Focus and Goals
*Setting health and life goals
*Possible challenges you may need to consider
*Preparing your way ahead
*Noticing when you need help
*Plans that help with progress
How we think can have an enormous impact on our willingness to consciously set goals. Being able to set goals can help us towards being able to regain skills and habits, and can also influence our behaviour helping us with social skills and reintegrating with the community. Setting goals can be an important step towards regaining independence.
It is a good idea to separate life and health goals so that you can maintain your focus more easily. You will know what you can manage depending on where you are on the rewiring and recovery path. There will be grey areas where a goal will meet both health and life needs; one can help improve the other.
Depending on the severity of your cognitive challenges you may need help and support. You may find this with a local support group, through a counsellor, or this may be offered as part of rehabilitation services or occupational therapy. If you are under the care of a specialist or are seeking care, they will be able to advise and guide you.
Your cognitive challenges may make thinking difficult and it may be difficult for you to break things down. If you don’t have professional help looking at your goals will help you as part of the process of rewiring your brain. This is because you will be practicing at using the skills that you are struggling with.
Research shows that people can struggle with attaining goals following a brain injury. If we can understand why this happens, we can look to avoid some of the pitfalls.
Those with a strong sense of self-efficacy will have robust beliefs in their innate ability to achieve their goals. If you consider your current personal judgments and memories in terms of how well you historically executed specific courses of action, you will get a sense of how much foundational work you will need to do before setting new targets.
Think about who you are rather than what your brain can now do. You can use your inbuilt tenacity – something we all have – and can build your confidence by considering all the achievements you have made to get you to where you are now.
You have driven your brain by using your mind, by using thoughts and beliefs, to get you through every single challenge that has arisen in your life. Brain Injury doesn’t take this ability away – if you support your brain – it will support you.
Your brain needs this ‘thinking’ and the innate you, more now than ever. Our brains believe everything we tell them so we need to be very careful about how we ‘speak’ to and encourage our brains. Be kind to your brain, it is hurt and broken and it needs your positivity and support. Each thought you have counts. Each thought will either help you along the road to recovery or will alternatively become an obstacle of your own making. Think in terms of choice – you are in charge – not your brain.
Think of your brain as an injured animal. You are going to pick it up, nurture it, be gentle in your touch and compassion, and you are going to feed it and coax it back to health. No one can do more for your brain than you can.
Think of every thought as being a prayer; we get what we ‘ask’ for. On a quantum level, every thought we have is energy and every thought is heard by the universal consciousness. Each thought you have is an intention and it has great power to change your life. What you intend in your thoughts is what you will create and manifest in your physical world. What you think is what you will experience.
If you are struggling with controlling negative thinking patterns, it can help to address these first.
You may find that even though you know you were a high achiever before the brain injury, that you can’t remember what processes you followed, or remember what you believed and how that drove you.
Those with self-efficacy have an innate resilience and drive, which makes achieving results and success much more likely. Even when people cannot remember the details about the ‘how-and-what’ mechanisms they formerly used, the innate drivers will still be working. Think of it as being similar to being able to ride a bike after decades of not doing so and release any worries over details – it is who you are beneath your current cognitive challenges that matters.
Some people are able to deal with possible prospective situations with a more open mind. Flexibility helps us to adapt our goals when anything changes or unexpectedly challenges us. This is certainly a healthy approach as dealing with change at a practical level helps people to avoid disappointments and distractions. Changes will happen – it is an inevitable part of life.
Expectations of self-efficacy affect whether you will be able to exhibit coping behaviour and will also determine how long you can sustain effort in the face of any obstacles that crop up. If you believe in yourself, you will automatically wield sufficient effort to attain successful outcomes. On the other hand, people who are struggling with self-belief are much more likely to lapse in their efforts and fail.
If you feel any sense of lack of self-worth, it is a good idea to pause while you reflect on this and rebuild some of your beliefs before you set out specific goals and start working towards them. Habitual patterns of thinking can remain hidden from our consciousness and giving some time to considering how our habits affect our thinking and self-efficacy can strengthen our resolve.
