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Many people who experience Brain Injury are thrust into an inescapable state of cognitive dissonance by sudden, dramatic changes in their abilities and functioning. Coming from a life that usually did not include disability, people encounter the very same negative beliefs and attitudes that they once held onto. In fact, the battle often takes place within themselves as they face the reality of their functional limitations. This causes terrible pain and must be overcome for the person to live productively in society. Sometimes they fight with all of their might and energy to resist their newfound reality. For most, the striving is in vain.

I cannot count the number of times others have told me that they want to be "normal" again or to have "normal" friends or to have the person they love return to being "normal." This clearly indicates that anything outside of their limited belief of what constitutes normalcy, is abnormal and therefore to be resisted or shunned. It also serves to illuminate the depth to which their attitude is rooted.

Normal is a subjective term that is open for individual interpretation. It masks reality because in many cases, unless a person told you that they bumped their head once upon a time, you would not know. Therefore, in your perception, they might fit into your "normal" category. I play the so-called "normal" card every day of my life. And that qualifies me to write about it. You see, I pass.

Educating people about the reality of cognitive impairment can have a powerful effect upon their ability to accept others with cognitive disabilities. It is the perceptual balance that must be maintained to overcome cognitive dissonance in the minds of all people.

It is still taking me a great deal of energy to overcome the dissonance produced by my thoughts about my writing and knowledge. How can I trust that my fingers can press the right keys to produce words that connect with each other to convey messages that are accurate and relevant to my audience? I’m wrestling with my perceptions about my abilities.

I know this subject from the inside out. I’ve lived it like a terrible episode of the "Twilight Zone" when everything repeats like a broken record and it takes the actors several stops in the town of Sunnyvale to realize that the train they are on is traveling on a circular track. Their ignorance locks them into a pattern of suffering that disempowers them. Not until they realize the underlying cause of their dilemma can they get off the train and deal with reality. There is no way out of Sunnyvale. The railroad does not lead them to happiness and freedom. That reality causes dissonance. However, acceptance brings peace.

I advocate for living life to the fullest. I suggest true acceptance of one’s ability to live and enjoy all that life has to offer within the functional context of their circumstances.

Pure evil can reside in and spread through ignorance. Many societal and cultural barriers restrict a person’s ability to overcome dissonance by suffocating them with language of dis-ability. Over and over again, we hear about what we can’t do. We are shown our shortcomings. We are forced to see everything that is imperfect. Instead of building on our abilities, we are forced to put energy into overcoming our inadequacies and disabilities. Like the circular track in the fictional Sunnyvale example, we keep riding the train of inability, powerlessness, inadequacy, inability, incapacity, and unhappiness. The time comes for us to get off of the train and figure out what it is that we can do and to improve on those things. We do not need to keep buying the tickets the railroaders are selling.

People with disabilities are divided from those without disabilities. People with severe disabilities are separated from those with moderate and mild disabilities. We separate ourselves from others based on categorical labels that have grown out of the medical model garden of disability. Even people who accept and apply these labels to themselves separate themselves from others who have accepted different badges. Many people are taught that they are different and that they will always be different. They buy into this labeling crap and push it on the rest of society. Some have good cause to do this-money. Other do not receive a pay-off. Therefore, in many cases the badge falls off or they take it off.

We are forced to hear others describe us as inferior. We are subjected to subordinate, second-class treatment. Oh, they may not actually use the word ‘inferior.’ Instead, they sugar-coat it in the labels that mask the negative connotations dung that the labels imply. It all smells the same, regardless of how they present it to us.

Unless and until a person experiences disability, they cannot fully understand the reality of the abuses, oppression and civil rights violations that routinely occur to us. Without a first-hand experience of disability, a person must rely on others to express the reality to them. In this way, the majority of people alive on this planet are ignorant of our very real struggle against the odds and the cognitive dissonance it causes.

While my children were busy devising plans to trick me on April 1^st, I thought about how powerful it would be to have everyone that never experienced brain injury wake up one day with the functional limitations of brain injury. Hey, guess what, those of you who never had a brain injury just woke up from a coma! You just stepped up from breathing cadaver status. Unless you get walking and talking soon, that vegetable label will stick and they’ll want to plant you in the ground. Yeah, that sucks, but hey, it’s the luck of the draw. You don’t have a clue what happened. Someone is wiping the slobber from your chin and even though you recognize them, you don’t have a hint of who they are. You’re angry as hell. Everyone is calling you all sorts of names that make absolutely no sense to you. You are full of rage. Your life has just been dumped down the freaking toilet. Yeah, forget about your spouse. School? Huh? Yeah, right! You think you even have a chance of finishing that degree? Forget about it! Everything you ever knew as your life has been wiped clean. Your friends; Do you remember them? They forgot all about you while you were in coma-land on the clean-slate express. Your job has been eliminated by your replacement. You are now a step on the ladder instead of the stepper. Too bad for YOU! You no longer belong to us, you are now one of them.

