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An Insider’s Guide to Understanding the Iraq & Afghanistan Veteran’s Fight To Recover from Brain Injury/PTSD/Depression BY JULIEN MODICA, MPH, MPP Book Proposal The Jeff Herman Agency P.O. Box 1522, 9 South Street Stockbridge, MA Telephone: 413-298-8188

Brain injury is the signature wound of the Iraq and Afghanistan wars. The words, ”signature wound” sound important and for thousands of veterans now affected with this disease recovery will forever be part of their lives. Their brain, the essence of human life, has been attacked. Starting with the Vietnam War, soldiers now survive injuries where death was once a near certainty. But growing evidence shows that survival will be the easiest part of their struggle. In fact, without new laws and appropriate public policy full recovery for many veterans is just unattainable. Like Julien Modica’s personal recovery story, which shows that veterans of brain injury can take charge of their own rehabilitation and life, Absolutely Screwed…, will show all Americans the need to understand the currently recognized gap in long term rehabilitative care that veterans with traumatic brain injury (TBI) are receiving, and that the quality of veteran care relies solely on internal Veteran Administration studies or committees, without the benefit of independent research shown to help integrate survivors of brain injury into their community. The author, Julien Modica, MPH, MPP, is a rare example of full physical, cognitive, and emotional recovery from severe brain injury (GCS<4) with experience drawn from hundreds of personal anecdotes that taught him that there is much more to brain injury rehabilitation than therapy and support groups. Julien Modica identifies three public policy problems:  The introduction of a fidelity standard regarding the relationship between a guardian and a veteran who is neurologically incapacitated. This standard must provide a Clear and Convincing Evidence standard for what is necessary to be a guardian of veterans with neurological injury. Guardianship responsibilities are defined as a person lawfully invested with the power and charged with the duty, of taking care of a veteran with neurological injury and/or mental health needs and with managing the property and rights of that person, who is, by reason of neurological injury and mental health needs, considered incapable of administering their own affairs. A guardianship establishes a legal relationship between a veteran with neurological injury and/or mental health needs and an adult. A guardian relationship does not deny a veteran with neurological injury and/or mental health needs an "absolute and unconditional" right to be represented by an attorney, and as such, has the right to expect the attorney to act as an advocate and not a guardian ad litem. Community reintegration to a veteran with neurological injury and mental health needs has long term affects. Employment is one criterion used to determine reintegration success. To accomplish this, programs are needed that develop a relationship between government agencies, independent organizations serving U.S. veterans, corporate America, and veterans suffering from acute neurological injury, post traumatic stress disorder, and/or depression. These programs will be putting veterans into “real environments” in which they will fail the first, second, third, and possibly a fourth time. But veterans have to go through this trial and error process in order to find success. Public policy must be written so as to minimize the long term legal effect of these failures.



To address the mental health needs of returning veterans, the VA has established Returning Veteran teams in 90 sites that work with Vet Centers to conduct outreach in the community and “in-reach” to facilitate the identification of mental health conditions in primary care; educate veterans and family members; and provide services in a context specific to new veterans. VA has implemented screening for depression, Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), and problem drinking, with follow-up for positive screens to determine whether care is needed. The Initiative has been driven by two high priority needs: responding to the mental health needs of returning OIF/OEF veterans and implementing the VHA Comprehensive Mental Health Strategic Plan. Veterans still, after all this, commit suicide at an alarming rate. When medicine has run its course and there are no more options, public policy plays a critical role. A Rehabilitation/Diagnostic Center of last resort has to be built to satisfy this role.

