Opening Thoughts from Dr. John Evans

Greetings,

Today, in the midst of summer, I am thinking of autumn and the wonderful conference we have planned for October 22 and 23. I hope you will take few moments today to visit our new web site and to read about our key note address speakers. While you are there, please accept my invitation to register for our 2010 Wellness & Writing Connections Conference and take advantage of our early registration period. Your registrations and contributions are what make our work possible. I hope you enjoy this month's newsletter with Satia Renee's interview of Barbara Stahura and poetry by Alex Lemon.

Traumatic Brain Injury (TBI) is the focus of our June newsletter interview with Barbara Stahura. TBI is much in the news these days because soldiers returning from conflicts often suffer from this injury, but not all such injuries are the result of soldiering. Some traumatic brain injuries are the results of car accidents, domestic abuse, or natural catastrophes. Whatever the cause of these injuries, the resulting effects are often devastating and life-changing for the injured persons and primary care givers. Addressing issues surrounding these injuries are recent research studies and practices that suggest journaling can be an effective modality for treating Traumatic Brain Injury.

Barbara Stahura knows first-hand the effects of TBI and how journaling can help those afflicted. In our newsletter interview, Barbara describes caring for her husband who suffered a traumatic brain injury in an accident. From her experience, Barbara has written a book, After Brain Injury: Telling Your Story that provides excellent tools for how journaling can help overcome many of the symptoms of TBI and promote healing for both the injured and care giver.

I would also like to add that after our interview, Barbara presented her work with TBI and PTSD at a conference for the National Guard and was enthusiastically received. We are excited that Barbara has agreed to be on our program at the 2010 Wellness & Writing Connections Conference, October 22 and 23, at the Georgia Tech Global Learning Center in Atlanta, Georgia. Please visit our web site www.wellnessandwritingconnections.com for more information about our conference. And join our fan page on Facebook.

Best Wishes,

John

Interview With Barbara Stahura

We are happy to share an interview with Barbara Stahura who has published both a journaling workbook and a memoir. Barbara’s emphasis on the importance of journaling as a tool for wellness comes through not only in her writing but in her responses to our questions.

Q: Barbara, I thought we could begin with discussing how you came to lead a journaling workshop with a focus on brain injury.

A: The workshop came about several years after my husband, Ken, sustained a traumatic brain injury. When that happened, I researched and read as much as I could about TBI, and I also continued to journal through that entire time. My journal was the one place where I could find a tiny bit of sanctuary or sanity amid all the chaos. Then, in 2007, someone asked if I could teach a creative writing class for people with TBI. I’m not qualified to do that, but after having been a long-time journaler, I knew the benefits of journaling from the work of James Pennebaker and Kathleen Adams. So I began creating a journaling workshop called “After Brain Injury: Telling Your Story” that would give people with brain injury the opportunity to use various journaling techniques to tell their stories.

I discussed the idea with Susan Schuster, who had been Ken’s outpatient speech therapist. She loved the idea, and we got permission to begin holding the group at the rehabilitation center here in Tucson where she works. By early 2009, I’d begun turning the workshop into a book, also titled After Brain Injury: Telling Your Story, with assistance from Susan.

I’ll add, too, that my journal from the time of Ken’s accident and recovery became a rich source of information and details for several personal essays about our experience, some of which ended up in my book, What I Thought I Knew, and others in magazines.

Q: After reading your book, After Brain Injury, I was surprised to find that many of the journaling exercises were easily made universal with simple rephrasing of terms—in my case replacing “brain injury” with “vertigo” or something along those lines. Have you had any response from readers or workshop attendees who haven’t had an injury but still benefit from what you have developed? If so, can you share a story with us about this experience?

A: I haven’t yet had any communication from people using the book to journal about anything other than brain injury. But that’s an excellent idea! Some portions of the book are specifically devoted to brain injury, but in many other areas, the prompts could be changed to reflect whatever illness or condition the person wants to write about. For instance, the book has a section called “Making Metaphor,” and one of the prompts is, “A brain injury is like…” So, to use your example, the prompt would become, “Vertigo is like…” Or instead of writing a dialogue with the brain, as we ask people with brain injury to do, others could dialogue with vertigo, or cancer, or a broken leg.

