My Latent Self Anne Ricketts

My Latent Self

Recovering My Soul After Brain Injury
Recovering My Soul After Brain Injury

Repetition and Myelin

The one main thing that gave me my life back was REPETITION…

When I eventually started occupational therapy in 2005, I had no idea of the huge impact learning to undertake my daily routines again was going to have on my life as a whole.

I received occupational therapy from the spring of 2005 to the autumn of 2006. The absolute gratitude that I hold for my therapist, Emma Clemens, Laidlaw Day Hospital, St Mary’s, Isle of Wight, for giving me my life and my ‘self’ back, will be with me always.

Repetition, repetition, repetition…

Traumatic brain injury can cause immense amounts of damage to the physical structure of the brain. Because of synaptic plasticity the brain is constantly establishing new neural pathways through learning and experience. This also happens in an injured brain.

In the injured brain there can often be a lot of memory loss, in which case, I feel, the brain has more work to do to build new neural pathways because it has no stored data that it can use to support new learning, and it can therefore feel as though you are starting from scratch. I believe that the memories that we are not able to recall, or bring to mind, are most probably still stored, and this certainly seems to be the case for me, but, the path to the information has been damaged, and therefore there is no access to it until these new neural pathways are ‘fixed.’

When the path to our past learning is disrupted the conscious brain, that we use to compute the data which is ‘incoming’ via all of our senses, can easily be overloaded because there is a lack of recognition of everyday things, environments and situations.

The conscious mind can process about 2,000 bits of information per second and the short-term memory can handle about 20 seconds of information. These statistics vary from one expert to the next, but, my point here is that if this capacity is being used to judge everything in your environment one step at a time, then it doesn’t leave you room to make a considered judgement about what is going on around you. In the healthy brain the sensory input is automatic and happens in a split second, and it can weigh up its environment within that same fraction of time. When this isn’t happening, the brain is trying to work out what is relevent and what is not whilst assimilating its environment – hence why it can feel as there is no room for ‘you’ when the brain is damaged.

There is no quick and easy fix. Your brain has one priority and that is to ensure the safety of the body that it serves. This prioritisation is automatic and as far as I am aware you cannot ‘override’ this system, this in-built nature… You can’t say, ‘stuff everything in my external world whilst I focus my mind on what flavour ice cream I wish to eat,’ it doesn’t work like that… Time is the literal healer here, because,over time you naturally add to your ‘experiences’ database. The more data you hold, the less your brain has to spend its time computing everything step-by-step…

When we repeat any task over and again what we are actually doing is practicing at improving and honing the skills we need to be able to perform any task. Practicing anything adds layers of myelin to the nerve fibres in our brains. These nerve fibres are like little trunk roads that lead to a task specific neuron. The more the pathway is used, the thicker the layer of myelin becomes. The thicker the myelin, the faster the information travelling down the nerve fibre moves. The pathways with thick layers of myelin are the ones that help us to perform at our best.

It is important that you be patient with yourself; things will come back and you can speed up the process of healing with the right help…

An excerpt from ‘My Latent Self:’

Brain learning is a slow process – just look at any child. We all know you can’t just show a child the alphabet and expect them to know it immediately. It literally takes them years to learn new things through repetition, and so it is with us too… How long does it take a child of three or four-years-old to learn to put their arms in their sleeves and their head through the neck hole? The added complication is getting the back at the back, and the front at the front! How long does it take to learn to tie shoelaces? An injured brain is doing the same thing. It is using an unutilised, or ‘virgin,’ part of it to learn ‘new’ tasks. It isn’t repairing the damaged bit – this is ‘dead’ – it is finding a whole new network to configure for the jobs it can no longer do.

As we move through our juvenile years the more we repeat tasks and the more a substance called myelin wraps itself around the nerve fibres in our brains – thus enabling us to eventually circumnavigate around effort and conscious input. Myelin increases the speed at which electrical impulses travel in the brain. Repetition, the ‘god’ of brain injury recovery, increases the production of myelin and in turn, myelin increases the speed a task specific neuron can and will work at. I don’t think myelin really gets involved until the brain is ‘convinced’ about the role a neuron is undertaking. It is ‘practice’ dependent. If things were hard-wired ‘too soon,’ then we wouldn’t be able to remain flexible during our early learning processes. It is what neuroscientists call ‘deep practice’ which enables our movements and thoughts to be finally ‘etched’ into ‘habit’ by myelin. You don’t want to form a habit until you are sure it works for you, and I am sure the brain works in total harmony with this. Learning is ‘supposed’ to be slow.

