a picture of a brain over a purple background - interoception concussion and traumatic brain injury

Interoception, Concussion & Traumatic Brain Injury

Hi everyone. Kelly Mahler, occupational therapist, and this month we’re taking time to talk about the intersection between interoception, concussion and other traumatic brain injuries. Now, there is a lot of overlap in these topics, and I want to give you the top three reasons why we need to be talking more about the connection between interoception and brain injury, especially when we’re talking about the healing process.

3 Reasons Interoception is Essential for Concussion and Brain Injury Healing

#1 Standard Concussion/Brain Injury Healing Guidelines are Based on Noticing Interoceptive Sensations

So number one, we know that the healing process from concussion, from brain injury, oftentimes requires a lot of reliance on body noticing. What do I mean by that? Many times, people who experience a brain injury are asked to report on their symptoms and how their body is feeling. That recovery process is highly dependent on their ability to notice their body sensations. That’s all about interoception, right?

For example, in phase one of concussion recovery, it’s all about resting and really monitoring your symptoms (hello interoception!). And as you can move into the next phase of recovery where you can start some light activity, it is usually “light activity as tolerated”. And what does that mean? It means listening to your body and stopping when you start to feel or notice certain sensations in your body and taking a rest (again heavy on the interoception side of things!).

And as you move through the recovery phase, it’s more and more reliance on activity is tolerated. Noticing how your body feels, stopping when your body is telling you to stop, taking a rest until your body feels better (that is so interoception heavy!).

Give all of this, are we even taking into consideration a person’s interoceptive capacity? For example what was their natural baseline even before injury. We know that some people are more connected to how their body feels and other people are less connected. But we also know that concussion and brain injury can impact interoception in many different ways. So we need to consider if a person has the interoception capacity to reliably ‘listen to their body’ and promote the most optimal healing path.

#2 Rates of Alexithymia (aka Interoception Differences) are much Higher in Concussion and Brain Injury

We know that alexithymia rates are much higher in the brain injury population. So, if you have a brain injury, you have a higher chance of experiencing alexithymia.

Alexithymia is a topic we’ve talked a lot about. It refers to difficulty identifying and describing the way your body feels, difficulty identifying and describing your emotions. That’s all about interoception. Interoception is the scientific underlying reason why a person experiences alexithymia.

So, something is happening. Researchers don’t understand what is happening quite yet between when someone experiences a brain injury and it leading to higher rates of alexithymia. And there’s even research that’s suggesting that those alexithymia rates are tied to emotional regulation differences. And we talk a lot about that too. You have to be clearly aware of how you’re feeling in order to be able to regulate how you’re feeling effectively.

The brain injury process can lead to difficulty identifying and describing the way that you feel and also regulating those feels.  Therefore, we need to nurture the foundation, which is interoception.  Interoception-based work can help to enhance the clarity of our inner experience, on how we’re feeling, and on what our body needs to be bettered regulated.

#3 Brain Injury can be both a physical and psychological trauma: Interoception as an important aspect of healing from PTSD

The third reason is all about the emerging research suggesting that PTSD is highly associated with concussion and brain injury. People who have experienced brain injury have very high rates of PTSD, suggesting that a brain injury is not only a physical injury to the brain and the body, it also is a psychological injury.

Some research suggests rates of PTSD can very much depend on how a person may have gotten their brain injury. Maybe that event was a physical injury to their brain, but also it could have been a very big psychological injury or trauma, whether it may be, perhaps, a motor vehicle accident, or war/combat, or an athletic accident, or many other possibilities.

With these rates of PTSD, we know that interoception is affected in every single person who experiences trauma. That means we need to have more interoception-based considerations and supports in brain injury and concussion treatment processes. We need to incorporate and explore interoception with these clients, helping them to safely become reconnected to their bodies, to help them safely understand and trust their bodies again, so that they can regulate and have greater rates of positive mental health.

To learn more about Interoception, Concussion and Brain Injury check out our new online course. Registration comes with video instruction AND exclusive access to lots of adapted materials from The Interoception Curriculum–all adapted for serving this client group:

  • 71 page workbook filled with Descriptor Menus, Focus Area Experiments and more
  • 15 Guided Body Part Meditations for Sensation Noticing (mp3)
  • 10 Body Part Coloring Pages to Guide Meditation and Sensation Noticing
  • 17 Pages of Feel-Good Menus all Divided by Type (e.g., Vagus Nerve Activities; Deep Touch Pressure Activities, Vision Activities, Creative Activities, etc)
  • Blank Template for Developing a Personalized Feel Good Menu and Feel Good Routines
  • 30 Inspirational Quotes Paired with Reminders to Notice Sensation in a Specific Body part
a graphic for the course on interoception, concussion and traumatic brain injury

Until next time.