Family members of people with brain injury, or other conditions, can also use the prompts for themselves by making a few changes. People can use this book on their own, or in groups, or with a therapist or counselor. If people aren’t able to write or type on a computer, they can speak their answers into a tape recorder or use voice-recognition software if they have that. In at least one instance I know about, a couple uses the prompts as conversation starters since the wife, who has the brain injury, does not like to write. And, a family member or counselor could also write down the words spoken by the person with brain injury, although they have to simply scribe and not make any judgments or corrections.

Q: Can you describe a typical workshop? What would a person participating in your workshop experience and what can they expect?

A: Our workshops here in Tucson typically have six weekly sessions of 90-minutes each, although they can be customized as needed. We’ve had from four to nine participants. During every session, we begin with a short check-in, and then, depending on the journal exercises for the day, do two or three writes, one at a time. I’ve found that 10 minutes is a good span for the writing—not too long or too short. In that time, some of the participants can write a page or more, while others are able to write only a few sentences. But no matter how long their entries are, what’s important is that they have the opportunity to express themselves on the page. Most of them haven’t journaled before, or written down their thoughts and feelings about their post-injury lives. And, especially after such a life-changing event as a brain injury, telling those stories can help them deal with what’s happened, at least a little bit, and can help them move forward.

After each write, those who want to read their entries aloud to the group can do so. Most of the participants read, usually with much enthusiasm, even when the topic is emotional for them. I think the reading is the best part of the session, because of the way the participants support and encourage one another--no one can really understand what it’s like to live with a brain injury except another person who is also living with one. It’s an honor to work with them. They have inspired me so much with their courage and honesty, that I’m now enrolled in the Certified Journal Facilitator Program at the Center for Journal Therapy.

Q . What are the challenges you yourself faced as a caretaker for someone?

A. I’ve described the whole situation in terms of being kidnapped to another planet, where the whole environment is alien, and it feels as though one wrong decision could bring catastrophe crashing down. The challenges were unlike anything I’d ever dealt with before. Here are just a few. The biggest one was simply holding myself together, beginning when I heard Ken was in ICU and continuing for months after. I felt semi-hysterical for several months, even if it didn’t show on the outside. But since he could not speak for himself or understand what was going on, like thousands of other caregivers I did my best to put one foot in front of the other, one hour or one day at a time. Just a few days after the accident, the hospital social worker walked me down to the ER of the hospital where Ken was, since I’d been having chest pains for a few days. Fortunately, it was nothing serious, but it was a reminder to take care of myself and release stress—which never happened until some time after he’d come home from rehab. It was a very gradual recovery for me, too. It was hard to eat or do much of anything “normal” because of the anxiety. I was sleep-deprived the whole time, even with meds prescribed by the ER doc, because my mind was always running, and fear was always present.

When Ken was days away from coming home from rehab, he suffered a pulmonary embolism and was rushed back to acute care, which sent me into emotional overdrive again, just as I had started feeling safe once more. Then, when he was finally home, he often had two or three appointments a day with doctors and various therapists, so I was the scheduler and driver. I was happy to do all of this, but it was exhausting. Also, when we were home I had to help him do a lot of basic tasks and keep an eye on him, since he was still wobbly and I was terrified he’d fall and suffer another head injury.

Fortunately, I was able to put my freelance writing aside for this time and didn’t have to worry about losing my job, and we didn’t have kids at home to worry about. Many family caregivers have to contend with these serious issues on top of everything else.

Finally, the last challenge was giving up my role as overprotective caregiver. Over time, as Ken recovered pretty well, I had to let go of the hyper-vigilance and need to hover. I had to understand that I really could do nothing to protect him out in the world, and simply trust that he would stay safe. Or not. So my options were either driving myself crazy with worry or releasing it. I chose the latter. More than six years later, we’re both doing well.

Q. Can you share with us some more about your writing a memoir? What was your process? What did you experience emotionally, spiritually, psychologically, etc.?

A. What I Thought I Knew wasn’t supposed to be called a memoir. As I wrote it, it was a collection of personal essays. But, since they revolve around the theme of how changing my mind changed my life and are arranged chronologically, people started calling it a memoir, which is fine with me.

My process was to stay in the chair and write—simple and extremely difficult at the same time. One of the things I most enjoy about writing personal experience is the challenge of finally, after much revision, saying exactly what I want to say. Getting the descriptions just right or finding—to me—the perfect metaphor. And I can’t even express how helpful it was to have my old journals—I began journaling in the early 90s. Many of the essays could not have been written without the records contained in those journals.