For people who have experienced brain injury, it is no joke. No one yells APRIL FOOL! Instead, you get to live it day in and day out. You learn vocabulary words that belong in medical dictionaries. You experience humility and humiliation. You get to realize that nothing will ever be the same again. You get to see people leave your life. You get to mourn and grieve the death of your personality and identity, without closure. You get to watch others suffer through the verbal abuses that you throw out of your angry mouth. And you get to see others look at you condescendingly or with fear or abhorrence. You are forced to feel how some hate you for living and imposing upon their model lives. You must repeatedly watch others become repulsed at the sight of you and view you as an abomination. And you get to do this without a training manual. No one hands you a book to study. There is no test at the end. The testing happens every day as your entire life becomes a series of experimental trials and tribulations. Scary, huh? Try living it. Then try doing it without any outward signs. Live it with hidden scars. Would you be compassionate and stick around to help your fellow human beings? Or would you run like the devil was nipping at you backside, to get as far away from them as possible?

The labeling used in our society makes a clear distinction between us and them. No matter whom we and they are. In cases of disability, it often begins with a medical diagnosis. When we look at disability labels and the way that they are used in reference to people, it is clear that the line is drawn. This line separates groups of people from each other. The people who believe they are not disabled separate themselves from those who experience disability. The language employed in the process draws the line, illustrates it, colors it and strengthens it deep in the minds of all people. Maybe this explains why so many people with disabilities use the same type of language to refer to themselves that the medical community and the rest of the population uses. Language is a type of social currency that includes us in the cultural ‘norms’ that work to oppress us.

All people who experience brain injury can be helped through the timely, consistent delivery of services designed to maximize their potential. We can prepare people to battle attitudinal barriers and create more opportunities to aid people to live independently and help them overcome dissonance, thereby reducing stress and improving cognition. This could get the spiral to reverse and have significant positive impact upon the individuals who experience brain injury and the people around them.

Our use of language, whether written or spoken gives us a means to communicate ideas to each other. Everyone knows this. We can prepare people to confront the cultural and societal barriers that restrict their full participation in society by helping them to understand the barriers and the words that erect the barriers in the world. This preparation can reduce the ignorance that masks the evil of prejudice.

Battling to destroy the many prejudices that cause dissonance is hampered by the fact that they continually rise and spread themselves like a thick, putrid, vaporous fog from stagnant attitudes. They’ve become rooted in the human mind by virtue of our nature. We are a competitive breed, living in a competitive world. Corporate America has been built on the ‘Survival of the Fittest’ philosophy. As our economy becomes increasingly global, the competitive tension is rising too. We sing about love while practicing hate. Our practice of stepping on our fellow humans rules supreme while climbing the ladder of success. Bump your head and you become demoted from stepper to step.

Unfortunately, many view their fellow human beings as disposable. This too, is reinforced with language designed to reduce the importance of human life. I believe this attitude is powered by the disposable nature of our materialistic culture. Disposable lighters fuel the flames of our collective throwaway mentality. Millions of unborn children testify to the truth of this reality. And we think we have no consequences for this attitude?

We have grown into a spiritually dead culture. Many people alive today are locked into a live now-die tomorrow philosophy. Selfishness leads to heartless attitudes. We’ve learned to thrive on the latest, newest, greatest consumers’ goods. The old ‘Keep up with the Jones’ philosophy has been replaced with a new one; ‘Outdo the Jones’ in every way possible and at any cost.

Everything has been objectified, including human beings. Objects of our desire become worn out when they no longer meet our needs or pleasure. The purveyors of pornography thrive on this aspect of our behavior. This multi billion-dollar business bares an image of our collective soul. And it’s not a pretty picture.

Objectification and a throwaway attitude make it easy for a spouse to use the words ‘till death do us part’ without meaning literal death. We have removed the actual meaning of death and replaced it with the ‘useful life’ concept of consumer goods. This is fortified with language used to describe people who experience brain injury. We get rid of things when they become soiled or damaged. We discard our possessions when they become inferior by standards that are always changing. And we dump people from our lives when they no longer serve us. We test our pregnant mothers for signs of disability in their unborn children and give them the choice to cull the child if it is less than perfect. After all, it’s all about what’s best for us; right?

We are beginning to embrace the concept of removing people in a persistent coma from our population. The unsung song goes a little like this; Unplug them. What good are they? Why waste precious resources on them? They are no good to us. They are no good to our culture. They are a detriment to our society. They offer little or no return on our investment. But the song is masked in a cloak of caring and ‘quality of life’ attitudes. Usually it is parents’ who cry out for justice in the name of the people whom fate has silenced. However, we never hear from those whom no one advocates for. They are the silent voices that cry out from the grave, begging for an ear.

