Navigating the complex world of traumatic brain injuries (TBIs), Daniel Gospodarek LCSW, a courageous survivor, joins me to paint a vivid picture of the immense impact of TBIs on individuals. From his traumatic experience to his journey of recovery, Daniel enlightens us about the various types, causes, and symptoms of TBIs, helping us differentiate them from mental health issues. He underscores the critical importance of adequate assessments, effective collaboration with medical professionals, and a comprehensive understanding of how TBIs can reshape an individual's identity.
We also unpack the emotional turmoil and financial strain associated with TBIs. The profound repercussions not only lead to feelings of powerlessness but also significantly alter one's identity. Daniel and I discuss the significance of finding the right therapeutic team and how to identify a suitable therapist. We also discuss the instrumental role of social support in recovery and share strategies to forge a robust support system.
To learn more about Daniel Gospodarek, LCSW
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Clinical website
More about James Marrugo, LPC:
https://morningcoffeecounseling.com/
If there are questions you want answered or topics you want me to cover, send me an email at
James.Marrugo@MorningCoffeeCounseling.com
Music by AlexGrohl from Pixabay
Navigating the complex world of traumatic brain injuries (TBIs), Daniel Gospodarek LCSW, a courageous survivor, joins me to paint a vivid picture of the immense impact of TBIs on individuals. From his traumatic experience to his journey of recovery, Daniel enlightens us about the various types, causes, and symptoms of TBIs, helping us differentiate them from mental health issues. He underscores the critical importance of adequate assessments, effective collaboration with medical professionals, and a comprehensive understanding of how TBIs can reshape an individual's identity.
We also unpack the emotional turmoil and financial strain associated with TBIs. The profound repercussions not only lead to feelings of powerlessness but also significantly alter one's identity. Daniel and I discuss the significance of finding the right therapeutic team and how to identify a suitable therapist. We also discuss the instrumental role of social support in recovery and share strategies to forge a robust support system.
To learn more about Daniel Gospodarek, LCSW
Facebook
Instagram
Clinical website
More about James Marrugo, LPC:
https://morningcoffeecounseling.com/
If there are questions you want answered or topics you want me to cover, send me an email at
James.Marrugo@MorningCoffeeCounseling.com
Music by AlexGrohl from Pixabay
Hello and welcome to another episode of the Mental Health Without the Bullshit. For today I wanted to talk about traumatic brain injuries, but before we get into the meat of the conversation, i have a guest that will need an introduction. Go ahead and let the listeners hear your voice.
Speaker 2:Hi, my name is Daniel Gaspardaric. I'm a licensed clinical social worker based here in Denver, Colorado.
Speaker 1:Awesome. Thank you so much. So first, you had disclosed prior to us starting the podcast and recording that you actually have your own TBI and you had asked if you could talk about it during your introduction. Go ahead, what happened? Tell us about it.
Speaker 2:Yeah, so originally from Wisconsin and it was a car accident, so roll over. We rolled over four times, don't remember it. Then they took me to the hospital, had that brain surgery fractured. My skull, left lung was collapsed Because of the brain bleed. I had a stroke in my prefrontal lobe And it's kind of a tough situation. They told my family that they weren't sure if they was going to make it through the night in the next 24 hours would kind of tell a lot about what recovery is going to look like. So they put me in a medically induced coma for three days and then they would kind of titrate me in and out during the day and back in at night And then did seven, seven, so 10 days in the ICU, seven days inpatient rehab, then three months of physical therapy outpatient and then 17 months of speech therapy outpatient. So Wow, yeah, it was a long journey going in. So that was the summer going into my senior year of high school.
Speaker 1:Oh man, That I mean it's a miracle that you're alive after an accident like that And then, obviously, with such a long recovery, so many questions about that as far as, like your mental health, your physical health, the trauma of you, your family as well that so much goes into recovering from a TBI. And would you say that you experiencing this accident did it propel you to help people with their own traumatic experiences and treating TBI? So that's what a part of your clinical focus is traumatic brain injuries, TBI. So would you say that this definitely propelled you.
Speaker 2:It was probably the precipice of it that really started it, because even before the TBI it's kind of one of those kids like drifting around right, don't really know what the calling is in life, maybe just join the military, you know, get or get a regular business degree and just kind of float through. But then once this happened it was like okay, like how do I do this as a physical therapies, a speech therapies and mental health therapy, which I ended up going into right As in nursing whatever, whatever kind of helping profession right Or serve an orient profession it is. And then it just kind of went from there. And my sister's actually a social worker back in Wisconsin too, so then she was like check out social work, and then it was just part of it, part of the snowball started there.
Speaker 1:Yeah, that's such a beautiful story. I'm glad that you're here. To talk about your experience and also to talk about TBI is to help others who've gone through similar experiences, either themselves or someone they care about, because TBI is, it's not like they're uncommon to find in the general public. So before we get further into it, let's talk about what is a TBI. When we say traumatic brain injury and we brief it with TBI, what is it?
Speaker 2:So there's different types, right, you can have something that's external, that hits the head right Car accident, bullet, a fall right And then you can also have internal, so infections right, strokes and stuff like that. So penetrating, non penetrating, so acquired brain injury, the non acquired.
Speaker 1:so So how do TBI's happen, is it? you know what's the difference between like playing football, right, a high contact sport in comparison to, you know, tripping, and just on like the sidewalk, and both of those cause TBI's.
