The following excerpt is adapted from “This Is My Brain on Yoga: From Injury to Enlightenment” by Lisa Yee.
I donβt remember anything about the 2008 car crash we now call “The Accident.”
Only much later did my husband realize why a medic, calling for him to meet us at Loyola University Medical Center in Chicago as I was being loaded into a helicopter, urged him to hurry. It was to give him a chance to say goodbye.
When I awoke in the hospital a week later with a broken body and a traumatic brain injury, no one knew if Iβd ever be the same. After a month, I still couldnβt retain short-term memories. Iβd recognized my husband and daughter right away (but how had she gotten older?). No problem recalling Dad or my many siblings either, but I kept asking if Mom was still alive. Sheβd died of cancer in 2007.
Living With a Traumatic Brain Injury (TBI)
Such is the sometimes amusing, sometimes emotionally wrenching and always baffling world of the TBI patient. According to brainline.org, a TBI is βa blow or jolt to the head or a penetrating head injury that disrupts the function of the brain.β Such injuries affect 1.7 million people a year (and cause 52,000 deaths) in the United States.
In my case, the diagnosis was βmoderateβ TBI. Among other scary things Iβve found in trying to review the data my husband has summarized into a 3-inch-thick binder over the years, this diagnosis had to do with my rating on the Glasgow Coma Scale (not so good, apparently), my “initial decerebrate posture” (a rigid body position with legs straight, toes down and neck arched) and seizures. I also read about “my months of physical and cognitive therapy” and my βresidual neuro-cognitive problems,β depression, hampered mobility and trouble with βactivities of daily living.β As much as I resisted it, we arranged for a home-care assistant.
The Seizure Diary
Finally, I looked through my husbandβs transcription of my βseizure diary,β a combination of my thoughts and his descriptions of my seizures, some of which heβd captured on video so the doctors could witness them. This trip down βno-memory laneβ was my attempt to figure out the year I started yoga (2011? 2012? Iβm not so good with numbers anymore), but I couldnβt stop reading about my now-extremely rare episodes. This one, from March 2012, was from a night Ted was working late:
βI get ready for bed early, multitasking brushing my teeth on the john, when I hear my phone. … Feel a seizure coming on and lean forward. Next thing I remember, Tedβs home and heβs coming to bed. Itβs hours later. Iβd gotten myself cleaned up, into bed, lights out. (Discover a sore on outside of lip the next day, another insideβ from my teeth. Also blood and toothpaste in my hair.)β
Today, as we approach our nine-year βAcci-versary,β itβs hard to identify with that version of myself, a newspaper editor forced to face a new reality. So much has changed β my physical recovery and return to fitness, new neurologists, the right medications, a deeper relationship with my husband … and yoga.
Yoga For TBI Recovery – Focus is Key
Ted (whoβs become so knowledgeable that people think heβs a doctor) had urged me to try tai chi for its intense focus. I wanted something more athletic, so the instructor directed me to a yoga class taught by his wife, Lynda.
I now understand why Ted was drawn to focusing techniques like tai chi as a therapy for me.
In Dr. Norman Doigeβs 2007 bestseller, βThe Brain That Changes Itself,β the author discusses why people tend to become forgetful as they age. He explains that the nucleus basalis, a group of neurons in the brain, is designed to secrete acetylcholine, which helps form clear memories. Those neurons get neglected from a lack of mental stimulation, or from being βset in our ways.β
βAnything that requires highly focused attention will help that system β new physical activities, challenging puzzles, new careers that require learning new skills,β neuroscientist Michael Merzenich says in the book. He also touts the brain benefits of learning a new language in adulthood (Sanskrit, anyone?) and getting “sensory input from our feet.”
Learning something new? Check. Focusing intensely? Check. Going barefoot? Check. Whatever, I was sold.
A New Perspective
I began attending classes three times a week, jogging the mile to the community center since I no longer drove. It felt good to work my muscles in new ways and to see myself in the big mirror holding (what I considered) perfect poses. But soon something inside me began to change. Iβd catch a glimpse of my face in that mirror, and Iβd be grinning, not grimacing. Iβd see a classmateβs pose and think, βYou can do it!β instead of feeling self-conscious or competitive (my default modes). And after class, Iβd feel calm.
These are not unusual effects of yoga and meditation, of βbeing in the present moment,β Iβve learned.
Antoine Lutz, Ph.D., and Richard Davidson of the University of Wisconsin at Madison, have studied “Vipassana” or βinsightβ meditation for years. According to Psychology Today (Dec. 12, 2012), they found that the practice improved emotional regulation and stress control even when their test subjects were not meditating. When the researchers trained a different group in “compassion meditation” β having them focus on loved ones and then wish them “well-being and freedom from suffering” β this group showed evidence of increased empathy. In the brain, that was evidenced by more activation in the right amygdala in response to images of human suffering.