It is Julien Modica’s aim in this book to show readers what it takes to have an exceptional recovery, empowering them to take responsibility for their own or their loved ones rehabilitation and well being. Although Mr. Modica acknowledges the importance of physical and occupational therapy, emotional counseling, and a healthy lifestyle - the standard staples of brain injury rehabilitation – he stresses that there is an even deeper level of human and community public policy experience that is necessary in order to achieve full recovery. Unlike other books on brain injury, Absolutely Screwed…, does not prescribe a casual approach to physical or cognitive rehabilitation for anyone who wants to recover. Instead it takes an aggressive approach, urging veterans to create a trial and error approach by employing unequivocal self confidence in combination with a community ready to lend a hand when all things have “gone-a-rye.” While seemingly revolutionary, Julien Modica’s message is simple: You can do much more to enhance the recovery process than you think you can. This is true whether you are an elected official or community leader, if you are a loved one or if you are a veteran who suffers the affect of brain injury.

Absolutely Screwed… could not be more timely. Each year the number of U.S. veterans with brain injury increases as soldiers returning from America’s most recent wars come home. However, as the survivors are welcomed home after pursuing a dutiful career serving their country, a new generation of men and women suffering from mild- to severe- brain injuries, TBI, are greeted with decreasing medical budgets, inadequate public policy and flawed TBI methodologies, which don’t provide the necessary services and therapies to recover from their newly developed disabilities. While the precise facts may not be familiar to most Americans, the awareness of increased suicide and of increased TBI/Post Traumatic Stress Disorder/Depression among returning U.S. soldiers receives constant media coverage. The awareness of the need for a healthy military, coupled with a widespread loss of faith in the Veterans Administration among affected veterans and fear of ineffective public policy, combine to produce a market that is ready for a book emphasizing the community component in healing, especially in reference to brain injury.

COMPETITION: Most authors approach the subject from the physician’s or neuropsychologist’s point of view, urging veterans to follow their particular approach to attain a full recovery. There is little emphasis by these authors on the patient’s or community’s own responsibility for wellness or the public policy changes that must be made for any rehabilitative path to work. Among the best known recent books: Courage After Fire: Coping Strategies for Troops, by Keith Armstrong, Dr. Suzanne Best, Dr. Paula Domenici (Ulysses Press 2006). Although this book, like most others, advocates for these well deserving young men and women, it provides little insight regarding the rehabilitative path necessary to attain any level of recovery. Without changes in individual thinking and level of community support, readers of this and similar books will find it difficult, if not impossible, to follow what will seem to be a never ending life of recovery. In War and the Soul: Healing Our Nations Veterans from Post-Traumatic Stress Disorder (Quest Books, 2005), Edward Tick addresses the idea of disorder identity caused by PTSD. While important, the book emphasizes only one manifestation of PTSD and does not empower readers with the tools needed to combat that disease. After the War Zone: A Practical Guide for Returning Troops and their Families, by Matthew J. Friedman, Ph.D. and Laurie B. Slone, Ph.D. (Da Capo Press, 2008), describes how many service members and loved ones are not prepared for the rollercoaster of changes brought on by both deployment and return, while providing practical usable advice to transition home. While these are important points, the treatment of brain injury must encompass other approaches as well. The author also fails to provide sufficient motivation for behavioral changes in the readers. The best book on understanding and recovering from brain injury is Lynn K. Hall’s Counseling Military Families – What Mental Health Professionals Need to Know (Taylor & Francis Group, 2008). This highly successful book describes the difficult and unpredictable lives of the military family. The importance of this approach is questionable, but remains by far the best on the market; unfortunately, the material is presented in a dense, academic style not easily accessible to the lay reader. It also focuses on Dr. Hall’s counseling work as the only way to manage grief, loss, and change, excluding other more balanced approaches.

