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Traumatic Brain Injury

How Does Brain Injury Damage Self-Love?

Personal Perspective: This is how we begin to answer the question.

John Hain/Pixabay
Source: John Hain/Pixabay

Our closest relationship is with ourself. To thrive, dream, and follow our dreams, we need to love ourselves as we love others—as a person worthy to exist, with a purpose and a role to play, welcomed in society. That’s why when the “ourself” we love dies under brain injury, our grief differs from other kinds of grief. We’ve lost the person closest to ourself.

Every Brain Injury Damages the Relationship to Ourself

An injury, from viral to car crash, can damage one part while leaving another intact. That leads to unexpected problems amid seemingly normal functioning. It feels like you’re lopsided. And forever angry or devoid of all anger. That abnormal anger state is one way brain injury disconnects us from ourself.

The neurophysiology of brain injury anger eludes complete understanding, but one perspective suggests that when the front parts of our brains are injured, that allows a deep, primitive part to act unchecked. The amygdala reacts to people and situations like an unthinking, cornered animal. Normally, the front part of our brains, the prefrontal cortex, starts developing and reaches full maturity in our early twenties. That helps us during our growing up years to learn how to interpret facial expressions and body language to navigate different types of situations so that we stop reacting without thinking and start responding without excessive anger or rage.

Can Neurophysiology Findings Apply to Brain Injury Changes?

As I read Mary-Frances O'Connor's book, The Grieving Brain, I pondered how research findings applied to losing ourself and brain injury grief. Perhaps the brain map of ourself in the posterior cingulate cortex no longer matches the person we see in the mirror, the way they look, the way they move. And so they look like “not me!” But unlike when a person dies and we attend funerals to provide our brain with external proof that the brain map needs changing, our death provides confusing external cues and doesn’t shift our attention to the present like funerals do. We see our faces, our bodies; hear our voice, the rustling of our clothes; see others talking to us, not to a photo or gravestone; taste food and smell the flattened skunk; sense heat on our skin and cold on our cheeks.

Our past is our present; the present a distorted future. Our brain doesn’t change its belief we will return nor its brain map of ourself to the new person in the mirror. It doesn’t shift its attention from the past to the present without proof.

But what happens to our closeness dimension with ourself? How does our brain react when our mind is severed from our brain? Our self no longer exists as a unified whole?

According to O’Connor, our nucleus accumbens activates and creates yearning, as seen in research subjects shown photos of living children or romantic partners. People who experience complicated grief showed greater activation in this region than those in the resilient grief group. We’re alive like people in those photos. If shown photos of ourself before brain injury, would we not pine? Would we not yearn so much it becomes physical pain? We do. It’s not surprising that we yearn night and day for our old self, like our mind is yearning to be made one with our old, healthy brain again.

Yearning for Ourself

Brain injury rips our identity out and hurls it into a distant ocean of grief. This isn’t a search for identity or purpose; it’s a savaging of our core, leaving us asking where we went and who we are. The questions score, gouge, and lacerate us day after day. When we receive neurostimulation therapies and stabilize our identity and personality, then we join those searching for purpose.

Like those experiencing complicated grief who continue to yearn for their dead in anticipation of the reward of seeing them again as we do living loved ones, our brains continue to predict the rewarding outcome of seeing ourself again as possible.

[But] the accumulating losses of skills, talents, and abilities, cognitions and emotions, the ability to read people and converse, the discombobulation of worsening after seemingly getting better, heaves us back to childhood or lands us in the chaotic throes of adolescence.

Brain Injury Mood

Emotions and mood may feel like they’re not physical—for decades, we’ve categorized them as mental states, divorced from our physical bodies—but they are very much based in the physical brain.

Just as we cannot will a broken leg to walk normally without a cast, pins, or paste applied to the break to rejoin the broken bone, we cannot will or strategize good mood, healthy emotions, and social behaviours without the right treatments to regrow neurons, reboot microglia to repair and sustain neurons, and reconnect our neural networks.

Neurons with short axons regenerate or rewire in no time. But some axons stretch across the brain. Regrowing those, even with neurostimulation therapy speeding regrowth and restoring healthy immune function, takes time. It’s like rebuilding a bridge that spans the Pacific Ocean. A healthy brain balances regions working independently with working together. Long axons help with that integration. And perhaps an integrated brain leads to better mood?

Rumination Takes You Away from Yourself

Like the word “fatigue” doesn’t describe the neuro-fatigue after brain injury, rumination after brain injury is not the same as in a healthy person.

Not only has brain injury slowed down our processing speed, but rumination hogs whatever resources are left, making thinking, feeling, talking, listening, walking, etc. slower, exhausting, and tough. Meditation, deep breathing, and positive thinking don’t stop busy brain: Even if temporarily suppressed, rumination surges back. This isn’t being anxious or a worry wart. It’s a physical effect of the injury to our brain as reflected in high levels of particular brainwave frequencies between 24 to 36 Hz.

Even though life experiences and abusive people damage our self-love, nothing takes away the relationship with ourself like brain injury does.

This post is an adapted excerpt from my book, Brain Injury, Trauma, and Grief: How to Heal When You Are Alone.

Copyright ©2022-2024 Shireen Anne Jeejeebhoy


O'Connor, Mary-Frances.(2022). The Grieving Brain: The Surprising Science of How We Learn from Love and Loss. HarperOne.

Nakazawa, Donna Jackson. (2021). The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine. Penguin Random House.

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