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Cognitive Impairment

Understanding Cognitive Impairment 

*The Outcomes of DES often overlap as many things may be happening together

*It is usually easier to distinguish the cause of cognitive outcomes

*Cognitive disruption is mainly caused by the primary effects of brain injury – tearing, shearing etc

*Cognitive symptoms, such as ‘brain fog,’ are exacerbated by the secondary outcomes such as inflammation

*Understanding brain injury plays a huge role in the eventual recovery

*The brain isn’t ‘who we are’ – it is a tool that we use

*Forming new networks is dependent on repetition


Dysexecutive Syndrome (DES) is considered in three broad categories – cognitive, behavioural and emotional.

The signs of behavioural and emotional outcomes often overlap in most peoples’ observations, but the indications of cognitive issues are generally easier to spot. However, it can be difficult for people to understand what is causing a particular behaviour or action because often, many things are happening all at once.

For example, being glued to the sofa could be apathy, problems with knowing where to start, flooding, depression, difficulty breaking things down, and so on. It could also be all of these things happening together. The best thing to do, as an observer, is to resist making any judgements because often these are based on what we would typically assume about the everyday world, rather than being based in clear and objective understanding about brain injury.

Getting it wrong can inadvertently lead to an awful lot of upset, as many of you may well have found out.

By learning more about the outcomes, and what causes them, we can all start to be better objective observers, and those who are learning all over again can become more self-objective


Cognitive disruption is mainly caused by the ‘physical’ neurological damage such as tearing, shearing, and any resulting cell death. However, secondary outcomes also contribute to this insult. There are supplements which can help stem the biological cascade of harmful chemicals and can help at any stage following brain trauma. Many alternative holistic treatments can support healing.

The main thing is that regardless of the initial cause, the executive functions are significant contributors to ‘familiar thinking’ and feeling a recognisable inner sense of self.

The ‘how’ of how we individually think has a huge part to play in how we feel about ourselves and our ability to maintain our unique integrity following trauma. Based on many things, this sense of self includes our history, upbringing, beliefs, habits, and experiential memories. Brain injury can disrupt all of these aspects.

People must feel understood and supported, and often, especially where there is a lack of medical treatment and understanding, family and friends find that they take on the role of caregiver. ‘Helping’ can be a mammoth and seemingly impossible task – but it is never fruitless – even when you are getting it all wrong – all feedback and communication can help.

All interaction is helping because it is all giving the injured brain a chance to learn. Understanding more can help with the stress levels, and when reduced, so is cortisol output. Please see the dangers of stress and cortisol.

Mind and Brain

The brain is a ‘tool’ used by the mind. The brain isn’t ‘who we are.’

The mind can conjure all kinds of flexible thought that the brain could never even imagine – let alone do. It is by understanding that the brain is a ‘broken tool’ that the mind can start to fathom how to fix it. Think of the mind as the observer and overseer. Without understanding this ‘healing’ is drastically slowed. We have to be able to sort the wheat from the chaff and know who the boss is. The ‘mind’ is definitely in charge and is useful in directing the broken brain.

If this seems confusing, one thing that many people are familiar with is how we can all struggle to think when we feel overwhelmed – it can feel as though all our faculties have deserted us. Depressed moods are another good example because people very often feel as though they can’t ‘choose’ their thoughts. It is this ability to be in control and to make choices about our ideas that give us a real sense of feeling that we are more than just our brain.

That quantum science now understands that we are indeed much more than the physical brain organ supports the descriptions people give of their struggles with brain injury.

Many people report losing awareness of the ‘thinking voice’ in their head, and this is frightening, upsetting and confusing. You can work out whether you can still ‘hear’ your inner narrator by running a quick test on yourself. Look over to one wall of the room you are in and, in your head, describe it to yourself. If you can ‘hear’ what you are saying, then this is your ‘mind.’ It is the inner voice that many people ‘forget’ to hear after brain injury. Practising this simple exercise in times when it feels as though we can’t interrupt ‘streaming’ and incessant thoughts can help remind us that we do have the power to choose and also the capability to redirect.

If this exercise was quite strenuous for you, there are things you can do to help this such as, journaling, reflective techniques and mindful breathing exercises, from the Cleveland Clinic. ‘Black seed oil‘ also helps at any stage post-injury.

When you get the gist of using your ‘thinking voice’ you can then use this ‘boss’ to start fixing your brain. Without this realisation, we can easily be stuck never realising there is something we can do.

It isn’t always the emotional overload that keeps people perplexed – sometimes it is caused by not knowing what is going on.

Keep practising with the techniques. They are all part of rewiring the physically broken pieces of your brain. Repetition builds new pathways.

Repetition Builds New Pathways

This is an excellent picture of the myelin sheath because it shows the ‘growth rings’ – just like a tree has.

There is so much information about the myelin sheath, and repairing and rebuilding it, that it gets its’ own page!

Damage to this sheath is the thing that causes problems with memory, cognitive function, and also movement, to name just a few. The primary damage caused by brain injury means we often have to start from scratch with a lot of our learning and skills.

Forming new ‘networks’ is entirely dependant on repetition. There is a lot we can do to help this process, and ourselves, and it is very well worth the ‘deeper’ look.

The secondary injury also damages the myelin sheath, as can diet and toxins in our environment. Addressing the health of the brain environment is imperative. We must do everything we can to support all brain function and make sure we don’t do any further damage to it. Black seed oil has been shown to benefit the repair of the myelin sheath.

Cognitive Intelligence

In general, many people interpret their intelligence based on how ‘easily’ they can problem-solve. Cognitive impairment doesn’t directly affect innate intelligence – instead, it affects the way this intelligence can work.

Cognitive impairments include outcomes such as difficulties or inability to plan and organise. It doesn’t matter how much you may ‘want’ to do these things – if you have a brain injury, the fact is, you can’t, or will struggle. The map ‘to it’ has been erased or damaged. Sometimes you have to start again; sometimes there is a lot of work to do to improve function.

The intricacies of rewiring will depend on the damage that has happened uniquely in your brain. The power of nature is on your side, and there is an awful lot you can do to help it.

Let’s look at things one at a time:-



Executive Skills

Experiential Memory


Perceptual & Sensory


Loss of Insight


Science Direct – Nigella Stavia (black seed oil) as a promising remyelinating agent


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