Mindfulness Supports Healing After Head Trauma

Recovering from traumatic brain injury takes time, and there are numerous stages of healing along the way. Once any initial life-threatening injuries have been stabilized, formal rehabilitation begins. There are many components to rehabilitation including physical rehab, cognitive rehab, speech therapy, and occupational therapy, to name a few.

One important element of rehabilitation is developing a plan for the emotional and psychological healing that needs to occur for both the patient and their loved ones. If you suffered a serious head trauma it can mean that there are permanent changes to how your mind and body function. New ways of knowing who you are, how others see you after the injury, and how you navigate the world have to emerge. This can feel overwhelming. The good news is there are many types of support that work with your own belief systems, and life philosophy.

Woman painting
Jen Brister / Stocksy United

Managing Stress

Stress management is an important skill when coping with the life changes associated with head trauma. While there is an important physiological role for medications such as antidepressants, there are also alternative therapies available. Research shows that practices such as prayer, meditation, mindfulness, and exercises that integrate personal awareness, such as tai chi, can improve long-term outcomes. These are sometimes classified as alternative or complementary therapies.

Long-term studies to determine the effectiveness of alternative and complementary therapies have already been completed and new studies to build on the initial findings are happening now. Many smaller studies completed at the point of care and by rehabilitation therapists and other medical providers demonstrate that mindfulness after a serious accident helps relieve pain, improve sleep, and increase hopefulness about the future. Other studies show that practicing mindfulness helps train the brain to remain more alert and focused in certain situations.

Mindfulness in Head Trauma Recovery

Traumatic brain injury is known to change how messages are communicated between nerve cells in the brain. This can make reacting appropriately to the environment difficult. If there are seven important things going on around you, but you are only able to pay attention to four of them, it is less likely you will respond appropriately. Understanding the big picture becomes more difficult.

A study published in the journal Brain Injury showed that mindfulness training helped head trauma participants keep their focus on the present moment. This meant they were also better able to understand the cues in the environment and respond in ways that were most appropriate to the needs of that moment.

In another, 2015 study on military veterans who suffered traumatic brain injury, mindfulness training was found to improve attention span and reduce symptoms of post-traumatic stress disorder (PTSD). These benefits were still present three months after the study ended.

To be mindful means to stay aware and present. This may sound intuitive, but many of us are not paying attention to what is happening right now. We are thinking about our families, bills, things that are happening in the news, and what the future holds. If you are recovering from a brain injury it can be really difficult to stay in the moment and remain mindful, because you are also focused on new worries from the injury itself. In fact, avoiding the moment can be a coping mechanism if it’s really hard to face what has happened. But eventually, it’s best to face fear, frustration, or grief and work through them.

So, how do you practice mindfulness?

Mindful Focusing

The cornerstone of mindfulness is staying present. You are able to accomplish this by having a specific point of focus that pulls your attention into the body. The most commonly used point of focus is the breath. In mindfulness training you are instructed to feel the air entering through your nose, filling your lungs, and expanding into your lower abdomen. Then, you follow the breath out of the body along that same pathway.

Other elements of the body in space can also be used as a point of focus, such as being aware of how you are standing, sitting, lying down, or how the breeze feels on your skin.

When the mind is primarily focused on the breath, it’s harder for it to get caught up in the thoughts and worries that develop after having an accident. Repetitive, fearful thoughts after an accident are pretty common because much has changed, and there are new worries. Focusing on those worries then makes them seem bigger than they really are, which in turn affects breathing and raises your stress level.

However, when the focus is kept inside the body, it is possible to take a step back and observe the fearful thoughts, and no longer feel like those thoughts are taking over. The thoughts may return, but instead of following the train of the thought, the focus goes back to the breath.

Remaining mindful and keeping the focus inside the body is helpful during physical rehabilitation because the mind-body connection is stronger. Spending time being mindful of going to rehab can help the process and support learning.

