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Help & advice, Brain Injuries | 6 minute read

How To Develop Greater Self-Awareness After A Concussion

Written by Anna Leggett, 13 July 2021

How To Develop Greater Self-Awareness After A Concussion

Learning to become more self-aware has been an important part of my recovery journey from post-concussion syndrome. In this post, I want to talk about what self-awareness is and a bit about my own experiences of working to become more self-aware.

Self-awareness is the act of focusing attention on ourselves in order to have a better understanding of ourselves both internally and externally as we relate to others and the world around us. It’s something that all humans have to a greater or lesser extent and it’s something that can be developed.

When we become more self-aware, we’re better able to tap into our thoughts, emotions, feelings, behaviours and responses. We can appreciate our strengths while at the same time noticing areas for improvement. As a result, we can make better choices and take more informed action. This isn’t about being self-centred. In the context of this blog post, it’s about becoming more attuned with ourselves in order to heal and function better in the world after an injury. It’s also about you feeling more empowered and less like you have no control over your situation.

As we tune into and focus attention on ourselves and get curious, we can get to know ourselves better, gather important information and identify areas in our lives where we’d like to make changes. We can begin to ask questions like, “What emotion am I feeling here?”, “Why am I feeling like this?”, “Where does this emotion come from?”, “What pattern do I see here that is triggering my symptoms?” and “What do I need to do in order to change this situation?”.

Increased self-awareness can help you to feel more confident in yourself and in your different environments

Whether that’s work, home, leisure or social. You will learn to trust yourself, your intuition and your ability to make decisions more, and in turn, you will feel more confident in your day-to-day life.

With a brain injury, the ability to be self-aware can be impaired due to damage to certain parts of the brain. It isn’t clear exactly what parts of the brain are responsible for self-awareness. Some researchers have stated that developing self-awareness happens largely in an area of the brain located in the frontal lobe region, called the anterior cingulate cortex. However other research suggests that even with extensive damage to this area of the brain, self-awareness was still retained, suggesting that awareness ‘may instead arise from interactions distributed among brain networks’. (verywellmind.com/what-is-self-awareness-2795023).

I know from personal experience how upsetting and frustrating it can be to lack self-awareness after a brain injury, especially in relation to interactions with other people. I definitely noticed and can reflect back that, especially earlier on, I didn’t have the insights or self-control that I used to have. And sometimes, I wouldn’t be aware of this and it would take someone else telling me for me to realise.

It could be that I’d suddenly snap at my husband or one of my children out of nowhere or overreact to something. Or I wouldn't be aware of how my behaviour or something that I said was impacting other people. Sometimes it would take my husband or my children or a friend to point something out to me that I’d said or done. I tried not to take it too personally and I would apologise if I needed to. Other times I would just say something like, “Look, I'm really doing my best. I can't help this. But I will try better next time.”. I would give myself self-compassion, grace and forgiveness about the situation, and always try to learn from it and use a different approach in the future.

I’ve found that slowing down and taking the time to regularly, intentionally, sit with my emotions and feelings and look at them and ask them what they're trying to tell me, has been incredibly helpful. Other times, I’ve taken time to reflect on a situation that perhaps didn’t go so well and make a decision to do things differently in future. I really encourage you to become comfortable with taking time to try to understand and reflect on your emotions and your life and to become good friends with that inner voice inside you.

Sometimes, as we become more aware of our emotions and feelings, this can be uncomfortable. The temptation then can often be to bury them, push them away and generally avoid them. But the more we take notice of them and give them our attention, the more we realise these are important messages that need to be listened to and attended to. It can be quite a painful experience to do this but we can build up gently and we can be compassionate and non-judgmental with ourselves.

Our emotions can seem quite scary if they are strong and feel negative, especially when we've had a traumatic experience. If this sounds familiar to you, then you may find it may be helpful to work with a therapist or counsellor to help you process some of those emotions or to learn to handle them better and not be afraid of them. Strong emotions aren’t necessarily ‘bad’ – they can be very helpful at alerting us to something we need to give our attention to.

