The Trauma Behind Concussion with Michaela Olson
Show Notes:
In addition to the physical damage that occurs during a concussion or a traumatic brain injury, there are emotional side-effects that can last decades. Talking to us today about the link between brain-based injuries and mental health, is psychotherapist and clinical research associate, Michaela Olson. Tune in to find out how Michaela identified the gap in the medical understanding of concussions and TBI and the treatment of those injuries, and how she moved into clinical mental health counselling to address this gap.
We hear why Michaela believes that being educated about the biological root cause of your symptoms can set you on the road to recovery, and how she teaches patients to cope with their mental and emotional trauma. We discuss the link between concussions and PTSD, and why all trauma (no matter the cause) is distressing to patients. Michaela also reminds us that we aren’t alone, so join us today to learn all about the biology underlying the mental health issues that form part of post concussion syndrome!
Key Points From This Episode:
• An introduction to Michaela Olson, psychotherapist specializing in the connections between brain-based conditions and mental health.
• How Michaela ended up specializing in concussion-related therapy: identifying the gap.
• A breakdown of how trauma affects the brain and the biological root of the symptoms.
• The link between concussion or a TBI and PTSD.
• How PTSD is caused and how the cause differs between patients.
• Why Michaela thinks learning more about the root cause of post concussion symptoms is the key to starting the road to recovery.
• Why talking to someone is one of the best therapies.
• Michaela’s advice on how to express your emotions when suffering from a brain injury.
• A reminder that you aren’t alone, and where you can reach out for help.
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Transcript - Click to Read
[INTRO]
[00:00:05] BP: Hi. I’m your host, Bella Paige. Welcome to the Post Concussion Podcast; all about life after experiencing a concussion. Help us make the invisible injury become visible.
[DISCLAIMER]
The Post Concussion Podcast is strictly an information podcast about concussions and post concussion syndrome. It does not provide, nor substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician, or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice, or delay in seeking it because of something you have heard on this podcast. The opinions expressed in this podcast are simply intended to spark discussion about concussions and post concussion syndrome.
[EPISODE]
[00:01:03] BP: Welcome to today’s episode of the Post Concussion Podcast, with myself, Bella Paige, and today’s guest, Michaela Olson. Michaela is a registered psychotherapist in the State of Colorado. She completed a master’s of science program through Capella University for Clinical Mental Health Counseling. She received her Bachelor of Science in Psychology from the University of Colorado, Denver, and is currently a Chi Sigma Iota member, which is the honor society for professional counseling.
Michaela has five years of experience working in the clinical field for an advanced brain imaging company. She also began a career in clinical research and works for a large international clinical research organization managing drug trials. Her passion lies in finding the connections between brain-based conditions and how mental health is affected when neurological and neuropsychiatric factors impact one’s quality of life. Michaela capitalizes on her knowledge of brain anatomy and function to help her clients understand the root cause behind their symptoms, and gives them the right tools to move forward. Her specialties include first responder trauma, anxiety, post-traumatic stress disorder, depression and anxiety following mild traumatic brain injury or concussion.
She utilizes cognitive behavioral approaches, mindfulness and somatic approaches to help clients learn to identify challenge and redirect thought patterns associated with emotional distress. She helps clients to reprocess and clear emotional traumas from the body. Michaela’s completed and advanced training and childhood trauma, neglect and abuse through Dr. Bruce Perry’s neurosequential modeling program back in 2018. She helps plans on beginning the certification process for EMDR therapy. Michaela is a Colorado native and spends her time skiing, horseback riding and traveling with her husband when she is outside of the office. Welcome to the show, Michaela.
[00:02:56] MO: Thank you so much. Glad to be here.
[00:02:59] BP: So, to start, do you want to tell everyone a little bit about your background and how you got into concussion-related therapy?
