Posts Tagged sense of self

[BLOG POST] Me, Myself, and My (More or Less) Creative I (after traumatic brain injury)

By Bill Herrin

Working with the topic of brain injury at Lash & Associates Publishing, I’ve heard on quite a few occasions that TBI can seriously alter a person’s ability to do certain things that they were once highly skilled at. Some basic things can also be affected, like driving a car, riding a bicycle, outdoor activities, walking/balance and more.

Many may also sustain a brain injury that affects them on an even deeper level – such as paralysis, cognition, thought patterns, speech, logic, etc. The one thing that is very intriguing about TBI is how it can affect creativity – and how it may change a more logical “left-brained” person, and make them more creative, imaginative, musical, or artistic. This also could bring the opposite effect to a more “right-brained” person and erase most or all of their previous creative strengths and talents. Although I’m not a TBI Survivor, I truly empathize with those who have dealt with these extreme changes and thought that it would be an interesting topic to explore.

One such case was Hilary Zayed. She worked as a teacher, was a flutist, a passionate horseback rider, and a mother of 2 grown children when she had a brain injury. Her recovery and subsequent reinvention of her prior life came with much hard work. She couldn’t enjoy music like she used to, so she worked toward finding a creative outlet – and soon discovered the art of making mosaics, paintings, and more.

After three years of being at home with a rotation of visiting nurses – often lying on the couch, she started to maneuver down the stairs to her art studio/space more and more. Some health professionals encouraged her to exhibit her works (art and writing), and soon she found herself doing several other solo shows across the Northeast. She found that sharing her experience through her art opened doors for others to be inspired to try harder after their own TBI. Here is a quote taken directly from Hilary’s book titled: Reinventing Oneself After Loss:

“One of the biggest lessons I learned was the importance of sharing my experience. It seemed to speak to people and inspire them to do the same. It felt as if the “butterfly effect” was happening and I was the one with the moving wings. As I finish writing this personal journey it has been almost seven years. I cannot say that I have fully reinvented myself but I have attempted to stay on course, refine my goals and continue to work hard on moving through

obstacles and leaning forward. Oddly, it was leaning forward on my horse, that fateful day, which changed my life. That action gave me the gift of making art and writing about it, on this journey to reinvent myself after loss.

May you find the courage to move forward as you deal with loss.”*

With every instance of people that make gains creatively after TBI, there are also people who suffer losses in the same arena. Being creative, artistic, musical, inventor, a writer, etc. is a gift that can be rewarding, and even help a person identify with others on a huge level. Losing that creative spark can be a harsh reality. Overall “loss of self” is basically the same thing, but it’s a huge transition for a creative person.

Shown below, I’m referencing an incredible article (by Dahlia W. Zaidel) that discusses the neurological changes that can take place in the brain of a creative person after a TBI, and also changes in a less creative person…here’s an excerpt:
“Neurological cases of visual artists who had practiced their craft professionally prior to the brain damage can help point the way to neuroanatomical and neurofunctional underpinnings of creativity. Approximately 50 or so cases with unilateral brain damage (largely in one side of the brain, and where the etiology is commonly stroke or tumor) have by now been described in the neurological literature (Rose, 2004Bogousslavsky and Boller, 2005Zaidel, 20052013a,cFinger et al., 2013Mazzucchi et al., 2013Piechowski-Jozwiak and Bogousslavsky, 2013).

The key questions concern post-damage alterations in creativity, as well as loss of talent, or skill. A review of the majority of these neurological cases suggests that, on the whole, they go on producing art, sometimes prolifically, despite the damage’s laterality or localization (Zaidel, 2005). Importantly, post-damage output has revealed that their creativity does not increase, nor diminish (Zaidel, 200520102013b). Given that the damage arises unilaterally (only one or the other hemisphere), artistic creativity in the healthy brain can not simply be attributed to a single hemisphere, dedicated neural “regional center”, network, or pathway, but rather to a diffusely represented capacity in the brain. Indeed, it would further seem that creativity is highly sensitive to brain damage, more so than artistic productivity, talent, or skill.

We could speculate that in the healthy brain cognitive associative networks in the left hemisphere alone, in the right hemisphere alone, or both hemispheres working together contribute to the creative process in art. However, recent functional neuroimaging evidence based on non-artistic behavior in healthy volunteers points to greater left hemisphere involvement in creativity (Gonen-Yaacovi et al., 2013). Where do the original ideas in the artwork arise, is a complex question that researchers would like understand (Dietrich and Kanso, 2010Heilman and Acosta, 2013Jung and Haier, 2013). The likely answer with regards to the cerebral hemispheres is that both are functional in exceptional creativity, but with each hemisphere contributing a different facet, yet little understood, to the creativity process (Zaidel, 2013d).”**

From the most basic approaches to eye/hand coordination, thought and cognition, and creative expression – to advanced creativity and artistic endeavors after TBI, the persistence and determination required to persevere takes incredible inner strength. As I often say, every person’s TBI is different, and each has its own starting point – and the ending point remains to be determined. Finding your way through the maze of TBI (of which there may be many causes such as concussions, blast injuries, stroke, etc.) is one of total commitment to stay the course. Time, along with effort brings results for many TBI survivors, but not all.