This is one area where our families and friends (and carers if we have them) can help us to speed up our learning. Normal people on the outside can recognise what is a good thing to learn and practice, and can therefore encourage repetition of these actions. If the wheat is sorted from the chaff for us, and there is someone who can supervise us practicing simple tasks over and over, then the brain will be able to learn faster. If you only do something once or twice a day, then that learning is extremely slow, purely because there is a lack of reinforcement.

My experiences…

When I first saw Emma I used to tell her that I felt as though I no longer had any space in my brain to think. I said that it felt as though my brain was the size of the moon on my little finger nail, instead of being the size of a car-cleaning sponge. Over the time we worked together, the more Emma encouraged, supported and reminded me about all the things I needed to do, the more they became familiar to me.

Once I was out of bed in the morning, the day became an immediate muddle to me. Because I had severe problems with initiation, processing and memory, my brain felt as though it had come up against a brick wall as soon as there were ‘decisions’ to make. Thought ‘A’ could take a long time coming in itself, and most of the time ‘A’ didn’t ever get to ‘B.’ If I was both thirsty and in need of the bathroom, I would become totally confused. I couldn’t prioritise and this disability would keep me rooted to the spot I was in, leaving me standing there like a clown wearing concrete boots.

Woe betides me if I made a move towards the kitchen and the bathroom and actually realised that I couldn’t see properly! Having to include some consideration about putting my contact lenses in would totally overwhelm me, my brain would be overloaded with ‘emptiness’ and there was a very, very strong possibility that nothing would get done!

Even after Emma and I finished working together I continued to have to work really hard on achieving the very simplest of tasks for more than four years. Some things I now have ‘off pat’ and I am back to being ‘normal’ and so don’t have to think carefully about, and through, what I am doing. Now, 80% of the time when I boil the kettle, I also make the tea and nearly always remember to drink it! Most of the time I put the teabag in the cup instead of in the kettle!

What I found was that over time, the more my ‘routine’ tasks became habitual, the more space I had in my brain. The more space I had in my brain, the more I had the ability to give my attention to the other aspects of my life. As it was, gaining ‘space’ allowed my self-awareness to return. Up to this point I had been oblivious of the consequences of my actions and behaviours. I was unable to ‘read’ people’s reactions to me, and because I couldn’t process incoming data in ‘real’ time, every reaction to me went straight over my head. Whilst I was like this, it was impossible for me to recognise that I was learning anything.

I refer to the summer of 2005 to that of 2006 when my self-awareness began to return as ‘my horrible year.’ The more self-aware I became, the more I would be devastated by the outcomes of everything I did. I was horrified to the very core of my soul when I finally realised that I had been running on autopilot, without any conscious input into my behaviour, for over five years. My psyche underwent a year of incredibly intense trauma, my heart was wracked with pain, I was sickened to the very deepest depths of my mind, and all I could do was to keep picking myself up…

I was in deep shock. How could ‘I’ ever have behaved like that? How could ‘I’ have been so insensitive? How could ‘I’ have physically been in this world and yet totally unconscious of who I was, or who I was being?

My heart shattered, my mind splintered into a billion pieces. I kept going. The bones of my nature made me tenacious by default. Without any conscious effort I did what an Annie does; I kept going, I kept putting another foot forward… Each and every single step landed me upon another mine. The internal artillery was bombarding me relentlessly. But, I pushed and I pushed and I wore my smile…

Tears fell from my heart; absolute grief engulfed my mind…  I was aware within every cell of my body that I had lost my soul…

Repetition had afforded me the space in my brain to finally come to realise that what was missing were my core beliefs. I am eternally grateful that I realised that I had to be very careful about what I put back. I also understood, from my many, many experiences of how my vulnerability left me open to manipulation, that I needed to be very careful about the sources of my inspiration and learning.

I only really started to return to my ‘Self’ in 2010, last year, when I sat down and wrote Latent Beliefs. This is a book that is not only about my spiritual recovery from brain injury, but one that also fully describes how I came to be where I am now. It is the sond book in ‘The Latent Series.’

I still have disabilities in my cognitive functioning, but outside of these I am filled with a great sense of inner clarity and peace. I feel totally comfortable within my inner world…

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(c) 2011 - Anne Ricketts - Sandown, Isle of Wight, PO36 9EL - Tel: 01983 407557 - Traumatic Brain Injury, Loss of Self, Loss of Soul, Misdiagnosis, Survivors Guide

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