26. Concussion (and ABI) Emotions 101

September 23, 2022
The TBI Therapist Podcast with Dr. Jen Blanchette

The podcast is back for the start of fall! My hope is to have episodes weekly for you on Fridays through the fall. I recorded this episode in the summer that was based off of this blog article that gives you an overview of brain injury emotions.

Takeaways

There is a wide range of emotions after a concussion. It can feel very unsettling to say the least. The lack of control over these emotions can cause a lot of distress. Keeping a log or tracking your emotions is very helpful. Sometimes it’s the time of day or after overtaxing your brain. Sometimes just moving through the emotion and noting a beginning, middle, and end. It’s normal to get stuck. Tools for big emotions include movement, physical touch, using your senses, compassion for yourself about your changing emotions (this is HUGE!).

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Speaker 0 00:00:02 Hello, welcome back to the TBI Therapist podcast. I’m really excited to welcome you back. I’ve been away since about July was my last episode, and so I just forget how busy the summers are here in the state of Maine in the us. So if you are from New England, you might understand that when it’s warm, people just disperse and they are ripping and running, and I feel like the summer just really flew by here. So school started. My kiddos are back at school, so that’s giving me a little bit more time. And I think it’s just going to be a regular cadence for me to have recordings not happen in July and August. And that’s okay. So if I pre-plan and have some stuff available for you, that would be great, but if not, then I will probably take a break in the summer. Anyway, so I’m, today I’m coming on to introduce an episode that I launched that I, I recorded, Excuse me, I recorded this episode in July and I was gonna rerecord it, but I didn’t, and I think the sound quality’s okay.
Speaker 0 00:01:15 So I’m gonna give myself a pass and say it’s gonna be good because there’s good information there that I really want you to have. So also, it’s tied to a blog post that I did, that I published in the summer, but I didn’t really put anything out about that either. So I’m gonna have that come out, show that to you. I’m finding my words too. I’ve been at a podcasting for a while, <laugh>. So it’s gonna be a journey, right, of how I can start talking in, you know, sentences that make sense. Of course there’s a loud truck behind me. Love that. I’m just gonna pause while that goes by. I put something out to you guys in on my Instagram rather in July, and I was asking you about your emotional experience after a brain injury. So many of you told me that. And the, my biggest takeaway was that there is just a greater range of emotions that was really, I think, unsettling.
Speaker 0 00:02:15 One person said, I can go from zero to a hundred in a drop of a hat. Another person said that they could be crying like a child and then not understand how to get back from that. And I also, from working with hundreds of survivors, understand that some of the, I think more fearful experiences after a concussion or a brain injury were the lack of control of their emotion. So it just felt like the, the emotions were this runaway train and it wasn’t coming back. I’m not gonna sing the song, although I, I almost went there. I almost was gonna start sing to you, <laugh>. All right, I’m in a mood at y’all. I think I’m in a mood. All right, so I talk about brain injuries having a normal range, have have a range of emotions that is probably greater than before injury. A lot of people also talk about not having any emotion anymore after their injury, and I’ve certainly seen that, but I think more specifically with concussion, I see greater emotion, greater emotional range.
Speaker 0 00:03:23 And then there is a subset of people after brain injury that have a lack of emotion. And so they’re struggling with that more interpersonally, I think, or feeling more depressive symptoms. Like, why don’t I feel the same things that I used to feel? Why am why do I not feel like things are exciting or meaningful? And that is, that is definitely a struggle. I’ve, I’ve heard from people and that they, they wanted to work on that work on maybe experiencing a greater range of emotion. So one or the other, it tends to be a lot of emotion in going around or not much emotion going on. So it’s important to understand what you’re feeling so that you can cope better. So a lot of times I ask people to use feeling words when they’re in therapy. So whether that be I’m feeling sad, I’m feeling mad, I’m feeling frustrated because after an injury, many times I feel like people, it just feels like this ball of emotion and they’re like, Ah, it’s just in my throat. And so I say, Let’s slow it down. Let’s take a breath. What is this?
Speaker 0 00:04:27 What is this emotional state that we are struggling with right now? For some people it could be sadness, anxiety, fear, fatigue. So some people are like, You know what, I’m, I’m not really emotional, I’m just tired. But then I, I started crying and I don’t know why. And then they couldn’t identify anything that anything else was really wrong. So that’s one person, but it just, it’s, it varies for everyone. So emotional identification is first, journaling if you’re able to journal, that can be really helpful if you’re not able to journal. I love if people can walk and feel, walk and kind of notice their body. Notice emotions just kind of be present with things.
