Begin Where You Are
In the marvelously simple words of international educator Dr. Paul Linden, “Trauma is overwhelm”—overwhelm of both our capabilities and our defenses. Addressing any traumatic injury must include re-integrating a sense of wholeness and capability—not the capability to do “everything” (whatever that is) but to live and interact with our environment in an interesting way. Dealing with a trauma without integrating the body is painfully inefficient.
The Israeli physicist Dr. Moshe Feldenkrais created one of the best practices for integrating movement into whole body healing. The Feldenkrais Method focused on improving posture, flexibiliby, coordination and artistic ability in those suffering from chronic pain and tension. Dr. Feldenkrais had a deep appreciation for the strength of human beings and did not define them by their limitations. Always advocating for a cooperative approach, one that created an environment conducive to learning, he worked miracles by improving whatever function a person could manage.
Changing the rules
When someone has a traumatic brain injury (TBI), the rules of their life change. Weird may be the new normal. Learning how to function afterward means learning under a new set of rules. Every injury is unique, as is every person and no predetermined technique can be accurate. Instead, an exploratory strategy, and a learning orientation, is needed.
As we now know, the brain never stops changing. Living things grow and change. The whole nervous system changes constantly, adding new connections and deleting old ones. This is known as neuroplasticity.
Deleting can be a very good thing. During our teenage years, we prune away outdated childhood connections. Our size has changed, our needs have changed. We must lose some of the concepts and habits on which we formerly depended. Without this house-cleaning in our nervous system, we could not move on to a more adult way of functioning. It’s important in looking at brain function to remember that loss is part of health.
Adding connections is also a life-long process. The saying in neuroscience is “Neurons that fire together, wire together.” Nerves that are used in a sequence or group become linked. If a pattern is helpful, it becomes automatic. Learning never stops. We now know that new brain cells constantly grow, and that there is no clear limit to change in the neural structure of humans.
A whole body approach, like that taught through the Feldenkrais Method, moves the focus off the limitations of the body and on to improving overall function. Organic learning is more pleasant than obsessively confronting inability. The improvement this will bring to a person’s emotional world should be obvious, yet making room for this exploration can be difficult. Anxious voices must be quieted. These are the voices, both internal and external, that want a quick return to normalcy. Hurrying is not helpful, and the anxiety itself can mask new sensations and hinder learning. There is no separation of mind and body. Slowing down and attending to the body slows down the mind. Mindful movement develops the capacity to notice and integrate detail. Learning becomes easier, more pleasant, and deeper.
As social animals, humans crave communication. TBI often interrupts and alters speech. The social aspect of this is intense. One TBI survivor recalls, “The thing that drove me wild— just wild—was people mimicking my speech patterns back at me. They thought I was ‘pretending.’”
Experiments have shown that gesturing while speaking improves a person’s ability to articulate clearly. Movement supports speech by improving analytical thinking. Parallel investigation shows that the act of tracing will improve understanding of math problems. Speech and analytical thinking can be frustrating after TBI. Working through the body in movement can gain access to improving function while avoiding those frustrations.
Speech therapists are the backbone of recovery for many. Fortunately, most medical professionals recognize the skill and devotion these practitioners offer. Likewise, there are incredible opportunities in going even farther back to the foundations of survival, and working with functional movement. “Movement, your other native language”—the slogan from the Laban Institute of Movement Studies, reminds us that we are all movers first, and speakers later. As we communicate nonverbally, we also support and develop our identity.
Calming the emotions
TBI can cause challenging mood swings. Alcohol can modulate them, but that clearly leads to problems. Taking away a coping mechanism without eliminating the stress is cruel (and generally futile), if we don’t offer a replacement. Mindfulness practices are a drug-free response to the need. These are incorporated into movement-based learning. Body-centered approaches have long been known to be the most direct and skillful path to building a meditation practice. Working this way offers TBI survivors multiple benefits, restoring physical function, stabilizing emotion and sharpening cognitive skills.
Balance can be a big challenge. Following the chronology of development, the Feldenkrais Method works on balance from lying down, and builds toward walking and standing still. Rather than wobbling about, which can reinforce a sense of struggle and anxiety, we’d want to re-connect with security, and then build on that comforting awareness. Better perception of support then allows a better quality of movement—safer, more consistent and more fun.
TBIs are disorienting, and often decrease short term memory. More simply, you forget stuff quickly. There are great tricks for coping, like sticky notes, carrying a notepad and using the voice memo function on your phone. But short term memory is not magically constructed. It is related to “muscle memory”—the neural connection of movement and sensation. Recent studies on memory in older adults have shown that dance does more to improve short term memory than traditional exercises such as crossword puzzles or memorization games.
Again, shame and frustration hinder learning and recovery. Working from whatever level of consistent success a person has, be that as simple as inhaling and exhaling, we can improve a person’s self image—not just the social part, but one’s whole sense of being alive—and so improve the odds of successful recovery.
For over 24 years, Dan Schmidt has worked with people ranging from the severely injured to high level performers who are pursuing extreme capabilities. He maintains a private practice in SLC, and also offers advanced training for massage therapists. He is a frequent CATALYST contributor. DanTheBodyworker@gmail.com