Body Scan

Dissociating from the body is a common coping technique after serious physical injury. You try to shut out the pain, or the body-memory of the accident.

However, being aware of the body becomes very important during rehabilitation. The mind needs to be present in order to relearn and refine both large and small movements. Mindful body scanning helps identify areas of tension, and by simply focusing the awareness on those areas, they can begin to relax and respond more readily.

Mindful body scanning follows a step-by-step process. During the body scan, each part of the body, from the top of the scalp, down the face and head, over the shoulders, down the arms and torso, through the pelvis and into the legs and feet is focused on for a period of time. It is also possible to keep awareness of the breath in the background at the same time that you are scanning the body. The goal of mindful body scanning is again to break free from repetitive, fearful thoughts and develop greater awareness of the body in space.

This is beneficial in several ways. For one thing, it helps the mind stop imagining all kinds of complications and difficulties that are not beneficial to the healing process. In addition, when the primary focus is in the body and the thoughts are kept in the background, it becomes easier to sense areas of physical strength, weakness, and tension.

Body scanning prior to physical or occupational therapy brings you more directly into the experience and exercises. It helps you to understand the nuances of the activities you are learning and allows you to let go of judgmental thoughts if you are not successful in initial attempts. Instead of believing that you are a failure, bringing your awareness back into the body returns your focus to the activity and away from beating yourself up over common setbacks everyone experiences in the beginning.

Active Mindfulness

You don’t have to sit completely still in order to reap the benefits of mindfulness. It can also be practiced when eating or walking.

For example, during mindful eating, each bite is taken slowly and savored. The aroma, texture, and flavor of food are enjoyed. Appreciating where the food came from, and feeling how it nourishes and heals the body contributes to the overall relaxation and pleasure of the eating process. When healing from brain injury, staying in the moment and allowing the brain to be present with this type of sense experience stimulates those nerve cells.

Mindful eating also slows the eating process. Instead of being distracted by the television, news, or worrying about the future, mindful eating brings you directly into the enjoyment of a good meal. This contributes to stress reduction which is an important element of the recovery process.

Mindful walking works on the same principle. During mindful walking, several things are happening. You are maintaining an awareness of the breath in your body. You are also paying particular attention to coordination, balance, the feel of the ground under your feet and the air on your skin. The brain is slowing its thoughts to remain in the present moment and see, hear, feel, everything.

This is a particularly important process because, after brain injury, some individuals have a hard time processing complex inputs from their immediate environment. Mindful walking contributes to retraining the brain to stay in the moment and take in more relevant information. It also helps with balance and coordination.

What About Music and Art Therapy?

Mindfulness has been around for ages and is expressed in different ways throughout history. While people currently associate mindfulness with a newer, alternative approach, mindfulness is ingrained in art therapies such as dance, drawing and music therapy. Art brings one’s attention to the present moment and allows negative thoughts to rest in the background.

There are numerous studies that support music and art therapy as successful in helping a traumatized brain recover from its injuries. Similar to mindfulness training, being immersed in beautiful sounds or focusing on drawing or sculpting puts worrisome thoughts that contribute to stress and fear into the background.

In addition, these activities stimulate the brain in new ways.

Research studies show that listening to music, drawing, or mimicking artistic processes by trying to copy a painting, cause these artistic areas of the brain to become more active. The nerve cells in the brain reorganize how they send and receive information, to adapt to the new learning. This is called neuroplasticity. Neuroplasticity enables the brain to use alternative pathways when sending information. After head trauma, this may be important if nerve damage in certain areas of the brain get in the way of sending information.

It is important to remember there are many therapies available when recovering from head trauma. Mindfulness is an approach that complements medical therapies and has been shown to reduce suffering and improve healing in those receptive to the practices.

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By Eva Hvingelby, NP, PhD
Eva Hvingelby NP, PhD, is a nurse practitioner, researcher, educator, and health consultant specializing in trauma.