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ISSN: 2574 -1241
ISSN: 2574 -1241
Received: March 19, 2025; Published: April 02, 2025
*Corresponding author: Leighton J Reynolds, Treatment and Tools for Trauma in Greater Los Angeles, California, USA
DOI: 10.26717/BJSTR.2025.61.009566
Abbreviations: PCS: Post-Concussion Syndrome; FMRI: Functional MRI
Almost 9 years ago now, I began working with my first PCS (post-concussion syndrome) patient, a National Hockey League player who had suffered a severe concussion during an NHL game [1]. By the time he began working with me 20 years later he was struggling with trauma induced epilepsy. This is how and where I got started working with traumatic brain injuries [2]. And this article is an update on what I have learned about healing trauma to the brain (including TBI, stroke, seizures, infections in the brain, illnesses and diseases of the brain, major mental illness, and PTSD and C-PTSD). Let’s begin with 2 cases:
Ms. R came to see me after her accident case from 2021 had settled. The original accident occurred in 2021 when she was struck from behind and on the side of her vehicle by a self-driving Telsa doing 80 miles per hour down a freeway. Sadly, the driver became intoxicated at a party and decided to use her self-driving vehicle to take her home safely. Here was the result, not exactly safe and raising the interesting issue of who (person or vehicle) was responsible for the accident. Ms. R went through the usual dragged out court case over liability, and three years later her case did settle. However, after 3 years and a settlement she was almost penniless and suffering from serious cognitive decline. Despite the medical treatment she had received over those three years, she was still in cognitive decline, and seriously so. She did credit her time in physical therapy with helping her toward some of her recovery. But the fact remained that she was in serious cognitive decline as evidenced by the following issues:
• Short-term memory problems.
• Difficulties with decision making, judgements, and goal setting.
• Increasingly, feeling depressed and hopeless along with major bouts of anxiety and panic.
• She hardly slept at all during the night.
What I want to point out about her case is the fact that here is proof of the neurodegenerative progression of trauma to the brain [3]. That, unfortunately, none of treatment she received during those 3 years directly involved healing her brain. Three years, a court case she won, medical treatment given during those 3 years (lacking as it was in my opinion), and she is way worse off than when she got into her SUV to drive home from her work that night. To say the least this is unfair, but it occurs to so many accident victims around the country every day in the US (and probably around the world). And again, there is very little recognition of the neurodegenerative progression of these injuries [4].
The case of Mr. A, also from an automobile accident, is somewhat different. He was already struggling with sleepless nights, chronic back pain, and C-PTSD when he was broadsided by another vehicle running a red light, causing him to suffer a concussion from the accident. Here we have the immediate problem of the “perfect storm” in the brain (Architecture Four in the Complex Architecture model) [5]. Prior PTSD, and PTSD directly from the accident, causes the stress hormones in the brain/mind/body to speed up, while the concussion itself causes the brain/mind to slow down, “running like a slow computer.” This is literally a clash of forces in the brain/mind. And his symptoms expressed just this:
• He became increasingly depressed and hopeless.
• He began to have short-term memory problems.
• He struggled with chronic fatigue.
• He was frequently agitated and hostile around other people.
• He had increasing sensitivity to light and sound.
• And his sleep patterns got worse.
In a very important way, his case is different from that of Ms. because he sought immediate treatment and was placed on the protocol outlined below. Elsewhere, I have written about the importance of seeking immediate treatment following a concussion [6]. Unfortunately, the traditional response in the ER is maybe an MRI (which really does not show the kinds of information we need to help these patients), and go home and rest for a week, maybe 2 weeks. In my experience, these patients need to be on an immediate protocol like the one shown below. Which Mr. A did, with positive results.
• Supplements and nutrients over drugs.
• A total immersion program which would include a daily schedule of rest and healing.
• Stimulation to the brain (with music preferably using noise canceling headphones).
• The creation of daily “flow experiences” to reduce demands on the brain.
• Chiropractic appointments to keep the nervous system healthy (all head injuries are also neck injuries).
• Daily exercise.
• Clean, healthy eating.
• Neuro-Psychoanalytic sessions to process the injury.
What are the “take aways” I have come away with after working with brain injured patients for almost 9 years?
Trauma to the brain/mind always causes problems leading to neurodegenerative disease progression in the brain. This may seem like a very broad statement to make, but I have found this to be true in all the cases I have worked with. The understanding that a concussion (and I believe all trauma to the brain/mind) is not a single event (like a broken arm) was first articulated 20 years ago by Dr. Brent Masel. (See his original article (3) and an interview with him at: https://www.brainline.org/article/brain-injury-chronic-disease-interview- brent-masel-md). In all the work I have done with brain injured patients, this is the classic hallmark of all these cases. Things only get worse for the person because of how the brain responds to being injured, traumatized, infected, or diseased. It is a neurodegenerative disease process that we must recognize and treat.
