Goal setting after a brain injury

BY: ALISON

Before my concussion, I was always busy.

I worked long hours, travelled three times a year, hosted parties, played sports, volunteered and maintained a blog. I had one-year fitness goals, five-year career goals, 10-year family goals, and 30-year financial goals. After my injury, my symptoms were so debilitating and unpredictable that I couldn’t even make plans for 10 minutes in the future. I was close to giving up entirely, until I changed my perspective and approach to goal-setting.

women standing in running shoes
photo credit: 2012Vegas 676 via photopin (license)

How to Set Goals After a Brain Injury

Step 1: Change Your Perspective and Set Your Goal(s).

First you have to decide what you want your goal to be. It is imperative you don’t set yourself up for failure by having unfair expectations. If you set an unrealistic goal, you will de-motivate yourself and give up. Through accomplishing a series of challenging, yet do-able goals, you will achieve the once seemingly impossible ones.

Set simple goals that are achievable in the short term (i.e. daily and/or weekly). Then gradually work your way up to more difficult goals.

After my injury, just lifting my head off the bed to drink water was exhausting, so my first goal was to perform one task every three days. Tasks included taking a shower, folding clothes, or going to an appointment. Once I could do that, I slowly increased the frequency and difficulty of the tasks.

I then added outings to my goals, which later included running errands. Eventually, I was performing multiple tasks each day, having outings a few times per week, and running multiple errands per outing.

As my energy levels improved, I also set my first fitness goal, to walk for at least 10 minutes each day. Over time, this evolved to taking longer walks and faster-paced walks. Once I had more confidence in my capabilities, I focused on social goals. I started with phone conversations and one-on-one meetings, before working my way up to group dinners at bustling restaurants. Finally, I started hosting parties in my home.

Exercise is well-known to improve brain function, depression, anxiety, and sleeping problems. Furthermore, recent studies indicate that moderate exercise is the best treatment for concussions.

a freshly made bed
photo credit: Mazzali bedroom via photopin (license)

Step 2: Plan Out Your Goals and Take One Tiny Step at a Time.

Now that you’ve set your goal, the next step towards achieving it is to make a plan. Write your plan down on a piece of paper so you can follow it easily and cross things off as you complete them.

The best approach to planning (and executing that plan), is to take things one tiny step at a time. Break down each goal into as many small, manageable components as you can, then tackle one component at a time. The definition of ‘manageable’ is different for everyone and will change as you recover.

For example, these were the tiny, manageable steps that I planned for my goal of going for a walk:

  1. Stand up (you could break this step down further. e.g. lift head off bed, then lift head and shoulders off bed, then sit up, then sit on the side of the bed, then stand up.)
  2. Drink some water
  3. Change my clothes
  4. Gather my cell phone, keys, and health card
  5. Put walking/running shoes on
  6. Leave the house (i.e. simply step outside)
  7. Start walking (even if it’s just a few feet) and rest as needed
  8. Walk home and rest as needed
  9. Stretch
  10. Drink some water

When you start executing your plan, the most important thing to remember is to focus only on the task. Don’t even think about how you’re going to tackle the next step until you’ve completed the current one. That means, not worrying about whether or not you’ll be able to complete all of the steps, and not counting the number of steps you have left.

Taking one tiny step at a time will earn you little wins, keep you motivated, and make your goal seem less daunting. Take breaks when you need them and try again later.

It helps to have someone else’s support when you’re working towards a goal, but only if they understand the importance of taking things one step at a time. I remember one night in the winter, my partner wanted to take me to the mall to help me achieve my daily walking goal. I was fatigued and dizzy and convinced that I wouldn’t be able to do it. But he talked me through one step at a time. He said, we’re just going to get in the car and we’re just going to drive to the mall. If you’re still not feeling well when we get there, you don’t have to get out of the car, we’ll come straight home. So he helped me up off the couch and into the car. He drove me to the mall, turned the engine off, and asked if I was able to get out of the car. I was, and in that moment, we set a goal of walking to the mall entrance and back. When I got to the entrance, I felt okay, so we went inside. That night, I ended up walking for longer than my daily goal.

drinking a glass of water
photo credit: Denise via photopin (license)

So when you’re faced with a particularly daunting moment, keep repeating to yourself, “I’m just going to do this tiny task. That’s not too hard.” One and a half years of tiny steps later, I jogged 5 km in the BIST Run, Walk & Roll. I’m working towards running a 10 km race next year.

Step 3: Be Flexible and Be Kind to Yourself.

Celebrate each tiny success and never criticize or punish yourself for set-backs. Goal-setting after a brain injury requires time and practice through trial and error, so be patient with yourself, do what you can, and be flexible with changes to your plans. If something’s not working for you, try again and then try something different. You might need to re-evaluate your goals, revisit them at a later time, or break certain steps into smaller components. Don’t be afraid to ask someone for help.

Step 4: Set New Goals and Keep Challenging Yourself.

As your symptoms improve, you’ll be able to accomplish more each day. When you’re further along in your recovery process, gradually increase the breadth and difficulty of your steps. Soon, you’ll be working on various goals (e.g. fitness, cognitive, financial and social) simultaneously.

Eventually, your goals will become more and more challenging, complex, and long-term. No matter what your physical barriers are, there’s always something to learn, something to improve, and new ways to challenge yourself. As long as you take things one step at a time, you’ll look back one day and surprise yourself with how far you’ve come.


‘Mind Yourself with Alison’ is a collection of self-help tips, research, and personal experiences dedicated to helping people thrive after brain injury (or other trauma). Check out Alison’s other BIST Blog articles Women and Brain Injury: What you need to know and How to be a Good Friend to a Survivor.

 

 

Advertisements