It’s my hope to encourage you in your creative outlets, to find solace in your “new normal”, and to express yourself through creativity…and creativity doesn’t just have to be visual arts, it can be writing, crafting, music, knitting or crocheting, poetry, relaxing with an adult coloring book, and lots more. Everything we see around us was created by someone – including the devices we are reading this post on! Make the most of every day, and my prayer for all of us is that we find abundant personal reward from all that we aspire to accomplish in life…creative or otherwise!

Feel free to leave a comment, and share your story regarding the changes in creativity, too. It may inspire, it may not…but your story is important – and it’s worth sharing!

**Here is the link to the entire referenced article by Dahlia W. Zaidel:

https://www.frontiersin.org/articles/10.3389/fnhum.2014.00389/full

via Me, Myself, and My (More or Less) Creative I (after traumatic brain injury)

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[BLOG POST] A Brain Injury Life – formerly TBI to LIFE

Perception of Self after Brain Injury

Lately I’ve been wondering whether brain injury really changed the person I am or if it just added a new layer to my old self.  It may be impossible to articulate and probably unanswerable. Obviously, an injury physically changes how the brain works and directly causes a host of problems—physical pain, cognitive deficits, and the loss of identity (e.g. the tendency to ask existential questions like this). But cause and effect are not always clear. There are many problems that could be organic or could just as well be new incarnations of innate character traits.

I’ve gotten used to the idea that everything different in my life since my TBI has either been caused by the brain injury or what I learned in my neuropsychological rehabilitation. But what if there are fewer changes than I imagined? Am I still who I was but with some parts missing? That would explain the feeling of being lost in a foreign land.

For example, I used to think I was always right. But if brain injury has altered me functionally (it has, now I am often wrong), while leaving my sense of self intact (i.e. I still see myself as in the right), my perception would contradict reality. Since I’m nothing if not logical, one or the other would have to give. The belief of always being right could, unconsciously, be directed somewhere else. So instead of being convinced that my answers were better, I’d think I was wiser because I’d learned the best strategies, and was convinced that I could recognize a brain injury—or deficit—intuitively and in the moment. Which I am.

Does that make any sense? One more try:

If brain injury changed the life I lived—the structure, productivity, and satisfaction—but not who I think I am in life, it would explain why I feel rudderless. I keep trying to find my place in the world, a goal I can realistically accomplish and the initiation to follow through. Instead, I feel like I have no purpose. I come up with labels to define myself like an advocate (really?), a leader in the community (since when—6 years ago?), or educating people about brain injury (who am I teaching?). So what’s up with that?

All I can say with certainty is that the feeling of being unmoored seems to grow deeper as time passes.

via A Brain Injury Life – formerly TBI to LIFE

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[ARTICLE] Music Upper Limb Therapy—Integrated: An Enriched Collaborative Approach for Stroke Rehabilitation – Full Text 

Stroke is a leading cause of disability worldwide. It leads to a sudden and overwhelming disruption in one’s physical body, and alters the stroke survivors’ sense of self. Long-term recovery requires that bodily perception, social participation and sense of self are restored; this is challenging to achieve, particularly with a single intervention. However, rhythmic synchronization of movement to external stimuli facilitates sensorimotor coupling for movement recovery, enhances emotional engagement, and has positive effects on interpersonal relationships.

In this proof-of-concept study, we designed a group music-making intervention, Music Upper Limb Therapy-Integrated (MULT-I), to address the physical, psychological and social domains of rehabilitation simultaneously, and investigated its effects on long-term post-stroke upper limb recovery. The study used a mixed-method pre-post design with one-year follow up.

Thirteen subjects completed the 45-minute intervention twice a week for six weeks. The primary outcome was reduced upper limb motor impairment on the Fugl-Meyer Scale. Secondary outcomes included sensory impairment (two-point discrimination test), activity limitation (Modified Rankin scale), well-being (WHO well-being index), and participation (Stroke Impact Scale). Repeated measures ANOVA was used to test for differences between pre- and post-intervention, and one-year follow up scores. Significant improvement was found in upper limb motor impairment, sensory impairment, activity limitation, and well-being immediately post-intervention that persisted at 1 year. Activities of daily living and social participation improved only from post-intervention to one-year follow up. The improvement in upper limb motor impairment was more pronounced in a subset of lower functioning individuals as determined by their pre-intervention wrist range of motion. Qualitatively, subjects reported new feelings of ownership of their impaired limb, more spontaneous movement, and enhanced emotional engagement.

The results suggest that the MULT-I intervention may help stroke survivors re-create their sense of self by integrating sensorimotor, emotional and interoceptive information, and facilitate long-term recovery across multiple domains of disability, even in the chronic stage post-stroke. Randomized controlled trials are warranted to confirm the efficacy of this approach. Clinical Trial Registration: National Institutes of Health, clinicaltrials.gov, NCT01586221.

Continue —> Frontiers | Music Upper Limb Therapy—Integrated: An Enriched Collaborative Approach for Stroke Rehabilitation | Frontiers in Human Neuroscience

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