2. Stick to a daily schedule.
Developing a routine and sticking to it helps you become accustomed to the new demands work places on your mind and body. This schedule should include three meals a day, 8 hours of sleep and 30 minutes of exercise every day.
3. Drink non-caffeinated beverages to reduce feelings of anxiety.
Starting work after an extended absence can be quite stressful. Feelings of anxiety are par for the course. If you’re experiencing any anxiety, stay away from caffeine until you are accustomed to your new employment and daily schedule. Stay hydrated by drinking water – this will also keep potential headaches at bay.
4. Use productivity apps on your smart phone.
The right app can keep you on time and on target in numerous areas of your life. Some even function as your very own personal assistant. (See Top 12 Smart Phone Apps for People with a TBI atLifeSkillsVillage.com for recommendations.)
5. Focus on one task at a time.
When most people claim to be overwhelmed at work, the culprit is often multi-tasking. This isn’t to say that nobody should multi-task – some people find it enhances their creativity – but for most, focusing on a single task will allow your brain to pay attention to every detail and you’ll do a better job.
6. Take copious notes (details, procedures, dates, times, etc.).
Following an extended, health-related absence – whether brain injury-related or otherwise – your brain will need time to adapt to your new setting and activities. While that adaptation is taking place behind the scenes, you might miss things happening right in front of you. Stay focused as much as possible and write everything down. This will help reinforce the details in your memory.
7. Ask for clarification if you don’t understand an assignment.
If your boss gives you a task but leaves out some key points (or you just don’t understand what s/he wants), asking for clarification is the best solution. It’s always better to do a job right the first time than to deliver an incorrect or incomplete project.
8. Don’t be daunted by a large project. Break it down into manageable bite-sized jobs and prioritize them.
Not only will this strategy help relieve the stress of a big project, but it will also make you feel more productive as you cross those bite-size jobs off your to-do list.
9. Learn to be a flexible thinker.
Another fact of life is that everything changes. This is especially true in the workplace. Whether a new supervisor alters your duties or a deadline is moved up, you should be flexible enough to roll with the punches. Easier said than done, but being “easy going” will make moving forward in your job a less challenging prospect.
10. Always double-check your work.
This is important for a multitude of reasons. The two most critical are that
1) You will hopefully catch any mistakes before handing off the project to your supervisor and 2) You’ll gain confidence from knowing you’ve done everything possible to complete the task correctly.
11. Welcome feedback from co-workers and supervisors. Offer yours.
Whether you’re a president or a pizza-maker, we can ALL improve our performance with a little feedback. Positive and negative feedback can both be useful when you’re trying to do the best possible job. Remember, just like you, people are more responsive to feedback provided in a positive tone.
12. Build in short breaks to account for fatigue (cognitive or otherwise).
Everyone needs a breather now and again – especially people getting re-acquainted with the workplace. Some companies have nap rooms, some are near parks where you can imbibe fresh air – but every company has a break room. Taking five minutes every couple hours for a bottle of water and a “brain break” will reduce feelings of exhaustion later in the day and keep you hydrated too!
13. Feeling overwhelmed? Ask for help.
If there is more work on your plate than you think you can complete in the allotted time, let your supervisor know that you will require help. There is no shame in this – your supervisor (or most, anyway) would rather know to add staff to a project than miss a deadline. No one knows your capabilities better than you and no one can read your mind.
14. Limit socializing with fellow employees while engaged in a task.
Distraction has its place, but the workplace isn’t one of them. If you must socialize or gossip, wait for a break or until you’ve completed the immediate task at hand. Until you’re confident in your capabilities and are comfortable being back at work, do your best to stay focused on the work.
15. Stop and think before making a decision – be pragmatic and don’t allow your emotions to cloud an issue.
It’s all too easy to make a snap decision based on passing positive or negative emotions. Rather than react to a problematic situation immediately, make the decision to step back. Take a breather. Then review your options from a less stressed perspective. Inevitably, you will make a better decision.
16. Keep a positive attitude.
Remember that your mood/attitude affects everyone around you – just as their moods affect you.
17. Before complaining about a problem, try to resolve the issue yourself.
An employee is always more valuable to an employer if s/he can solve an issue on their own rather than running for help every time something goes awry. Within reason and the scope of your job, attempt to solve problems on your own before bringing in a supervisor to iron out the issue.
18. View mistakes as lessons and write them down to reinforce them in your mind.
Everyone makes mistakes. Don’t beat yourself up when you do – try to learn and gain something positive from the mistake. If you have a memory deficit, it is even more vital to write those lessons down in a notebook to reinforce them.
19. Organize and prioritize your thoughts before speaking to supervisors or co-workers.
If necessary, write them down so you stay focused and on topic during the conversation.
20. When giving your opinion on a subject, make sure you ask the opinions of others too.
Everyone wants to be liked. That’s why soliciting the opinions of others and listening to them is as important as having an informed opinion of your own. This is relatively easy way to maintain mutual respect between you and your co-workers.