Absolutely Screwed… will be a 60,000- to 70,000-word book targeted to U.S. veterans and loved ones as well as military-conscious Americans. Unlike other books on veteran mental health, it will focus on the “facts of the connection between recovery and community as it relates to neurological disease, showing readers how to use that connection to heal the brain.” The book will be written in a narrative nonfiction style, in Julien Modica’s voice, in order to capture the emotional intensity of recovery. It will begin with a discussion of brain injury and show how traditional medicine fails to prevent or cure it. Subsequent chapters will deal with the recoverycommunity connection, and the role in healing of community support systems, self-esteem, and

faith. In order to help veterans begin the path of recovery, Julien Modica shows how they can create their own “daily regimen” that combines physical therapy, cardiovascular training, and use of positive imagery. Throughout the book, he will present personal anecdotes that demonstrate how he has overcome his physical, cognitive, and emotional disabilities to lead a healthy and productive life. In addition to a thorough discussion of the outcomes of brain injury, the book will include tests and checklists that readers may use to gauge progress, and exercises, ranging from the very intense to the very plain repetition of physical movement, that strengthen the body and help heal the brain. At the end of each chapter readers will be introduced to a rehabilitative/public policy “Summary” that will enable them to put the advice of the chapter into immediate practice. Through example and encouragement Absolutely Screwed… will offer veterans a variety of strategies for coping with brain injury, to be taken at once or used in combination. Above all an accessible, practical narration, Absolutely Screwed… will present readers with a workable outline for creating an environment to recover and the self-confidence to overcome the many obstacles they face.

Julien Modica, MPH, MPP is a nationally renown survivor of brain injury with more than thirty years’ experience in rehabilitation, public policy research, and advocacy. A pioneer of aggressive applications of individualized physical therapy and conditioning, a NIDRR TBI Model System Grant Advisory Board Member at Medical College of Virginia, developer of numerous brain injury meetings/conferences/seminars, Julien Modica has long advocated the need for new dimensions of awareness in health and the healing arts. As a former President & CEO of The JMA Foundation, Inc., his open acknowledgement of individual responsibility as the core of brain rehabilitation puts him on the cutting edge of those in traditional medicine who are beginning to create the medical arts practices of the future. Julien Modica has been a speaker at conferences throughout the United States, as well as London England. His firm, Julien Modica’s PAC for Veteran Health Care, is dedicated to the rehabilitation of veterans with brain injury through the development of human potential and the creation of public policy that enhances the rehabilitative environment. Julien Modica is the founder of the Recovery Center, a 250 bed diagnostic center for veterans, being built in New Kent, Virginia. The successful recovery he has made in his own life prove he is a man not only of vision and deeds, but an author whose beliefs spring from the truths of daily living. RESUME:

by JULIEN MODICA, MPH, MPP Chapter Outline Contents Chapter One YOU AND YOUR BRAIN Traditional medicine doesn’t and can’t “cure” brain damage. The rate of full recovery after brain injury is nearly zero percent, while successful rehabilitation only mitigates the problems, but does not cure it. The author proposes a new way of looking at brain injury, one in which veterans and the community becomes responsible for the care and well-being of veterans of brain injury, in partnership with their respective physicians. Following a brief, understandable discussion of the physiology of neurological disease and brain injury, further topics covered in this chapter include: Brain injury is a shutting down of your body. Many of us go through life never wondering how our bodies move, completely unaware until a crisis occurs. The brain talks to us and it is up to us to listen and try to understand the messages. The brain is the center of the nervous system containing roughly 100 billion neurons linked up to 10,000 synaptic connections each. A disruption in any of the neurons or synaptic connections will have a cataclysmic effect. This section explores the effect of brain injury as a lost “learning experience” we have to relearn, what relearning may mean, and what we can do to enhance the relearning process. Why medical tests and treatments are not enough. You, the veteran, and the community are ultimately responsible for recovery. Placing all faith in a doctor or therapist is a way of abdicating that responsibility. The physician/therapist is not a healer; rather, he or she sets the stage for the veteran’s own rehabilitation to heal itself. Brain injury is an extraction of knowledge from the body’s systems. Medical procedures can help temporarily, but the real solution lies in the veteran’s becoming aware of their loss and relearning it. This can take years, even decades to accomplish, but Julien Modica is proof it can be done. Getting the best (while avoiding the worst) of modern medicine. In the author’s view, the most important aspect of medicine is the veteran/physician relationship. Unfortunately, this relationship is often cold, superficial, professional. The veteran goes into the medical pipeline, endures a number of tests, then comes out the other end with a diagnosis, which is a scarlet letter he or she is destined to carry for life. This view of brain injury ignores the veteran as the main character in the healing process. Veterans are advised to work with the medical team to learn what spasticity, Babinski, muscle tone, aphasia, PTSD, depression, etc, etc all mean. They are further advised how to enlist a team of support people to increase their own knowledge of brain injury and learn the neurological self-healing mechanisms within.

