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Rehabilitation is Relearning


The Habit Retraining Model:

Promoting Rehabilitation Through Incremental Goal Achievement in the Areas of Love, Work & Play

By Mike Martelli, Ph.D.

Although the brain cells present when original learning takes place, and the stored knowledge that sustains important learned habits, can be erased by injury or illness, the ability to re-learn is seldom destroyed. Importantly, human beings are the greatest learning organisms ever to roam the earth. While animals are controlled by instincts, human behavior is driven by complex learning and the establishing of very complex habits. From the time of birth, almost everything that humans do is learned. Everyday functioning becomes increasingly sophisticated through the construction of a complex sequence of complex habits which are built on top of more basic habits. The complex behaviors that make up the average humans everyday behaviors are performed efficiently and automatically because of a hierarchy of habits.

Through converting repeated behaviors into habits, complex behaviors are performed automatically, freeing up concentration, energy and effort for other tasks. However, if even some of the most basic habits are weakened or erased, everyday abilities and routines can be seriously disrupted and efficiency lost. What was once automatic and effortless can require the same effort it took before efficient ways of performing any of the components of daily activities were learned. Fortunately, even if very basic and important learned habits are erased, newly learned habits can be developed as replacements.

Importantly, we know what is required for both learning and relearning. Further, we are discovering that the most important variables relating to how much can be relearned, and how many habits can be replaced, are, in fact, our attitudes and expectancies. These attitudes can either promote and guide re-establishment of new habits, or prevent their development.

If we think we can't learn, if we think only the old learning/ way of knowing how to do things are sufficient, or if we think that only children can or should learn, then we will undermine relearning. Many attitudes can undermine relearning, and these attitudes represent rehabilitation poisons.

The essential ingredients for relearning (or learning) can be summarized as the following 3 P's: (1) Plan; (2) Practice; (3) Promoting attitude.

Importantly, the greatest obstacle to learning or relearning is the redirection of energy away from goal directed activity and toward debilitating activity. Some of the most potent relearning or rehabilitation debilitating attitudes, or poisons, are depression, anger and resentment, feelings of victimization, fear, and inertia. These are the things that take our energy away from relearning and put it somewhere else. Relearning is challenging, but can become impossible in the presence of significant internal obstacles.

In an attempt to summarize the adaptive, facultative, or rehabilitation promoting attitudes characterized by rehabilitation patients who have accomplished remarkable progress despite insurmountable odds, the "Five Commandments of Rehabilitation" has been devised. These commandments serve as a prescription for rehabilitation achievement. These commandments will be published in a future issue of Headways.

Importantly, the envisioning of a progressively more desirable future is the guiding principle, or magnet, that pulls persons to their goals. To the extent that one focuses on the vision of a desirable future, breaks progress down into small, progressive steps, and develops facilitative habits, incremental movement toward desired goals can be expected. Importantly, patterns of interpreting events, and expectancies about how things will turn out, represent predictions of the future. Habitual patterns of expecting failure or dissatisfaction, or mistreatment, and habitual patterns of becoming depressed, or angry, or fearful, etc., are debilitative habits that help drag persons toward failure. In contrast, the single best remedy, or antidote, is a graduated successes, self-esteem habit. This facilitative habit is broken down and presented in the Commandments of Rehabilitation. Making accurate comparisons, learning new ways to do old things, building one self up and employing positive self-coaching, and viewing rehabilitation as a series of small steps each requiring celebration, are some of the important prescriptions offered by "the commandments".

The antidotes included in the "Five Commandments of Rehabilitation" are the medicines that interrupt the rehabilitation poison cycles. Importantly, energy will multiply in a cyclical fashion. If it proceeds in a negative direction, more and more energy will be robbed from the healing reserve, wasted in poisonous attitudes, and made unavailable for relearning and accomplishment. For example, a depression habit in response to physical losses can reduce activity and hence relearning, which will lead to more depression by depletion of brain chemicals that protect mood, and more depression, in turn, leads to poorer progress and more reason to be depressed.

Antidotes like the "Five Commandments", a positive vision of a gradually improved future, and planning and practicing compensatory behavioral self-control strategies serve to protect the healing reserve by inoculating persons against depression, anger, and destructive emotion. This ensures that energy and motivation will be available so that desired goals can persistently pursued, with each step of progress adding new energy, hope and effort for the next step. With the addition of task analyses and scheduling that help promote routines, energy is turned toward protecting your healing reserve, taking your antidotes, and letting your goals pull you toward a more desirable future. Remember, anything that is consistently repeated will become a habit. Therefore, promote the attitude and activity routines will produce facilitative habits that turn your energy toward protecting your attitudes, taking your antidotes, and letting your healing reserve pull you like a magnet toward your goals.