Belief in your innate abilities means valuing much more than just your particular set of cognitive strengths. How well we value ourselves and our inner sense of self-worth can also have a strong bearing on success. Working towards any goal involves determination and tenacity and being able to keep focused on what you are doing, and why you want to do it, helps to ensure success.
Being aware is being prepared, so whatever your background has been, everyone has the same chances of success in achieving their personal goals. If you believe you can attain something – you will. It doesn’t matter if you have exercised self-belief in the past – focus on practising it now.
Be conscious of whether you are being your best friend to yourself or your own worst enemy. Make a conscious choice about which attitude will best support you to get you to where you want to go.
Use smart, straightforward thinking. Make choices that are easy to remember and write them down so that you can keep coming back to them.
Again, if you have been going-it-alone, it may be worth speaking to your doctor and asking for a referral to a therapist or counsellor. Make sure this person is experienced in working with people who are living with the outcomes of brain injury. They will understand your symptoms and will be able to help you make any necessary adjustments you need to work in conjunction with any coping strategies that you use.
It can take time to resolve emotional upsets, and we all have our ways of working through things. These difficulties are intensified following a brain injury because we don’t have the same cognitive tools to tackle inner conflicts that we did before. It may be necessary to try and work on improving skills while giving yourself time to work emotional problems out.
There are a number of conscious choices that you can make to help you through the worst of things and understanding that you can change your relationship with your thinking is empowering. You can use a vision board as a tool. This not only encourages you to use your creative brain but also helps you to keep focused on your life goals.
By using the power of choice we can make decisions that we can write out on a vision board so that we don’t keep going back to addressing things we have already made a choice about. For example, we may know in our hearts that no matter what amount of energy we use in thinking about past events – we cannot change them. This may be something you write on your vision board. ‘I cannot change the past.’
You might then add something like – ‘as time goes on I will understand the past better and will be able to see it differently.’ There are many things that our experience tells us is true for us, and exploring what we think and why can help us find the pathway back to our experiences and memories.
It is these personal inner truths that also help us re-find our inner strength and keep us going – no matter what is showing up in our world.
Cognitive and executive challenges
For those who are in the early stages of a significant injury, there should be on-going rehabilitation therapy. If you don’t have any support it is important to ask your doctor for a referral to specialist services, and, indeed, anyone can do this at any stage following injury.
A neuropsychologist will be able to refer you to a team of people, including an occupational therapist, who will be able to help you understand your cognitive deficits and will be able to help you work on a programme to identify your goals.
Sometimes there is limited awareness of interpersonal functioning and often people need help in identifying and understanding the outcomes of their injury. Understanding what is broken helps us to set realistic goals, and also learn about, and appreciate, any need for rehabilitation. It is important to be able to recognise and understand that rehabilitation is focused on rebuilding the brain, and who you are as a person is encouraged to facilitate this through accepting that it is the brain that is injured, and not who you are.
Any therapist should be supportive and non-directive – the real work comes from you, and the therapist acts as a rudder guiding you in the right direction, enabling you to appreciate what is achievable and realistic. The more realistic your goals are the more chance you have of achieving them. As you get one goal under your belt, you can move onto the next target.
Think in terms of stepping stones rather than a mighty leap that carries risks. Breaking things down allows us to see what lies ahead.
Sense of self
We often refer to these levels in terms of, ‘rising above it,’ or ‘taking the higher road.’ When the brain is calm and free of ‘fog’ we notice that our thinking is something that we are better able to control. The calmer the brain, the more purposeful and directed our thinking is.
We tend to think of putting mind over matter, and this idea is primarily about making conscious choices; the mind feels as though it is ‘us’ – whereas the chaotic or foggy brain feels as though we have no control.
For many people living with the outcomes of a brain injury, it can feel as though you get stuck with a brain that has gone AWOL and is not only rebellious but simply will not do anything other than stream inner noise that we have no idea how to stop.
