In this blog and other Mindful Concussion resources I tease out the trauma-sensitive and concussion-sensitive modifications I have figured out on my own, as well as modifications I have learned from others.
For now, let me briefly introduce the basic elements of the core modifications of my Mindful Concussion approach. Yes, I know that these Top Ten lists I make may seem silly, but it is easier for us concussion survivors to take in information via lists like this rather than via beautiful prose…..
1. We ask ourselves: Where am I on the Merging Map of Nervous System concepts?
This is not so much a modification to traditional practice, as an additional resource that came to me one day when so many different concepts I had been learning about nervous system regulation gelled together in my mind. This map helps us see clearly and quickly the state of our nervous system (and our stress levels) at any given moment.
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At any time of day, we can imagine the Merging Map of Nervous System Concepts in our mind and place ourselves on it. Are we in the Green Zone of Calm? Blue Zone of Flow? Purple Zone of Learning? Pink Zone of the Slow Drip of Stress? The Red Zone of Overwhelm? We can notice where we are on the Nervous System Arousal Meter from 1 (hypo arousal) to 10 (hyper arousal).
We can learn to listen to the warning signs before they turn into alarm bells. If need be, we can pause, pivot, and proceed with actions that will take us back into our Window of Tolerance.
2. We start in the parking lot of learning with anchors that are least likely to overwhelm
Meditation classes often start with an intimate exploration of the sensations in the body, but this is not an effective way for concussion and trauma survivors to begin mindfulness training. There is very little incentive to practice if every time we touch into the present moment we feel terrible! Eventually we really do need to cultivate awareness of the sensations in our body, and the wisdom of the messages these sensations tell us, but this is not a wise starting point.
I want to take you by the hand and introduce mindful concepts and skills in a gentle way. The Mindful Concussion approach starts in the ‘parking lot’ of learning, with anchors that are least likely to lead to overwhelm. We learn to strengthen the come-back-to-the-present muscle with pleasant anchors. We start with anchors that are external to our body, like the wind in the trees. Then we move to anchors that use exteroception (external body sensations) such as the sun on our face or the taste of jelly beans. Lastly we sink into interoception (internal body sensations), such as tight muscles or a clenching in the chest). This gradual introduction of the felt sense of our emotions helps us concussion and trauma survivors build our capacity to stay in the present moment without becoming overwhelmed.
3. We lean into the difficult, but only when we are ready
Meditation classes often have a heavy emphasis on leaning into the difficult very early on in practice. We are not going to do that at first because it can be too overwhelming for our discombobulated nervous systems.
It’s not a question of avoiding the difficult, it’s about when and how to sit with the hard stuff. We do need to learn to ‘go downtown at rush hour’ and allow ourselves to feel the hard realities of our brain injuries, but it is not where we will start.
In this we consider what I call ‘Jessie’s Four Ts: Time, Titration, Trauma, Therapy.’ We ask ourselves, is this a good Time to lean into this difficulty? Am I resourced enough right now? Is this difficulty something I had best Titrate (Titration: dip a toe into the difficult and then put attention on a neutral anchor until we feel settled enough to touch into what is hard again). Or is this a BIG T Trauma that I had best dig into with a Therapist?
I want to offer you a range of things you can do to settle your system first, so that by the time you lean into the hard stuff you are feeling well resourced, and you have the capacity to begin to sit with the difficult in ways that are healing, not overwhelming.
I encourage you to lean into the hard stuff, when you are ready, but Don’t lean In when you are Out (of your Window of Tolerance). Just like we cautiously open a pop bottle that has been shaken to avoid an explosion, we want to cautiously, slowly, touch into our trauma and our concussion symptoms to avoid overwhelm.
4. We take long, slow, deep, breaths
Often traditional meditation encourages us just to notice the breath, rather than control or change it in any way. Once a teacher teased us yoga practitioners in the room for taking long, slow breaths. I thought to myself, why on earth would I want to notice that my breath is short and shallow and not encourage it to be long and deep? We know that for most people long, slow, deep breaths are like magical portals to nervous system regulation. Why wouldn’t we want to encourage that?
Some people find that attention to the breath is unsettling, but if it feels good, it is so empowering to learn to settle our system by encouraging some long, slow, deep breaths, where the exhale is longer than the inhale.
One of the first supports I got from the GF Strong Rehab Centre was this exceptional video on how to take long, slow, deep breaths as an essential element of concussion care. Practicing with this video gave me my first taste of the calm clarity my injured brain so desperately needed. Long, slow, deep breaths are still my main go-to when the going gets tough.
5. We prioritize concentration over open-awareness and insight practices
Often traditional mindfulness encourages students to start with Concentration (paying attention to an anchor), but often teachers very quickly move on to Open Awareness (allowing attention to move from one anchor to another depending on what is most prominent in any given moment). We are not going to start with Open Awareness because it is often too dizzying for the concussed brain to flit about from one anchor to another like that. Insights can wait. Enlightenment, whatever. Our priority is just to settle the mind and body.
