Listening in the Silence, Seeing in the Dark: Reconstructing Life after Brain Injury.

R. K. Johansen

University of California Press 

Los Angeles, CA

2002, 246 pages, $24.95 (hardcover)

Traumatic brain injury impacts a vast majority of persons in the United States. The author asserts that traumatic brain injury (TBI) has reached near epidemic proportions. The widespread effect of this disability touches not only the individual with TBI and his or her family, but also society in general. This book, which was originally crafted as a mother's journal of her family's journey through tragedy, eloquently and realistically allows the reader a window into the fragility of the mind and soul in the face of disability. While there are no resource lists of treatment centers, hospitals, or support groups, this text is an invaluable resource for people who deal with the effects of TBI, either on a personal or professional level. Ruthann Johansen allows the reader to participate in her journey as a mother and a wife who faces the daily battles experienced when her son incurs a disability.

This book not only tells Erik's (Johansen's son) story, but it serves as a vehicle to allow people without disabilities to vicariously experience the trials and triumphs that define life. The text chronicles her family's journey from the time of her son's accident through his hospital stay and his awakening from a coma, his rehabilitation, and the eventual restructuring of his life. In her own words, Johansen (2002) asserts, "I wish to bear witness for all who struggle courageously, though often invisibly, to restore their lives following traumatic brain injury."

Eight chapters chronicle Erik's life story as well as giving insight into the struggles to recovery he and his family faced. Johansen's philosophical recounting of the events gives an especially comprehensive picture of each family members healing process in the face of adversity. Each chapter takes the reader through a phase of Erik's recovery and the struggles encountered to fathom the process. Johansen asks the reader to look beyond the typical meanings of self, love, and sacrifice as she presents more in-depth, comprehensive, and philosophically insightful definitions of these terms.

The text chapters--The Impact of Vulnerability, Waiting in Crisis, Uncertain Deliveries, Becoming Again, The Scattered Self, Improvisational Selves, Accepting Vulnerability, and Crossing the Threshold--give a personal account of feelings of helplessness, grief, loss, hope, frustration, fear, triumph, progress, understanding, and acceptance experienced by the family and the individual. This gives people who are unaware of the process to recovery some understanding of the points of view of the individual with a disability and those who care for him or her. Johansen gives a poignant view of the recovery process, highlighting frustrations with the medical profession and the insensitivity of the "medical model." She reveals the importance and necessity of family being engaged in the recovery process, the struggle a parent faces with relenting control over to "strangers," as well as the difficulty both for herself and Erik in coming to terms with change.

The strength of this book begins simply with Johansen's truthful reflection of her family's story and then with Erik's own reflections of his journey. Unlike other texts where the authors may keep the experience focused on their own struggle and recounting of events through their eyes, Johansen makes a specific effort to include Erik in the telling of his story. Erik's version of his story and his understanding of the difficulties he encountered, the struggle his family faced, and his struggle to restructure his life enhance the value of the book by giving individual perspectives and understanding of the experience. The text ends with Johansen summarizing what Erik and his family learned through their experience with disability. She revisits the necessity for people to understand the true value of "self" and to redefine that meaning into more than intelligence, physical strength, emotion, and normalcy. Through a constant redefining of "self" and what it embodies and a reliance on their faith, Erik and his family were reconstructed and disability became a part of who they were collectively and not viewed as something that "afflicts" Erik. Johansen ends the text by challenging and inviting readers to examine their life meanings and to see the person beyond the disability; not in the same "person first" sense that rehabilitation professionals uphold, but more so in a sense of owning disability. Johansen's philosophical and psychological perspectives ultimately challenge the reader to "recognize all brokenness and disability as belonging."

While this text is not instructional in its format, it can be used by rehabilitation professionals, educators, and students as a window into the experience of disability. Rehabilitation counselors may find this story useful in gaining understanding of how traumatic brain injury not only impacts the individual, but also his or her family. Consumers and their families could benefit as well from this text and may find it to be supportive of their personal experience with traumatic brain injury. Rehabilitation professionals who work in hospital settings, day treatment programs, or group homes might find this text especially useful in illustrating some of the daily issues persons with traumatic brain injury might face. These professionals may also gleam some insight as to their role in assisting persons with traumatic brain injury live more independently. Instructors might find this text useful as a tool to introduce students to psychosocial adaptation to disability. Book reviews and critiques guided by targeted questions regarding the "disability experience" can assist students in gaining a more comprehensive understanding of disability beyond physical accommodations. University disability specialists might also find this text useful in understanding the impact of disability and their role in accommodating student needs.

The author admits that this one story does not represent all experiences with disability, but is hopeful that this one story does bring a level of compassion and understanding to people without a personal experience with disability. In addition to allowing the readers to journey with the Erik and his family through the restructuring of their lives, it abstractly and concretely allows the readers to question themselves, their definition of themselves, and how they define "self" in the realm of disability.

Chandra M. Donnell, Ph.D., CRC 

Assistant Professor

Rehabilitation Counseling Program

The University of Memphis