Speaker 2:So mild concussions right are considered TBI's. They can impact cognitive function, even if it's briefly, especially when you get into the situation of sports right, especially football, hockey, those high contact sports, even soccer on some level. So if your concussion or your mild TBI is not at the adequate time it needs to heal right Which everyone's different And then you sustain another one right And then another one. It's kind of like I don't it's hard to describe it in terms of what that looks like in your brain, but it's essentially like if you, if you have a scar in your skin and you you get another cut on that scar and then scar tissue gets stronger right And then stronger after cut, after cut right, so it's gets thicker, it's gets harder, and that can.
Speaker 2:Then those compounding TBI's can impact people's abilities. There's cognitive functioning for, you know, months at a time, years at a time or their whole lifespan, and then it also brings into account of what areas of the head get hit right. Is the fall on grass? do they trip and fall on grass versus concrete right? Like all those different variables come into play.
Speaker 1:So a mild to moderate concussion if it's not allowed time to heal or if it's just, you know, like in high contact sports where those things are common, such as like football and hockey, you know, boxing and martial arts people get hit in the head frequently. That can create a scarring effect in which it impairs cognitive function because of just repeat damage to a person's brain. And obviously I would imagine the same thing happens if people have repeated strokes. It's not hard contact, blunt force trauma to the head, but strokes are obviously very bad for the brain And I would imagine if someone has repeated strokes without getting medical care that kind of have the similar effect of cognitive functioning getting worse in particular areas that accurate.
Speaker 2:Yeah, yeah, i mean, and again it's going to come back to like what, where does the person get hit in their head? right, football, obviously you're running forward, but you can get from the side, you can fall backwards, right All these different things. Strokes can happen in your language area of your brain, in your prefrontal cortex right, in your hippocampus right. So those areas of the brain control many different components of your cognitive functioning your, your expression of language, your ability to interpret, affect right or just observe somebody's emotions shift right, and that impacts people. There's such a degree of uniqueness to TBI's themselves and also the person and how, the way that they sustain them.
Speaker 1:Hmm fascinating.
Speaker 2:That's part of the reason they're so complex, right is? it's not a fractured arm set. It don't move it for two, three weeks. We'll do a repeat x-ray. Hopefully everything's good. Things aren't good, okay, we'll put screws in, right Like there's not this clear formula.
Speaker 1:Yeah, our brains are complex and it's not like we can just, you know, open someone's skull and see what's going on in there. it's not how this works. There needs to be very specific and drastic reasons to perform brain surgery on anyone. You know, usually it's like the last result, so it's harder for that to heal And it's, you know, our brains mushy, like it's just, it's not, you know, it is solid mass but it's not like a bone where you can just grab it and put someone unconscious, open it up and put screws in it. Like there's the brain's mushy. you know, too much pressure and things just like literally fall apart if they're like scrambled eggs, so it's harder to care and heal for that.
Speaker 1:So it's obviously very important that we protect our skull because our brain's just kind of floating and fluid. So too much movement, you know your brain slaps up against the inside of your skull and then that causes problems from trauma. And then obviously you know some of the things you'd mentioned infections and strokes and other things. you know we don't want those to reach the brain for that specific reason. it could cause permanent damage And that's an issue. One thing I wanted to definitely talk to you about is symptoms of a TBI And I would imagine it's. it's kind of varied in nuance because it depends on different areas of the brain, but are there more common symptoms of a TBI? or how would someone know if they have a TBI that just hasn't been caught by someone yet?
Speaker 2:So I think you know, working backwards from that question of how would somebody know if they had a TBI Like A, if somebody, somebody like maybe somebody blacked out because they were drinking, right, and they fell and hit their head. So somebody telling them, hey, maybe we might want to go get checked out, right. Or conscious awareness of getting hit in the head And then and then seeing these prolonged things happen. So some of some of the kind of the hallmark right TBI piece, tbi symptoms come from challenges with concentration, focus, right, irritability, anger, rage, like that kind of emotional fluctuation or rapid shifts in affect, challenges with sleep and challenges with sleep sleeping too much, sleeping too little, right. But also sometimes there's this chronic fatigue that even if you're getting enough sleep, you're still tired. Or even if you're sleeping too little and you don't need that much sleep, you're still tired, right, it's just kind of pervasive. But again, these mental health symptoms can also rapid shifts in move or in mood, right. That could signal bipolar.
Speaker 2:If somebody is not aware of somebody their client has a TBI history, right. So then they put them on mood stabilizers and stuff and you know, thorough assessments are really important as well as, like you said, tbi is our nuance right. One TBI we you and I could get hit in the head on this in the same area but have different symptoms because of different regions of the brain that got that were impacted right. So those aren't cookie cutter symptoms, right. They can be very nuanced from not feeling it, not feeling yourself, not feeling how do I want to say it like like your own person, like you are, who you are right, like why do I get so upset? Why can't I be patient, like where's my impulse control right? or people telling me how come you can't just settle down right, and all those pieces kind of are can be evidence that there's there's something else going on around the TBI and working with trained people right to support that recovery process can be done.
Speaker 1:Hmm, it's as you were talking. One thing that I noticed was a lot of the symptoms of a TBI also look like another mental health issues that you and I also you know help with our clients, such as inability to focus, trouble sleeping, impulse control. A lot of those also are markers of various other diagnoses From your perspective, like is is how do you, when you get a new client, they're seeing you because they believe they have a TBI, or they know they have a TBI. They're discussing your symptoms. How do you differentiate between TBI and something like bipolar?
