Ik heb een hersenschudding

en wat nu?

Jeanne: Progress in my recovery!

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People whom I’ve recently spoken to already know I’ve made a lot of progress in recovery. Some people of course ask how I’ve achieved that. This post is an attempt at explaining it 🙂

In particular, I now realise in what way rest has influenced my recovery. As you will know the standard advice in case of a concussion is to maintain rest. I think I only now fully realise what rest means and how important it is to differentiate between different types of rest in order to really experience it:

(1) Physical rest (body)

(2) Cognitive rest (thinking, mind) and

(3) Emotional rest (feelings and emotions)

Every concussion is different and so is every person. But perhaps my story has some benefit for your case as well. In this blog I zoom in on emotional rest, because I believe it gets far too little attention compared to physical and cognitive rest (and otherwise this blog would really become too long ;)). Also, the latter two types of rest are covered already to a significant extent in conventional treatment methods.

Vicious circle

I have always found it important to consider the effects of a concussion on both body and mind and emotions, because as a result of the impact I experienced not only physical but also cognitive and emotional symptoms.

In rehabilitation I learned about ‘fatigue in brain injury’ and how various symptoms affect each other: as a result of the concussion I had more trouble processing information and therefore I tired more easily. That in turn made me emotionally unstable and I was able to deal with less; I irritated quickly, which overloaded my mind, which then made me highly-strung and subsequently I was unable to concentrate and very tired. In other words, this is the well-known vicious cycle. I really wanted to break this cycle, however, that was not going to happen on its own.

The rehabilitation and therapy that I’ve had were focused only on either the cognitive aspect, or the psychological aspect or just the physical aspect. Don’t misunderstand me, it was beneficial and I learned a lot. I worked hard on getting physical and cognitive rest and made some progress with that. But one aspect remained untreated: as a result of the setbacks which I experienced with social security, contradictory advise (or incompetence) of clinicians, medical discussions which ended in misapprehension, etc., the pile of emotions continued to grow.

The focus remained mostly on physical and cognitive rest such as concentration and memory issues, however, I really wanted to get to grips with all the changes and the emotions that came with those changes. I also received different, sometimes conflicting, diagnoses which translated to a lack of cognitive rest and again emotional unrest. After my concussion there was a lot of confusion which needed to be cleared up. Clarity leads to cognitive rest. To be able to recover at all, I realised that cognitive and physical rest alone would not cut it. It was time to dive into my emotions and feelings!

Limbic system

So that is what I have been doing this spring. I read an article by a former neurologist who from a neurobiological perspective sees all these factors come together in the limbic system of your brain. This makes sense, as in addition to cognition, emotion is also regulated in the brain. His limbic explanation says that as a result of the emotional response to something like a concussion (or whiplash, etc.), emotional dysregulation can occur. The emotional response can cause old and repressed emotions to resurface again. Together they can in that way maintain the symptoms of (for instance) a concussion, and later as a result of the unrest even add additional symptoms[1].

For that reason I have dived headlong into an examination of my emotions and feelings over the past months. As a result I got to take a good look at and a better handle on my emotions, which created rest in my head and increased my energy. However, my progress soon stagnated. Apparently those repressed emotions had not come to the surface sufficiently. According to theory the solution was in finding the most important personal emotion, or ‘stressor’. But how could I do that?

Unearthing repressed emotions

In the book of the former neurologist there is a nice pattern which I have used to get in touch with repressed emotions, namely via your child emotions. To get these to the surface I took a trip down memory lane and tried to re-experience some situations from my childhood which I experienced as hurtful or which left an impression. These will differ for everyone, but can also be things which now seem minor, such as that time you were bullied or when someone laughed at you. I understood from the former neurologist that we experience child emotions as eternal and enormous, because compared to an adult a child is less able to put emotions in a broader perspective.

Through this I was able to take a good look at the inside of my ‘basement’ of repressed emotions. For me, the feeling of rejection turned out to be the stressor which was at the root of the emotional turbulence in my head. This made sense in relation to my experiences with for instance social security or the ignorance of a doctor.

An important amplifier of my feeling of rejection was the iatrogenic influence of some clinicians, who did not take away my emotional unrest but on the other hand reinforced it. Some therapists told me to slightly exceed my limits in order to gradually extend them. Conversely, other therapists told me to listen to my symptoms and not exceed the limits of what I felt capable of. It was contradictory.