Speaker 0 00:05:15 Could include relaxation, techniques, journaling, talking to a counselor. So I took a lot about emotional regulation or breaking the stress cycle. So many times I, I think it’s important to note emotions have a beginning, middle, and an end. We often think that they will last forever. They do always change. And one of my favorite quotes by r I believe that’s correct, I’ll get it correct in the show notes, if not is no feeling is final. We may believe that a feeling that we’re we’re having will stay forever, but they do change. So some tools, participating in activities that make you happy such as movement, watching something funny, receiving physical affection. And that could be from a pet, if you have a pet in your life, you know, some people do live alone. So I think about like that physical affection isn’t for everybody of course, but you can also show yourself, you can rub your arm. You’ve had people, you know, just kind of have a soothing touch on the for themselves if they can tolerate that. Also, other things that can break the stress cycle. Typically I like to engage the senses. So sometimes for people they can tolerate their sense of smell. It’s smelling like so kind of candle can even do an orange if you can’t do perfume or just something that does have a scent that can be helpful to kind of kind of get you out if you need to transition away from that emotional state, compassion is important. So being really compassionate with yourself.
Speaker 0 00:06:54 Many of the survivors I’ve worked with and have been on the podcast have told me time is the biggest thing they wish they could have told themselves. Like, it’s just gonna take time. And that’s not the greatest answer I understand, but healing takes time. It’s your brain. And so it’s the center of your thinking, behavior, emotions, and it’s a brain injury. Just disrupts that delicate balance that we have between emotion, cognition, understanding, all of that. So it does take time and to be patient with yourself that you’re doing the best you can. You’re not doing anything wrong with your recovery. You didn’t mess this up. There’s a lot of shame. Sometimes people will say like, I just, you know, I’m just broken, or I just did something wrong. You didn’t do anything wrong. So I always send that message to people if they need to hear it. I definitely tell them if emotions persist for an extended period of time or become too hard to handle, just certainly reach out for professional help. You know, whether they be counseling or with your doctor, reaching out for some type of help is important. So check out this podcast episode. I might have repeated myself in this intro, but I hope you enjoy it. Let me know what has been helpful and maybe some other things. I always like to learn new tools that survivors are telling me. I learn the best ones from you, so certainly tell me what things you’ve picked up. I’d love to hear it.
Speaker 0 00:08:25 Hi everyone, welcome to the TBI Therapist podcast. I’m your host, Dr. Jen Blin shot where we explore the heart of brain injury
Speaker 2 00:08:43 Survivor. It’s been a while since I talked with you. So here we are in July, It’s the beginning of the month and I asked a question on my Instagram stories, which was, why are brain injury emotions so hard? And actually I was kind of survi surprised at some of your answers, uh, because I’ve sat with survivors in the therapy room for over 10 years and I have the felt sense of how hard it is for my survivors. But I, I think listening more to what my folks were saying on Instagram, I was learning that it’s not just the intensity of the emotions, but how quickly emotions can change. One person described it as a rollercoaster from going, You are just fine until feeling like you’re on the floor crying. That it’s really surprising how quickly emotional states can change. And I see that frequently. I remember one of my beloved clients that suffered from a concussion would come in every week crying and they cried for months.
Speaker 2 00:09:55 And I desperately wanted to help the crying stop. But as a therapist, you don’t stop crying, You allow the crying to come even if it’s uncomfortable. So as a therapist, we’re trained to really be able to really just sit with things, just sit with the things that people don’t sit with. And I think what strikes me about that is, is how invalidating difficult emotions can be for us. So when I have an intense emotion, personally even I feel like I need to temper that emotion for whomever I’m talking with. For a survivor, however, tempering an emotion can feel like it’s impossible if not very difficult. So I wanted to talk a little bit about the emotional rollercoaster of brain injury and maybe some ideas for how to manage that. So as I’ve said, there may times when you feel great and then suddenly you experience an intense emotion for no apparent reason.