After a brain injury, we can get stuck in negative feedback loops that aren’t helpful. It’s a good thing if we can identify a negative thought or emotional feedback loop and then work towards breaking it and learn how to change our emotional state into something more helpful. When we identify and break out of negative patterns, we feel more energised, positive and hopeful. We can really start to listen to our needs, wants and desires and we can see things in a better light and make better decisions that will help us. We will gain more clarity on how we want to move forwards on our recovery journey and in our lives.

Doing this can be as simple as noticing what we are thinking or feeling, and if it’s not helpful, then making a decision to think or feel something different. Or it could mean taking 5 or 10 seconds to think before we say or do something. I have also found that changing my activity can be helpful for shifting my emotional state. For example, if I find myself sitting on the sofa over-thinking or feeling a bit down, then I might decide to go for a walk instead.

Having more self-awareness can help with alleviating and managing post-concussion symptoms

Start by noticing what your symptoms are and how you are feeling at a given moment and then try to figure out what in your external environment or what internally might be triggering them.

For example, if you’re in a supermarket, you might notice that the bright lights, large space and a large number of people cause you to feel overwhelmed and dizzy. So, to make that a more manageable experience, you might decide to go to the supermarket at a time of day when you are feeling most alert and when there are fewer people. You may decide to wear dark glasses or coloured lenses to dampen the glare of the lights and earplugs to reduce the sound level. Or you may ask someone to go with you and then decide to take a rest when you get home afterwards. I found that over time, by making small changes like these, I began to find a trip to the supermarket less overwhelming and gradually my symptoms subsided. Although I’m now usually OK in a supermarket, I still do sometimes do things to help, like taking a comprehensive shopping list so I know exactly what I have to buy, going when I know it won’t be so busy and wearing earphones and listening to calming music on my phone.

Track your symptoms and see if there is a pattern

Another thing I recommend is tracking your symptoms and seeing if you notice any patterns. This will help you to identify your triggers and you’ll be able to find ways to address them. You could also track your nutrition and start to figure out what foods or supplements might be helping/hindering you.

After having headaches every day for several months after my car accident, I started tracking my symptoms by just writing down the date I had them, the severity of the headache, what I had been doing that day and the day before, and what my sleep had been like the night before. I started to notice certain patterns – for example, I would feel worse after driving - and was able to adjust my day-to-day routines and find solutions. I was also able to share this information with a neuro physiotherapist and she was able to recommend some supplements that helped me.

I just wrote my symptoms down on a paper tracker but I’ve recently learned about a free, easy-to-use online symptom tracker at www.powerofpatients.com for recording all concussion/brain injury symptoms. Tracking your symptoms not only helps you to manage your symptoms on a day-to-day basis but you can also share that information with your healthcare provider, which helps them to be more informed about your condition and this, in turn, can help you and them to find appropriate treatments more quickly. For example, by tracking the dizziness and light sensitivity that I mentioned earlier, I was able to be referred by a neurologist to a neuro physiotherapist who treated me for Benign Paroxysmal Positional Vertigo (BPPV).

It’s also important to notice when you feel good and not just when you feel bad. What makes you feel happy, energised, excited or calm? For me, for example, I feel great when I go swimming. I’ve always loved swimming and when I go, I find I forget about everything else and feel calm and energised by the endorphins. I still deal with some chronic pain but I notice that for some time after going swimming the pain has either decreased or disappeared.

Doing more of the things you enjoy and that make you feel happier and better will create momentum for your recovery. This benefits you both physically and mentally. So, for example, if you find that being out in nature lifts your spirits, then go for more walks in beautiful, calm places. It seems obvious, but when we are suffering it can be hard to see this. There’s growing scientific evidence of the link between mind and body, and how they are not separate entities but are intertwined and affect one another. The more awareness we have around this, the more we can influence our healing. We will be better at identifying what we find to be beneficial for our physical and mental health and as a result, we can engage in activities that enhance our feeling of well-being.

Anna Leggett

By Anna Leggett
Guest blogger

On 10 November 2016, Anna Leggett life was turned upside down when she suffered a mild traumatic brain injury in a car accident.

Read other articles by Anna Leggett

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