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Be aware

Introduction

If you have been living with a brain injury for a long time it can help to be aware of some things before working with neuro experts. Depending on the severity of your brain injury, and where you are on your recovery path, you may have initial difficulties with involvement and understanding. Brain injury outcomes and symptoms can affect the way we can participate.

For example, loss of hope, apathy and loss of self-awareness can interfere with our ability to process incoming information and the main difficulty presented can be not realising this. Psychological blocks can also be invisible to us, and while we think we are giving everything we have, we can easily miss the point.

The auto-pilot

Following brain injury, a lot of our responses come from the reptilian complex which drives our auto-pilot.

The degree to which this happens, and how long it lasts, depends on many factors and, as such, each person will experience things differently. For this reason, the information here is very broad and based on the way things can be, rather than being definitive for each person.

The injured brain knows that it isn’t functioning correctly. Some people are consciously aware of this, while others are not. The main job of the brain is to ensure survival, and because of this, the automatic brain takes over. The less damage there is to the neocortex and the less clogging there is in the brain environment, the more noticeable difficulties are likely to be because you have more clarity and room to think.

When people around us talk about denial, they are often observing ‘a blindness’ in understanding rather than a psychological refusal to consciously accept the brain injury.

The changes that set the auto-pilot in motion are why people find themselves doing and saying out-of-character things – the auto-pilot is effectively bypassing the reasoning/choice brain in the neocortex and is doing its’ best to get us from one moment to the next – from A to B.

Because the reptilian brain is essentially where all sponsoring thoughts and responses come from, the impetus to act feels entirely natural. The automatic firing of the brain is still working – it is the signal that travels differently.

Broken signals

Brain injury outcomes and symptoms effectively form a barrier between what is initiated by the reptilian brain and what comes out.

In this way, intentions can be precisely the same, and yet, what is observed can be something else entirely. In effect, the filtering systems in the neocortex are circumnavigated – what we see is a semblance of the raw article rather than the entirety of the person. It can take time for the brain to start utilising personal history again.

These experienced outcomes can create immense amounts of confusion and frustration for people because there is a complete lack of control over this consequence of brain injury. You can’t force the brain to go and look at the broader range of personal data before the response comes out.

Many aspects of the ‘self’ are circumnavigated this way, including:

  • personal choice
  • personal history and memories
  • experiential memories
  • knowledge
  • innate and working beliefs
  • associations
  • empathy and understanding

It can feel as though the subconscious mind is no longer working. Many people are only aware that something is different and find it very difficult to describe the details of their experience.

Outcomes

Many of the consequences of this process are misunderstood, and some people think they are psychological in nature or driven by personality. Difficulties with getting what we want to come out can be seen as denial, just as often as we can miss realising that the conscious brain itself can lose the understanding that there is anything wrong.

While this can be true in some cases, very often a severe brain injury will involve other factors such as loss of self-awareness of self-insight. Emotional flattening can play also play a huge role, as can the effects of the biochemical cascade, which alters the brain environment slowing electrical signalling making thinking, understanding and the processing of incoming information very difficult.

For many people, there is a feeling that if they could get their ‘true self’ to work again that they could take back control and work clearly and practically on rewiring. Without this clarity of thought, therapists can find it challenging to break through the layers of dysfunction to reach the reasoning brain.

The more we understand about what is or could be happening to us before we start working with neuro therapists, the more chance we have of embracing the feedback and information they give us.

A crucial piece of understanding to take with you is that it is your brain that is broken – not who you are. If you feel a loss of hope or are overwhelmed by apathy, you may also have a lack of faith or a predetermined expectation of failure. Neuro therapists need you to be involved, and this means that it can help if you can shift or understand negative emotions before you start.

Although a therapist will undoubtedly help you with working through barriers, there is often little they can do if you aren’t ready to start helping yourself. Overcoming unconscious denial is where some of the information on this site can help you. Because it is peer-led and based on experiential knowledge, it is delivered from your point of view. It is much easy to recognise meaning when it synchronises with how you feel than it is to try and process someone telling you what is happening to you from their perspective.

Many people struggle with trust following a brain injury – if you make your own decisions, this is a barrier you won’t need to overcome – and neither will your therapist.

Why does it matter if you are going to get help with all of this? 

Depending on where you live health services can provide very differently. An insurance company or health authority may limit the number of sessions you can get. If this is the case, you want to be able to make the most of every moment you are working with any specialist.

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