When my sister Deborah was diagnosed with heart disease at age 18, none of us knew that we would face a grim reality one day. While waiting for a heart transplant at age 42, surgeons installed two external mechanical pumps in place of her failed heart. She was given massive doses of heparin and other blood thinners to reduce the clotting that the pumps were known to cause. This medicine caused a severe hemorrhage in her brain. When the doctor showed us the CT Scan images, I knew at once what the large amount of dark area meant. The kind doctor gently explained to our parents that half of her brain was showing no activity and the other half was operating below 50%. Because of her reduced brain activity, she was removed from the heart transplant list. We had to make a choice-life without chance of recovery or remove life support systems.

This was an agonizing decision. The choice was clear, but our parents didn’t understand. I had to explain that their daughter, the essence of her, the person that they knew, was gone. All that remained was her body being kept alive by mechanical means. To keep her attached to the machines would be torturous and cruel. I cried as I stood with her during her final 45 minutes, as the surgeons eased her passing. Each time her heart rate faded and then rebounded, I felt pain. Cognitive dissonance robbed my peace of mind as I agonized over the decision and my influence on our parents. As her body slowly became grey, I struggled with the moral dilemma. Was this really the right thing to do? As my sister breathed her last breath, I concluded, that it was, for her sake. It is sometimes difficult to let go of our loved ones. In some cases, the choice is clear. We didn’t starve my sister to death by removing a feeding tube. We removed the machines that were postponing the inevitable. I know the difference between life and death. The word ‘meaningful’ has no bearing on reality when applied to the word ‘recovery.’. This is not a matter that I’ve taken lightly.

Our replacement mentality is quickly moving into every aspect of life on earth. When a human being whom we claim to love is traumatically injured, it is easy for many to replace them or walk away. They no longer serve our needs. You know? It is all about us. Our life, our needs, our pleasure. We do it all for ourselves. If we happen to be able to help someone else or bring pleasure to them, then that is Ok too, so long as our needs are met. We have over-developed the selfish gene. Please understand this: I know that many people are not in this camp. Countless spouses and parents dedicate their lives to caring for and loving their mate or children. Yet more often than not, people in our culture willingly dump their ‘loved" ones into the care of people who believe they are underpaid "professionals." Is that where you want to go when it is your turn? Face it, if you live long enough, chances are good that you will find yourself disabled. Hard living and stress exacerbate and accelerate the process.

My ex-wife specified my differences post-injury as her main reason for casting me aside. I’m not complaining, I’m explaining. In the years since I was injured, I’ve met countless people who have been discarded like the daily trash. Story after story has created a definite understanding of this type of behavior in me. Do yourself a favor, don’t send me the, "I care, but. . ." letters, Ok? I know all sides of this issue from the inside out.

This playground world is full of replacements and it is easy for us to find a new unit to replace the defective one. And how do we know if a person has become defective? We label them using terminology that implies insignificance, worthlessness and uselessness. We separate them from us by the differences disability labels cause. And we use this as justification for our disregard.

Pointlessness is offered as reason enough to terminate life. We imply hopelessness and that puts forth just cause to remove life support. Misery, bleakness and despair are alluded to through smart language choices that degrade human life and simplify our choice to end it. The worst part of this is the depth to which it has pervaded our culture. There is a very real line between life and death. Too many people pull the plug unnecessarily.

As a society, we have become selfish, greedy, boastful, and conceited. We view life through self-centered magnifying glasses. We are insulting to people who are different from us and are ungrateful for our abilities and luxuries. We are unkind to some people who experience brain injury and merciless to others. Our violence and fierceness know no bounds. We hate the good; are treacherous, reckless, and swollen with pride. And we love pleasure rather than God. Recently, millions of dollars have been spent in movie theaters to please us with ‘The Passion of The Christ’, yet how many of us are willing to sacrifice a piece of bread for a hungry child or adult? How many of us give anything to anyone for any reason? Oh, sure, we hold to the outward form of our religion, but reject its real power. Otherwise, I’d have nothing to write about here.

Providing a small enough incentive to change our language and beliefs in these well-worn, stench-filled attitudes is difficult. We must be willing to change. Only then can we begin the work of overcoming prejudice. Uprooting prejudice will help us reduce cognitive dissonance. Reducing dissonance will help people live happier and healthier lives post injury.

One useful analogy is racism. In the male dominated struggle between one group of men and others, the racist compensates for his negative self-appraisal by creating an inferior image of others. Language is used to reinforce this position and thereby enable the propaganda and oppression to continue. The racist thrives on thrusting his opinions on others with word choices that incite hatred and disrespect. The racist imposes his insecurity on others via his impositions.

