This document appears to be a presentation on trauma, rehabilitation, and recovery from brain injury. It discusses topics such as pain research, the body-mind connection, neuroplasticity, depression, identity reconstruction, and harnessing one's power after trauma. The presentation provides an overview of the speaker's personal journey of recovery from a brain injury caused by an addiction to OxyContin. It also describes the services offered by Northern Lights Canada and their national vocational rehabilitation consortium, Voc Rehab Canada.

1. Val Lougheed
Northern Lights Canada
1-800-361-4642
www.northernlightscanada.ca
vlougheed@northernlightscanada.ca
Trauma, Rehab, and
Recovery
Harnessing the Power
after Brian Injury
~ Keep Your Fork ~

2. “You don’t want your
impairments to define
you – you want them
to inform you.”
(Hanita Dagan, personal communication, 2005)

3. Agenda
• Beginning …
• Middle …
• End …

4. Harnessing Our Power
1. What does it mean to recover
and return to work?
2. Why can some people return to
work and others can’t?
3. What can I do to facilitate
recovery and a return to work?

5. Rated PG-113
People Strongly Cautioned!
May contain bad language, brief nudity,
sexual overtones, and drug usage.

10. Sept. 9, 2003 - morning

11. Sept. 9 – p.m.

12. Sept. 15 2003 – Jan. 19 2004
Journey Back to Life

17. Research

18. Dominant Themes
• Narcotic Pain Killers
• ABI
• Pain
• Trauma
• Depression
• Methods of Helping
• Return to Work
• Life

19. Foundation for
Understanding
Experience

20. Body-Mind Connection
Psychoimmunoendocrine
Network
 The nervous, endocrine, and immune
systems are functionally integrated –
the brain is only one part of this non-
hierarchical network
 Memories, emotions, behaviours and
physiology are all connected at the
molecular level
(Candace Pert, 1997, p. 171 – 179)

21. February 2004 – Present
Starting Point

22. Identity Disintegration
and
The Re-organization of Self
March 2004

23. “In the aftermath of traumatic
life events … [the] sense of self
has been shattered.”
(Herman, 1992, p. 61)
“An existential crisis …”
(Hanita Dagan, personal communication, 2005)

24. OxyContin™ Research
Early 1900’s Oxycodone™ developed in Germany
1995 Purdue Pharmacy (USA) launches
OxyContin™ – controlled-release
formula
1996 Approved in Canada
2002 OxyContin™ earns Purdue more than
$1 billion U.S.
2003 OxyContin™ is one of Canada’s 3
most-prescribed narcotic painkillers
Nov. 2003 –
Oct. 2004
783,762 prescriptions for OxyContin™
dispensed in Canada
(Dalhousie, March 2005)

25. A Foothold
• Mild – moderate ABI
• Depressed (dysphoria)
• Working memory problems
• Hiding pain
1st
Neuropsychological Assessment
June 2004 -- Results

26. ABI – Measuring Loss
“Pre-morbid intelligence is a crucial variable …”
Subjective Report – difficulty retrieving words and communicating ideas
Objective Report – above-average performance on neuropsychological measures
(Prigatano, 1999, p. 59)

27. Losing My Grip
My IWRP
August 2004

29. Rescued in the Valley of
Despair
Head Injury Program
Oct. – Dec. 2004

31. GO TO WORK

32. GRTW – The Plan
Jan. 3 – Feb. 7, 2005
(5 weeks)

33. GRTW – The Reality

34. GRTW – The Reality

35. GRTW – The Reality

36. GRTW – The Reality

37. GRTW – The Reality

38. GRTW – The Reality

39. GRTW – The Reality

40. GRTW – The Reality

41. GRTW – The Reality

42. Rescue Attempts
• Case Manager
• Job Coach
• Colleagues/Friends/
Psychologist

43. Sliding Back Down
Into The Abyss
• Non-compliance
• Malingering
• Trying too hard
• Not trying hard enough
2nd
Neuropsychological Assessment
May 2005 -- Edmonton

44. Test Results
• Mild to Moderate ABI
• Pain?
• Depression?
• Motivation?
• “a high flyer”
• “phobic avoidance”
• Future plans – “live off dividends”
[from company]

45. Lesson
ASSUMPTION
S
REVEAL BIAS

46. • Mild – moderate ABI
• Good prognosis
• Post-Traumatic amnesia
• Pain?
• Depression?
• “Adjustment Disorder with
Anxiety and Depressed Mood”
3rd Neuropsychological
Assessment
August 2005 -- Calgary

47. Symptom Overlap
(co-morbidity)
(Michael Sullivan, Centre for Research on Pain and
Disability, McGill University, September, 2006)
Pain, Trauma, Depression,
ABI

49. Oct. 3 – Dec. 11

51. Pain Research
1600’s – Rene Descartes (philosopher)

52. Pain Research
1950’s – Wilder Penfield (brain surgeon)

54. Pain Research
Patrick Wall (physiologist)
Ronald Melzack (psychologist)

55. Pain Research
Gate Control Theory
• Acute and chronic pain
• Pain sensation travels up the central nervous system to the
brain through a “gate”
• “Gate” – triggered by cell changes – sends descending
messages that alter sensory input
• Pain isn’t pain until it reaches the brain
• Emotions, context, etc. affect pain sensations
• Pain is a negotiable, individual experience
• Pain centres in the brain – they just keep moving around
(Jackson, 2002, p. 21)