Speaker 2:Sure, that's a really good question And just kind of piggyback, right, like challenges with concentration, focus, right, adhd. Right Now people are on, you know, stimulants, right? Challenges with sleep irritability that could be bipolar, that could be depression, right, restlessness, anxiety. So, going back and now answering your current question, right, how do you differentiate? Well, a what does the client self report? right, as a client willing to sign a release of information for a medical provider to kind of collaborate in terms of providing care? Does the client have TBI records themselves that they could email you to review, right, neuro neuropsychological testing can be really important. Not to say that won't say whether somebody has a TBI or not. However, it will say, if you know somebody has a TBI, here are the domains in their lives that they're really struggling And here are compensatory strategies that can help alleviate some of that distress or maybe create a little more predictability, right, and and also give some tips for caregivers to support them.
Speaker 2:So, looking at when was the TBI acquired, right or sustained, and did symptoms follow that or were symptoms present before the TBI right, can be really, really great information to start teasing out. How long were they around, right where they were? they were they there, but at a low level, and then they increased in severity after the TBI, or maybe they went away after the TBI. Right, and our brains are complex, our bodies are so complex And so really just having those those curious discussions about tell me, tell me your story, what happened, how did things change? Right, Fascinating.
Speaker 1:Yeah, it's such interesting work that you do So I mean for me, the moral of you know that that answer is be mindful of yourself and any changes you know. Have you been hit in the head? Have you blacked out for any reason? You know? are people giving you feedback that something's different about you? Do you feel like you're a normal self? you know normal range of how you normally operate day to day? And if those things aren't, you know checking boxes, start looking for professional help to make sure that you are okay.
Speaker 1:That's not only mental health, but make sure like your brain's okay and everything's functioning there, because a lot of those symptoms can look like something else entirely Right, like you mentioned, the restlessness can come off as anxious, but if that's not how that person normally operates or if there's been a recent change they've been hit in the head or blacked out or, you know, had an infection that that traveled up to their brain.
Speaker 1:That's something to look at is I might be struggling with not just mental health due to a traumatic band injury, but there's might be something neurologically going on with my my head due to whatever happened recently.
Speaker 1:So it's and I love that you talked about signing a release of information and ROI to partner with people on the medical side of things, because if someone does have a TBI, it's. I would imagine it's challenging be like how much of this is due to the TBI And how much of this is just mental health related, due to previous trauma unrelated to the TBI, because we all have our own life experiences that do cause mental health issues, but if we don't check in on the medical side of things, we might be missing the mark by not wanting to collaborate with other medical professionals. I think it's an important message that if you are getting treatment for a TBI, there's multiple ways to heal and to grow and to get a team of people to help you as best they can. Are you? how often do you get a chance to work with someone's doctor or neurologist or something of the sort?
Speaker 2:So I would say it's you know, case by case, because not everyone I treat in my private practice it has a TBI right. For people that do have medical issues, i mean I would say it's it would be continuity of care to have a real trial and or beginning to have some discussions with the client around signing releases. So it's more likely than not that there will be. Now some people can also say, hey, like my TBI was, you know, 12 years ago. These are still some of the challenges that I'm having, maybe around like identity, like maybe the job they could do prior to the TBI in the income they could earn has decreased in terms of earning potential and or just the intensity of how much they can work right. So adjustment around that right Now, if they're pretty stable, having a ROI may may not be really needed right.
Speaker 2:But if somebody is like actively going to neurology, working with a neurologist right Like, or a neuropsychologist for testing, i mean that continuity of care, like nobody heals in a vacuum And it really does take holistic, a holistic approach to support recovery. It can't just be a therapist, it can't just be two or three people. I mean it comes down to diet, it comes down to sleep hygiene. It comes down to the small things that a lot of people, myself included, right We take for granted. We push ourselves. Come on, read one more book, do one more note, whatever it is.
Speaker 1:Yeah, i love that. It's about the continuity of care, being on the team and understanding that each situation it's new wants to that individual. You had said something super important I wanted to segue into, which is a person's identity possibly changing after a TBI. Talk to me about the mental health aspect of that. What do you do to help? What do people experience? What kind of toll does that take on a person? Because this is something you've also personally experienced, having your own TBIs. I would imagine part of your identity also shifted before and after.
Speaker 2:Sure, yeah, and it definitely did. That's such a big question. I'm trying to figure out how to break it into chunks, right? So Identities can shift depending on the severity of the TBI. Also the age at which they were acquired or sustained. So you know, a 13 year old or a 16 year old experience in TBI. They also have youth on their side versus somebody who's 60, right, somebody that's younger, their recovery process might be better, right. There also might be medical advancements in their life that can help them make Huge jumps that somebody who's older may not a live to see, right, or B Even be or open to trying, right. So it just so. It depends And that's a hard answer, right, because it's such a such a big topic.
Speaker 2:But in terms of identity, right, we're looking at if, if there's fatigue, right, and you can't hang out with your friends, you know, however old you are, like that's a loss. And it's a loss in terms of positive connection with others, humor, joy, right, or a decrease in it if you can still do it, but not as often, not as frequent. In terms of earnings or job potential, right, ability to execute at your job. So demotions, changes in positions, changes in income, job loss. And then moving on to, possibly, government benefits, right, medicaid, medicare, social security, fixed income, and then also, if you have a family, right Now, like You know, this tech, this kind of country was built on like the mail, is the provider right? And, and I think what we've seen, especially in Denver, is it takes two or three incomes to support a household, right That that that does not exist. The nuclear family, as it did in the 50s, does not exist anymore. And And what does that say for your family's quality of life, or your loved one's quality of life, right? So downsizing homes, right? changing from private to public schools, right? I mean the list can go on and on in terms of identity shifts, and that's just social and occupational right.