21. If you MUST interrupt someone during a conversation or meeting, be polite.
As a general rule, interrupting a speaker mid-sentence is considered bad form. If there are extenuating circumstances (for example, the speaker is making decisions based on outdated information and you have the update), simply say “Excuse me, but I think you’ll want to consider X, Y and Z.) When interrupting, always be polite, never rude or arrogant.
22. Do not discuss religion, politics or sex at work.
These three topics are legendary for creating disputes everywhere from the home and office to the General Assembly at the UN. Everyone has a right to an opinion and keeping yours to yourself at work will not harm you in any way. On the other hand, delving into one of these topics can cause impassioned arguments and, ultimately, a toxic work environment. Stay above the fray.
23. Even when you’re having a bad day, put on a “positive face.” This can help your attitude and those of your co-workers too.
The old saying, “Smile and the world smiles with you” is easily confirmed by smiling at one of your co-workers or even a random person on the street. Almost inevitably, they will smile back. Unfortunately, negativity is equally contagious. So if you’re not feeling up to snuff or something at work has raised your ire, try to keep it to yourself.
24. Don’t take the behavior of others personally.
When a co-worker is in a bad mood or blames you for something you didn’t do, chances are good that the real issue has nothing to do with you. Your co-worker is blowing off steam at your expense. Don’t take this behavior to heart – keep your positive attitude and, with any luck, your co-worker’s malaise won’t infect anyone else.
25. Take a walk or get some other form of exercise during the day.
There’s nothing like a lunchtime stroll to get your blood moving again. Research also shows that walking 20 – 30 minutes during lunch can boost your productivity.
Reaching the “return to work” stage after an injury or an illness is a major accomplishment. It’s one of the final steps in returning your life to normal and regaining your independence. Success is very dependent on preparation - especially for people with a traumatic brain injury. If possible, utilize the services of a vocational rehab therapist or join a “work hardening” or work re-entry program to redevelop or hone the soft skills required for the workplace. Wherever you begin the work re-entry process, utilizing these tips can make the difference between failure and success.
Have you recently re-entered the workforce after a TBI or other health-related absence? If so, I would enjoy hearing what has worked for you…please share your experiences in the comments section below.
I know what you’re thinking: don’t people with a traumatic brain injury have enough to relearn without training in new technology for their smart phone? Short answer: yes and no. Yes, which is why the twelve apps I have suggested below are meant to complement existing therapies and programming. No, because the more often someone with a TBI is able to exercise his mind, the more functional it will be for in the future. Learning is a lifelong process – with or without a TBI.
There are literally dozens of apps available for people with a brain injury and hundreds for people with similar problems. I have selected the following apps because they provide an augmented solution to the three primary deficit categories common to many people with a brain injury:
Specifically, these apps help clients/patients work on the following: short-term memory loss, communication/socialization problems, anxiety, behavioral and organization issues:
Free w/$1.99 Upgrade Available (iOS)
(Android counterpart: Lists Alarmed!)
This is short-term memory at your fingertips. A productivity app for the masses, people with traumatic brain injuries can use Alarmed to create multiple reminders with unique, memorable tones for each task. Reminders can be customized in tandem with a To Do list and send duplicate emails. This app also comes with a timer to assist in programming.
Free (iOS + Android)
For anyone who could use a time out to relax, Breath2Relax has been proven to help mood stabilization, anger control and anxiety. Simply indicate your level of stress and follow the audio instructions to breathe your way back to serenity. Essentially, this app provides on-site audio diaphragmatic breathing exercises.
Clear Record Premium
Price ranges from .99 - $1.99 (iOS) depending on upgrades
(Android counterpart: AndRecord, Free)
This audio recording app allows the user to record conversations in practically any environment and play it back at the speed and volume of their choosing. Unlike many other voice-recording apps, Clear Record Premium filters out ambient sound to ensures correct pitch and clear voices.
$1.99 (iOS + Android)
For non-verbal clients, this app utilizes two large, color-coded buttons. A recognizable green for “Yes” and red for “No.” When either button is pressed, the app vocalizes the users decision. This is a wonderful tool to help those with a brain injury or speech problem communicate without a struggle.
Cozi Family Organizer
Free with a paid version featuring advanced functionality (iOS + Android)
Families can stay in sync on multiple platforms using this app that combines a shared calendar, shopping and to do lists. With everyone on the same “page,” organizational skills can be greatly enhanced and frustration diminished.
Free (iOS + Android)
Speak and this app will recognize your voice and transcribe what you say into text messages, emails and even update social media. Perfect mass media communication tool for anyone with a physical limitation.
In Case of Emergency
$1.99 (iOS + Android)
This app allows people to store their medical information in a single location that is convenient for medical personnel in the event of any urgent situation. You can also use this app to find the nearest hospital.