Another analogy we can use is the historical struggle between men and women. Men have rationalized and justified male superiority through physical differentiation and behavioral exhibitions. For many men and women, masculinity is symbolized by external physical characteristics. In this way, a deep voice, being muscular, hairy, and having a large penis are perceived as characteristics of strength. The man who can ‘stand up’ for himself in the face of adversity and one who can dominate others is considered to be strong. A man who cannot stand up for himself to defend his life, his wife and children is perceived to be inferior. The man who exhibits effeminate qualities is shunned by others who are insecure about their own masculinity.

On the other hand, women find approval by exhibiting behaviors and physical characteristics that represent weakness (to men). A caring motherly attitude, high pitched or gentle soft voice, petite figure, shaved legs and lack of muscle mass are considered to be feminine.

For men, externalizing gives life. For women, internalizing gives life. Anything that upsets this changes our perception of the individual. People who become disabled after living life without disability, may find that their changes in ability and function alter their roles in this respect. Brain injury can change an externalizing person into an internalizing person. And the opposite holds true also. Behavioral shifts can cause cognitive dissonance in the individual, the spouse and all other people in their lives.

Brain Injury thrusts people into a category of disability and oftentimes, weakness. They become that which they and others perceive to be negative and inferior. People who once exhibited strength and determination may find that they are less able to do things for themselves. This can cause them to feel humiliated. Coupled with others’ reactions, treatment, language and attitudes, this situation can cause massive dissonance.

What if a bump on the head caused women to lose their breasts, to grow facial hair and deepened their voices? What if TBI caused men to lose all aspects of their masculinity? Would this become a motivation to prevent brain injury? Would we care more? Would we strive to improve safety?

Imagine if you will for a moment, the following scenario:

Wealthy plantation owners who own slaves wake up one day to find that they are now African American or Native American Slaves. They are stripped of their identity, their position, and their wealth. How will they deal with this sudden change into a class category that they hold negative superiority perceptions about?

Most of their spouses would divorce them. They would lose their position in society, their employment, their friends and possibly families. Others would constantly remind them of their changes in appearance, ability and status. Many would use debilitating language when referring to these converts.

This transfer from a position of perceived power and superiority into one of perceived weakness and inferiority would cause massive cognitive dissonance. Left untreated and unresolved this could cause individuals to suffer greatly. Depression might result. Others in society would write about them, talk about them and introduce them with language that was demeaning and humiliating.

Some might become violent and angry. They might make every effort to return to the life they had before the transformation. Most would be unsuccessful.

Others would deny the changes, and attempt to go on living as if nothing had happened. They would meet resistance every step of the way. They would be battled against continuously. Their new ‘disability’ would be forced upon their consciousness at every turn. Those who could pass as non-slaves would be driven to do just that in order to escape the oppression and suffering.

Many of these new slaves might resist the other plantation owners’ attempts to get them to resign themselves to being slaves. The wealthy plantation owners who had not been transformed yet would refuse to hear their pleas and might punish them for attempting to get back. After all, they no longer look like they did. They might sound different. In some cases, their language would become confusing. In worst cases, they might lose all manner of speech. Their behavior might change. They might lose their manners. They may have lost access to their educational background. By virtue of the changes, they might never be able to regain their position in society because society is biased against them. By design, the society they participated in as oppressors would now oppress them.

Now, consider the possibility of wiping all or part of their conscious memory clean. Remove their ability to recall clearly. In the worst cases, they might not even remember who they are or who their loved ones are. They might find themselves void of all knowledge of their personality, family and history.

Some of these converts would lose all sense of whom they were and become as if born over again. Some might have to be taught basic skills like eating, drinking, bathing and dressing.

The most resistant would be labeled ‘troublemakers’, ‘non-compliant’, ‘in denial’, a menace to themselves and others, subhuman, inferior or lazy. Many would be held against their will in housing that was built for them and older slaves that could no longer work. Others would be incarcerated. And many would be killed for their own good and the good of society.

Being on the other side of the coin would cause massive amounts of dissonance. The amount of energy required to fight the ‘‘stacked deck’’ would teach some to give up all hope. They would resign themselves to dealing with the stereotypes, prejudices, attitudes and language barriers. This would make adapting to being a slave a viable option for them. Others might consider suicide as a way out. Some would have well-meaning family members who would keep them in protective custody. Others might ‘pass’ as non-slaves and ignore the plight of their fellow humans.

And still others would fight with everything they had to help free themselves and all other slaves. Each would find ways to accept or reject the new information.

And accepting or rejecting the dissonant cognitions is what it’s all about.

Next Time: Cognitive Dissonance X, Affirmative Action

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