Speaker 2:In terms of functioning, can you still walk, right? some people can't, especially if there's this final injury. Right, can you? can you do the stairs? So, selling a house, moving All these different pieces, that's physical, cognitive. We kind of talked on with the execution. Can you cook? Are you able to follow a menu or not a menu, but a? My mind's blinking on this recipe recipe, thank you, i was thinking like structure a lot. I haven't had any coffee yet today, so So can you follow a recipe right Or do you get lost in it? I mean then looking also at financial, like Can you balance a checkbook, can you track, can you count change at the cashier Right, because that takes that takes a lot of concentration of focus and tasks, working memory and there's also social pressure about people watching you. So there's many different areas where our identity shift and then the grief and loss that comes with them, right, and then also Moving into the antidote of acceptance, which is a very active and can be difficult and painful process, right.
Speaker 1:Hmm, i mean the potential for identity shift and forming a new identity. That that alone causes a lot of mental health issues and people and lots of concerns regarding identity formation. But when it comes from, you know, an accident regarding a TBI that's, it's usually shocking and sudden and Unwanted, which causes that sense of grief and loss and confusion and that could take someone you know hours and sometimes years to recover from, particularly if it's Just a higher sense of grief and trauma that goes along with it. We're talking about traumatic brain injury, but the word trauma is in that, which means right health trauma too. Mm-hmm, yeah, do you?
Speaker 2:have a TBI and PTSD right? Exactly, yeah. And then that powerlessness that comes with that TBI right, That inability to exert control in your environment right, It's, it's, it's so powerful.
Speaker 1:It's absolutely heavy.
Speaker 1:Yeah, i've done a little bit of work with vets with PTSD and some of them had TBIs and My work was mainly just focusing on the emotional aspect and they had other people for the medical stuff.
Speaker 1:But I remember them talking how they're Identity shifted because there were some cognitive functions that they could no longer engage in and were learning To work around, which then caused more mental health concerns as far as like frustration and depression and anxiety, because then they had to relearn things or learn to do things in a different way or just have Find acceptance that it's just not something they do anymore, ever, because that part of their brain is just Effectively not there anymore, because they're there TBI, and then they have all these other concerns along with it. Now, just remember, for them It was a near constant battle which, looked from an outside perspective, absolutely exhausting and So sad because it was like constantly on their mind in and out of the sessions. It was like all they thought about, all they talked about and And it seemed to me like the emotional toll was just Immeasurable. Has that been your experience as well, and helping people with TBIs?
Speaker 2:Yes, i would say. I think the immeasurable effects of the TBI hit everyone and show up so uniquely and differently that It's not like you're working with a cluster of depression symptoms. Right, depression may be in there and it could predate or post date the TBI, just Like trauma, like PTSD, right I Would. I would say that Part of people who work with anyone I mean even mental health right is being able to hold that space of like this sucks And it might more than suck and we can add explicit in right mm-hmm and I'll hold that space while we work Right, because you've you hold it all the time Right and just trying to create even if it's 15 minutes of just breathing room right, and then, when you can, you know,
Speaker 2:once you start to, once you, once you start to know clients, especially working with the TBIs, you get to figure out where are their deficits and in functioning right, where are their challenges? How do we target those right? and Again, our perspective in this country is still very individualistic and I actually just made a post about TBIs and finances yesterday and One of the five ways to cope with, like TBIs and finances was to also ask for help Right to take somebody with you when you go shopping, set limits on your debit card or credit card So you don't overspend impulsively, right? so there are creative ways that we can kind of put buffers in place. and, going back to that individualism, it's not very much like our society, especially Older generations, to say, hey, can you help me with this?
Speaker 1:Mmm, you brought up a lot of really interesting points and one thing that came to mind As you're talking about, you know, putting limits on on spending, i wanted to ask, from your perspective, or people who are struggling with TBI recovery, are they more vulnerable, in comparison to someone without a TBI, to financial abuse, anything financial abuse? you know social injustice. I'm sure it depends on Their condition and what's going on with their brain. but I think something important to note is Are some of those individuals, are they more vulnerable in some Areas of their life in comparison to those who don't have a TBI?
Speaker 2:for sure, My answer would be yes in granted, like even people without TBI's can still be exploited, right? I Mean just starting in terms of TBI. Like medical costs, right, i mean, when I was in the ICU, cost for an ICU for one day was 10k And I was in for 10 days. Right, and that doesn't count. The years of therapy, right, or the surgery or the CAT scans, right, or the MRIs, or the fuel right to drive to and from the hospital to do these things, right. The time off of work of caregivers right, i'm speaking, like you know, from my own experience.
Speaker 2:But at the same time That's one part if you don't have insurance, do you go without care because you can't afford it? Do you go into debt because you need the care? Do you sell your house? So Homelessness, right. What do you do? Can you know? let's say, let's say you move past the medical costs and you look at Somebody who struggles to really manage them, their finances. Do they need a payee in place to manage their funds and only give them a hundred dollars when they go to the store? right, there's some creative ways, like you can electronically load debit cards and stuff like that, but still somebody needs to be there. And then the thought of okay, what happens if that person ends up passing away? who takes that role on is does the family absorb that? Right, that's a lot on our family. You So getting into that part of payeeship then kind of what we already talked about too with like decrease in employment, decrease in earned wages, right? So vulnerabilities, yeah 100%.
