Thread: New daughter
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Unread 04-20-2004, 04:56 PM   #241
nexxo
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Join Date: Jul 2002
Location: Brimingham, UK
Posts: 385
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Good to hear your wife continues to make progress. Working memory takes a while to recover, more so because it is dependent on other cognitive variables such as attention/concentration, processing speed and fatigue, all of which are affected in a brain injury.

It is important to know that an injury to the lymbic system (of which basal ganglia are a part) can affect emotional expression as well as the experience of emotion in itself. This means that some people can experience the full range and depth of emotion they always could, but (the largely automatic processes of) expression may be affected. As such they may appear flat and distant, but this is not necessarily a reflection of what they are feeling inside.

Expression of emotion is also associated with "initiation". This is governed largely by the Cingulate Gyrus of the right-hand frontal lobe, which is very near the right-hand thalamic and lymbic system areas. If memory serves me this is where Heather sustained the largest injury.

Initiation should not be confused with motivation, although of course the latter is affected by the former. Initiation is the get-up-and-go impulse we experience when we engage in action, and also affects depth of cognitive processing (i.e. how well and thoroughly we think about things) and emotional expression. Without initiation we become passive, easily led and seem indifferent to things that we once felt strongly about.

This is why I said in the past that Heather feeling tearful and upset was a good thing. As long as she experiences strong feelings, she has a spark in there. Other things that affect emotion and initiation are of course fatigue and energy levels, and self-confidence. Don't underestimate how pummeled by life she must feel, and how insecure and vulnerable. Give her time and encouragement and it will start to come together.
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