Interestingly, the compassion group also showed reduced rates of depression, as measured by psychological tests. βDavidson and Lutzβs work suggests that through mindfulness training, people can develop skills that promote happiness and compassion,β Psychology Today says. βPeople are not just stuck at their respective set points. We can take advantage of the brainβs plasticity and train it to enhance these qualities.”
Neuroplasticity – How the Brain ‘Changes Itself’
I remember hearing a lot about neuroplasticity, even in the early days, when I didnβt quite know what Ted was talking about. What it means is the brain is capable of growing and changing over time, depending on how you use it. Doige explains it much better in βThe Brain That Changes Itself:β
βClearly, when we learn, we increase what we know, but… we can also change the very structure of the brain itself and increase its capacity to learn. Unlike a computer, the brain is constantly adapting.”
But the old βuse-it-or-lose-itβ principle is at work here as well. βMerzinich thinks our neglect of intensive learning as we age leads the systems in the brain that modulate, regulate and control plasticity to waste away,β Doige says.
βIntensive learning,β eh? I have a feeling my husband took that phrase to heart when he … encouraged? … suggested? … okay, pushed me to sign up for yoga teacher training at Prairie Yoga in the neighboring suburb ofΒ Lisle in 2015. Sure, I loved my yoga classes at the community center. I adored Lyndaβs warm, witty style, and I had made a group of wonderful friends, even if I couldnβt always put the right name with the right face (and still, to my embarrassment, sometimes call Jim βSteveβ and Cathy βCindyβ).
Lingering Neurological Issues
Hmm. At this point, Iβm thinking Iβd better back up and fill you in on the rest of my lingering … letβs say βpeculiarities.β
Gail Denton, Ph.D., who suffered a mild TBI herself in a 1991 skating accident, discusses the issue in the book βBrainlash: Maximize Your Recovery From Mild Brain Injury,β which she calls βan outwardly invisible illness.β Although my case is moderate (in between mild and severe), I still appear normal … well, depending on what Iβm wearing!
What people donβt see (unless theyβre my husband) are the emotional fragility, the intense need for routine, and especially the mental fogginess when itβs nearing time for my 10 to 12 hours of nightly sleep.
In her book, Denton says TBI patients tend to get mentally fatigued because they lack the energy reserves that keep βnormalβ people from getting overwhelmed.Β An illustration shows the βEnergy Pieβ model of peopleβs physical, cognitive and emotional stores.
Denton also lists a number of deficits in the brainβs executive functioning that are so me:
- Processing speed. This is why, when new yoga cues are given, I often tilt my head quizzically and then just copy what my neighbor is doing.
- Attention span. Oh, look! My cat just woke up!
- Sensory overload. I donβt wear the dark glasses just to look like Mrs Cool. Also, big crowds, noise? Iβm outta there.
- Word finding.Β Thatβs gotten much better, but … who did you say you were again?
- Disinhibition. Uh-oh. My childlike lack of decorum (βIβll break into song at the grocery store if I want to!β)
- Multitasking. Gah! Go, away, cat, Iβm trying to write a thesis.
- Follow-through. Oh, Iβll write that one later …
- Sense of humor. Ha! See above.
Scientific Studies of Yoga as a Treatment for Traumatic Brain Injuries
Numerous other studies have pointed to the benefits of yoga and meditation for TBI patients.
Yoga For Combat Veterans
One study that I found especially interesting was the yoga program for soldiers returning from Afghanistan and Iraq at Eisenhower Army Medical Center in Fort Gordon, Georgia. Dr. John Rigg, director of the TBI Clinic at the base, describes on NPRβs All Things Considered how a blast in combat can affect a soldier:
βWhat happens is that primitive animal instinct, which is located in the subcortical brain, becomes hyper-aroused. … The subcortical brain doesnβt understand geography and stays hyper-aroused. Their muscles are tightened up.β
But after a short time in yoga, he says, participants report better sleep, relaxed muscles and a better outlook. βItβs an enlightening factor, even for people who donβt continue in yoga, to see that they can use breath and physical movement to actually change the way they feel.β
Meditation as Memory Booster
In other brain-positive research, a 2013 study at Beth Israel Deaconess Medical Center in Boston compared MRI scans of cognitively impaired people after an eight-week program of yoga, meditation and mindfulness with those of similar patients who had gotten standard care. According to the April-May 2015 edition of Neurology Now, the program group showed better connectivity in the hippocampus, which is related to learning and memory. (Score! The hippocampus is where most of my damage is!)
Balance, Strength, and Confidence
And then thereβs this, from the June 2015 edition of the medical journal Disability and Rehabilitation: An eight-week mixed-methods case study in which yoga teachers worked individually with TBI patients showed a 36 percent improvement in balance (a biggie for me; I still struggle with those types of poses). Other benefits, as measured by physical assessments and interviews, were confidence, lower-extremity strength and endurance. Said one patient: βI mean, itβs rocked my world. Itβs changed my lifeβI mean, all the different aspects. I mean, physically, emotionally, mentallyβitβs given me, you know, my life back.β
Physically, emotionally, mentally. … I know, right? But for me thereβs more.