Speaker 1:The more we talk about TBI's and how it impacts people's day-to-day function with like work and physicality. every type of social health mental health, physical health, career health even can be impacted by TBI. Now we're talking about, depending on their cognitive impairments, anything else going on with the TBI they might be more vulnerable, easier to exploit if certain parts of their brain aren't functioning as they used to prior to the TBI, and in thinking of if they need more assistance, aside from all the medical care, which could be tens of thousands and sometimes hundreds of thousands of dollars of potential debt and bills and I'm sure financial trauma can go along with all that as well. With the clients that you've helped, does the topic of financial trauma come up in regards to TBI recovery?
Speaker 2:It shows up, yes, not in terms of the vulnerability piece, but the stress right, and I guess you could equate vulnerability to stress, but it is definitely a factor that shows up. And not to say that there aren't people who experience TBI's and have that vulnerability right, they just haven't had them come through my practice.
Speaker 1:Right. In regards to your practice, one thing I like to talk about on the podcast is when I get a specialist. What does recovery look like with your type of specialty? How do we find the right therapist for this type of specialty? How do you know it's working? All those things.
Speaker 2:In a baseline.
Speaker 1:If someone wants to see you or someone like you for a TBI, what do you do? what are you doing? Take a peek behind the curtain.
Speaker 2:Yeah. So usually two to three sessions is maybe even more depending on the person right, it's just us getting to know each other. Healing takes place in safety and we're not going to get there for just rushing in and putting out fires, right? So in those sessions it's going to be a very thorough assessment to figure out what is driving symptomology right. How much or to what extent is the TBI impacting functioning? to what degree is mental health and impacting functioning? Are there other life stressors? Is there substance use? right? What is kind of driving this stuff? So we'll be doing a lot of work around there.
Speaker 2:Usually I will use a lot of acceptance and commitment therapy and the acceptance piece usually comes later down the road. But we're going to try to create some space between our symptoms and who we are, so that we can build up a little more room in between those stimuli that create stress in our lives and symptoms, so that we can respond versus react. So learning that ability. So a lot of mindfulness work, right? How do we get back into our bodies and start feeling our nervous system shifting? right In terms of figuring out identity. So exploring that.
Speaker 2:How is it shifted? Where do you want your identity to go Right. Are you comfortable here, are you not? What do we need to start doing right? What are our values, so that we can start pushing towards that direction, despite the shit that's going on? right, we can always take those small steps and then in there, right, as ACT really pushes a psychological flexibility, and then that takes a lot of acceptance so that we can oscillate between discomfort, comfort, moving towards our values, maybe to staying back and sleeping if we're tired, right, and being very dynamic in how we approach our life or their life, right.
Speaker 1:I love that A good chunk of it is practicing acceptance for what happened, for what might be permanent, what needs to change as well, but also assessing for what is or is not realistic for this individual in terms of cognitive functioning or anything else related to TBI, because some TBI's come from physical trauma right. Car accidents such as yours, where you might have spinal injury or some other things that create more limitations and medical problems. Yeah, and then processing as well.
Speaker 2:Yeah, so in terms of processing right, like if there is that PTSD, your trauma component right Grief and loss and the person is stable enough, then we can also begin EMDR right, and that has a really nice way of just allowing that dysfunctional material, just to clear out that gunk inside the nervous system, start the body's innate ability to start healing again.
Speaker 1:I love that. Start healing again. How does someone know that? the person they're seeing from your perspective? what are the signs, indicators, symptoms that the traditional talk therapy or EMDR therapy is working for them? What should they be looking for to create evidence that this is helping me and I should continue? Yeah?
Speaker 2:Beautiful question. So obviously there's going to be the small pieces of like. Okay, i practice mindfulness, you know, four times over the last seven days, right, if you're doing weekly sessions, that's the practice component, right, but then you also have to look at application, implementation, and so you know so and so in my life started raising their voice so I walked away Right Now. Now you're, now you're starting to see growth, right, starting to regulate diet, sleep, sleep hygiene, right, Doing things despite maybe feeling too tired and obviously not overly exerting yourself, but that chronic fatigue can really isolate somebody. So, trying to, even if it's to, go grab a you know a tea or coffee or whatever it might be with a friend and then coming back and taking a nap, right, can you do both instead of just one? So so, looking at those pieces, are people are people kind of narrowing and honing in and on their values right In terms of therapy? right, feeling like watching their suds levels? So suds is subjected units of distress scale, right that we monitor in EMDR.
Speaker 2:Let's say, somebody starts at an eight. Can we get it down to a zero, right In a number of sessions? Sometimes we can. Sometimes there will be the piece where it's an ecological one and or, i'm sorry, ecological zero, but it's still a one. Just because EMDR will not heal the TBI itself. Right, and there will be some changes, but can we get rid of the dysfunctional thought processes thought processes about I'm less, than, i'm not worthy anymore, i can't provide for my family or the people I care about? right? Those are the pieces that EMDR can really start to target.
Speaker 1:Man. so it's such a heavy topic and some of the concepts you bring up as far as like feeling less than and understanding recovery and having acceptance for that things might be permanently different. A lot of this sounds like trauma work essentially, which, as you and I both know as therapists, it's heavy stuff. It's very valuable work And the recovery sometimes can be long. but the symptoms through recovery is generally the individual, the client, the patient is feeling better about their life for themselves and they're noticing small but significant changes such as like being less depressed, feeling more motivated, being able to find more joy, having more acceptance, feeling like there's a sense of emotional relief off their shoulders.