The Architecture Model that I have developed to understand this neurodegenerative disease progression in the brain fits what my patients are bringing into their treatment [7].
• One: Traumatic Shock.
• Two: Electrical and Chemical Disruptions throughout the neuronal networks leaving the brain working like a slow computer. This makes an effective response to life very difficult.
• Three: Homeostatic Imbalance in the brain/mind/body leading to a serious breakdown in the person’s ability to function on a daily basis. And the creation of a wide range of symptoms these patients are forced to deal with.
• Four: The Creation of the “perfect storm” in the brain. This is the result of opposing forces in the brain clashing. Stress hormones in the brain speed things up adapting to PTSD, while physical trauma to the brain (through a TBI, a stroke, seizures, infections, brain illnesses and diseases, and major mental illness) slows things down. No wonder patients just feel crazy at times and don’t know what to do with themselves. Sadly, at this point for many patients, suicide becomes an option.
To heal trauma to the brain, demands on the brain for functioning must be dramatically reduced. If not, the brain has no space within which to heal. This is very difficult for many patients because they must live their lives, and this requires energy from the brain/mind. But injuries to the brain/mind are not like any other injury to the body. You can rest a broke arm or leg in a cast and not use it, but the brain is responsible for everything we do to stay alive, and how do you rest this? In my experience the best explanation for why the issue of demands on the brain is so important, has to do with how neuro plasticity responds when the brain is injured. Through neuroplasticity the brain works to find new pathways in the neuronal networks following an injury, so it can function adequately. But this process is very slow (which accounts for why the brain is functioning like a slow computer) and requires additional energy. In the end, this is why almost all brain injured patients experience chronic fatigue daily. Hence the need for reduced demands on the brain to save what little energy the brain does have to begin healing itself.
All injuries and trauma to the brain involve a person who brings with them their own personal history. If this is not addressed these issues can and do interfere with the success of the treatment. So, not only is the clinician addressing the physical damage, but they must also pay attention to personal damage, damage to the individual’s personhood.
The process of healing brain injuries, illnesses, and diseases demands a lot more from both the clinician and the patient, than simply prescribing medications (which mainly treat symptoms), or running lab and diagnostic tests, and looking at brain imaging. It demands a doctor-patient relationship, which allows the patient to be fully engaged in the treatment. In 100% of the cases I have worked with where the patient is engaged in the treatment, rather than only doing something for them, they get better. For all the advancements we have made with technology, brain imaging, and medications, I find that it is the relationship and the engagement the patient has in their treatment that really makes the difference. Again, in 100% cases I have worked, the patient’s engagement in the treatment works 100% of the time.
I have found the information available from an fMRI (functional MRI) to be crucial in understanding the extent of damage to the brain. Amazingly, I have found that in every case thus far, the symptoms presented by the patient match the brain network that has been identified as being abnormal. Our understanding of networks in the brain is a recent development. Fortunately, I am able to be involved in a research study using fMRI technology to study the 10 networks in the brain that we understand thus far. Again, damage to the network that we can see on an fMRI matches exactly which symptoms the patient is experiencing.
Sleep and dreams are crucial to recovery, yet sleep disturbances are one of the consistent issues with trauma to the brain. I have been fortunate enough to discover (through one of my patients) that following sleep patterns at night using an Apple Watch (or similar device) tells us a deal about their sleep and dreams. And it is an accurate predictor of events of the next day including seizures, black outs, and increases in depression and anxiety. This insight has been quite amazing to me, because a “simple” device can tell us so much that is helpful to the patient regarding their health!
Finally, I believe what we are talking about in an overall conceptual sense is the use of complexity science to understand and treat trauma to the brain. Complexity Science is the study of complex systems that exhibit collective behaviors beyond the sum of their parts. Examples include:
• Political Entities
• Ecosystems
• The Human Brain
• Ant Colonies
• Economic Networks
• The Earth’s Global Climate
• Power Grids
• Transportation and Communication Systems
• A Living Cell
• An Organism
• And the Entire Universe
Complexity Science expands across disciplines from physics and mathematics to biology and social science. It focuses on how the various components interact and self-organize to exhibit non-trivial global structures and behaviors [8]. The seven principles of Complexity Science include:
• Nonlinearity
• Diversity
• Emergence
• Self-organization
• Adaptation
• Unpredictability
• Interacting Agents
In treating brain injuries, illnesses, and diseases for almost 9 years now, I have come to understand that we need to take a much wider picture of the patient’s difficulties, because our brains are involved in so much of our lives [9].
The above 8 principles are what have guided my work with brain injured patients. This includes TBI patients, stroke patients, patients suffering from seizure disorders, infections, illnesses and diseases in the brain, major mental illness, and PTSD and Complex-PTSD. I have found that when following the above 8 principles in the treatment of trauma to the brain, the patients get better 100% of the time!
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