Neutralising rejection

When one wants to avoid a feeling of rejection (pain), a person tends to start pleasing other people or to try to ‘be strong’. Your own will and desires want to be nurtured, that is a very basic need. To please someone or to be strong can be very useful at times, whereby you aim to satisfy someone else’s expectations (keeping to behavioural norms). Too much of this behavior can, however, be destructive as you exceed or ignore your own limits in order to prevent being confronted by that feeling of rejection. It fascinated me to what extent those emotions still played a role in my current life as part of a behavioural pattern such as pleasing or perfectionism. It costs a lot of energy and therefore you can see it as ‘energy leakage’.

Because I became aware of these patterns I could discover my energy leaks and as an adult I now had a choice: either I please (which costs energy and ignores my own feelings) or I act according to my ‘Own Will’ and I disregard the feeling of rejection.

I had to practice a lot with this, as I found it difficult to recognise my own patterns at the start. Through continuing to please people I did not have to feel rejection. I did it automatically and was unaware of it. I had to learn not to avoid the feeling of rejection and I had to realise that it is a child emotion which was valid in the past but isn’t anymore.

As a small example, someone asks if I can help her. Automatically I say yes and drop everything I’m doing. When I’m done I don’t feel well, am tired and annoyed (negative emotions). I walk into my kitchen and see that I was actually cooking. At that moment I realise that I said yes without thinking. From then on I tried to pay attention to it and follow the following strategy:

Someone asks for help.

Step 1: What do I want (instead of responding automatically)? ‘Yes, I want to help but not now’.

Step 2: OK, either I offer to help her later or otherwise I cannot help right now.

Step 3: I answer ‘Yes, later’, or otherwise ‘No’.

This is a small example, but very useful as I could easily practice at this level. I saw how the automatism would have answered ‘Yes’ here, while when I examined my own feelings my answer would have been ‘later or no’. That was my pattern: to automatically consent (and thus prevent being rejected by someone).

Before the concussion I had no problem saying ‘Yes’ as I was full of energy. But after the concussion I wasn’t anymore. I needed all my energy and focus for things like cooking and working on my recovery. I did realise that before my concussion I also made myself available to others easily. That did not make me ill as I was stable enough cognitively, physically and emotionally, but it did cost energy. And when I overdid it I did get tired, of course, but it did not give me the severe symptoms (motor and balance problems, exhaustion severe emotional instability, etc.) which I experienced after my concussion (and thus after the emotional dysregulation).

The treatment/therapy gave me clarity, cognitive and emotional rest. It felt very comforting to have tools that first reduced and then prevented my symptoms from occurring. It gave me a great boost of emotive rest, which in turn increased my cognitive abilities and made me less high-strung. That then gave me the strength to believe in myself and my recovery again. A whole new dimension to the word ‘self-confidence’!

Let me make clear that all of this wasn’t easy. For months I worked intensely on discovering my stressor, sometimes 7 days per week. Because of automatisms (emotional patterns) and what I’d been through, it took significant time to unearth everything.

I again learned that my emotions and personal limits are extremely dear to me. It all makes sense now; however, it definitely did not when I started. I was completely stuck with my conventional cognitive/physical therapies and as a result of the symptoms of my concussion as well as the various other setbacks I was extremely vulnerable.

When I learned how to break this pattern, I tried to be gentle with myself and others. Because rejecting yourself and others in this process is very easy ;). I realised that everyone has to deal with rejection to some extent. Some people have little trouble with this but for some, like me, it is a great challenge. It is an extra gift that I now also recognise such patterns in others.

Sometimes I am still overwhelmed by emotion. I was hit by a field hockey ball to the temple on 19 August 2012, 4 years ago almost to the day. I notice that I need time to digest this long period of illness.

But now the world is opening up to me again. For instance, I am now able to stand again in a tram; this used to be impossible because of balance issues. After so much time it’s very emotional to discover I can do that again! I am rediscovering the world again and taking some time to let it all sink in. I have not had any motor or speech issues anymore since my recovery. Sometimes I feel the start of something again when I cross my emotional or physical limits. However, I have proven to myself that I have and can maintain control!

[1] He further elaborates on this in his book ‘Zaken doen met emoties’ (2015), M. Klaver (only available in Dutch).

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credits and source of illustration: asoftwrongness

 

 

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