Speaker 1:How does someone find the right TBI for traditional talk therapy, like you and I do? So I don't specialize in TBI's. I've only worked in passing with people in previous agencies that I've worked for that mostly service vets and things like that. So it just came with the nature of going to war. You're likely to have a TBI from everything that's happening. But how does someone find the right specialist to do mental health work for a TBI?
Speaker 2:So I would jump on Google, right, and I think one of the few benefits of COVID is the push for teleotherapy, that you can access therapy on different parts of the state or in different parts of the country. Obviously, looking at TBI therapists or therapists that specialize in trauma and stuff like that, it should be listed on their website. If that's where specialty, like there should be clear communication. This is who I support, this is who I serve, right, and it'll be on different different channels of communication outside the website to probably so, instagram, facebook, so so just kind of scouring those, please, those, those sources of information as well.
Speaker 2:As you know, this is your treatment. So if you start with somebody who even specializes in it but you don't feel a good fit, it's okay to say that and find somebody else. Right, like this is your treatment, your voice, like you need to find that person that fits with you and or at least have conversations with that therapist about this is like I don't think we're meeting eye to eye here. Can we talk about this, right, and then bring that up? I would say it's a red flag if your therapist therapist can't have that conversation.
Speaker 1:So wonderful. Some highlights there is finding congruency between what's on their website and if there's any other information about this potential therapist for you, you know. look at their Facebook or Instagram or, if they're on a directory, see if what they're saying essentially their marketing is is repeating it in various different you know online sources to make sure that they are the right person for you, because they're saying the same thing in various different locations online and you know being able to talk about it If your therapist, you know, isn't willing to talk about it. that is red flag And that's something I've spoken about recently in the most recent podcast is red flags when looking for the right therapist, particularly around trauma, and I love that you brought that up that if you think you have a TBI or you know you have a TBI, you want to bring it up to your therapist and your therapist is unwilling to go there.
Speaker 1:That's an indicator you might want to reevaluate. continuing that relationship. I love that you brought that up as a red flag is so rarely do we as therapists talk about red flags of finding therapy. Tell me more about some other red flags as far as if you have a TBI or you think you have a TBI, and what are other signs that this particular therapist is not working for you? you might want to find someone else.
Speaker 2:Mm-hmm, I think some more red flags that could arise are. What is there like if you ask them, what is your understanding of a TBI, right? I mean, most of us have heard the acronym or the phrase Traumatic Brain Injury. Do they know different types, right? What is their kind of experience with them? Right, In red flags maybe, but maybe these are just yellow flags too, if there are also other red flags and it just starts to kind of tilt that teeter-totter in the direction of finding another therapist Trying to think of other red flags off the top of my head.
Speaker 1:No, that's great A question I had for you. Is there a particular question you wish people would ask more? Is it a potential client? to make sure that, like you're the right fit Because this is something that I've noticed with in my private practice is there's a lot of common questions like what's your clinical experience? How long you've been in business? Are you comfortable with this particular topic? right, those are pretty baseline ones, but ones I wish people would ask me more is what is your style? How do you communicate? Tell me about your counseling approach. Things are a bit more nuanced to me. In particular comparison, you're just having a question that you would have locked and loaded for every therapist.
Speaker 1:If a client of mine, a potential client, doesn't ask me those particular questions, i've made it a point to just talk about them anyway to help differentiate me between every other therapist, so that way they know whether or not I'm the right fit. So when they tell me or ask me if I talk about how I communicate, i usually tell people I'm forward, i'm honest and I'm blunt because I want to help you and I don't want to waste your time and money here. Are you okay with someone who's forward like that? Maybe, maybe not. What are questions regarding TBI as a specialty that you wish? clients would ask more when they're meeting a new therapist for the first time.
Speaker 2:Sure, And specifically around TBI's, I think a great question would be do you have a network of professionals that you can lean on for support?
Speaker 1:Oh, that's awesome. Even I didn't even think about that because the type of clients I see in my practice it's strictly mental health related most of the time. So I personally don't have a network of medical professionals that I refer to or talk to, because it's just not something that's common in my business. But I think that's a genius question. If you know or suspect you have a TBI and you're seeking mental health services, that is something that would be relevant because if you know they're shrugging something neurologically, that's not your field of expertise as a therapist. You're not a neuroscientist, You're not a medical doctor, right, so that you would want to rely on those professionals. I think that's a fabulous question for people who have TBI's to ask their potential therapist What is the purpose of that? Depending on the answer, what does that say to the client?
Speaker 2:then Let's go that route. I think it communicates A what is your kind of bandwidth for getting support if there's a difficult clinical presentation? B it kind of shows are you in the network of traumatic brain injuries, are you not? And some people may answer that and say, no, i'm not, i just moved here, right.
Speaker 2:And that might be like, okay, maybe that's just a yellow flag, right, if you just moved here. But having those connections in that I mean not just medical, but even psychiatrists, right? Some psychiatrists don't really care to work with TBI's because it's very complex, right? Typically, if somebody has a TBI and they need not just psychological testing, because that's different than neuropsychological testing, right, neuropsychology is a specialty, a special training, fellowships and an additional training that a psychologist goes through to be able to evaluate neuropsychological challenges, right? So are you connected to those people? Do you have physical therapists, occupational speech, massage therapists, whatever it might be? I love that.
Speaker 1:This is such a fascinating part of being able to find the right therapist when you suspect or do have a TBI. I love that you pointed out it could be a yellow flag that if someone's new to the area or just getting into this market they might not have all that set up, but that doesn't necessarily mean they're a bad fit.