How to assess your medical team. Ten questions a veteran needs to ask in order to increase the likelihood the expected outcome will be achieved. Taking charge of your own medical care. Rather than being passive, veterans are urged to directly confront their disability and the reasons for it, asking themselves: How can I find a cause at the deepest level? What have I learned about my disability? What have I learned about myself? Exceptional veterans with brain injury don’t allow themselves to be overwhelmed by their disability; rather, they are convinced it is a temporary problem, most of the time selflimited, and that they have a power within to overcome it. Seven keys to a successful recovery. Whether presently healthy or already suffering the affects of brain injury, there is a great deal veterans can do to improve and maintain the health of their brains. The most important component of such a plan is to have a commitment to a healthy brain. The author offers the following seven keys to a healthy brain: respect your body; take time to relax every day; accept, respect, and appreciate yourself; share your deepest feelings; establish life goals; nourish your spiritual self; love yourself unconditionally. Each of these aspects of brain care will be examined in detail in later chapters. Brainskill #1: Learning to evaluate your own recovery. Physical quickness is a wave of neurons sent from the brain; physical quickness therefore provides important information about brain function. The easiest way to measure quickness is by running: start slowly and gradually increase speed and duration until you reach a plateau. Start again; do this repeatedly until quickness and endurance are no longer a concern. Constantly be aware of how your body moves the closer you get to each plateau. Exaggerate your physical movements to avoid getting sloppy and to increase body strength. This exercise will include charts so that veterans can track and learn their own stage of recovery for each type of therapy and be alerted to irregularities and changes that may require a different therapeutic approach. Chapter Two YOUR BRAIN AND THE COMMUNITY This chapter begins to explore the connection between brain injury recovery and community as it relates to neurological disease. Early in the chapter readers will learn about the three stages of Julien’s life and his crushing diagnoses. These include the pre-Julien, who at the age of 16 was a very successful student, Virginia state champion pole vaulter, and Herndon High School varsity quarterback. Julien had already decided he wanted to attend the U.S. Naval Academy. In fact, weeks before his brain injury, Julien had accepted an athletic scholarship to attend Episcopal High School in Alexandria, Virginia. This decision and the reasons surrounding it are at the core of Julien’s entire life, post-brain injury, and why appropriate public policy crafted to protect veterans from loved ones may be their only hope of survival. Julien’s-injury, which was a combination of gross negligence on the part of the Fairfax County School Board; the inability of an American community to intercede when family decisions are being made that have long-term negative effects; and personal injury statutes unable to protect the rights of brain injury survivors over an extended period of time. The post-Julien, who for thirty years has fought the practice of medicine and law through an epidemiological study that evaluates the conditions that contribute