[00:03:06] MO: Yeah, definitely. So, I started with a bachelor of science degree in psychology. I earned that through the University of Colorado here in Denver. I then went on to earn a master of science degree in mental health counseling. Just finished that program a few months ago. Very glad that that’s over and behind me now. So, then I worked in a radiology practice, actually for about six years, and it was in this space that I worked with a lot of concussion patients, people who had had head injuries from sporting events, football, lacrosse, soccer, both children and adolescents as well as professional athletes. We also worked with a lot of patients who had suffered a head injury or a traumatic brain injury from slips or falls, car accidents, just about any type of mechanism of how a concussion can happen, are the patients that would come through this radiology clinic.
My job with this small Denver-based clinic was to work with patients in the diagnostic process of concussion and TBI. This involved a lot of advanced brain imaging. We would work with a team of radiologists who specialized in neuroanatomy functioning, how different parts of the brain are affected when there’s a concussion and a head injury. Through my work there, the six years with that group, I really started to find that there was a pretty large disconnect not only in the medical understanding of concussions and TBI, but also in the treatment of those injuries. As anyone who’s had a concussion can attest, there is a whole host of symptoms that come with those injuries. It’s not always just memory loss, headaches, trouble focusing or concentrating. There can be a whole spectrum of psychological and emotional issues that stem from that injury as well. And a lot of the patients I worked with at this radiology clinic were pretty desperate for someone to help them rebuild their emotional capacity, whether they went through personality changes, perhaps their children, their spouse, their family members noticed a big difference in their personality and their emotional stability after that head injury.
That’s kind of where my interest has shifted out of purely medical, diagnostic work with concussion patients and really moved into the therapeutic space. That’s where I am now. I work closely with a colleague of mine who runs her own psychotherapy group here in Denver. A good portion of the patients that come through our clinic for psychotherapy are patients with concussions or TBI.
[00:06:13] BP: Well, it’s always interesting to hear people’s backgrounds and how they got into it, because I always find it’s very different for everyone. I like how you noticed the I call it a gap. It’s like our healthcare has a huge gap in it. We focus on all these physical aspects that are happening, but they’re forgetting about the other half of you, and the lifestyle things that affect your every day-to-day life when you’re just living with these injuries. it’s often forgotten, and it can be really hard to manage because a brain injury can be very traumatic. I know it’s something you’ve talked on before. How does trauma really affect our brains?
[00:06:54] MO: Yeah. One of the first ways if I’m working with a patient in a therapeutic setting, we go through a lot of psychoeducation on the actual process of how the brain works, and then how that process is altered after an injury. Trauma can be defined in many different ways. Every person has their own definition of trauma. At our psychotherapy group, we rely on the DSM, which is the Diagnostic and Statistical Manual, nice big booklet of psychological disorders. Within that manual they talk about or the authors refer to trauma, as something that is life altering. It can be physical, as well as emotional, more often than not, it is a combination of both. When I would work with or when I do work with patients in the therapeutic setting, I always like to start out with the biological root of the trauma response.
In a normal — I’ll call it normal. In a normal functioning brain, a brain that maybe hasn’t been exposed to a life-threatening trauma. We kind of have these two systems within the brain that work cohesively. We have what’s called the limbic system of the brain, which is, from an evolutionary perspective, very old. Humans have had a limbic system for millennia. Most mammals and even non-mammals have a limbic system. This is the biological root or where our emotions are generated from. This is where the fight or flight response is managed. This is the system that tells us are we hungry, are we thirsty, are we in danger? It’s the core processing software of the brain. Over time, as humans evolved, we developed bigger brains, a bigger capacity for conscious thought and that’s called the cortex.
Now, one of the main segments of the cortex that I refer to a lot when I talk about trauma is the prefrontal cortex. That’s what sits on the very front of the anterior portion of the brain, and this is responsible for our cognition. This is the part of the brain that helps us focus, concentrate, make rational decisions, think logically through situations. Again, in a normal, non-traumatized brain, that limbic system and that prefrontal cortex have this nice symbiotic relationship. They work together, the limbic system may say “Hhmm, I heard a weird noise. What was that?” The limbic or the prefrontal cortex then says, “No big deal. That’s a car driving down the street, what have you. It’s not a threat.”
