by Claire Perrault

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There are certain things in our lives that we all count on. When we get up the morning we trust that we will have those skills and abilities that we have already learned and acquired. The train may be late but we can still read the train schedule and see when the next train is coming. We know where the bowl for our cereal is and how to open the milk container. Our hands cooperate and do the tasks we ask of them. Our feet obey us automatically as we put our shoes on, our hands lace those shoes and off we go to face the day. That is unless we have had our world and our trust shattered by a traumatic brain injury and things are no longer the way they were. Not only are basic abilities lost, but a sense of trust is also gone. If such a devastation can happen, what can we have trust in? It has to be in ourselves and in other people and we regain that sense of trust by being treated with respect and honesty.

Just as small children learn by their parents' daily behavior which behaviors are acceptable, TBI survivors learn from those around them. This is not the conscious, planned teaching of ADL skills, the written goals for relearning lost skills. It is the subtle ways we relate to each other and behave, the social skills that seem unimportant in relation to the more debilitating deficits of memory loss, speech impairment, physical limitations. It is part of regaining a sense of self-respect and self-regard and it comes from being treated with respect and kindness. It is part of rebuilding trust in the world around us.

Years ago Hiam Ginott wrote a book called "Between Parent and Child." He describes a scene in which a child has spilled something on the coffee table and rug, perhaps an ashtray or a drink. The mother comes into the room, sees the mess, and berates the child, calling him clumsy, sloppy and other such derogatory names. Ginott then describes a similar scene, but this time it is Aunt Harriet who has made the mess. The mother's reaction is to say that it's no problem, easily cleared up, don't give it another thought. The mother cleans the mess up cheerfully. What a difference! And how different the child and Aunt Harriet feel!

A quick glance through the literature on TBI shows that caring for TBI survivors can be difficult for the caregivers, whether they are relatives or paid workers. There is lots of useful information and advice, quick tips and lengthy articles. Notable in its absence, though, is the importance of teaching the intangibles of trust and self-regard by example. Consistently treating another person with respect, with basic politeness, eventually pays off even though it may not appear to be having any immediate effect. We feel better about ourselves and the other person feels better about himself and about the people around him. Say please and thank you, knock on his door before you go in, ask him to do something instead of ordering him to do it, wait for him to respond giving plenty of time for him to process the information. In essence you are saying, "You are a worthwhile person. You can count on me, you can trust me, to treat you as a person who deserves respect." This is not always easy, sometimes it's impossible. Just as we, as caregivers, encourage the TBI survivor to try again after a set-back or "failure," we too can try again after saying "the wrong thing," being impatient, perhaps being rude. We can apologize and move on. The positive things that we do and say have a cumulative effect and, with time, will help rebuild a sense of trust, a necessary component of a healthy life.

Revised: Saturday, February 23, 2002 08:42 AM