We can see how the injured brain can interfere with our ability to make choices and to stick with them. Our sense of self can help us to be realistic and can also help us with using our history and experience, where these are available to our memory, to be able to set achievable targets.
Nobody knows us better than we know ourselves, and often people have to rely on gut instinct following a brain injury because the ability to reach inside and pluck out whatever we need, isn’t the same anymore.
It can be difficult to trust other people and their interpretations of importance and priority for several reasons. One reason is that people living with the outcomes of brain injury often struggle with seeing alternative perspectives. They also want to maintain their independence which is why it is so crucial that people guide those with brain injury towards setting their own goals, and why no one else must try to step in and make decisions on their behalf unless necessary.
Everything takes extraordinary effort and it is through these efforts, and an absolute willingness to work hard, that we can progress in a meaningful way towards getting our lives back. We may need to work harder at achieving our goals if we have a lowered sense of self or memory problems that interfere with our ability to make choices.
Lack of goals
Without direction, people tend towards a meandering path that stops and starts again. It can feel as though life is a series of hiccups or can feel as though life is full of disasters, which seemingly keep cropping up out of nowhere. Sometimes, for some people, despite every best effort, few things seem to go smoothly and there always seems to be something that needs to be addressed.
This rollercoaster effect can certainly be much worse in the first months and years following a brain injury and is often caused by a myriad of complexities that are difficult to grasp or understand.
Setting goals can help us focus on one thing at a time. Goals can help us break things down and create new understandings about our challenges. Remaining open, flexible, and being willing to listen to others are all key to being able to make qualified and sustainable progressions towards rewiring and recovery.
Many people feel that they are already open and flexible, and may have difficulty in understanding how the changes in the neurological structures of the brain can interfere with these personal assets. It is important to be willing to listen to others as their feedback can help increase our awareness of the ways in which the brain injury is getting in the way of our personal attributes. Other people have an objective perspective that can help us understand any sticking points in our beliefs and attitudes. If we are in denial about anything – we need to know.
Whilst the underlying intentions and motivations can feel familiar, it can be difficult to ‘see’ or understand that what comes out, or is observed by others, isn’t what we think it should have been. Much of this is about learning about what is broken so that we can accept these changes and work with others towards fixing executive impairments.
Life and environment challenges
If we can eliminate as many of the possible challenges that can arise at the outset, we can remove some of the barriers that might otherwise have popped up along the way.
For example, some of our goals might need financial investment to achieve, and if they do, we will need to set time aside to consider our finances. This may become one of the first steps we need to take and this, in itself, may also need breaking down into manageable steps with certain targets to achieve before we set off trying to do other things.
There will be a practical order to overcoming barriers and understanding what these are may take a lot of work in the early stages. Life is a process and to flow with it, we need to be able to understand what courses of action we need to take so that we can break these down.
We may need support and encouragement from others, and often many people don’t feel as though they have anyone to turn to, which creates a need to make choices. Do we ask a member of our family if they can give us a set amount of time each day to help us, or, do we feel that everyone else is too busy with their own lives and don’t feel as though we ‘should’ ask?
If we are afraid to ask the people around us for help we may need to consider why. Finding someone who can help us may become an early goal we need to set. There are always options and certainly, unless we ask, we will never know what someone may say. If you don’t ask you have a definite ‘no’ without having given yourself or someone else the opportunity to get to a ‘yes.’
You gain more by asking than by not asking. Remember, this is likely going to be a long-term commitment for everyone. The amount of help you will need will vary depending on the severity of impairments so until you get so well versed in the process of goal setting, and you can do this alone, it may be that you ask more than one person to help.
Try to think outside the box and don’t give way to any lack of self-esteem. Be assertive because this is the quality of the rest of your life that is at stake. If you can get a referral to an occupational therapist or counsellor, do so. Investigate every opportunity open to you. Maybe someone at a local support group or church will be able to help or may be able to suggest someone else.