In a patient who has some sort of history, with a traumatic experience, that relationship or the communication between the limbic system and the prefrontal cortex can be quite impacted in a negative way. That limbic system may be on overdrive and more sensitive to external stimuli that it deems threatening. When that limbic system takes over. That logical rational part of our prefrontal cortex doesn’t have a whole lot of say, in the matter, that limbic system tends to override the rational logical response. That’s a very large roundabout way that I start to talk about trauma from a biological root, and then we dive into more of the emotional impacts that that relationship can have.
[00:10:44] BP: Yeah, it’s very interesting, because for myself, the trauma was more after actually, not the injury itself. It was more the effect of the injury, I guess, would really be my trauma. That was traumatic, because I spent years really ill. It’s interesting because some people, a few people that have been on the podcast, they have severe PTSD from the incident themselves and things like that. There’s lots of different ways to experience trauma. I think PTSD can be a very broad term, actually. Because PTSD for one person can be a very minimal experience, something that they deal with where other people can really take over. You want to touch on PTSD a little bit more.
[00:11:29] MO: Yeah, absolutely. PTSD or Post Traumatic Stress Disorder is very common. For a long time, diagnosticians in the psychological world would sometimes steer away from that diagnosis. Over the past, gosh, probably few decades or so, it’s become a much more frequently used term or diagnosis. And oftentimes, when we think about PTSD, we think about perhaps war veterans or soldiers who are returning home from overseas. Back in my days at the radiology practice, we did work with a lot of veterans, military personnel. And unfortunately, PTSD is one of the hallmark diagnoses that these patients will come home with.
Just to your point, you are exactly spot on when you say that PTSD can come not only from the incident itself, but the months or years of recovery from whatever that traumatic experience was. That’s also part of the biological process of how the brain is physically rewired after that traumatic experience occurs. One of my favorite examples that I use with patients all the time is a veteran example. This is a made-up scenario, but I’m sure a lot of people could identify with it. But take, for example, a soldier returning from overseas, perhaps they were exposed to enemy fire. Their survival was threatened. Perhaps they were in a very scary situation, a pretty typical life for a soldier. And perhaps in that time, they experienced a loss of a fellow soldier, perhaps they were injured themselves in that battle. That experience itself rewires the limbic system of the brain to remember that traumatic experience and avoid any repetition. The brain does not want to undergo that same stressor again.
Then, a few months or years later, that veteran returns home. Any stimuli that mimics or is relatively similar to what they experienced in that overseas situation comes back to haunt them a little bit. Perhaps the noise of a car backfiring sounds very similar to gunshots or fireworks going off on Fourth of July can be very triggering for people who are sensitive to that type of stimuli, because their limbic system is conditioned to remember that that’s a dangerous life-threatening noise or stimulus.
PTSD then is the repetition of that stressor, even though you’re in an environment that is relatively safe and secure. Through the PTSD diagnostic process, you know, us as therapists, or counselors or psychologists will go through and really dive into the root basis of those triggers to help work through that trauma response and kind of break that cycle and rewire the limbic system to realize that fireworks on the Fourth of July aren’t the same type of threat that happened many years ago.
[00:15:16] BP: Mm-hmm. Yeah. I like that you explained it as — I always think it’s interesting to say that it’s a way of your body protecting you in the wrong way.
[00:15:26] MO: Yeah.
[00:15:26] BP: Yeah. Because that’s essentially what it is. It’s thinking “Okay, this was really bad last time, let’s not do it —" like you said, “Again”. It’s interesting to think of it that way, because I think putting it into different perspectives can really help people because sometimes, we think PTSD and we think really extreme things like veterans who deal with PTSD. But sometimes PTSD isn’t from such extreme events, and I think it’s important to remember that, that just because you didn’t go through something so severe as maybe a veteran did. It doesn’t mean that your trauma isn’t any more real and it doesn’t mean that your brain isn’t reacting the same way that theirs is.