Speaker 2 00:11:00 Some of my folks with a concussion or with other forms of brain injury can be triggered by the event of their brain injury. So a by psychological and a physical trauma. So maybe they go back in the car and they start to feel intense emotional experiences, or maybe they’re struggling with vestibular issues, dizziness, or they’re in a position where their heart just starts racing, which can occur with some conditions after a brain injury. And that can trigger the nervous system to just pretty much go crazy, which can look to people like anxiety. It can look like you’re freaking out, but you have no control that your heart rate decided to spike because you moved into a different position. It just happens. And I think when you’re dealing with things that are just happening all the time, you feel powerless. And I think that’s where the hopelessness and the fatigue really come in with regard to emotions.
Speaker 2 00:11:58 So I’d say the brain is an amazing organ. It allows us to think, to feel and experience the world around us. It controls our movement, regulates our bodies and stores our memories. So when the brain is injured, it can have a pro profound effect on every aspect of our lives. I don’t need to tell a survivor this, but I think sometimes you also need to hear it, that it really does affect every facet of your life. Also, unlike a physical injury, the brain, a brain injury is unique in that you can’t see it, it can’t be readily understood, but you don’t have a social script for other people to understand that you’re still struggling. And I think on the other side of this, for the loved one, I’ve sat with loved ones and caregivers in my office, they desperately want to understand, but it’s just their not lived experience. So I try to help them understand through education, which can be really powerful to the survivor, to have their partner or caregiver really invest that time with a provider or just educating themselves in general about what you are experiencing. So I would say if you’re a caregiver or you are a partner of someone with a brain injury, certainly take that time and let them know that you want to understand, you want to learn. And hopefully that will buy you guys a little time to help figure out the next step.
Speaker 2 00:13:33 So what are some typical emotions that I see after a brain injury? So I often see folks feeling more anxious, irritable, or sad. I think it’s important to remember that these changes are a normal part of the healing process. Do they feel normal? No, they suck to go through. And you know, just like considering, thinking about some of my clients who come in and just cry and cry and cry, I know they don’t wanna be crying, but I know they can also stop that they’re in that emotional state. And just like grief work, which is deeply connected to brain injury work, you have to move through that sadness in order to figure out what’s on the other side of it because you’re dealing with so many changes. I find if we start to track emotions and look for patterns, it can be helpful. Sometimes I’ve noticed my survivors and you know you are, you’ll push yourself because you don’t wanna have to rest, you don’t wanna have to wait.
Speaker 2 00:14:37 Sometimes you just get really annoyed by your symptoms and I don’t blame you. I if you could do things a certain way before your injury, it can feel really hard to wanna do that differently or have to take breaks or need to break up a task that you feel like you really want to complete today. So why we track emotions is figuring out, okay, maybe you worked for a little bit longer that day. You should have probably capped your work day at three or four hours versus five or six or whatever your, your time frame is looking like at the present moment. So also we wanna be aware of, okay, am I feeling sadness every day at two o’clock? What’s, what’s happening there? Could it be something as simple as nutrition? We can manage that with nutrition, with a break, with rest, with relaxation techniques, journaling or talking to a counselor.
Speaker 2 00:15:35 So I find that if we start to identify patterns that can help us figure out the tool that we need because we can’t just use the same tool for everything. Uh, that just doesn’t work. So one of the big things I talk about are tools that help with emotional regulation or breaking the stress cycle. There’s no question to me as a trauma therapist as well, that brain injuries are incredibly traumatic both physically and emotionally. But there are tools that are helpful that we know can be helpful for dealing with the nervous system regulation and also with the trauma. So participating in activities that make us happy, that include movement, if you can do that, watching something funny or receiving physical affection from a loved one or pat can help break that nervous system cycle and assist in a more renewing state. So in one of the therapies that I use by, which is biofeedback, uh, or the one that I use is called heart math actually, which you should, I’ll link that in the show notes.
Speaker 2 00:16:39 You should check out heart math because it’s really accessible and it’s not complicated. So a lot of people think I’ve had this complex problem for so long and the more and more I’m learning about concussion and brain injury recovery, it really needs to be simpler because simple things help heal us. So everybody’s like, Oh, okay, I can watch a funny movie, I can, that’s just one thing that you can do. But it’s understanding the concept of nervous system regulation that when my brain is constantly stuck in fight or flight, I need to get it unstuck. And those things may be simple, but the action of doing that can be challenging. And I think it does help to have someone in your corner, whether that be a provider or someone that’s been through it before that can help assist you in figuring out what that mix is for you.
