There are a lot of rooms in my head, and always have been, but since the cerebral hemorrhage/stroke I have been taking inventory, visiting each of them to ensure that they aren’t empty, that everything is still there.  Oh sure, there is a certain amount  of disarray in the mansion that is my mind.  Its actually quite roomy, and hasn’t been a studio type apartment for decades.  I haven’t really checked the place out for a while, so why would it surprise me to discover that furniture has been moved around, and there are a lot of dust covered knick-knacks and objet d’art, old books, music and odd little items that I had forgotten about  demanding my attention?  There is still so much more warehoused in there that needs exploring and re-examination to truly bring myself up to date on who I have become and how I got to here.

To be totally honest and truthful about it, I am spending way too much time in my head instead of getting on with the business of living my life as it is now.  And quite seriously, there isn’t a whole lot wrong with my life, even post stroke.

I’m not a stroked out zombie, though I am still questioning part of my cognitive capabilities and ‘executive functioning’.

And of course, there is always the question of what to do about the ‘attention deficit’ which I continue to insist was there before the stroke.  If it didn’t or doesn’t hold any interest for me I have always been apt to promptly dismiss it, selfishly in some cases, and often the dismissal has been dependent on who was presenting.  The stroke has just become a convenient point for my family to leverage criticism of this behaviour, to be able to get me to focus on it without unduly riling me.  But as I explore the rooms in my head, I have discovered that I am easily irritated when disturbed.  My patience wears thin with the basic situation I am in.

Oh yes, and I do find myself obsessing about some things, like the status of my disability insurance claims and the technologies in the house that need updating and replacing, and the bloody awful weather, not to mention my dependence on family and friends to get around in the world outside that I want to explore.  Complicate it all by stirring in the promises that I made to myself about what I would actually try to accomplish while I was off work, and the new dramas and traumas that are being reported to me by my team at work, and the antics of my darling wife’s family.  The frustration of my visual deficits just complete the distortions of an otherwise charmed life.

One of the core challenges with being away from the work environment, socially disconnected and forced into a situation which I have caught myself describing as being similar to ‘house arrest’ has been the necessity of  ‘living in my head’ the ease with which I fall into patterns of negative ‘self talk’.

‘Self-talk’ of itself is an interesting phenomenon.  I’m starting to think that self-talk is not that different than openly talking to yourself, the only difference being that at some point with self-talk is that you cross the line to wanting to be able to speak it, and hear it, to understand the statements and questions you’re making.  So what is ‘self-talk’?  Well think of yourself sitting on the sofa watching television, be it the latest Ellen DeGeneres episode, or some sporting event.  At some point you get up to get a beer, or a cup of tea.  Normally you’d do this fairly instinctively.  Self-Talk is when you actually form the sentence in your head; “I think I’ll have a beer”.  It’s not about the getting up and getting it.  Its about the forming of the sentence in your mind that you then respond to.

I’ve heard the old saw that goes something like “at least when I talk to myself I know someone is listening, and I usually get the answers I want”.  But not all self-talk is as innocuous as it would seem.  Self-Talk in stressful situations and especially after a brain injury is your mind finding an alternate way to process thoughts and could be construed as a way that you are adding structure to your thinking by consciously forming the sentences in your head, that may never be spoken out loud.

As I wander through he rooms in my head, I indulge in the self-talk, often with statements like ‘well, that was dumb’, or more positive affirmations like ‘I can do better than that’.  But self-talk as a focusing mechanism has the downside of amplifying as well as focusing and in a lot of cases, we’re not at our best and we use the self-talk to focus on and amplify our less than stellar behaviours.  Remembering the assumption that we are the sum of our experiences, and that our core values and beliefs guide us through our day to day activities, self-talk latches on to those beliefs and values and can amplify and distort how we behave.  All that stuff that we have been internalizing over the years to help us move easily through the world and the way we interact with society and the people closest to us can become huge liabilities as we pursue recovery.  Our basic thought processes which are guided by our internalized learnings become the basis for self-talk which then become the situational reactions that those around us see.  On one level it becomes a bit frustrating because where we function perfectly well without self-talk on a regular basis, except for the occasional affirmation, when we’re ill, or dealing with the aftershocks of something as traumatic as a brain injury or stroke, we use self-talk a lot to get things back in perspective.  Is this the right approach or is it wrong?  I don’t know, but I do know that it has been helpful to me especially in the early days when I was coaching myself along the path to recovery, but now I’m finding it out of control.

Cognitive models basically suggest the following sequence and interdependencies.  So let’s assume we are presented with a ‘situation’.  Our powerful minds dip into our life experiences and teachings and sift through the core beliefs, learned responses and cultural biases to present the conscious mind with the automatic thoughts we’re used to using to move forward in the world, or with the language of self-talk to help us focus.  The automatic thought generation or the self-talk is a precursor or complimentary response to the overall reaction to the situation.  The Reaction is usually emotional, behavioural or physical.

The challenge with self-talk is that it both focuses and amplifies, and self-talk can then become very harsh and negative and can reinforce a slide into depression by amplifying anxieties.  We must maintain control.  Some of our beliefs and values about who and what we are may become unreasonable or unfair in light of a life changing event such as a brain injury.  We have to become flexible and compassionate about ourselves and our capabilities.