Beyond Science, The Spirit
In βBrainLash,β Denton concludes with what she calls a βtake-it-or-leave-itβ chapter that βintroduces the concept of an increased or newly installed skill known as ‘extrasensory awareness.’ It is a potential product acquired with brain injury. It serves your pleasure.β
Itβs hard to describe, but I feel a new sense of connectedness now. Things happen because theyβre supposed to happen; everything works out. If The Accident made me who I am today, Iβm glad. I like myself better now. I think this awareness came several years later, when I was no longer in βsurvivalβ mode, going from seizure to seizure, so maybe my brain had a chance to heal somewhat.
The feeling grew when I started yoga β and exploded when I learned to meditate. In fact, shortly after a three-day meditation seminar at Prairie by visiting teacher Nicolai Bachman Β — that, honestly, did not hold my interest — I became aware of a strange phenomenon. When I closed my eyes, I could βseeβ what looked like an open eye at about the bridge of my nose. Being an idiot, I mentioned this to a classmate, figuring it was some bizarre βneurological thingyβ from my old TBI. She said something like, βWhoa, thatβs really advanced.β So I did some reading (in my own Teacher Training Manual, for gosh sakes) and concluded that I was seeing that famed βThird Eyeβ that lets you βsee from a deeper placeβ and βtrust your own intuition.β
Whoa, indeed.
From Skepticism to Spirituality
While itβs not βlike I have ESPN or somethingβ (to reference “Mean Girls,” one of my daughterβs favorite movies from middle school), I do get little intuitions. Mostly, though, this Third Eye brings me comfort. Says Denton in “BrainLash:” βYou may experience an increased interest in spiritual matters … for which you had no interest. This may be a general awakening to a higher power.”
That has certainly been the case for me. I was raised in a church-going family, but at a young age I found religious doctrine illogical. The idea of God didnβt make sense to me, though I wasnβt about to admit this to my parents.
Decades later, though, I had an epiphany, but itβs unclear exactly when. My husband says I found God a few years ago — after the Accident but before meditation — and very shortly before a recurrence of severe seizures that led to an episode of post-ictal psychosis for which I was hospitalized for a month. Ted says I got spooky religious and was even convinced at one point that a male orderly was God.
The only religious awakening I do remember was a gradual one, when the peace of meditation became a way to connect with the Universe, with God.
Or maybe Iβm just nuts.
But my shrink assures me Iβm not. βYour participation in yoga helped you to shift to a level of being more peaceful inside,β says psychologist Joseph Keegan of Naperville, with whom Iβve worked for I-forget-how-many years now. βPrior to that, you were at more of a frenetic paceβanxious, pensive. Yoga provided you with a sense of equanimity and altered your sense of interconnection with the world.β
He says yoga βopened up a door to a sense of spiritualityβ and even points out that my habit of picking up litter and recycling as I walk home βreflects that you feel you have a place in the universe.”
I guess the point of all this is that yoga and meditation — plus music, nature, friends, family (especially a devoted, selfless spouse) and faith — are the keys to coping with brain injury. Oh, and prescription drugs. And excellent doctors. (I highly recommend Dr. Elizabeth Gerard at Northwestern Memorial.) … And did I mention the drugs?
Just for fun, Iβll leave you with this:
Yoga
TO THE TUNE OF βLOLAβ BY THE KINKS
Had a steady desk job
At the paper in town
When a nasty car crash
Turned our lives upside down
In a moment.
Mo-mo-mo-mo-moment.
They airlifted me
And they worked on my brain,
But they still didnβt know
Why I wouldnβt come out of a coma.
Co-co-co-co-coma.
Co-co-co-co-coma.
I almost died.
My family cried.
Ted fell to his knees.
Then I looked at him and he at me.
Now, thatβs not the way
that it went down that day.
But Iβm still here today,
so thereβs that. Hip-hooray!
Now thereβs yoga.
Yo-yo-yo-yo-yoga.
Now, Iβd left my home gym just a month before,
And Iβd never, ever kicked to handstand before.
But Lori smiled and demoβed for the class,
And I did the pose! Didnβt fall on my a — !
And thatβs the way that I want it to stay.
Yes, I always want it to be that way For my yoga.
Yo-yo-yo-yo-yoga.
Now, Iβm not dumb,
but I canβt understand Why my memoryβs so badβ
oh, now waitβyes, I can, thanks to yoga,
That research for yoga.
Yo-yo-yo-yo-yoga.
Yoga.
Yo-yo-yo-yo-yoga.
Yo-yo-yo-yo-yoga.
(REPEAT AND FADE OUT)
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