Speaker 1:It's just you know they're early on into the process, either because they've moved here and they don't have any connections yet, or they just started. You know this clinical experience for them is relatively new and they just haven't been able to establish relationships yet. I also love how you talked about you know specific types of other medical referrals as far as, like, speech therapy, physical therapy, you know, and that those things matter. I love that and it's not something even I had thought about. I mean, i'm learning a lot about TBI's. Honestly, as a therapist, i also avoid individuals with TBI's because I don't know what I'm doing. Honestly, it's not something I've researched, it's not something I've experienced a lot clinically, so it's just not something that's common.
Speaker 1:And my business now that I'm hearing you talk about the referrals I would need to have even if I wanted to get into helping people with TBI's, i'm not. My business is even set up. I literally don't have any of those connections, even if I wanted to add that to my practice, because that is super important to have those, because I'm not a one man army for someone's overall health. I focus on the mental aspect and everything that impacts that. But if they need a speech therapist, i'm useless. I literally can't do anything for this person.
Speaker 1:Not only do I know very little about TBI's I have no one else to refer them to because I'm not set up for that and it makes me realize how important for TBI's in particular you need to have a team of people who you can rely on and refer to, not only for the individuals or recovery, like their own social support which is something you've talked about as well, as far as them needing help but also for the professionals that they use to not work in a vacuum and try to do things on their own in isolation, which I've never agreed upon.
Speaker 1:I've always tried to build professional relationships with not only just therapists but other people, because I'm not a one man army, i'm not a one stop shop. That's not how I operate. In terms of something we haven't talked enough about, in my opinion social support for someone with TBI recovery. Do you help with that? I know you are their therapist and that is, you are part of their social support. First, let's talk about how important social support is and then we'll go into what to use a therapist can. How can you help these people build their social support from a clinical perspective?
Speaker 2:Sure, so I mean the importance of social support relates back to identity, right, self-esteem, self-worth, feeling of being wanted by other people, which we all need, whether we have a TBI, a mental illness or nothing, right? So that's where that importance is in figuring out who. Are we still the same person? Has our social network shifted right? Which it might. If you can't go snowboarding anymore because if you get hit in the head again you're going to have another traumatic brain injury, you may have to distance yourself from friends at times, like if they go to the mountains, maybe you just stay in the lodge, maybe, right, maybe you don't hang out with them at all during the winter months, right, you set those boundaries. So, working on what feels right right, that's what we would work on is what does feel right? Does going to the lodge feel great? Does you know, maybe just saying yeah, just go up there, i'll catch you next weekend when you're not up there, right? Does that feel right? Also, exploring new groups Are there other connections out there? You know Meetup, it's amazing. Like Meetupcom, i mean, you can find groups for almost anything, right? People in recovery TBI's. So, accessing some of those networks to try to find meaning again, right, to try to find that connection. So we'll work on those pieces. We'll also work on what shows up when you're, you know, is it anxiety about trying to meet new people? right, telling your own story? right, like we'll work on what shows up and stuff around there in therapy And I'll obviously also support them in that process.
Speaker 2:But a lot of it is. You know, i'm only with them an hour a week, right, and there's how many hours in a week? It's a very small percentage. Whether somebody has a TBI or not, that's in my practice. They do majority of the work themselves, right. There's that empowerment component, like you are still a crucial part of your life. I can't lead you to recovery. I'm going to show you it And you got to be able to walk in it.
Speaker 1:I love that. For my practice, one thing I focus heavily on is self empowerment with people And having ownership of whatever's going on, and taking ownership and accountability of what you can and cannot change, and I love that piece of you know I'll show you the path, the journey to your recovery, but I can't push you down, that You have to take those steps, whatever that looks like on your own, but I'll be there to show you, regardless. You know every next step. I love that piece of your answer From your perspective, what makes you different from other people in your specialty?
Speaker 2:I think both my personal experience right of having kind of walked and continuing to walk recovery right, As well as my professional experience of working with a number of people who have experienced the traumatic brain injuries and changes in their lives, And also just like that genuine connection that we can develop inside of a session where there's attunement, whether safety, peace, maybe Right and we get to focus on what we need to focus on in that time, without the distractions of the world. I mean, yes, we might hear a car honk or something like that, but we're here, right, We're laser focused.
Speaker 1:I love that. I would agree when we're able to find a therapist who's gone through what we've been through they've been through it as a person first, so they know what it looks like the good and the bad, the beautiful and the ugly, the easy and the challenging. And to be able to take all of that from your own personal experience and add some clinical experience on top of that, i think makes you a very good candidate for a broad spectrum of people struggling with TBI. Because you know in yours, from my perspective, sounded absolutely horrendous. The car accident alone, the fact that you're alive to me is shocking, and the way you described all the stuff you had to go through not just you know your mental health but, like your finances, your physical recovery, the toll that is stuck on your family. You really went through the ringer and came out on top becoming a traditional talk therapist to help people with the very thing you fully understand of how shitty it can be to go through something like that. Is it still impacting you every day?
Speaker 2:I would say I think about it every day. I don't notice the hard effects other than like the awareness of okay, don't bump your head here, like you're going underneath the sink, make sure you're out of the sink before you bump, before you stand up right, like those pieces, like that awareness is still there. You know, obviously, scars and stuff I see every day, but at the same time I wouldn't say that the challenges I experienced with sleep, with irritability, attention, word finding unless I don't have coffee right, like we've seen that in the session Those aren't as prominent. I will say that if I've had a super long day, right, or maybe even like a rough stretch where you know only getting a few hours and I just sleep a few hours of sleep at night, i think for a number of days, like there are, some of those challenges may start coming back where difficulty, word finding, right, challenges with being restless or, you know, anxiety or something like that might start coming up.