Social Skills Sampler
(Android Counterpart: Habit Browser – Free)
This “Sampler” app includes 62 of the most common topics in the functional social skills system for people with brain injuries to model for appropriateness. Topics include: meeting/greeting people, taking responsibility, being polite, joining others in groups, apologizing/excusing self, following directions and handling criticism. Users watch a brief video of a person performing the correct behavior for the social situation and can then pattern their own behavior accordingly.
Keep It Green Habit Maker
Keep It Green Habit Maker helps clients/patients develop positive habits in their lives by keeping them organized, tracking their progress and maintaining motivation. The app allows you to set the habits you want to develop and receive reminders when they’re due. Users can color code habits based on the urgency or priority of the habit they want to develop. Or, the app provides automatic prioritization of tasks/habits based on recognizable color codes. This is a great app, but best launched with a therapist/caregiver to help set priority levels for each task/habit.
Free (iOS, Android, web)
EverNote helps improve memory, organizational skills and even creativity by syncing ideas on multiple devices. Users can take notes, capture photos, create to-do lists and record voice reminders. The searchability function can be a tremendous boon for those with short-term memory loss.
Spaced Retrieval TherAppy
Spaced Retrieval is a scientifically-proven way of improving recall of names, facts, other selections (user’s choice) and even the routines of several people. People with brain injuries can rehearse memory skills by recalling an answer over expanding intervals of time (1,2,4 and 8 minutes) and helps to cement the information in memory. Please note: this app is not intended for use without therapy.
Note: No direct Android counterpart, but Complete Memory Training Games for Android is a good free substitute, but without all of the training features as Spaced Retrieval Therappy.
Brainscape – Smart Flashcards
Free - $9.99 for In-app Purchases (iOS + Android)
Pick a subject from geography to vocabulary building to driver’s education and Brainscape has a set of smart digital flashcards. What makes these flashcards so smart? Besides being color-coded to aid recall, users are asked to indicate their prior knowledge of the answers. Those questions the user did not understand or answer correctly are repeated more frequently than those the user answers correctly. Subject matter is repeated until the user has gained mastery over the subject matter.
All apps labeled iOS can be found at the Apple App Store. Apps for Android can be found at either Google Play or the Amazon Appstore for Android.
Since this is by no means an exhaustive list, I would love to hear from people with traumatic brain injuries, physicians and caregivers about the apps they think work best.
Next Blog: Top Apps for Caregivers of People with TBI
The desire to help those who needed it most brought me into the field of psychiatry. Working with the brain injured has taught me that even an abundance of passion isn't enough to truly provide that help- a complete sea change had to occur in the way I viewed people with brain injuries. That view has become the foundation of how we treat and work with our clients.
I've outlined the principles we work by...that I hope will help our clients, their families, case managers and physicians see eye-to-eye on treatment of the brain injured - and each other.
People with traumatic brain injuries are people. Just like you and I. They have needs, wants, hopes, dreams and aspirations. They have unrealized, untapped capacities, functionality and motivation. They want to lead fulfilling lives; have the freedom to learn, work, socialize and love. Helping a person with a TBI requires patience, perseverance, acceptance and rehabilitation. Rehabilitation necessitates immense effort by the clinical team and the patient/client. It means a restoration to health by training and therapy by a gently guiding hand. Rehabilitation should stand under scrutiny, be consistent, clinically relevant, goal-oriented and patient-centered.
The social ramifications of a brain injury are cataclysmic. Brain injury hides behind a mask that looks just like you and I, but behind the facade lies one of the most painful of burdens to endure: pervasive loneliness. The cognitive and executive symptoms combined with affective instability and behavioral symptoms can sentence that person to social isolation. We must consider that each patient possesses the capacity to learn and feel fulfilled; the right to ongoing rehabilitation and opportunity for independence.
Rehabilitation should exist for the term of the injury. When a person has reached their capacity for self-satisfaction and happiness, it should cease. Although the brain injury may never be cured, the person who survives has the right to the rehabilitation that will, ultimately, help them recover happiness and fulfillment.
Life Skills Village's commitment to our clients is to ensure the very real possibility of that goal. We believe we will have the final, critical word in the care of our patients/clients. We will recommend only the level and types of care with the potential to promote true rehabilitation.
Life Skills Village promotes and supports the following:
1. All rehabilitative programs should show outcomes, primarily for functionality.
2. Residential placement for brain injury should monitor for living skills (i.e. grooming, cleanliness, organization, bill paying, etc).
3. Goals should be patient-centered; based on desire, potential and ability.
4. The decision regarding where all therapies are provided is clinical. This requires our scrutiny of all programs and residential facilities as well as discussion with case managers, caregivers and other physicians.
What's more, we commit to a constant evolution of new treatments devised at LSV or by another clinician/institution; so that we may continue to offer our clients hope, purpose, fulfillment and - ultimately - independence.
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About the Doc
Dr. Bryan Weinstein is a practicing psychiatrist with certification from the American Board of Psychiatry and Neurology. He has practiced psychiatric pharmacology and psychotherapy since 1997. Dr. Weinstein is the CEO of Life Skills Village.