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This may involve commitments of abstinence from alcohol or illicit substances, cessation of dangerous hobbies or reduction of aggressive behaviors. All of these are fantastic commitments for anyone to make, with or without a brain injury. However, some survivors fall into a trap that leads to a failure of their noble goals. Namely, they try to replace something with nothing.
When anyone makes a choice to stop an unhealthy behavior, they need to find a healthy behavior to take its place. For instance, if a person is accustomed to going to the bar for two hours every day just saying “I am not going to the bar anymore” is not enough. The person has 14 hours a week of empty time which, if not filled in a healthy manner, will likely lead to the person going back to the bar or engaging in a similarly unhealthy task. The same thing can be said for an unhealthy emotional behavior. A person with a history of verbal aggression can decide “I am not going to yell anymore” but unless that person learns a different action to take when upset, they are likely to go back to yelling. The rationale behind this is that stopping a negative behavior does not mean that a positive behavior will replace it; stopping the negative behavior just leaves a vacuum of behavior. That vacuum will need to be filled with a positive behavior and if not filled, will likely lead the survivor to return to the previous negative behavior.
Finding that “something”, which will be unique for each brain injury survivor, is a key part of therapy. Therapists spend time with patients identifying potential new activities or hobbies to engage in and problem-solving how to engage in those activities and hobbies most successfully. Many of the skills taught in therapy, such as stress management or social skills, are taught with the specific intent on replacing unhealthy emotional behaviors with healthy behaviors. Each patient is different in their skills, backgrounds, and life situations, so healthy behaviors, activities and skills have to be tailored to the individual patient. Physical, cognitive and emotional skills must all be taken into consideration. Survivors will sometimes state that they will “figure it out when I get home”. However, this means that the survivor is going home with no plan on how to replace the unhealthy behaviors and may have to figure things out as problematic situations arrive. It is always best to have a plan for healthy behaviors at home to maximize success and truly achieve positive life changes. You can’t replace something with nothing.