Speaker 1:So I love that. Thank you for your openness to disclose you know some of the personal stuff you've been through. I'll be honest the reason why I asked that question in particular was a lot of times in our field where we're helping people, particularly in the early stages of their growth and healing, they struggle to find hope and the possibility that they'll reach the other side because it's so distant and stories such as yourself. You know everything you've been through and the fact that you think about it every day but you're happy and you're healthy and your family's good. I asked that question to if anyone's listening who has a TBI and they're early and they're like I'm fucked forever and I'll never feel normal again, i'll never have a normal life again. That is, you know you can't And you're a perfect example because you live through a TBI. You have a TBI. You know you almost died through this whole process Even before you got to the hospital.
Speaker 1:You roll the car four times and you know, most people can't say they make it out of that. But you're here today with a career and a family and a life that you're excited to live in. That means, if you know there's a really strong chance, if they keep working and keep, you know, doing with a can to engage in self care, that they can get to a point where you are in which, yes, i know it's there and it affects me a little bit every day because I have to be careful with certain things, but I made it.
Speaker 1:Yeah, if someone's struggling right now and they're in the early stages and they're just really really struggling. What guidance could you give any potential listener struggling right now as far as growth or healing or, you know, positive messages or energy you can send them? What would you say?
Speaker 2:That's a tough question. Don't quit, Even if it gets harder. don't quit because no one else is going to do that work.
Speaker 1:Beautiful. I love that. That's awesome. I tell my clients something similar when I see them struggling. It's you know, you don't always have to make progress every day, but if you just show up for yourself every day and just don't quit on you, then you'll get there.
Speaker 2:but you can't get there if you quit, yeah, and I think too, like not just TBI's but mental health, right Like, when somebody starts therapy or psychiatric care, sometimes their gains are, i don't want to say they're fast, but like they're more noticeable, right Like wow I got through that target.
Speaker 2:In EMDR therapy It's a zero. You know, i'm not spending all day laying in bed, i'm going to my job, right. Like those are really cool, right, and they're meaningful and they create momentum as people gain time and recovery, right. Sometimes those shifts that you noticed in the beginning of your recovery process aren't there, they're more sporadic, right. So maybe it's now six months out, maybe you had an argument with your partner but you walked away, right, that's still. That's still a huge, huge ability from where you were, right, where you would amp up one to one, right. And now maybe you're five years out and you know somebody hits you in the car, right, And you're okay, but you're pissed off, but you still kind of pace around to let that steam off. Right, it doesn't mean like, recovery doesn't stop once you're done with therapy, it's this daily thing. But the gains in the how do I classify them? The treatment gains that you made in the first six months of therapy, they shift when you're six years out, they shift when you're 16 years out, right, but recovery continues.
Speaker 1:I love that. That's absolutely true. Something I've talked with many clients about is, you know, healing, growing, recovering, whatever you want to phrase it, it's all relevant. At the end It's about just feeling better, being happier, improving quality of life. It's a lifelong process and it's constantly shifting as the years goes on And it's as long as you, you know, continue to engage and have fine acceptance that it's not going to be perfect, it's not always going to be fun and easy, but it's about just engaging in yourself and for your own health, for your mental health. You know that's the target goal. It's not how much you improve, It's just more of how willing you are to just continue, even in the rough spots And I love your approach to talking about that with your clients.
Speaker 1:And you also live it. You understand what it means to really say that, because that is literally the therapy you give is because that's a life that you have. You continue to engage and you understand that as long as they keep showing up and keep engaging and don't quit, regardless of what the journey looks like, it's not about you know how many steps you take every day, it's just the fact that you show up to walk every day And that's the most important part And I love that. I know I've taken up plenty of your time today, on a Saturday, while we record, and thank you so much for showing up on a weekend to do this. If someone wants to find you and they are convinced that you're the person for them, how can we find you?
Speaker 2:Sure, so you can give me a call 720-295-6703. Visit my website, revitalizementalhealthcom, or you can send me a message on Instagram. We can schedule something So at revitalize-mentalhealthcom or notcom, but at revitalize-mentalhealth, and those are usually returned messages or phone calls within 48 hours, typically, except for the weekends and holidays.
Speaker 1:Awesome For those of you listening. I'll put all of that into the description of this episode. So if you need to reach out to him immediately because you're struggling or you just need some help regarding your mental health and he's the guy for you, you can just go to the description, find that information, reach out to him. Thank you so much. You've been an absolute pleasure, a blast. I've become a better person and better therapist because of this podcast and my discussions with you. I've learned more about the signs and symptoms of TBI and understand the importance of social support, vulnerability and how important it is to have a specialist for your TBI, both for your mental health and all the medical complications that come along with it.
Speaker 2:You've literally enlightened me to a topic I knew very little about and I just wanted to thank you for that, yeah, and thank you so much for having me and giving me this platform and the space to kind of share my message and just kind of educate listeners on how those TBI's impact people.
Speaker 1:Oh, it was honors online. This has been absolutely fabulous. If you ever want to come back and talk about anything at all, your foot is beyond being inside the door, Your voice is in my ears and in my head and your presence is in my heart and your existence is on my mind, So you can always come back to talk about more stuff regarding TBI's or anything else that you do. Anything that comes up, you're more than welcome back easily For all of you listening. This is it. Thank you so much. Catch you next time.