Jeffrey Kreutzer and Victoria Powell,
The National Resource Center for Traumatic Injury,
Virginia Commonwealth Model Systems of Care
One of the most important things to understand is that recovery can be divided up into at least two categories, physical and emotional,

Physical recovery means getting the body to work right again. Physical recovery is the biggest focus of most rehabilitation programs, especially hospital-based brain injury programs. When people talk about physical recovery, you may hear them saying things

“He wants his headaches to go away.”
“I’m tired all the time. I can’t work for more than 30 minutes without taking a break.”
“He wants his coordination to come back so he can play the piano at church again.”
“She’d like the ringing in her ears to stop.”
“He wants the dizziness to go away so he can jog again.”

On the other hand, the injured person and their family members are often emotionally affected by the injury. When talking about their emotions, you may hear people say things like …

“Since the accident, everyone in the family has been worried and upset.” Or Neglectful. “I’m emotionally drained. I’ll settle for just one good day.”
“We’ve done everything we can to help her. I’m not sure our lives will ever be the same.”
“His older sister cries all the time and I’m afraid she’s going to fail in school. On the other hand, his younger brother acts as if nothing has changed.”

Each person will be affected differently, and each will have a different rate of emotional recovery. Emotional recovery means feeling good about yourself and your life. When people have trouble with emotional recovery, you may also hear them saying things like …

“I wish our lives could be back to normal.”
“He wants to feel like his life means something.”
“She wants to feel like she’s as good as everyone else.”
“She wants to have a reason to get up in the morning.”
“He’d like to feel good about himself.”
“I wish someone would listen to me and not make false assumptions” . Including Family and Friends.”

Here are some things that you should know about physical and emotional recovery. Knowing more about each one can help you do better and feel better.

Physical recovery is usually faster than emotional recovery. In fact, many people don’t have noticeable physical problems 6 or 12 months after their injury.

Though family members have not had a physical injury, most will feel some emotional pain. How and when each person shows emotions differs greatly. One family member might seem to sleep “all the time,” while another may have problems sleeping. One might be jumpy and argue with everyone, while another may be quiet and stay by herself. One family member might be upset for two months and then feel fine. Another may show no reaction for two months and then suddenly start crying a lot and report feeling hopeless.

Emotional recovery for the patient and family members can take a very long time, five or ten years or longer.   As far as myself, 17 years later, the emotional trauma is not resolved. This is concerning to my doctors and they have asked lately if I needed more counseling to help in resolution.  But, I understand (researched based) if there is no support by those I love, no way of speaking what I’m feeling, not allowing myself to let my voice be heard, will ALWAYS hinder my recovery.  I also understand, that the damage to the brain is severe enough, it CAN heal, but the old Cathy is gone.  That took years to come to acceptance…alone.  I had excellent counselors and I was asked a few years ago to go through a program from home and worked with two wonderful TBI counsellers.  I liked it and it gave me more coping skills.  I slowly trusted them and let my real thoughts be known.  It’s not that my thoughts are bad, but most aren’t interested in knowing how it really feels to not be you anymore.  The frustrations, the embarrassments, the insecurity (my son often says he misses his confident mom), but I second guess myself constantly.  That wasn’t something I did a lot…I might think things over a while, but to constantly be second-guessing myself make me very frustrated and angry.  I second guess myself because of being misunderstood.  I try to be very open to people because I’m hoping if I say or do something, they will come to me and validate what they THOUGHT I said or what my actions felt like.  Many times I have no clue that is what was said, and it makes me feel so terrible.  I know I have said things I would normally not say.  This is called TBI.  It is called Alzheimers or Dementia for some.  But TBI, it seems, is not an acceptable reason.  So one clams up in their shell.  Then people think I’m upset.  Sometimes I wonder if it’s possible to get through the day and not have someone judge what I’m thinking or saying WITHOUT asking me.

More serious physical problems can mean more serious emotional problems.
Getting better physically or emotionally isn’t necessarily a smooth process. Sometimes people stop getting better for a time (plateau) and then make progress again. Sometimes people take one step back for every two steps forward.

New problems and stresses can affect emotional recovery. These may include the illness of another family member and problems at work or school.
Most people have a pretty good understanding of their physical problems and what they need to get better.

Many people have trouble thinking about and talking about their feelings. Try to understand your feelings and talk to others you trust about them. Doing so can help you feel better about your life and your recovery.  (This includes all family members, but having respect when speaking.  And this means allowing the patient to speak without telling them what they are feeling, doing and why.  If there is no listening, then there is no trust.  If expressions of wanting to speak to clear or air opinions, or to “let it out” to continue healing for everyone, then the patient gets time to talk and someone must be protecting their ability to have that time, and to keep others from taking over and not listening.  Patients soon learn, when they are not allowed to speak THEIR OWN thoughts, then they shut down.  Recovery is slower, or health gets worse.  Research has proven this over and over, yet it is not something that is talked about with the family at any doctors appointments.  CLT) 

**This article was written by staff of the Virginia TBI Model System and the National Resource Center for Traumatic Brain Injury (NRC). Our mission is to provide practical information for professionals, persons with brain injury, and family members. For more information about our educational and clinical programs and publication, catalog check our website ( – or call Mary Beth King at 804-828-9055 or toll free at 1-866-296-6904.

Survivors and their family members may also be interested in our family education and support program at Virginia Commonwealth University Medical Center. The VCU TBI Model System Family Support Program was designed to address the needs of survivors, their family members, and other persons close to the survivor. Participants in the program learn about what to expect after brain injury and important skills for adjusting and extending the recovery process. For more information about the program, please contact Taryn Dezfulian by phone at 804-828-3701, or by email at tdezfulian@mcvh-vcu. 

Their U-Tubes are excellent and here are a few below.
For your interest: Chronic Pain Education for Patients, Family and Friends (Facebook)
The best website for TBI is  It has great video’s and info for patients, families and physicians. You can find others there.

This is very important, as it addresses brain injury, along with Parkinson’s, Dementia and Alzheimer’s.  Although I have done other research regarding these problems, it makes sense to me.  Otherwise, you may have to look up other studies to understand.


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