The Five Commandments of Rehabilitation

Commandment 1: Thou Shall Make Only Accurate Comparisons. Thou shall not make false comparisons. That is, it is only fair (and adaptive) to compare oneself to persons with similar injuries, illnesses, disabilities and stress. It is unfair to compare ourselves to others without similar challenges, or to ourselves before we were challenged, as this makes us look poor by comparison. It is fair, however, to compare ourselves to others of similar injury, challenge, age, etc., as this comparison allows us to accurately measure ourselves.

Commandment 2: Thou Shall Learn New Ways to Do Old Things.

Learning new ways, or finding another way to do desired tasks, vs. giving up & feeling hopeless because the old way doesn't work, is the key to Challenging obstacles and overcoming them.

...Overcome Thinking that the old way is the best way (i.e., Stinking Thinking)

Commandment 3: Thou Shall Not Beat Thyself Up...Instead, Thou Shall Build Thyself Up! We clearly understand that when we have a physical injury, such as a broken leg, getting mad, yelling at, or hitting (i.e., beating up) the leg only delays recovery, increases symptoms and pain, and makes us and the leg function worse. We know that pampering the leg, massaging it and coaxing it along gently & patiently will help it recover. Unfortunately, we too often forget that our brains are similar. An injured brain will perform poorly when we get mad with it, or get frustrated. Instead, understanding it, pampering it, being patient, using pacing & coaxing it along in a supportive way will help you function your best, and help your recovery and rehabilitation. Talking to ourselves in supportive and understanding ways (vs. getting mad at ourselves for being injured) and coaxing things out gently is a good way of building ourselves up in order to face the challenges of rehabilitation. Rewarding ourselves for efforts and each small step of progress, despite tremendous obstacles & challenges, is the best way to build ourselves up!

...Child & Spouse Abuse are recognized as illegal and immoral....Self Abuse is just as bad!

Commandment 4: Thou Shall View Progress as a Series of Small Steps.

Rehab is appropriately viewed One Step At a Time - by focusing on the gains over where we were when we were one step behind where we are now, we can focus on the Graduated Successes and feelings of accomplishment (despite giant obstacles) which will leave us feeling proud and hopeful and enable us to focus and reach the next small step ahead, and make progress through the many small steps necessary to make substantial progress. Focusing on our current gains and small steps of progress (compared to where we were earlier in rehab and when we were at our worst) will build hope and a sense of challenge and growing victories (versus comparing ourselves to before the injury, which only makes us feel sad & depressed.

Inch by Inch & It's a Cinch. Meter by Meter, Life is Sweeter.

Commandment 5: Thou Shall Expect Challenge & Strive to Beat IT.

By Converting Complaint (I don't want) To Challenge (I want), We Can Make Our Future Through Our Vision and Driving Thoughts. We will actively shape our future by focusing on a vision of hope, challenge, control & satisfaction. By changing our focus from complaint and feelings of victimization & helplessness & pessimism, we can avoid giving up and giving in to a pessimistic prophecy of dissatisfaction and doom. (cf. "Thou Shall not Pretend to Have a Contract Guaranteeing Freedom from Injury, Disease, Illness or Unfair circumstances or Significant Stress!")

Phone: 804-270-5484 Facsimile: 804-346-1956

Rehabilitation is the

Sytematic Process of

Removing Obstacles

to Independence

& Accessing Opportunities

for Achievements

(Of Disired Goals)

in the areas of

Love, Work and Play!

The Purpose of Rehabilitation

is to

Change Destiny!

© 1997: M.F. Martelli, Ph.D. & "Obstacle Busters" Cope Group Members: Jan Flowers, Tom Byrnes, Jack Hodges, Dr. Joel Finklestein, Brain Stephens, John Mitchell, Tom Hale, Jim Fenerty, Evelyn Phillips, Rick Peters, J.P. Gibson, John Mitchell, Tom Hale, Jim Fenerty, Evelyn Phillips, Rick Peters, J.P. Gibson, Danny Burnett, Chris Hignutt, Tommy Peden, DavidBrummet, Sarah Goldmann, Matt Tacey, Jay Weaver & Lynn Batley, David Mourer, Rudy Lee, Patrick Quinn, Dennis Weymouth, Laura Watts, Laura Hunter, Barbara Watts, JD Smith, Jamal Alkayed, Charles Smith, Linda Beales, and others...

For Additional Habit Retraining and Rehab Related Readings

Simplified Neurophysiology & Recovery Requirements, Catastrophic Reaction & Recovery, Etc.

Vulnerable Personalities, Sample Protocols for Emotional Management, Etc.

HeadsUp - A Great Online Survivor Newsletter with many features and good articles!

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