Speaker 2 00:17:35 And I’d say for myself, I am, even though I’m not a survivor, I’ve worked with survivors for years, I, you know, do struggle with energy fatigue due to just hormonal changes that I have experienced due to a medical condition. So I do experience fatigue and I want to push through and I sometimes experience a great amount of stress in my nervous system due to that. And I think certainly because of the pandemic, most of us have been kicked into hyper arousal. The events in our country, if you’re in the us, all of us have dealt with a global pandemic. All of us have are now dealing with difficulty with increasing prices and things that can trigger us and make us feel like we’re unsafe. So I think if we have a nervous system that’s been turned on hyperdrive, all of us need these skills and especially my survivor.
Speaker 2 00:18:36 I’d also say that it’s important to be really patient with yourself. Healing takes time. I was reflecting on an interview with Crystal be Braden and I often ask my survivors, What was that pivot for you that helped you kind of get over, you know, when you got frustrated, how did what helped you get through it a little easier? And her one comment was time. And no one wants to hear that. No one wants to hear, we just need time. But it is true. It is true 100%. And that I think if we lean into in some ways you’re stuck in your recovery, you may not be working, you may not be doing the things that you wanna do a hundred percent. Does that mean you just resign yourself and say, you know, I can’t do anything? No, there’s certainly things that anyone can do. We can certainly still have things that we can do, but it does take a certain amount of patience with yourself, being compassionate with yourself to help yourself not deal with the shame and limitations post-injury. It’s okay to be sad when you need to be. So finding ways you can be kind with yourself while healing and finding new things to do. So sometimes that maybe may learn relearning how to do things that you used to be able to do without difficulty.
Speaker 2 00:20:09 I also say that if you’ve been struggling for difficulties with your mental health, please don’t wait. I have seen so many people years after a concussion or a brain injury and they might have seen a PT or a speech therapist. I am a psychologist by training. So I see people typically a little bit further out, uh, from their injury when I was in neuro rehab. I see them a little, a little sooner than I do now, but I encourage people don’t wait. You know, if you’re right in your recovery, it’s great to get those tools if you just had an injury them sooner than later. Also, seeking out a professional who has training in brain injury can be helpful. I know as a therapist that your therapist may not have training in brain injury, but a good trauma therapist or someone who’s really well versed in anxiety can, can work with your current treatment team and be a real asset.
Speaker 2 00:21:08 So don’t let that deter you if they don’t have training in brain injury because I think there’s ways around that, uh, by providing them education and being your own advocate for what you need. I also add with finding a mental health provider that it can take some time. So recently when I found my new, my newest therapist who I’ve seen, she’s not new, new, I’ve seen her, she’s been my pandemic therapist and still is of course, cuz she’s awesome. Shout out to my therapist, you know who you are is that it took me probably seeing about four or five people and one of those experiences was pretty invalidating. Oh, I could go for a while on that one. <laugh>, I mean, uh, in intake. I think someone kind of rejected me and was like, Oh, I don’t think I can deal with what you’re bringing in. And it just felt really tough and it also gave me some feedback as a provider of things not to do. And so just to know if you’ve had a bad experience to keep going because it is so important.
Speaker 2 00:22:11 So what we know as a brain injury is unique, it’s challenging, it’s invisible, all encompassing and not often understood by others. This can make it difficult for you to find the emotional sport you, you need after your brain injury. Your friends and family are so important, but they may not be able to provide everything someone with a brain injury needs. Seeking out a support group at a local rehabilitation center or somewhere near you is a great, great option. So I also wanna let you know that I am going to be launching a group in the fall for brain injury survivors. I’m gonna get the application for that group group up on my website, but that, uh, group will be starting in September. And I really wanted to start a coaching group because I want you guys to form your own group of survivors that you can work with and talk with, bounce ideas off of, get just support in general, uh, because this journey is lonely and I think you need the best support. So you can look for that offering on TBI therapists, www.tbitherapist.com/work with me. So if you are interested in doing joining that group, I’ll have the application up soon, but you can join the wait list today. Okay. I hope you’ve enjoyed this reflection. This is the end of my therapy week and I just wanted to put something out to you guys, so have a good one.
Speaker 4 00:23:58 Thank you for joining us today on the TBI Therapist podcast. Please visit tbi therapist.com for more information on brain injury, concussion and mental health. The information shared on today’s podcast is intended to provide information, awareness, and discussion on the topic. It is not clinical or medical advice. If you need mental health or medical advice, please seek a professional.

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