I believe there is a bias 'almost built in' to the diagnostic work done by Ph.D.'s and M.D.s. They see those of us who still test with very high intelligence and have that, "You are still so smart, you can't have a brain injury." Or "You are so smart, you are faking the low test scores" attitude.

Since they have never tested so high, they can not believe that we can be so dysfunctional and still have high intelligence scores. My first neuropsych labeled some of my performance on tests as at an extremely high level, Very superior, Very well, considerably higher level and other such terms. It is as if at some points, he is comparing me to his own testing levels.

He expresses doubt that these high levels can co-exist with my poor memory and processing speed without some level of malingering or highly guarded responding.

He thus suggest that I need serious psychiatric and psychological care and treatment. He even goes so far as to discount other test scales as invalid.

A later neuropsych even left out the validity scales as they directly disproved his labeling as malingering and psychological causation. The validity scales were at 48 and 49 out of 50 with 50 being absolutely no malingering or faking. The malingering part of the curve required scores in the 30's and lower. If the scores don't match the diagnosis, leave the scores out of the report.

How does the saying go? "Don't let the facts get in the way of your preconceived opinion."

It was like they were trying to find reasons an intelligent person could manifest these symptoms of poor memory and low processing speed but still score in the top 1 or 2 percent in the intelligence scales.

They blatantly disregarded the research that states that high intelligence scores and low memory and processing speeds can only be caused by an organic brain injury.

Their envy or whatever other motivating factor appears to cause them to need to dismiss our organic dysfunctions with a "You are so intelligent, stop obsessing about some minor memory or processing problems. I would give my right arm to have your intelligence."

It is like they expect a Olympic champion ice skater to skate at gold medal level even though their skates have dull edges.

The high functioning in intelligence tests cannot overcome the memory and processing dysfunctions. We know we can no longer work at peak performance levels because we never know when the monster is going to pop-up and tear our thoughts out of our mind. It is taking or has taken years of frustrating realization that our minds will not work at the historic high levels of the past. We may have occasional 'highs' but then, out of the blue, it is like someone turned the lights out in our brains.

The gut wrenching moments of understanding these limitations are played over and over as we habitually try to perform at past high levels and crash and burn.

I try to explain to others my limit at visualization. I tell them that I know that there is a wall and furniture behind me, but my mind cannot visualize any of that picture. Or, I can stop at a crossing street, look left and see the oncoming cars. I look right and see the oncoming cars. But now I have NO IDEA of what I JUST saw to the left. Some try to comprehend this scenario but most are just disbelieving or unwilling to believe. They express "How can you not remember what you just saw? It is right there."

I have learned to convert the visual picture into a verbal cue like, "It is clear of traffic to the left." But even these work-arounds can get me into trouble. How do we protect against the "brain farts" that just happen and stink up the works?

In my case, I accept that the brain farts happen and try to manipulate the environment to provide a level of safety in case my brain farts.

People may view me as stubborn or contradictory but these are my survival mechanisms. I live best with them. Without them, there are too many little fires to constantly need to extinguish and then explain to the ignorant.

The labels put upon us by those who think we set these fire on purpose or they are due to laziness seem to drag on behind us, no matter how much valid explanation is given.

And they think the problem is in OUR heads? A little effort to understand our dilemma would be appreciated.

At least on this forum, we are mostly with others who GET IT.

Hockey,
There is one sitcom that I like. I watch "the big bang theory". Sometimes I think that the character "Sheldon" has a TBI of his own. The cognitive inflexibility that I have trouble with, the Sheldon character is very bad with. You should give it a view sometime.

Mark, thanks soooooo much for your post. I just kept nodding (gently) my head.

I was lucky to have an excellent neuro-psychologist who clearly understood and recognized how brain injuries play out in the high functioning. He really went to bat with my GP who figured I was still "smart enough."

What outsiders need to understand is that deminished processing speed is only one part of the puzzle. People with serious brain injuries don't even have all the wires (axons) necessary to get proper imput and to process it. Mark talked about his difficulties visualizing. I just can't see patterns, which makes organization pretty much impossible. Like many of you, I am constantly bombarded with sounds (ticking clocks, multiple conversations, passing cars, ladybugs farting) that I can't filter or prioritize. Then there's the constant ringing in my ears. Oh yes, pain and fatigue are also great for cognition.

Ironically high functioning people are often under-diagnosed because what's left of our intelligence allows us to find coping methods. For example, before I'd had any cognitive therapy, I'd already learned to line up all the ingredients in order before cooking and to put them away as I used them.

All that said, I don't think lower IQ patients are getting a fair shake either. How elitist it is to say that that their TBI doesn't matter because they weren't smart anyway? I'm not great at patterns, but I see one here: the TBI patient can't win. Think about it, the TBI doesn't matter, either because you were too smart or too stupid before it happened. As always, the TBI patient gets shafted.

Mark
 

I totally agree - you have expressed it well, and hockey - I agree with what you have said about the low IQ as well.

One of my initial psychologists told me that it is worse if you had a low IQ as you did not have a lot to lose - so it would be more noticable!! Groan!!

Lynlee