Think ‘possible’ and believe that what you need can be brought to you. If you start off by thinking that no one will help you – this is exactly what you will experience. This is because you are creating a mindset that will either drive you to succeed or will lead you to the failure you expect. Make a conscious choice about the unlimited amount of possibilities that surround you and go with it.
Another thing that we can raise as a barrier is the way we think about time. Again, if we think and believe that either our time or someone else’s time, is limited – this is exactly what we will experience. Time is infinite, and in the quantum space of energy where all thought happens, there isn’t even any such thing as time. This means that you can find a flow that will work for you and for anyone helping you. Everything will work perfectly if you are open to it being so.
Another thing that helps with understanding time is being flexible. Try not to set goals that are limited by boundaries – think in terms of ‘process towards,’ and of everything happening as it should be.
Make you and getting better your top priority and focus on this. It is okay when other things crop up that need to be dealt with – these things are also a part of your process.
If you doubt yourself you will unconsciously create lots of events that confirm exactly why you should doubt yourself. If you believe in yourself you will create multiple occasions and events that confirm exactly why this is the perfect approach for you.
A brain injury doesn’t take away opportunity – it provides different opportunities to the ones we were used to before. Be open to learning lots of different and perhaps more profound things about yourself.
If you are struggling with fear, anxiety or depression, make addressing these things the first part of your goal. Build yourself up first and then tackle everything else. Don’t worry about what you think you can’t do – focus on the things that you can do and are doing well. Everything will take care of itself as you move through the rewiring and recovery process. Stay open to the certainty that you will find out all kinds of great things about yourself.
When we overcome barriers and challenges, we begin to feel great inside – be unstoppable!
There are several tools that we can use to help us sort out our priorities and enhance our understanding of deficits.
Once you know that improving your reading skill is a priority to you, then the next thing to do is to find tools and strategies that will help you to practice reading. Practicing any skill over and again is what creates new neurological pathways. You may come up with many ideas of your own and certainly, a speech and language therapist will be able to help you improve your reading skills.
Reading software can help with following information on a screen, as can printing something out and using highlighter pens and a ruler. You can also stick pieces of paper over logos and other information that makes things more visually complex but is not part of the information we need to understand.
For example, we may put the word ‘reading’ in the centre of the bubble and then ask ourselves how our difficulties affect our daily living. These visual tools help us with understanding and remembering in more depth, and are an aid to learning and getting to grips with our changed cognition.
We can create a vision board to hold visual tools which will help us remain focused on our goals. For example, you may notice that you have persistent problems with asking cognitive questions and, as such, find that you accept information without querying it, or relating it to your personal preferences.
You can make words become visually stimulating by using your imagination and creativity, both of which help you to think outside of the box and to take back your independence. Anything we do imaginatively and creatively can help us rediscover a lot about ourselves. Make sure that you keep a journal handy so that you can write down anything you re-realise about yourself.
Personal mission statement
Break things down based on what you need and want and feel you can tackle. Small goals each bring a sense of achievement and help us to avoid overloading the brain with too much at one time.
You can discuss your mission statement with your friends and family, which will encourage their support. You may want to open the conversation by mentioning any goals that you have, which include understanding their needs better or more clearly.
Your mission statement should be a short and sharp, simple statement that reflects your inner wishes. It should also be worded positively and be as clear as you can make it.
For example, saying that you want to learn not to repeat mistakes is not as positive as saying that you want to improve your ability to use strategies to support your daily life. Both you and your brain will work better with positive statements. You will want to revisit your work on setting goals if it brings a sense of pleasure and empowerment. The last thing you want to do is to remind yourself, or your brain, about the mistakes that happen because of neurological changes. You need to be aware of them, but not allow yourself to ‘become’ them. You are not your mistakes – mistakes are of benefit to you like any tool you use – increased awareness helps you to do the job with greater ease.
