Using the Open Chair Technique

Survivors with brain injuries push themselves to get better.  The staff at TLC see this every day.  Survivors push themselves to walk better.  They push themselves to speak better.  They push themselves to improve their memory.  They push themselves in every aspect of the rehabilitation experience.  But recovery from a serious brain injury can be quite slow.  It is almost always slower than the survivor would like it to be.  Unfortunately, this leads some survivors to talk badly about themselves.  They say things such as “I am a failure because I am not 100% improved” or “I should be much better than I am now.  I am doing poorly in therapy”.  This negative self-talk often leads emotional difficulties such as stress, low mood and sometimes even to depression.

If looked at objectively, this negative self-talk is often due to unrealistic expectations that the survivors have regarding their recoveries.  The survivors may believe that the amount of time necessary to recover is in excess of what they expected, even when the medical research shows that they are progressing at a normal rate.  By expecting faster or better results than is humanly possible, survivors can cause themselves unnecessary frustration.

Interestingly, these same survivors who hold unrealistic expectations of themselves generally do not hold these same expectations of others.  They are often more logical and understanding of other survivors than themselves.  It is common at TLC for the same patients who have unrealistic personal expectations to support realistic expectations in other patients.  They will make supportive statements to other patients such as “Don’t worry and take it slow.  You will get better over time.  You are running a marathon not a sprint.”  When the patients with unrealistic expectations are asked if they believe the advice they are giving to others, they always answer in the affirmative.  They understand that the brain injury recovery process is a slow process which requires lots of work.  They understand it is a long-term process.  But they tell themselves that their personal recovery should be quicker than everyone else, holding themselves up to unfair, often impossible, standards.

One way to manage this negative self-talk is by using the “open chair” technique.  How this technique works is that patients are asked to imagine they are sitting next to themselves and the person in their seat is someone else with the exact same issues and deficits that they have.  The patients are then asked to give this “other person” honest feedback about how the “other person” is doing.  Often, patients find that this leads them to soften their tone and make more supportive personal statements.  Similar to when they are actually talking to other patients, when they address themselves as the “other person”, patients demonstrate more realistic expectations and are less likely to attack themselves.  The “open chair” technique often helps patients treat themselves not only better, but also more fairly and honestly.  By being more fair and honest to themselves, survivors tend to have an improved mood.  And the better the mood that survivors have, the easier it is to go through the rehabilitation process.

Learn about brain injury treatment services at the Transitional Learning Center!  Visit us at: tlcrehab.org

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