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          You may experience the effects of head injury in the form of a looming anxiety; a sense of infinite difficulty and impending terror. Some of you may have an impaired ability to screen out stimuli, and as a result, exist in a state of sensitivity that is acute beyond usefulness. It may seem as if your nervous system has no protective covering and every event is recorded as pain. 

     If left untreated these symptoms can lead to a lifelong identity crisis. You may feel overwhelmed by a sense of personal disunity and find yourself at a lost for an explanation that makes sense. At other times you might feel threatened with the loss of your whole being. Such feelings are very common following brain injury. Frequently, your doctor, family, friends, or you yourself, may think that you should see a therapist. 

     There are many types of therapies, and many people who call themselves therapists. You will want to apply the preceding doctor finder chart when searching for the right therapist for you. In addition, you should ask, specifically, which school of therapy he/she subscribes to and which therapeutic approach he/she employs. You should ask questions concerning specific training and expertise relative to brain injury. Other aspects of their expertise and training that you should discuss concern issues of grief and loss, identity and displacement and their relationship to your brain injury. 

      When you seek counseling for the psychological effects of brain injury, you do not simply bring such symptoms with you; you bring your whole life history into the treatment milieu. You may find yourself grappling with the most fundamental questions you can ask yourself. "Who am I now?" "Why am I behaving this way?" "What is the meaning of my new experience?" "How will I survive?" "How long before I recover?" 

    The therapist you choose must be wise and compassionate, and above all, have a profound respect for you and your reality. You should feel comfortable with the therapist and feel secure that he/she is willing to approach your problems with an open mind. He/she, in turn, must be willing to share your pain and experience your confusion. The Doctor Finder Chart covers a number of items you should consider when looking for a therapist. The issue of PSYCHIC PAIN is discussed in detail later in this book. Read it, it may save your sanity. 

     One of the problems created by the proliferation of therapies is that the individual consumer is often at a loss to know what he or she wants, or, more accurately, what technique or approach has any hope of giving the individual what it is that he or she wants. With that in mind, the following is devoted to an examination of some of the more common therapeutic methods. The following list provides brief descriptions of many of the most common types of therapies in practice today.

Which Therapy is Right for You

     One of the problems created by the proliferation of therapeutic methods is that the individual consumer is often at a lost to know what he or she wants, or more accurately what technique or approach has any hope of giving the individual what it is that he or she wants. 

     Research has shown that therapeutic success, to a large degree, is dependent on compatibility factors -- how closely the personality and needs of the client match the personality, needs and skills of the therapist. In other words, no one therapist can be all things to all people. With that in mind the following pages are devoted to an examination of some of the more common methods. Other forms in this section will prepare you to identify compatibility factors. 
 
 

