26 months

In my book I talk about "super survivors" defined as a survivor who is “…so unwilling to let go of their career, their independence, or a personal passion that they are compelled to recover. They intertwine recovery with what they love to do.” When somebody can use their life's passion to drive recovery everything is made easier.

• It's easier for the therapist because they don't have to work so hard to motivate.
• It's easier for the stroke survivor because they have a cherished task on which to focus.
• It's easier for the survivor’s brain because when it comes to driving plastic changes "the power is in the focus.” And we tend to focus on what we care about.

There are other things that motivate survivors towards recovery. Things like career (and by extension money), fear (i.e. falling), friendship (many survivors talk about friends who have "ditched" them after their stroke), the need for independence etc. etc. All of these can be extraordinarily important, although I would suggest that they may be somewhat less important than the goals of the "super survivor" focused on a cherished task. But if the scale goes from "I need to get better because of friends, money, fear etc." to “I need to get better in order to get back to guitar playing (a cherished task)" there is actually one step further. That step is called Kathy. Kathy Spencer is the only survivor I know who has reached a “nirvana of recovery”.

People who get really good at stuff are not necessarily completely focused on outcomes. Most folks who become expert at something are focused on process. The goal in great musicians and athletes and students etc. is to learn. To learn is to forcibly rewire the brain. Relearning of movement after stroke is learning, called motor learning. I’ve discussed this before; learning new movements and learning French, piano, math or anything else is the same. They all happen through rewiring existing neurons in the cortex of the brain.

Learning ain’t easy. It necessarily takes work. But let me ask you this…Which student is going to get a better grade…

Jack: “I’m studying because I want a good grade.”

Jill: “I’m studying because this stuff is really cool.”

Outcome focused Vs. process focused.

Obviously the lines can get blurred because as more ability you have the more that can be done to achieve the outcome. But survivors spend much of their time in a no-mans land where they are working, but are not yet able to use their limbs functionally. And this is where the plot is often lost. If your only interest is the outcome you’ll probably say “the outcome is so far away and I may not get there.” If your interest is process the question is, “What can I do to get just a little bit more?

It seems to me like Kathy Spencer fell in love with the process. And it's tough to fall in love with the process that, unlike practicing soccer and guitar, had no guarantee for success, and where you’re not learning anything new, really. With Kathy it seems to be a leap of faith, although as you'll see faith may have had a bit to do with it. In the video below Kathy explains a little bit about the process she went through to recover. What is interesting to me is, not so much the particular exercises she did (these will be different for every survivor) but the perspective she takes. 26 months of hard work during which there was no guarantee.

26 months.

And yes, she mentions my book but I pinky swear, I was going to blog on this within the first 20 seconds of watching this great vid.