I am a huge advocate for talk therapy. We have no problem going to a doctor when a knee is sore, so I genuinely do not understand the stigma around seeking support for the mind. It is not weakness to want to understand yourself better. If anything, it is the opposite.
Why therapy matters in concussion recovery
Concussion affects the brain, and the brain is where emotion, identity, memory, and meaning live. The psychological consequences of a significant concussion, including anxiety, depression, grief, identity disruption, and relationship strain, are not secondary to the "real" injury. They are part of it. Treating the physical without addressing the psychological leaves a significant part of the recovery undone.
Therapy also offers something the tools in this library cannot: a relationship. A skilled therapist brings perspective you cannot give yourself, catches patterns you cannot see from inside them, and provides consistent, boundaried support through a process that is genuinely hard. The self-help tools here are useful. They are not a substitute for working with someone.
Finding the right fit takes time and sometimes several attempts. Different modalities suit different people and different issues. Here are the ones I have used and what each offered.
Cognitive Behavioural Therapy (CBT)
CBT is a framework for understanding how triggers, thoughts, emotions, and behaviours connect and reinforce each other. The core insight is that the sequence from event to feeling to action can happen in a split second and pass unnoticed, but it can also be slowed down, examined, and interrupted.
The four components:
- Trigger: the event or situation that starts the chain
- Thought: the interpretation the mind immediately applies
- Emotion: the feeling generated by that thought
- Behaviour: the action that follows from the emotion
Working in CBT involves learning to identify your triggers and notice the thoughts that follow before they become behaviours. It is useful for anxiety, depression, anger, and relationship patterns. The framework is evidence-based and widely available.
Acceptance and Commitment Therapy (ACT)
ACT works differently from CBT. Rather than examining and challenging thoughts, ACT focuses on accepting what you cannot control, identifying your values, and committing to action aligned with them regardless of how you feel. The goal is not to feel better before moving forward. It is to move forward while feeling what you feel.
The word acceptance itself was transformative for me in a specific way: accepting people as they are rather than battling why they are not different. I have a set of values that differ from other people's, and that is simply how it is. Letting go of the expectation that everyone should share my values, and accepting people as they actually are, released an enormous amount of unnecessary friction.
ACT is particularly well suited to chronic illness, ongoing pain, and prolonged recovery: situations where "fixing" the problem is not the immediate option and learning to live well alongside it is the actual task.
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a psychotherapy approach originally developed for trauma. The core process involves recalling distressing memories while the brain is engaged in bilateral stimulation, typically following a therapist's moving finger or a tapping pattern. This bilateral stimulation appears to support the brain in reprocessing the memory: reducing its emotional charge without erasing the event itself.
Trauma in this context is broader than the headline cases of severe violence or disaster. It includes any experience that created a stuck, distressing imprint: a difficult relationship, a period of helplessness, an accumulation of loss. Concussion recovery involves all of these. EMDR is worth knowing about, particularly if you feel like you are carrying things from the past that have not shifted through talking alone.
A note on finding the right therapist
Not every therapist will be the right fit. This is normal and worth persisting through. A few things that help: look for someone with experience in brain injury, chronic illness, or trauma specifically rather than a generalist. Ask about their modalities in a first session. Notice how you feel in the room: a good therapeutic relationship is the single strongest predictor of outcomes, across all modalities. If it does not feel right after two or three sessions, it is okay to try someone else.
I first saw a psychologist at twenty-three, to start figuring out my relationship with my mum. Over the years I have sought out different therapists using different modalities, and I have found each one useful in different ways and at different times.
I have also seen counsellors and a couples counsellor. My honest experience is that counsellors are great for being heard and for processing in the moment, but I have found qualified psychologists more useful for getting to the root of dysfunctional thoughts and patterns. That is a generalisation and your experience may be different. What matters is finding someone who helps you move.
I have no shame in asking for help, no shame in being wrong, and no shame in admitting I do not know something. I am only as good as the experiences I have and the lessons I learn from them. My parents did their best. They were also from a generation that did not speak about or have access to so much of this. The work of understanding yourself better is not a correction of the people who raised you. It is just continuing what they started.
CBT gave me a framework I still use. ACT helped me let go of the exhausting project of trying to change people and circumstances outside my control. EMDR helped me move things that years of talking had not shifted. All three have been part of the toolkit at different points.
If you are in concussion recovery and you are not working with someone: consider it. The brain that got injured is also the one trying to recover. Having an outside perspective on that process is not a luxury.