Always look for what you can learn and write it down. Write down everything as an achievement and congratulate your brain when it does well.
Health goals will need to focus on areas such as executive and cognitive deficits that you want to fix. It may help to work out what is broken so that you have a defined list and greater understanding of your needs. Once you have this list you can prioritise the items on it and from there, working on just the top priority first, you can break this down further too. Manage each item one thing at a time.
Your health goals will also need to include your plans for eating for nutrition, detoxifying your body and environment, and how you plan to increase your time outside and get more exercise. Reach out and use the services available to you. Speak to your doctor and let them know what you are planning and ask them to support you.
Things that you do for pleasure can also be a part of your mission statement for health as all creative and pleasurable pursuits increase our sense of well-being.
Your life goals might include career, finances, education, public service, and helping others, along with your plans to sustain or grow your family. Think positively and believe that everything is achievable.
Time doesn’t matter, and there is always time for everything. When we think of time as being something that is limiting or makes a goal seem to be too far away, we need to pause and reconsider time in terms of our overall life. Life events happen as they are supposed to do for us. We can’t run until we can walk and life has a way of bringing us everything when we are ready for it.
Keeping an open mind and accepting that things will only come as we are ready for them helps us to stay focused on the present. Each present moment is leading us gently into our future so, if we make our moments count, we are always doing everything we can to move towards achieving the things we want.
If you limit your dreams, then you are taking possibilities away from yourself. If you want love in your life then fill yourself with love and then you will become a magnet drawing someone else to you who is also filled with love.
Life is abundant. Look up at the night sky and begin to imagine the size and wealth of the universe. Size and amount are only relevant to us humans.
“Imagination is everything. It is the preview of life’s coming attractions.” Albert Einstein
The only thing that can prevent you from achieving whatever it is that you want – is you! You give birth to your ideas – the only way these ideas can diminish is if we stop holding our inner light to them. If you don’t believe in your goals don’t write them down. Make a ‘ruminating’ list instead so that you can revisit ideas later after you have nailed some other things on the head.
Committing to your goals
It is important to keep a list of all the goals you have worked on as a reminder to keep practising and using these new skills. Practise until you begin to feel that something is becoming a habit once more. You need to move through the learning processes until you are unconsciously competent again – or doing something so automatically that you don’t have to figure it out each time consciously.
Once you get started on working on your life goals, make sure you revisit your lists every day. Do one thing a day that helps you to move towards achieving a goal. Excuses are a way we tell ourselves that we either don’t believe in ourselves or, we don’t believe in our goals. If you find yourself making excuses, revisit your goal and revise it. Revise it or let it go, but never pretend the self-doubt or lack of commitment isn’t there.
If you are struggling with your commitment to anything pause and look at it and ask yourself what you can notice, what you can learn, and if you need to reprioritise the order you are addressing things. It may be, for example, that you need to do more work clearing your toxins and brain fog before you can focus on improving your reading or math skills.
Readjusting along the way is natural for everyone and especially important after a brain injury. Life is always going to keep happening around us and will always bring different daily demands.
Becoming your choices
Our choices are a part of who we are – they have the power to change us, and the potential to raise our game. Following a brain injury, we can feel very much as though we are a slave to our thinking voice. It can seem as though it takes on a life of its own and will not ‘bow-down’ to what we want and how we want to think. If this is happening to you, there are ways to take back control of your ruminating brain.
When you bring awareness of what you are doing to your inside world and acknowledge that you are taking positive steps to change your experience of life, you will feel motivated and empowered to do more. When we believe in what we are doing, we become those beliefs, and they start to drive us again.
Instead of always fire fighting, we are focused on fire prevention, and a whole new calmer world starts to open up to us. Put your power of choice before activities and consider the steps you will need to take to get to your planned end place.
We understand that it can be difficult to start new projects and to learn new things following a brain injury. However, if you give it a go, you may surprise yourself how much you can do. If you do struggle, please reach out to us – we are more than happy to provide more assistance as you need it.