CTE, TBIs, and Psychotherapy

Our understanding of Chronic Traumatic Encephalopathy (CTE) has changed the public’s understanding of the behavioral and emotional impacts of multiple symptomatic or asymptomatic traumatic brain injuries (TBIs). With CTE being diagnosed postmortem, this article will focus more on people understanding behavioral and emotional changes seen in TBIs from a psychotherapeutic perspective.

Knowing the symptoms

The common symptoms associated with CTE and TBI are impulsivity, aggression, irritability, depression, suicidality, cognitive issues, anxiety, fatigue, sleep issues, and headaches. A person suffering from chronic symptoms of TBIs will also typically struggle with a prolonged recovery process and continued distress from unknowns in their ability to fully return to their sense of normalcy. It’s important to note that these issues do not happen one at a time. Symptoms can often co-occur, cluster due to stress, and be confusing in their presentation. This can be especially distressful for the person experiencing them due to a lack of coherence in their presentation, along with the intensity of symptoms.

Assessing the impact

The impact of symptoms from chronic head traumas can be devastating to the overall life of someone experiencing them and their immediate relationships. Some special considerations are the lack of understanding of TBI recovery, the lack of a physical signal of recovery, such as a cast, and the significant impact on the person’s ability to handle cognitive load in daily life. The negative impact of symptoms from TBI recovery are a severe decline in the ability to work, begin new relationships, maintain old relationships, distress of the immediate spouse and family system, and impulsive behaviors that can result in the person feeling like they are “losing themselves.” The immediate and long-term impacts are typically debilitating, but it is also common to see the impact of previous traumatic experiences and TBI recoveries. The person’s ability to regulate themselves typically is diminished whenthe significant stressors they experience allow for previous traumatic events to come back to the surface. These impacts can lead to a feeling of further loss of self and a sense of permanence in the changing quality of life the person is undergoing.

Treating the whole patient

When a person comes in with significant issues from head trauma it is important that they find ways to create stability in their emotional regulation skills in the short term. Often, a person experiences significant emotional dysregulation in their day-to-day life that can be debilitating in itself. It’s important for the person to build back some of their sense of self through an increased ability to navigate through debilitating symptoms. When this occurs, the person can look toward unpacking more distressing emotional content with more confidence that they will be able to regulate themselves if they are distressed in between sessions. This is important because individual psychotherapy, when done properly, is a stress in itself. We need to be able to recover and manage this stress just like we manage working out, not too much but not too little, so we will be able to grow effectively over time. Once the base of emotional regulation is there, the person can work toward targeting more of the specific symptoms that are causing them emotional distress, such as older traumatic experiences and significant lifestyle and relationship changes.

It’s important for people to understand that the impacts of TBIs that lead to CTE are debilitating and life-threatening. Psychotherapy can be a pivotal tool in recovery or symptom management to help the person feel more empowered and free within their life.

Jacob Meyer, LSW, LAC, is experienced in working with patients who are experiencing chronic pain, chronic illnesses, TBIs, autoimmune issues, anxiety, depression, trauma, addiction, perfectionism, and relational dysfunction. Jacob is passionate about helping his patients become stronger through the therapeutic process and understands that issues present in ways that are unique to every individual. Jacob works to help you find your way through what you are going through and on to a path that you want to take. www.integratedbraincenters.com