60. Limbic System
The centre for emotional expression
(Prigatano, 1999, p. 132)
• Amygdala - attaches emotional tags to memories
(Dr. Suffield, personal communication, 2004)
• Hippocampus - controls the laying down of new
memories
(Ramachandran & Blakeslee, 1998, p. 15)
• Hypothalamus – controls the outward expression of
emotions
(Ramachandran & Blakeslee, 1998, p. 177)
Trauma Research

61. “In every encounter, basic trust is in
question.” ( Herman, 1992, p. 92)
“Survivors feel unsafe in their bodies
– and in any relationship with other
people.” (Herman, 1992, p. 160)
Rehab & Recovery

62. Trauma
Personal Experience
• Dissociation & Cocoon = Safety
• System on High Alert Always =
Survival
• World is black & white = Trust
Trust (Safety) = Love
No Trust (Life Threatening) = Hate

63. Trauma
Personal Experience
• Listen to me
• Understand me
• Respect me
• Are competent
I trust (love, feel safe with, will
try hard for) practitioners who:

66. “… depression [caused by
trauma] is not the same as
ordinary depression.”
( Herman, 1992, p. 118)
Depression

67. “Emotions are not in the
head – they are in every
cell in the body.”
(Pert (1995), in Bolen, 1996, p. 7)
Pscyhoimmunoendocrine
Network

70. Affects more than IQ ….
• We are sensitive to changes in higher
cerebral functioning
• Very important to a person’s sense of
self
• Touches core … of a person’s self-
esteem
(Prigatano, 1999, p. 58)
ABI

71. Back to Wilder Penfield – 1950’s
ABI
Localizationist

72. Paul Bach-y-Rita – 1934 – 2006
Scientist and Rehab Doctor
Neuroplasticity - 1969

73. Michael Merzenich
Neuroplastician
Neuroplasticity

74. Harnessing the
Power

76. “The words and attitudes of
others … are potent. They help
or hex healing and recovery.”
“ Expectations are powerful.”
“Neutrality can be deadly.”
(Bolen, 1996, p. 94)
Body-Mind Connection

77. • Hypothalamus
• Peptides
• Receptors
• Biochemical
Events

79. Quantum Connection
“There is something essential about the Now which
is just outside the realm of science.” Albert Einstein,
1963, in Oschman,
2003, p. 43
The Living Matrix -- 1995
• A type of energy exists that has previously gone
unnoticed.
• Cells/DNA influence matter through this form of
energy.
• DNA Phantom effect. Braden, 2007,
p. 45

80. “Loss of identity can evoke a
personal crisis, creating a need
for change.”
(Ornelas, in Smith & Johnson (Eds), 1997, p. 172)
The Re-Organization of
Self
Identity Research

81. Scaling the Canyon

82. Sept., 2005
Waskesiu

87. Breast Cancer
Reconstructive Surgery
March 2006

88. Convocation M.Ed. -- June
2006

89. Back in “a” Saddle
September 2007
• Officially change role/
title
• Re-organize NL
• Work part-time

91. Harnessing the Power - 101
Resilience
 Ability to return to original form after
being bent (bounce back)
Thriving in constant change, ability to be:
• Flexible
• Creative
• Adaptable
• Learn from experience
http://www.resiliencycenter.com/articles/5levels.shtml

92. Harnessing the Power --
201
Rehabilitation (habiter – to live
inside)
“Rehabilitation is the learning to live
inside not only one’s body, however
it is after an injury or illness, but
inside one’s very being.”
(Kabat-Zinn, in Meili, 2003, p. 241)

93. Harnessing the Power - 301
Recovery
Curing Focus on the illness/
impairment [outside]
Healing Focus on the person
[inside]
Crombez, October, 2003

94. Be Still

95. Harnessing Our Power
1. What does it mean to recover
and return to work?
2. Why can some people return to
work and others can’t?
3. What can I do to facilitate
recovery and a return to work?

96. Keep Your Fork

97. Northern Lights Canada is a person-centred
organization committed to providing innovative,
responsive links to real work.
We offer 4 major divisions of service:
• Vocational Rehabilitation Services
• Employment Services
• Employer Services
• Corporate Training
For more information, please contact us:
1-800-361-4642
www.northernlightscanada.ca

98. Voc Rehab Canada (VRCAN) is a national consortium of experienced
regional vocational rehabilitation companies. VRCAN provides
customers with single-point access to VR services anywhere they are
needed in Canada, whether on an individual service or contract basis.
Member companies include:
Argus Management Consultants, Inc. Sandra Preeper & Associates
Advantage Rehabilitation Consultants
Ltd.
Rehabilitation Alternatives Limited /
Vocational Alternatives Software
OPTIMA Rehabilitation CVE Inc.
Northern Lights Canada Occupational Rehabilitation Group of
Canada (ORGOC)
Western Rehabilitation Specialists Inc. Diversified Rehabilitation Group
Genesis Rehabilitation Ltd. Rehabilitation Focus
For more information, please feel free to contact us at 1-800-361-4642