[00:16:04] MO: Yeah, and I’m really glad you brought that up. And again, you’re exactly right. A lot of the patients that I work with in the therapy setting will say similar things. They’ll say, “This is my trauma, this is what I went through. But oh, it’s not nearly as bad as what it could have been”. It’s a good moment to pause and think about, no matter how the trauma occurred, the same type of biological process is happening in the brain. It really doesn’t matter in the grand scheme of things how “severe” the trauma appears on paper or on the surface. It’s those deeply ingrained processes and neural networks that are rewired in the brain, regardless of the type of trauma.
[00:16:52] BP: Well, I think that is a great discussion so far, and we’re going to take a quick break and get more into tips for handling trauma and relationships with it as well. So, let’s take a break.
[BREAK]
[00:17:09] BP: Wow! I can’t believe it’s been one year, the support from everyone has been truly amazing. Due to reaching our one-year anniversary, you can now book one-hour sessions with myself Bella Paige. I offer help with understanding loved ones, finding your new normal, and finding specialists near you. Find the work with Bella link in our episode description. I am looking forward to another great year.
[INTERVIEW CONTINUES]
[00:17:40] BP: Welcome back to the Post Concussion Podcast with myself, Bella Paige and today’s guest, Michaela Olson. So, something we wanted to get into was tips for handling trauma, essentially. A lot of concussion and brain injury survivors deal with trauma, and I think it’d be an important thing to talk about, and tips for kind of where to start, what to do, where to get help all that.
[00:18:04] MO: Yeah. I think one of the best ways to start on the road to recovery from an emotional perspective after a concussion or head injury, really is to learn more about it. That psychoeducation piece, I don’t think gets enough credit in the industry. And sometimes, simply just understanding why your brain and your body are reacting a certain way can really go far in helping you feel like you’re not crazy. There are reasons for why you’re having these symptoms. There are reasons why certain aspects of daily functioning are a struggle. And sometimes being able to pinpoint that why not only makes the therapeutic and the recovery process easier, but sometimes it’s just easier to sit with, it’s easier to process and know that things are happening for a reason. It’s not all something that’s fabricated or something that is being exaggerated.
[00:19:07] BP: Mm-hmm. I like that you touched on learning more about it, because I think a lot of people the biggest thing is they always start asking why. It can take a little bit to learn about these things, but it can really help you so you’re not blaming yourself so much.
[00:19:23] MO: Definitely, that psycho education piece, I think is one of the great places to start in that recovery process. Certainly, you can do that on your own. There are hundreds of thousands of research articles and resources for concussions survivors and in TBI patients. This podcast being one of them. But aside from learning about things on your own, finding a specialist, whether it’s a therapist, a counselor, a neurologist or a physician who’s well versed in how concussions can alter the brain and alter lifestyles is also a great place to start, to have someone in your court who knows what’s going on, who can explain things in a way that’s easy to understand and digest, perhaps give some materials or some ideas for those lifestyle adaptations, reaching out to people like that can be extremely helpful.
Kind of going back to my background, that’s one of the reasons why I got into this field was noticing that gap. There are a lot of therapists and counselors out there who work with concussion patients, TBI patients, and so just having someone to talk to who understands perhaps what you’re going through goes a long way.
[00:20:45] BP: Especially with this being invisible, as we often talk about on the show, because it is hard to explain to those around you and tell them what’s going on when sometimes you don’t really know the answer, either. I know a lot of the time when I was going through this, I didn’t really know what to say. I didn’t really know how to explain the thoughts that were going through my head. I didn’t know how to explain that I couldn’t control my emotions, and that I was raging, or crying and had no idea why. It was really hard for me to communicate with others around me because I didn’t know what was going on myself. If you don’t know that answer, it makes it even harder. Do you have any tips for individuals who do deal with things like PTSD, lack of emotional control and trying to communicate that with the ones that are around you?
[00:21:36] MO: Yes. I wish there was a manual or a step-by-step guide on how to do this. Of course, it’s very different for every person and it’s dependent upon your support system, what types of relationships you have in your life. But one of the things that I teach my patients and some of the things we’ll work through in counseling sessions is learning how to articulate and use a certain type of vocabulary to express those emotions. When you find yourself crying for no reason, or you feel irritated or frustrated at a certain situation, let’s work on developing some key phrases, or some key words to describe what’s going on internally.