Don’t get me wrong, the insights that come from investigating what arises in meditation is an essential component of successful concussion care. It’s just not our starting point. It will come later.
Remember that without mindfulness our attention is flitting about like a butterfly, going willy-nilly, from one thought to another. This is exhausting, especially for an injured brain. Concentration practice gives us a place for our tired brains to rest. It is such a relief to let the mind settle in this way. Concentration practice is still my go-to every day.
6. We learn to Discern which mindfulness practice to choose
I use what I call ‘Jessie’s three Ds’ to help me decide which mindfulness practice will serve me best in any given moment:
1. Decipher: What is my body telling me right now? Am I feeling a tightness in the chest? Shallow and fast breathing? Sweaty palms? Foggy brain?
2. Determine: Based on the signals my body is giving me, what am I feeling right now? What concussion symptoms are showing up? Anxiety? Anger? Fear? Overstimulation? Cognitive fatigue?
3. Decide: What do I need right now? How can I best resource myself given my symptoms and my feelings right now? How can I get back into my Window of Tolerance? How can I cultivate calm clarity in this moment?
If I am feeling cognitive fatigue, I usually choose to do sitting or lying down awareness of breath practice. I usually take 100 long slow deep breaths. Of course, I get lost along the way so I end up taking 200 breaths or more, but the point is I seek non-stimulating quiet calmness.
If I am feeling emotionally unsettled, awareness of breath and other body-based awareness can ramp up my symptoms. If I feel that happening, I choose a practice that is outside my body to come back to presence. For example, I look around the room, I look outside the window at the trees, or I go for a mindful walk in nature.
I have learned that I can call on a wide range of mindful practices, not simply the more traditional awareness of breath and deep body-based practices of meditation on the cushion
7. We learn how to practice Mindfulness in Nature
Sometimes traditional practice puts a lot of emphasis on formal sitting meditation (‘on the cushion’) and walking meditation (where attention is on the sensations of walking). I have found that often choosing ‘enjoying time in nature’ as my anchor is often more settling than these traditional practices, and thus a much easier place to start to learn how to stay in the present moment. Gazing at the wind in trees, touching the soft petals of a flower, hearing the twitter of the birds, smelling the freshness of the forest – these serve to pop me into presence and settle my monkey-mind right down.
8. We dig into yin and restorative yoga
Many mindfulness teachers recommend yoga so it’s not such a radical suggestion: as long as you keep bringing your mind back to the present moment (rather than just ‘stretching’ while lost in thought), yoga is meditation.
The difference here is that I recommend that you put fast-moving yoga practices aside for the moment (they may make you dizzy), and give slow-moving yin and restorative yoga a try. Our issues are in our tissues and the long, slow holds of yin yoga can help us release trapped energy. I also recommend Restorative yoga because it is a powerful tool to sink deeply into the Rest and Digest state we so desperately need.
9. We learn to Cultivate Self- Compassion within our mindfulness practice
Some teachers make a strong delineation between mindfulness and mindful self-compassion practices. They practice them separately. I do not. For me self-compassion is the secret sauce of support we need when times are tough. Mindful self-compassion offers us a kind friend (ourselves!) so that we are not alone as we lean in and feel the physical and emotional challenges we face due to our brain injuries.
One of my yoga teachers, Danielle Hoogenboom (fellow concussion survivor!) calls the chatter of the mind ‘the little itty bitty bitchy committee.’ I don’t know about you, but my mind chatter is not always very kind. Through mindful self-compassion we learn to quiet those negative voices, and we learn to be a kind friend to ourselves in times of need.
10. We explicitly resource ourselves to Cultivate Calm Clarity
Mindfulness is a powerful tool to help us to notice when we are reactive and helps us see how we can shift to become more responsive. Mindfulness is brilliant at helping us see the poor choices we use to push away (mask) or pull in (get lost in thought) when we have a strong reaction. But I have been rather shocked at times to realize the reluctance in some teachers to explicitly discuss how to respond once we notice we are reactive.
Rick Hanson, one of my very favorite mindfulness teachers (and a neuro-psychologist), expressed his own frustration with this tendency in an interview. He spoke of a “naive, strange, dogmatic assumption that if we just be with what is there, somehow all these other fruits will emerge.” Some people seem to think that just by noticing anxiety it will somehow dissipate on its own.
Rick Hanson suggests, and I agree, that noticing is not enough. He argues that while ‘being with’ (mindfulness) is essential, we must then learn to ‘work with’ what we find. This will not happen by osmosis; we need to actively learn specific practices and skills to help us get back into our Window of Tolerance.
This blog and other Mindful Concussion resources are full of a range of explicit queues to resource ourselves. Simply put, conscious effort towards nervous system regulation via practical skills is at the core of my personal practice, and an essential element of the ‘toolkit’ I share with you.
Some of these modifications may work for you and others may not. In any event, I hope that as we explore them further they will set you up for success, so that you can sense the healing balm of mindfulness, rather than feeling overwhelmed and giving up before some sweet calm clarity arises.