Some of the essays about my younger years had been written and published a long time before the book came about. I did some revising on those and didn’t experience much emotionally. But many of the essays were new for the book, such as the ones about meeting and marrying Ken and his brain injury, for instance. For those about the injury and its aftermath, it often felt cathartic to explore my memories while looking back after several years. In writing the last essay in the book, “Two Snakes,” I even unearthed some feelings I’d buried after going through the experience of watching my husband be so vulnerable and helpless after the accident. That was significant and healing for me. While there may be more to write about this experience someday, I feel as though I’ve dealt well with it in positive ways that wouldn’t have happened without all the writing.

Journal Prompt from After Brain Injury: Telling Your Story

How It Feels to be Me

After a brain injury, you’re very likely to feel different in some ways than you felt before it happened. How do you feel different? How do you feel the same?

Choose one of these prompts:

This is how it feels to be me today . . .

Next, if you don’t like the way you’re feeling, write about how you would like to feel instead. It is sometimes possible to improve your mood and perhaps even your physical state by actively thinking yourself into a better one.

I wish I could feel this way instead . . .

The Best Part, a poem by Alex Lemon

Alex Lemon, poet and professor, recently published a raw, often brutal, memoir about his having a stroke and his recovery from the surgery that followed. In Happy: A Memoir, Lemon carries the reader from symptom to diagnosis through recovery, from college freshman and athlete to wheelchair bound and learning to navigate through his life. The following poem is from Mosquito: Poems , a poetic exploration of his experience.

The Best Part
by Alex Lemon

The best part of brain surgery isn’t the shining
staples that keep it all in, the ways

fingers and tongues will find the scar.
It’s not wheelchair rides through maple leaves,

sunlight warming a bruise as I fumble
peeling an orange. Nor is it the gentle tug

of a nurse reminding muscles—bend, stretch,
and flex. The sweetest ingredient—

the best part is the cutting. Hollow space
that longs to be filled with what little I have.

The first bite, cold fruit. Bedridden, I weigh
my glass eye in wrinkle-mapped hand.

Healing the Healer: A Journal to the Self® Workshop

August 20-21, 2010
Winship Cancer Institute of Emory University
Patient Family Resource Center
1365C Clifton Road NE, 1st Floor
Atlanta, GA 30322

Certified Instructor: Jean Rowe, LCSW (404) 778-1202 jean.rowe@emoryhealthcare.org

Evidenced-based, peer-reviewed research indicates that expressive writing has been successful as a therapeutic tool for improved health and well-being and general functioning.

Workshop objectives include:

• Describe 5 or more journal techniques useful for stress management.
• Identify 3 or more ways to nurture self care.
• Discuss 2 or more journal strategies to address professional burnout.
• List 3 or more reasons why writing supports the healing process.
• Offer/Cite journal writing as a therapeutic intervention with client populations.

Approved for 12 CEU/contact hours through the NASW-GA, LPCA-GA and the Georgia Nurses' Association.

Download the registration form here.
Download the brochure here.

Please contact Jean Rowe with any questions.

Closing Thoughts from Satia Renée

Dear Readers,

I hope you love the new look of the newsletter as much as I do. If you haven’t taken a look, you should go to the website as well because we have done some wonderful changes over there which inspired the changes in our newsletter. Angela did a brilliant job on both the website and newsletter template so, for those of you who are coming to the conference, be sure to compliment her on a job very well done.

When I received a copy of Barbara Stahura’s After Brain Injury, I was curious but purely on an objective level. After all, I had not been injured and the title had little to nothing to do with me or my life. But as I began reading the content it wasn’t long before I realized that when I set the details aside and broadened the intention of the text. By rephrasing some of the exercises, I was able to apply the journaling prompts to my own experience and explore the text not solely from a distance but from an immersion into its applicability to my own life.

So much of the research I have found for wellness and writing may be specific in its focus but the applications seem to be universal. Although I know a lot of people who do not journal or use expressive writing in their own lives, I know far more who do or have at least used one or the other to help work through a personal crisis—like brain injury or some other unexpected life circumstance. For Alex Lemon, writing became both a tool and a promise after his stroke and now, with several books published, his ongoing success is ensured. By turning to the page to process the emotional fallout of having survived a stroke, Lemon has created resources for others to tap into their own healing through writing.

After our brief newsletter hiatus, hopefully we will be back on track. If you have any suggestions for future newsletter themes, resources you would like to share or recommend, please feel free to email me. I am always looking for content that is relevant.

Sincerely,

Satia Renée