to full recovery from brain injury and the Neurological Injury Protection Act of 2005 legislation that denies guardians the ability to negatively control veterans without severe consequences. The techniques that have allowed Julien to survive and recover will be discussed in the context of the brain injury recovery-community connection. How the brain injury community views brain injury: Recovery v. Community. Traditional medicine views the potential for brain injury recovery (physical therapy, occupational therapy, speech therapy, pre-morbid personality, age, physical health, family) as indicators of the likelihood of full recovery. In contrast, the author presents this view of rehabilitation as parts of an underlying problem, and discusses ways to change them. Physical, occupational, and speech therapy, for example, are not answers to the problem, which is, rather, neuronal regeneration and community reintegration. Physical, occupational, and speech therapy are just outlets that the veteran uses to minimize the effects of brain injury, which he or she believes are unfixable. Likewise pre-morbid personality, which is viewed by the medical establishment as a predictor of morbidity or quality of life post brain injury is also affected by the location of brain injury. (In any group of brain injury survivors, location of injury separates the mild, moderate, and severe disabilities, even if the trauma is severe.) Other elements besides the traditional view of recovery potential, such as tenacity, have shown to be instrumental in the recovery process. A veteran/family model of brain injury. It is not uncommon to hear stories like this: They were a very happy couple, newly married and pregnant. Then, the husband is brain injured by an IUD in Iraq. The wife, who is still very young, has no previous experience with brain injury and wants out of the marriage one year later. All too often there is a very close relationship between the effects of brain injury and divorce. Likewise veterans may often become dependent on family members and destroy the family bond. The other side of the coin is the innumerable veterans who use a variety of techniques to enlist the veteran-family connection in helping to overcome and even recover from the serious effects of brain injury. Rethinking your negative beliefs about brain injury. The first step in using the mind to help to heal the body is to imagine how movement/behavior occurred before neurological injury then recreate that movement/behavior repeatedly. Accomplished athletes have mastered this technique. Gymnasts, springboard divers, and pole-vaulters use this technique to master their respective events before they leave the ground. A negative and incorrect belief is that the possibilities for recovery are limited. The author asserts that these beliefs are untrue and that for veterans willing to learn from the experience, brain injury can be a path to self-improvement and growth. The healing personality: tapping into your body’s healing powers. Although the notion of a “recovering personality” may sound contradictory, the power of brain injury recovery is awareness, which can be achieved by anyone. The author describes his own discovery of spirituality through his full recovery and the realization that ultimately the origin of recovery is in the mind. This is why treating brain injury with medicine and surgery alone does not heal: because these methods ignore both the natural powers of the body/mind and the importance of community. How does one develop a “recovering personality?” The starting point is awareness of the spiritual power within. As the author states, in order to recover, one must become spiritual.

Writing your own script for a healthy brain. Before writing any script, one must set the stage, and in this case veterans are urged to see a neurologist or physiatrist and have a thorough checkup. This checkup will evaluate the extent of recovery and assess the health of other body organs as well. Once the scene is set, it is time to add in the other elements of a healthy brain, all of which will be explored in detail in the coming chapters. Making a contract with your brain We see obstacles only when we lose sight of our goals. How to make (either mentally or on paper) a contract with ones brain that promises to take care of the brain. Each individual veteran’s contract will be somewhat different; for example, someone who has left-sided hemiparesis might include in the contract the desire that in six months she would be able to walk so much. The point is to set realistic, achievable goals. Guidelines are provided for breaking larger goals down into small, easily achievable, steps. Creating goals for the future makes them a part of the present in the sense that it is today that we start pursuing them. What to do when you are overwhelmed. In the view of the author, the greatest reason for failure in rehabilitation is believing that recovery is not possible. These beliefs, which will go on all the time without our being aware of them, often include such thoughts as “Where are all my friends?” “Oh, no, you can’t be a quitter.” When we put ourselves down, we reinforce feelings of unworthiness and inadequacy, which leads to stress and illness. Guidelines are given for replacing such negative thoughts with more positive beliefs, including messages of love and healing. Brainskill #2: Sending healing energy to your brain. In this exercise, readers learn a simple visualization technique that will teach them how to get in touch with their natural healing powers and begin to heal their brain. Chapter Three THE FRIENDSHIP FACTOR: PLUGGING INTO YOUR SOCIAL SUPPORT SYSTEM Brain injury is not an isolated event, and the veteran with brain injury is not an isolated human being. Among the less medically obvious “causes for failure” involved in brain injury rehabilitation are social isolation. In this chapter the author discusses the importance of maintaining and strengthening all the social support aspects of the veteran’s life, including family, friendship, community, and sex. He shows how intimacy and connection can be used not just for comfort but also as actual healing tools. Sexual intimacy: the healing touch. Following brain injury, many veterans may lose confidence due to a loss of attractiveness or physical function. Citing recent studies, the author points out that there is a difference between making sex and making love. The desire for sex is a human need and is not limited to healthy people. Anybody who has had a brain injury still has sexual needs and ignoring them may be an unwanted cause of stress. Guidelines for when and how to resume sexual activity are offered. Other topics covered in this chapter include:

Keeping your loved ones healthy, and letting them keep you healthy How you may be unwittingly pushing others out of your life The art of nondefensive, nonreactive communication Accepting your loved ones’ feelings and your own How to enlist the support of family and friends Joining or starting your own support group Brainskill #3: Mapping your social support system

Chapter 4 CLEARING YOUR MIND: LEARNING TO MAKE FRIENDS WITH YOURSELF In addition to enlisting the support of others, for complete recovery it is necessary for the veteran to literally become a friend to himself and herself. This may entail changing old ways of thinking and responding, as well as developing new, healthier ways of relating to time and other external stresses. In this chapter the author explores Type A behavior, as well as proven techniques for dealing with life’s daily hassles and upsets. An important section of the chapter shows veterans how to love and cherish the “inner child,” that part of the personality that needs to be loved, to be acknowledged, and to have fun. Equally important is the guilt that each of us carries within, and that can lead not only to unhealthy behaviors but also to actual stress. The author gives exercises for learning to discover and absolve the hidden guilts that keep each of us from realizing our true healthy potential. Topics included in this chapter include: A positive approach to negative emotions The pros/cons of Type A behavior: a self test Being assertive without being angry Keeping your balance in the face of daily hassles and major setbacks Making a friend of time Letting go of hurts, regrets, resentments, and guilt Forgiving yourself and making a new start The trusting mind Brainskill #4: Forgiveness exercise Chapter 5 IDENTIFYING AND ELIMINATING OBSTACLES TO RECOVERY The science of neuronal regeneration is beginning to prove that new neuronal pathways are not only possible, but also universal. It has been demonstrated that improvement in the neural tract often precede greater function. Lab studies have shown that after diffuse axonal injury neurons can spontaneously adapt and recover by sprouting some of the remaining healthy fibers of the

neuron into the spaces once occupied by the degenerated axon. For veterans with brain injury, the fact the injury itself exists can become an inner stress factor that may hinder the recovery and worsen quality of life. Very few healthy veterans are blessed “physically and emotionally” to recover; they lack sufficient knowledge of the brain injury recovery process, they lack the patience, and the community support. In this chapter the author shows readers how to change obstacles into supporters, friends that aid in the recovery process. Included are guidelines to the four keys for advancing recovery: conditioning, repetition, attitude, and self-discipline. Why do you feel so overwhelmed Where do physical limitations come from and how do they effect your recovery Your recovery status checklist Staying in control Calculating your physical-exertion level at home and during exercise Recovery management Brainskill #5 Mapping your recovery hotspots Chapter 6 THE INSIDER AND COMMUNITY As the author points out, there are few studies in the field of brain injury recovery that use the survivor of brain injury as a credible resource, because physicians, like most scientists, shy away from what is called “soft data.” Soft data are anything outside the realm of physics, mathematics, etc.: “exact sciences.” As a survivor of brain injury, the author has grown ever more convinced of the body’s natural healing power, which is evoked from within and through spirit. No matter how “spirit” is defined, whether in traditional religious terms or as a component of personality, the truth is that in order to become healthy, it is necessary to become spiritual. In the author’s 33-year personal study in and around Fairfax Hospital in Fairfax, Virginia, he has proven that a loving community in addition to standard medical treatment provides the necessary environment to recovery more so than receiving medical treatment alone. The author encountered fewer problems with the public policy’s, courts, individuals and had a significantly higher level of recovery. This chapter explores the possible reasons for this startling result and illuminates the connection between community and recovery. The difference between spirituality and religion. A discussion of the differences between traditional views of spirituality and the new holistic approach that sees mind, body, and spirit as intimately connected and interdependent. The insider and brain injury. The healing personality is that of a person who takes care of is own body. He may also use such other “paramedical” means to get well as physical exercise, a proper diet, prayer, meditation, positive affirmations, and visualization techniques. The author surveys the techniques he used for 33 years that contribute to his full recovery. Other topics exploring the connection between the insider and community include:

Tapping into your personal mythology Forgiving yourself for brain injury Keeping a recovery-spiritual journal Brainskill #6: Consulting your inner adviser Chapter 7 PUTTING IT ALL TOGETHER: HOW TO DEVELOP YOUR OWN DAILY ROUTINE FOR A FULL RECOVERY Daily Routine as defined by the author is a personalized program in which veterans will choose from among the techniques offered in the book to create their own unique combination of physical, cognitive, and emotional healing exercises. Each component of the daily routine is fully explained. The techniques range from the familiar – healthful diet and exercise – to the more spiritual, including prayer, meditation, and visualization. Included are examples of use of each of these techniques as practiced by the author. The benefits of a daily routine Meditation: how to do it your way Stretching, strengthening, and sensory awareness Hearing with the mind’s ear, seeing with the minds eye The psychological benefits of exercise Healthy eating as a meditative practice The healing powers of silent prayer Creating your own visualization exercises Creating your own guided-imagery tapes Using other types of positive imagery Brainskill #7: Picking a routine that makes sense to you Chapter 8 LEARNING TO SMELL THE FLOWERS In our society, pleasure is often regarded as a selfish pursuit. We tend to feel that it is not as important as work. And yet the key element in brain injury is not pleasure, or satisfaction, or accomplishment; instead it is a narcissistic ability to regain function and to fully recover. Indeed, this ability has been proven to enable rehabilitation. In this chapter the author focuses on the ability to live in the moment, savoring all that human potential has to offer, from the simple physical pleasures of moving your arm to the more profound pleasures of romance and love. Topics covered in this chapter include a discussion of Type A behavior, which can be learned. The secrets of this type of behavior include self-assurance, self-motivation, and the ability to relax in the face of pressures. The author shows how even the most confirmed Type B veteran can, through self-knowledge, change outer-directed goals for inner ones, thus achieving the

physical, cognitive, and emotional recovery benefits of Type A lifestyle. Other topics discussed in this chapter include: Getting the most out of the present moment Taking an inventory of your goals Counting down to full recovery Running paths, strengthening exercises, repetition, tenacity, and endurance Touching; feeding the skin’s hunger for human touch Self as a helping partner Brainskill #8 Building islands of peace into your life Chapter 9 CREATING YOUR FUTURE The brain may be viewed in many different ways: as a high speed computer, as the center of the nervous system, as the “Soul.” The author suggests viewing the brain above all as a learning organ, the center of life, and existence to figuratively fill it with information. A positive result of brain injury is the sudden knowledge that one is not immortal, and the opportunity to plan for a more worthwhile, fulfilling life in the future. In this final chapter Julien Modica, MPH, MPP offers guidelines for setting and achieving goals for health of mind, body, and spirit. For each veteran the goals, and the means to achieve them, will be different. But as the author points out, this is a journey that everyone must take, veterans as well as doctors, veteran organizations as well as communities. No matter how different the paths we choose, we must realize veterans desire a second chance. The Art of Recovery Choosing your own path to recover Goals chosen by other veterans with brain injury Developing specific action steps Reinforcing and rethinking your life goals Finding your own meaning of full recovery Brainskill #9 Helping others to heal their brain Recommended Reading Appendix I FOR FRIENDS AND FAMILY: HOW TO SUPPORT AN EXCEPTIONAL VETERAN WITH TBI/PTSD/DEPRESSION Appendix II ON FINDING OR STARTING A SUPPORT GROUP

Appendix III ABOUT THE NEUROLOGICAL INJURY PROTECTION ACT of 2005 legislation Authors Notes Acknowledgements Index

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