When Priorities Compete, How Do You Choose?

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When you suffer a brain injury, your life turns into competing top priorities. I was asked to write on the following question: When everything is a high priority, how do you decide which one to tackle?

Catastrophic brain injury can affect every part of your life and every part of you, giving rise to multiple top priorities, which leads to things going awry financially, socially, in family relationships, health and health care, psychologically, cognitively, emotionally, concerning shelter, activities of daily living, and so on.

The first step to corralling order is deciding which is the most important to you, then making that an absolute, immovable topmost priority in every decision.

If you let other priorities take precedence, then either it isn’t as important as you thought, or you’re letting other people or other priorities dictate your topmost priority. If it’s the former, re-evaluate. If it’s the latter, stick notes on your fridge, your bathroom mirror, computer, and anywhere else to remind you that this area is topmost in every priority decision.

For me, it’s health.

Without health, all else worsens.

For a person with a brain injury, survival isn’t only about food, shelter, and clothing; it’s also about healing the injury.

Unfortunately, Canada's Medicare doesn't cover restorative neurostimulation and neuromodulation treatments. Private insurance for psychological, chiropractic, and/or physiotherapy may cover all or part of it. In the US, the situation may be similar. And so at first glance, these treatments that radically heal the brain appear unaffordable.

I faced this conundrum when I first found brain biofeedback at the ADD Centre. I needed it to restore my concentration, but I had no income and was mired in insurance lawsuits. I faced two competing priorities: health versus finances.

But I’d made health my topmost priority, which included restoring all my cognitive functioning. That meant I had to make the finances work, not elevate finances above my health. Where you put your focus, as well as having financial management skills, determines how much you can achieve.

For this reason, many have called for high schools to teach financial literacy; for example, Ontario will require financial literacy graduation to earn a high school diploma.

My mother began teaching me financial literacy when I was 8 years old; my parents’ accountant taught me basic small-business accounting. I adopted financial software early on. And so, even though confabulation tanked my credit rating by misleading me into thinking I’d paid my bills, I had enough of those skills left to know how to budget, the order of loans versus using savings, and how to negotiate in good humour with good faith when devising a way to afford neurostimulation.

My plan boiled down to: I need brain biofeedback; where can I take the money from; and can I reduce the monthly cost?

But if you didn’t develop or retain financial literacy, then either rely on a trustworthy person to make a plan or make finances your topmost priority so that you don’t end up in ever-increasing debt. The downside is that finances as the topmost priority may mean not being able to access neurostimulation and being stuck with the strategies and ineffective methods standard medical care uses currently.

Next on the list may be family. Usually, when a family sticks with their injured member, they support them. And so, when brain injury requires conscious effort for every daily activity, it’s disingenuous to ask you to put family (or friends) ahead of yourself. While a non-injured person can look after their basic needs, and so have the bandwidth to support others, people with brain injury struggle to look after their own basic needs, from remembering to brush their teeth to making a proper meal as opposed to grabbing a chocolate bar when extreme hunger reminds them too late.

Elevating family above health leads to worsening neuro-fatigue and having no chance at meeting your own goals, no matter how modest. When I’ve placed family above my own goals or my own health, I have always suffered and set back my progress. After too many years of this, I learnt my lesson and placed my goals and my health above my family’s desires. When family doesn't recognize the catastrophe of your brain injury, trying to make them happy doesn’t change a thing other than worsening your health. But when I stuck to keeping health as my topmost priority over family, my self-esteem rose through meeting my own goals, and my health improved. Same with friends.

When priorities clash, I use the decision-tree method.

“Draw a vertical line down the middle of the page and at the top of the page, title each column with decision options. For example, I created a decision tree to decide whether or not to travel to England. I titled the columns ‘Visit England’ and ‘Don’t Visit England.’ Draw two vertical lines down the page, one underneath each option. Write ‘Pros’ and ‘Cons’ at the top of the columns for each option. Now list supportive points in each column without thinking. For example, the pros and cons of visiting England, and the pros and cons of not visiting England. When done, you’ll notice what stands out. Discuss with your therapist or trusted person if you’re still unsure. For me, the biggest con was financial. I asked myself if financial cost overrode the biggest benefit. It didn’t, and I found a way to afford it. As a result, I experienced benefits that paid off dramatically in non-financial ways, and the money resolved itself in the end.” Chapter 26, Brain Injury, Trauma, and Grief: How to Heal When You Are Alone.

Traumatic Brain Injury Essential Reads

Opioid Overdose Is Not Sleep. It Can Be a Brain Injury Event

The Effect of Family History on Brain Injury

Read more about decision-making in my book.

Bottom line: decide on your topmost priority. Keep that at the top of all top-priority lists unless you realize it’s not as important to you as you’d thought. Use methods like the decision tree. Learn financial literacy if you can. Putting health topmost improves functionality and makes choosing a priority easier.

To find a therapist, visit the Psychology Today Therapy Directory.

Copyright ©2026 Shireen Anne Jeejeebhoy