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Therapies And Therapist
     ACUPUNCTURIST ... an individual who inserts fine wire needles into the skin at specific sites on the body, along a series of lines, or channels, called meridians. The needles are manipulated to produce analgesia or alter a body system. 
     BEHAVIORAL PSYCHOLOGIST ...  a psychologist who tests and counsels patients who have maladjusted patterns of behavior.
     BEHAVIORAL THERAPY ...  is most effective with people who are willing to put themselves in the hands of a therapist who actively guides the process. It involves, at its best, a willingness to follow regimens of reinforcing oneself, practicing desensitization, and relaxation exercises. Patients who insist on remaining in control and who can be characterized as resisting becoming disciplined have reported less comfort and success with behavioral methods.
     BIO-FEEDBACK THERAPIST ...  a person trained to provide a patient with visual and auditory information about bodily processes and methods of controlling such processes, which are usually thought of as involuntary and not subject to willful control. Such processes include blood pressure, muscle tension and brain waves.
     BODY APPROACHES ...  The move away from analytic approaches is most dramatically represented by the schools of thought that work directly on the body. Wilhelm Reich wrote decades ago about the "body armor" which represented the physical aspects of emotional conflicts and traumas. There are now many who accept the general notion that freeing up the musculature of the body leads to positive and often to powerful shifts in emotional, psychological well-being. Rolfing and Bioenergetics are prime examples of such therapies.
     CHIROPRACTOR ... an doctor who has taken special training and certification in a system of therapy based on the theory that a person's health is determined by the condition of his spinal column and nervous system. Treatment usually involves manipulation of the spine, physiotherapy and diet.
     CLINICAL NEUROPSYCHOLOGIST ... a psychologist with special skills who evaluates the mental functions of the brain —including brain injury — and plans training programs to assist the patient to return to normal functioning .
     CLINICAL PSYCHOLOGIST ...  a psychologist who tests and counsels patients with mental and emotional problems. 
     FAMILY THERAPY ...  for people whose problems are primarily experienced in relation to other family members (spouse, children or parents), family therapy is particularly appropriate. In family therapy no person is seen as having the problem; rather the system is seen as operating in a dysfunctional way. Family therapists typically prefer to treat problems as system ones. But this mode is not perfect for people with family members who are seen as problematic, but who refuse to cooperate in therapy to achieve understanding and resolution.
     GESTALT THERAPY ...  is a prime example of the more emotive or active methods of treatment. Fritz Perls, who developed gestalt therapy, was especially critical of analytic approaches that he thought could lead to talking about feelings rather than having and expressing them. He developed an approach which assists people in getting a deeper experience with their emotions. They may or may not end up understanding them, but they can better feel and express them. This approach is particularly effective with people who have no trouble talking about or analyzing their emotions (some seemingly endless), but for whom understanding seems to do nothing. 
     GESTALT THERAPY ...  is a prime example of the more emotive or active methods of treatment. Fritz Perls, who developed gestalt therapy, was especially critical of analytic approaches that he thought could lead to talking about feelings rather than having and expressing them. He developed an approach which assists people in getting a deeper experience with their emotions. They may or may not end up understanding them, but they can better feel and express them. This approach is particularly effective with people who have no trouble talking about or analyzing their emotions (some seemingly endless), but for whom understanding seems to do nothing. 
     GROUP THERAPY ...  virtually all schools of therapy have now been applied in both one-to-one and group therapy settings. Group therapy is valuable because the therapist and the patient work with others to relate what a person is doing, and because an individual is able to obtain reactions and input not only from a paid professional but from peers. Group therapy is less appropriate for those who experience debilitating anxiety in front of others or who refuse to accept as valuable any feedback that is not from a therapist. It is also difficult for those who, for emotional or psychological reasons, are unable to maintain a contact with reality in relating to other people.
     INSIGHT ORIENTED THERAPIES ...  of which Gestalt and psychodrama are prime examples, are not for the anti verbal. If someone does not want to deal with his feelings and their motivations at the verbal level, he should avoid these approaches. They are highly desirable, however, for people who have difficulty understanding their actions and talking about what they feel, even though they want to.

     People who experience anxiety, insecurity or shyness, and who resist letting others know their feelings are prime candidates for the so-called talking therapies. So, too, are people who have debilitating feelings or problems and can't understand why they can't seem to do anything about them. In these approaches people can move into talking about feelings at their own pace. They also begin to see how their feelings and problems get perpetuated by themselves in ways and for reasons that they are unaware of. 

      NEUROLOGIST ...  a doctor who specializes in diseases of the brain, nerves and muscles.
     NATUROPATH ...  a doctor who practices a system of therapeutic treatment based on the belief that illness can be healed by natural processes of the body aided by natural foods, light, warmth, fresh air, massage, regular exercise and avoidance of medication.
     NEUROPSYCHIATRIST ...  a psychiatrist (a medical doctor with special training in psychology) who has additional skills in the area of brain injury and how it relates to behavior. 
     NEUROPSYCHOLOGIST ...  a psychologist (holds a Ph.D.) who has special skills in the area of brain injury and how it relates to behavior. also see: http://www.neuro.mcg.edu/np/NPfaq.htm
     NEUROSURGEON ...  a medical doctor who is trained to care for a variety of brain problems, and to perform brain surgery if it becomes necessary. A neurosurgeon is primarily concerned with coordinating the medical treatment, and deciding whether or not there is a need for surgery. 
     OCCUPATIONAL THERAPIST ...  a specially trained and certified person who specializes in helping people who are limited by physical, or mental injury, and/or illness to prevent further disability, maintain health, and return to gainful employment and maximum independence. They carry out therapies prescribed by a medical doctor. OTs  focus on three main "performance" areas of an individual's life: 1. Self Care, 2. Leisure interests and activities, and Work and School.  Our goal is to fit the therapy to the client's stated goals and needs. 
     OSTEOPATH ...  a physician who specializes in the practice of medicine and uses all of the usual forms of medical therapy and diagnosis, including drugs, surgery and radiation, and also places great emphasis on the relationship of the organs to the musculoskeletal system. The osteopath focuses on structural problems and uses manipulation to correct them.
     PSYCHIATRIST ...  a physician who specializes in the management of emotional and behavioral problems.
     PSYCHODRAMA ...  developed by Joseph Moreno, psychodrama is a method in which people are assisted in literally acting out emotionally charged or conflict ridden situations in their lives so that they can get beyond the feelings that have been blocking them. It is highly emotionally charged and frequently produces very cathartic experiences.

