Every few years, there are those events that seem to press a psychological reset button. They help to remind us of valuable lessons, of concepts needing reinforcement, and of the value of life. Often the event is a loss, an illness or a disruption in daily life which allows such reflection. The initial impact can range from disarming to devastating, but there can generally be silver linings which shine through.
My most recent such event occurred in the form of a concussion. I was engaged in a mundane chore of bringing recycling materials to the dump and inadvertently tripped backward over a parking block, absorbing the majority of the fall onto the concrete with my head.
As we drove home, my husband jokingly asked if I knew the year or if I remembered where we had been that weekend; he didn’t expect me to be rather fuzzy on the answers and then became rather alarmed. Following several hours in the emergency room and a CAT scan, it was determined that I had suffered a moderate concussion.
Concussions apparently typically occur as a result of sudden changes of direction or speed to the head. The brain continues to move while the rest of the head doesn’t. It results in a stretching of neurons and other microscopic changes throughout the brain.
I learned that a concussion leads to some temporary interference with normal brain functioning and transitory deficits in how the brain operates cognitively and physically. Unlike more serious structural injuries, such as bleeding in the brain or a skull fracture, concussions are much more mild but do still need to be taken seriously. One of the messages becoming more known over the recent decade, especially with the proliferation of sports injuries, is that improper management of a concussion can lead to permanent functional deficits. Given that I rely on my brain very regularly, that information was pretty motivating in terms of following the doctors’ recommendations that I allow my brain to heal via some serious rest and relaxation.
Most of the memory surrounding the incident of my fall returned within the ensuing 24 hours, including the proper year and the activities leading up to the event; however, some of the post-concussion symptoms took a bit longer to resolve. During that time, I was forced to experience the process of facing life in a different way. Luckily, this injury was not life-threatening and a full recovery is expected. This experience is relatively minor in comparison to so many other tragedies that befall individuals every day and even in comparison to some events of my past, but it was yet another opportunity for me to learn more lessons and to appreciate the teachings. And given that the primary post-concussion treatment recommendation was to “do nothing,” the experience also allowed a fair amount of thinking about thinking.
I am a hopeless multi-tasker. I am the type of person who likes to fold laundry while talking on the phone, draft a letter while walking the dog or listen to a TED Talk while making dinner. But during the recovery from my concussion, I was forced to approach tasks in more of a uni-tasking manner. The doctors had warned that headaches would ensue if the brain was overstimulated during the healing time, and indeed they were right.
At first, any type of overstimulation felt strangely overwhelming. I was not especially surprised that overstimulation could occur with loud music or action scenes of a movie, but I was surprised that it could occur with even more seemingly simple activities, such as staring at the ceiling fan. Eventually, I advanced to one activity at a time – but which one? Did I want the radio on or did I want to make a sandwich? Was I going to walk to get the mail or make a phone call? Engaging in simple tasks in a serial manner provided practice in experiencing the matters more attentively. I observed more trees, flowers and animals. I tasted and smelled food differently. I noticed the smooth texture of the pillowcases and towels. I heard song melodies more fully.
I learned that one of the best places to uni-task is outside. I have generally loved being outside but so often the tasks of technology and daily household chores pull me indoors. As it turns out, simply watching the leaves sway in the wind or the clouds drift by was plenty stimulating and much more settling. I kept being reminded of Richard Louv’s hypothesis in his 2005 book Last Child in the Woods: “Nature Deficit Disorder” from spending so little time outside. I have so often recommended this book to parents of kids of the current techonology generation but realized I, too, need to practice what I preach.
Lessons learned: I can’t do it all; I am not supposed to. Nature provides many gifts for us to experience. And, behold, sometimes things are better done one thing at a time.
My concussion came amid my engagement in an eight-session course on DBT skills for therapists. It seemed so fortuitous to be in this specific therapist training group which ended up proving to be instrumental in my recovery. My level of emotional dysregulation remained generally more minimal, but the skills proved so valuable nonetheless. The process of observing and describing was pivotal in terms of taking on my uni-tasking challenge. Noticing the positives provided terrific distraction and joy enhancement during the process of adjusting to temporarily less productive days temporarily. Being nonjudgmental of my need for an earlier bedtime and radically accepting that I simply couldn’t take all of my usual daily tasks for a period of time proved beneficial to me.
The interpersonal skills module was also addressed in the sense that I had to practice one area in particular during my recovery: accepting help. I think of myself as a fairly independent (some might say stubborn) individual. I am very familiar with the helper role but less comfortable with the being helped role. The recommendation that I not drive, not engage in much physical activity nor work for at least a week after the concussion forced me to really consider how I needed to change my usual mode of operation. Allowing a friend to do an errand for me or my family members to drive me places was difficult to accept at first but was required and, ultimately, was actually rather connecting and reaffirming.
Lessons learned: DBT skills are powerful, for our clients and for ourselves. I also am reminded once again of how fortunate I am to have an inherently well-functioning system of sensitivity and reasonable resources for coping with reactivity, something which is not true for so many of our clients.
One of the many curious things that happened in the hour after my concussion was how I suddenly kept spontaneously singing lyrics to a Katy Perry song entitled “Wide Awake.” The lines that repeatedly resonated in my head included: “Wish I knew then, What I know now…Gravity hurts…’Til I woke up on, On the concrete…”
Let it be known that I didn’t know that I knew this song, never mind specific lyrics, and couldn’t even have identified which song this came from myself, until my 13-year-old daughter looked it up on her iPad as she sat next to me in the hospital room. The way in which the mind can dig into some hidden crevice of the brain to recall lyrics of a song I must have heard at some point on the radio is simply amazing. And it reminds me that part of why I love my job is because we get to work regularly with one of the most fascinating and most complex organs of the body, the human brain.
Katy Perry, as it turns out, apparently wrote the “Wide Awake” song about a breakup and was sharing how the event forced her to suddenly come off of cloud nine to wake up to reality. As it turns out, my head literally hitting the concrete also forced me to wake up. I have been jostled into greater awareness, appreciation, patience, and joy in the mundane. I am grateful for friends and family. I am glad to have had the experience of being a patient and noticing how other clinicians’ questions, notes, and body language affected me. I am awed at the power of the mind and the power of techniques that we teach in terms of really helping to settle, to calm, and to focus. I am back to focusing on the little things, the real priorities in life — like agreeing to my daughter’s request to do her nails instead of finishing the journal article or choosing to take the time to write a friend even though the chores are not completed. I am reminded of the challenges our clients face every day in incorporating skills we teach and encourage.
Lessons learned: Being awake for daily life is valuable. Gravity can hurt, but it’s also grounding and so very necessary.
And may my memory for all of these lessons remain intact for many years to come.