You probably remember learning about Maslow’s Hierarchy of Needs. That pyramid with some basic things at the bottom like food and shelter. Then safety and love and eventually at the tiny top self actualization, meaning creativity and the desire to be the best you can be.

Well there is a similar pyramid in brain rehabilitation. The bottom layers are energy and processing speed. Followed by concentration and attention above. And then memory and learning new things. And the top is executive functioning.

Generally healthy employed people have mastered executive functioning, though we all master to different degrees. But us TBIers take a loooong time to get all those bottom layers. If we ever master them at all.

I went to a speech language pathologist S in 2019 (the first year of my recovery) who was a lifeeeeee savor helping me with these things. She helped me when I was on the brink of total oblivion. We organized. We made schedules. She had the same name as my best friend. It felt like she swooped in from another world and put mine back together.

S and I made routines such as : 1. wake up 2. get the shower 3. put your contacts in 4. brush your teeth 5. make breakfast. It was that granular. Because my brain needed that granular.

So you might wonder, how could one hold a job? Well, one can’t really. Most of the people I have talked to with a similar condition don’t work, or only work part time. And that is a struggle. Such is my life. I have been working about 10 hours a week for the past year and few months. A lovely human convinced her team to take a chance on me. I had lost my full time job prior to that during my first year of recovery.

Mastering things like faster processing speed, memory retention and retrieval, focusing for a longer period of time- these are all like training for a marathon. Training for a marathon equals every. single. thing. in life. All progress in various types of therapy are baby steps. So tiny it’s more like a baby in the womb.