Cognitive Empathy for Reading Loss After Brain Injury

How cognitive empathy can help restore reading after brain injury.

Posted May 05, 2018

Shireen Jeejeebhoy
Source: Shireen Jeejeebhoy

Dr. Brian Goldman, a Toronto ER doctor and host of White Coat Black Art on CBC Radio, was on CBC Radio’s Ontario Today at noon, Friday, May 4, talking about his newest book on kindness. I had to listen. He defined cognitive empathy as the ability to imagine a patient’s experience, to put yourself in their shoes and act accordingly. In my quest to receive help for restoring my reading, I’ve met psychologists and psychiatrists who’ve thought about it, who’ve listened, who’ve helped for a little while, and/or who’ve talked about how they don’t read novels anymore and would love to have the time to do that — as if I, as a writer, want to read only as a form of leisure, as if they, as professionals with value, don’t have the time so why should I worry about my reading?

And as if restoring reading for pleasure is not something worth their time.

What I haven’t found: experts actually imagining what it’s like to not be able to read for their job. They haven’t seemed to put themselves in my shoes — to think about not being able to read, understand, and retain patient charts, medical reports, their own notes, referrals, articles clients bring, relevant journal articles, continuing education materials to receive credits that the professional colleges require, hospital or clinic or college missives (well, okay, it might not be such a bad thing if one can’t read the slurry of administrivia) — and still be able to do their job.

Have you thought about how your colleagues or patients and most importantly, yourself, would respond if you read client reports and charts and understood nothing, retained nothing?

As a writer, I need to be able to read books, manuscripts, articles, emails, newsletters, newspapers, magazines, social media several hours per day. Hours. Not the purported twenty minutes per day of the average reader. And I need to not have such enormous cognitive fatigue after any amount of long-form reading that I must nap for one to two hours.

I once emailed one of my health care team a tweet with an amusing poster that illustrated what reading is for me. Emailing allowed my injured brain to open up communication and show my grief over my reading loss. I’m a writer; I express myself in writing in ways I cannot verbally. People with all sorts of issues sometimes find it’s much, much easier to write what one is thinking and feeling than to verbalize it. Writing is a legitimate form of expression between and during sessions. Unfortunately, the neuropsychiatrist I emailed was the only member of my team who eschewed this form of communication. But I persisted because I was desperate for someone to put themselves in my shoes and act accordingly.

I emailed him the tweet in the hope that he would imagine what it would be like to have once been that kind of reader and to no longer be. I needed him to act to help me express verbally my loss and grief and to restore my reading.

What would acting accordingly have looked like?

Begin by printing out Daniel Pennac's and Quentin Blake's poster in the tweet. At our session immediately following me sending that email, he could’ve shown me the poster and read it out to me then asked: “Tell me how you feel or what you’re thinking as I read that out to you?” I probably would’ve bumbled around or resented being asked how I feel since half the time back then I had no clue. So then he could’ve brought up each pictogram, maybe mused about what he thought of the first one, "The right not to read," and the amusing illustration of it, and so drawn me into a discussion. That at least would’ve initiated my thinking brainwaves. It would’ve brought up memories, like walking on the sidewalk with my latest mystery paperback firmly in front of my eyes, my feet knowing exactly when and where to stop at the traffic light. The memory would’ve dragged up emotions as he casually and gently asked me to tell him more about my sidewalk reading, probably his expert probing spilling over into the next sessions and the next pictograms before the grief revealed itself — over time.

Time is the key. Sticking to reviewing the poster over multiple sessions in a structured way would’ve benefitted me and would’ve allowed him to understand better my brain injury and part of my resultant PTSD. But discussing the poster for only one session would’ve stopped my broken brain remembering since what I feel and what others say to me only begin to process in the hours after my session or during the days between sessions. Going on to some other topic in the following session would’ve halted whatever my subconscious had begun to raise up to the surface. Confining it to a few minutes as an afterthought to therapy about family relationships would’ve halted the agonizing process of reconnecting memories to emotions.

None of that happened. Not taking reading loss as a profoundly serious issue prevented the processing of my grief and has impeded my reading restoration.

The neuropsychiatrist didn’t engage cognitive empathy when he received that email because the format of the communication was more important than its content, and reading restoration wasn't as important to him as it was to me. Instead, he did his professional duty by reading, signing, and filing the email away in my chart.

Copyright ©2018 Shireen Anne Jeejeebhoy. May not be reprinted or reposted without permission.