For example, say you are cooking dinner with your spouse or your significant other, and something happens, perhaps they mess up something in the recipe, or they didn’t clean the dish that you needed to use next. Let’s work on words and language to describe why that act is frustrating to you. Instead of blowing up, or crying or what may feel like overreacting to a small situation. Let’s take some deep breaths. Let’s pause in that moment when the emotions start to happen, and pick up those key words or key phrases. Sometimes, having a go-to dictionary so to speak, can be something that you rely on in many different situations. From patients that I’ve worked on this with, it’s a helpful tool, a helpful skill for them to develop that dictionary. That’s what they can use to describe the difficult emotions, they’re feeling.
Over time, that dictionary can grow. The words can adapt and change. But for example, just taking that deep breath, pausing in the moment and telling your spouse “You not washing that dish in that kitchen made me feel this way”, and leave it at that and practice those statements of expressing yourself in a calm, collected manner. And over time, that behavior becomes repetitive as we practice and implement it. And oftentimes that helps the spouse or the significant other or whoever else is involved in that situation also understand that “They’re not reacting because they’re mad at me or because they hate me, they’re reacting because their brains and their bodies are trying to learn ways to deal with these difficult and oftentimes new emotions”.
[00:24:30] BP: Yeah. I really like that you mentioned so many things, especially the support system because of course, everyone’s support system is very different. Some of us have very large ones. Some of us have one person, and some people don’t have anyone really, which is why Concussion Connect was launched to help others reach out with other brain injury survivors and other professionals that they can just talk to on a casual basis who understand what you’re going through can really help you relieve some of that tension and bottling up feeling that I think a lot of people tend to do. We know that bottling up is not a good idea, because it usually results in an explosion. We don’t want to explode on the people that are there to support us and help us. We want to come up with tools that prevent us from doing that, even though it might feel like you don’t have a lot of control about that.
So, you’ve given us a lot of advice, a lot of tips, a lot of things on a very sensitive topic like trauma. Is there anything else you’d like to add before we end today’s episode?
[00:25:36] MO: I think the only other thing that I like to preface with patients that I work with in this space is that you’re not alone. You really aren’t. There are so many people out there who have suffered from concussions, head injuries. It might have even been a concussion that was undiagnosed, and symptoms catch up to you, sometimes in adulthood. As the brain naturally ages, those symptoms can certainly start to change as we age. Even concussions that were deemed not as severe, perhaps a doctor an emergency room didn’t diagnose you with a concussion didn’t catch it. I would have to say, the likelihood of bumping into someone on the street who’s never had any head injuries or concussions before is probably pretty rare.
For a lot of the patients I work with, that can be a really calming idea that you aren’t alone in these situations and these struggles. So, resources where you can meet other people who have gone through similar situations, you commiserate with others, vent about certain things, share success stories. That’s a really powerful place to heal from.
[00:26:58] BP: Mm-hmm. Well, I think you’re exactly right on a lot of that, and you’re not alone. We talk about that a lot here, that’s why we exist today. It’s actually crazy. I’ll have conversations just the other day at a dinner party, and someone told me their whole life concussion story and they said they’d never really talked to anyone about it before because they didn’t know there was other people there like that. That’s crazy how so many people feel that way, but we’re working on changing that. Thank you so much for joining us today, and sharing your experience with concussion and trauma.
[00:27:32] MO: Thank you so much for having me.
[END OF EPISODE]
[00:27:38] BP: Support the podcast. If you truly love the podcast, please consider supporting us through our tip jar. Find the support the podcast link in our episode description. All tips are greatly appreciated.
Has your life been affected by concussions? Join our podcast by getting in touch. Thank you so much for listening to the Post Concussion Podcast and be sure to help us educate the world about the reality of concussions by giving us a share. To learn more, don’t forget to subscribe.
[END]
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