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No Twelve Step Program for Brain Injury Rehabilitation

While we don’t know the details, we certainly know that two of our country’s finest and most famous athletes have made public apologies for sexual interactions with women – Tiger Woods and Ben Roethlisberger. On another of our blogs yesterday, we commented on Roethlisberger’s generic apology.’t-appeal-his-suspension.html If our concern that part of his problem in controlling his behavior is neurobehavioral (being caused by brain damage) then his “necessary improvements” cannot be simplified into some 12 step program.

There is no magic cure for brain injury, no tried and true system that consistently corrects neurobehavior issues, there is no 12 step program. Part of the problem is – depending on how severe the injury or how vulnerable the brain that was injured – there may be brain damage that cannot be repaired. While the old rule that neurons (the operative brain and nerve cell) don’t regrow has notable exceptions, the reality is that once neural connections have been severed, the brain will work differently. When the damage is in the emotional or inhibitory sectors of the brain, that damage materially changes behavior and may leave the injured person with little or no ability to conform his behavior to standards for adult conduct.

The other problem in applying classic addiction therapy to neurobehavior problems is that when rehab does improve function after brain damage, it is a very slow process. A long time friend and the brain injury lawyer I have admired the longest, Dianne Weaver of Florida, says this: “We learn to become adults in our frontal lobes.”

The important part of that statement is not that our manners, our socialization, our adulthood resides in our frontal lobes, but that it takes us from the time we are children, until we are college graduation age, to “learn to become adults.” If we can improve neurobehavior problems, we can’t do it by a six week stay in the Betty Ford clinic.

Here is the reality about brain injury rehabilitation. Some things can’t be fixed. Those that can require long term, hands on guidance, like raising a child. Like with a child, the brain injured survivor may need a human guide to keep them out of trouble, until they relearn the manners, the gray areas of the rules, the judgment to know right from wrong. Unfortunately, normal human maturing is very difficult to duplicate process when it is an adult who must relearn to be an adult.

We grew up under the tutelage of mom and dad, a dozen teachers and numerous friends, each working in concert to make us better persons. Telescoping that generation long process into a finite “in patient” stay is a terribly difficult thing to accomplish.

If Roethlisberger’s behavior problems stem from brain damage, there is one element to his treatment that must be adhered to: no more brain injuries. The effects of brain injury are cumulative and if brain damage has already impacted his ability to inhibit his behavior to this extent, any more damage may wind up with him in a far more unfriendly rehab environment: prison.

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