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Awareness Challenges

Awareness Challenges


There are some outcomes of brain injury which are less well known and understood because of a lack of information. There are also several ‘hidden outcomes,’  buried in the complexity of neurological dysfunction. However, these ‘hidden’ outcomes are pretty horrendous for people to live with, and often cause confusion that makes it difficult for people to be aware of why they are struggling so much.

These outcomes can have a significant impact on how well someone can rehabilitate because their effects percolate into other issues. For example, a loss of insight will make it much harder for someone to grasp that they need any help and, when they do get help, it can make it much harder for therapists to help them understand the significance or relevance of strategies and therapies.

Loss of insight, self, and self-awareness

There can be a lot of confusion about what the different aspects of ‘loss’ mean.

Loss of Insight refers to the loss of self-observation skills.

Loss of Self‘ generally refers to the feelings people struggle with when they compare their life now, to how it was before. It is about the loss of self-identity connected with ambiguous loss and grief.

Loss of Self-awareness refers to the loss felt when experiential memories are wiped out – this can feel as though you have lost your soul and can leave people feeling that they have no idea who they are anymore.

These losses can happen individually or might be coexistent. For example, where a loss of insight and a loss of self-awareness happen together, the grief stage experienced in ‘loss of self,’ is often missed entirely because people often don’t have the cognitive capacity to consider the changes in their lives fully.  To be able to feel and acknowledge the loss of self, or self-identity, you need to be able to compare and remember consciously.

Further, because the loss of insight can happen in varying degrees, and doesn’t necessarily encompass a loss of experiential memories, many people will also feel an ambiguous loss of identity.

The terms ‘loss of self’ and ‘loss of self-awareness’ are often used interchangeably. However, the causes are very different, as is the way people feel these two experiences.

Other Outcomes

Many outcomes are contemporaneous and make it difficult for people to understand and to be able to specify what their struggles are. There can be many grey areas, and further problems can be caused when the general symptoms of brain injury are confused with or overlap with, psychological or mental health challenges and vice versa.

Breaking things down into manageable chunks can also be difficult because of these overlaps.

People can also struggle with asking pertinent questions to help elaborate understanding and very often, because of this, people forget that they have options and choices available to them. Cognitive impairments can seriously affect flexible thinking.

Other complications include:

  • Traumatic memories associated with the brain injury event
  • Negative emotions related to the brain injury event and lack of acceptance of changes
  • Grief and ambiguous loss
  • Changes in the dynamics in relationships
  • Lack of understanding of the importance of recreating positive practical and psychological habits
  • Lack of awareness about the importance of creating and recreating positive beliefs
  • Detachment from emotional intelligence or previous emotional aspects of memory

Giving attention to each of these areas can affect outcomes for people. They are addressed under the section, ‘Healing Your Brain.’ With support and encouragement, people can regain the ‘inner familiarity’ that we refer to as self, which gives them greater clarity and understanding of remaining cognitive impairments.

A neuropsychologist will help you or someone you love to address any of these challenges. Ask your doctor for a referral and be aware there may be a waiting list.

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