Sunday, October 4, 2015

Mind Change Day 4: Goals

When I first got to this goal-setting stage this past spring, my goal was to get insurance approval for more speech and cognitive therapy, and I eventually did. I wanted to develop strategies so my speech didn't outpace my thoughts; this is very awkward and common for me, like grasping a baton and running with it except there's not another runner down the track to take the hand-off.

My therapist Adriana was upbeat and enthusiastic; after doing another assessment we got to work. She wanted me to work on mnemonics and other memory strategies to help my daily functioning, and we did. I also tried out a lot of organizational tips that made my life a lot easier. So at the end of the approved number of sessions she said "Great job, star student. We're done."

I was shocked. What about my speech? We hadn't even started to work on that. And weren't there other cognitive rehab strategies that would improve my auditory processing speed ?

She said she didn't realize those were goals for this round of therapy. When she'd done an assessment the greatest deficits were in memory so that's what she'd written as her treatment plan; improve immediate and delayed recall by 50% using mnemonic tools and I'd done so much more than that, I should be proud. The speech delay isn't noticeable to most people but my memory was really bad.

Okay, but could I still work on my speech and auditory processing speed? She smiled and said I was, every day I spoke and listened. The change may not be noticeable to me but if I stopped focusing on the deficit and paid more attention to the conversation, I'd enjoy talking to other people a whole lot more, and being relaxed would bring my speech and thinking more into alignment.

That's when I realized that goals that aren't written down, witnessed and agreed on if they're mutual aren't really goals at all, they're aspirations, or wishes. But even more importantly, that by having very specific desires in terms of my recovery I give minimal attention to gains I make elsewhere, and enjoyed life a lot less than I'd like.

So when I went back to the goal-setting step of the DOCC Back In Control program, I was ready to see that the goals should be broad and about my life, not my recovery. Using the explanation that comes with the online template I could see that my first attempt I was intent on setting angsty "surviving and fixing" goals rather than envisioning a fulfilling life for myself, whether my remaining symptoms stayed or went away.

Although I worked on this on and off for a few months, I didn't make progress until a few weeks ago. I'd been pushing myself to fix a story problem, without success, and pulled out my notebook, flipping through it to see what I'd already tried (witness: memory strategies in action).

The notebook opened to this template, half-completed, half-scratched out. I opened a new page and had it done by the end of the afternoon and it was such an unburdening. You never know how narrow being injured can make your life until you realize the injury has almost nothing to do with who you are and what you want.

I walked to the nearby beach in awe of the possibilities.

Love, Lisa

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