     Psychodrama nor gestalt therapy would not be particularly suited for a person who insists on remaining in control of the expression of feelings or who wants to move toward his feelings with a gradual pace. Because both of these methods are typically group experiences, they are sometimes seen as too intimidating by those who have avoided emotions or have little or no experience with sharing their feelings with others. 

     PHYSIATRIST ...  a medical doctor who is primarily concerned with evaluating the impact of traumatic injury on the patient's body, and helping the patient overcome any physical disability that has resulted. 
     PHYSICAL THERAPIST ...  a person who is trained and certified to help the patient to regain maximum functioning of body movement through the use of exercise, the application of heat or cold packs, the use of sonar waves, traction and other techniques.
     PSYCHOANALYSIS ...  uses the much maligned couch and can be legitimately practiced by someone certified to do so. Generally speaking, it is a specific kind of therapeutic approach that follows the techniques first developed by Sigmund Freud. It emphasizes dream analysis and relies on free-association. Classical Psychoanalysis, involves three to four sessions a week over a period of three to five years.
     PSYCHOANALYTIC THERAPY ...  involves interaction with a therapist who may be a certified psychoanalyst or who may be simply a therapist who uses psychoanalytic theory and principles. Freud saw the goal of psychoanalysis as essentially a restructuring of the entire personality, rather than as a way of dealing with specific or acute problems. Generally, the more immediate and specific the problem, the less comfortable a person is working on it through psychoanalysis. Also, the person who is not interested in exploring the roots of his conflicts tends to become impatient and frustrated in psychoanalysis. One of the most frequent complaints of therapy patients is about the therapist who doesn't say anything, which usually means doesn't answer questions or give advice. This frustration is most likely to occur in traditional psychoanalysis. 
     PSYCHOLOGIST ...  a specialist who studies the structure and functions of the brain and related mental processes with regard to behavior. Psychotherapy and psychoanalysis were synonymous. Today, this is far from the case: there are so many different "brands" that it is difficult to know what they all are and what makes one more or less desirable.
     SOCIAL WORKER ...  an expert involved with the social aspects of treatment and rehabilitation. Social workers provide a wide range of services from finding funding sources to giving emotional support to their clients.
     SPEECH THERAPIST ...  a person specialize in abnormalities of speech and language,
thinking and cognitive skills, including memory, attention, problem solving, integration of thoughts, reading, writing, voice, and fluency.  Treatment goals include disorders affecting normal verbal communication in an effort to help them return to normal patterns of expressing and understanding language.
      TRANSACTIONAL ANALYSIS (TA) ...  is one of the most widely known and widely practiced methods of therapy derived from orthodox psychoanalysis. Like psychoanalysis, the group of therapists using TA includes both those who are fully trained and certified for competence, and many more who simply draw from Eric Berne's theory and use some of the principles and methods of TA. 

     Berne developed TA out of a conviction that therapy could be more efficient (faster) than psychoanalysis, and that it didn't have to include so much reconstructive digging into one's childhood. He disliked the fancy. and what he considered confusing, language included in psychoanalysis. The approach that he developed, and that has been popularized through such books as Games People Play and I'm Okay; You're Okay, revolves around a language system that is colloquial, easily understood and allows the individual to do a lot of the work of understanding his feelings and motivations on his own. While TA is usually practiced in groups, it is also used in one-to-one therapy. 

     VISION THERAPIST ...  an optometric doctor specially trained and certified to treat vision difficulties that result from physical trauma.
      VOCATIONAL THERAPIST ...  a person trained to help people who are disabled to determine what kind of employment they are capable of considering. 


 
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