Organizational Systems in Concussion/mTBI Recovery or: How I Learned to Stop Worrying and Like Planning
Five years ago, I transitioned into coaching individuals with Post-Concussion Syndrome (PCS) and mild Traumatic Brain Injuries (mTBIs) full-time. Almost immediately, I began to ask clients about their planning and organizational systems by the end of our first session.
There’s a reason for that: in my experience, having an effective planning and organizational system is one of the primary building blocks for recovery from persistent PCS, mTBI, and Moderate TBI.
Why, you might ask? Let me back up a little bit.
When you think of common Post-Concussive and brain injury effects what do you think of?
Maybe you think of physical symptoms, maybe fatigue, maybe irritability and anger, maybe anxiety and depression.
But pretty much everything else would be considered cognitive symptoms. And the vast majority of those cognitive symptoms are Executive Function deficits caused by the brain injury or concussion. (For the sake of not making this piece too long, I won’t go into the how’s and why’s of Executive Function deficits, but if you want to read more about it, click here.)
Here are the most common Executive Function deficits I encounter:
Short-Term Memory problems
Problems with sustained attention or staying on track
Problems with planning and organization
Problems with getting started on things
Problems making decisions
Set shifting/task-switching (which often manifests as problems dealing with ‘curveballs’ thrown your way)
Problems with multitasking
So, why is having an effective planning and organizational system fundamental to brain injury and concussion recovery?
In short, because it can have a positive effect on all of the PCS/mTBI-related common Executive Function deficits I listed above. How? Here are 6 ways it can do that:
It helps you compensate for short-term memory issues, as well as problems with focus and staying on track. By having something to refer back to, you can ensure that you remember appointments, things you need to do, and things you want to do. If you check your list several times a day, it helps you remember what you want to do when you forget or if you get off track. It also will help you on those days when you wake up and your mind feels blank: all you have to do is to just look at your to-do list and appointments for the day, and then follow the plan!
It helps you get organized and plan effectively. The first thing an effective planning and organization system enables you to do is to lay out for yourself everything you need and want to do. But it also enables you to get these things done by facilitating the next two steps: a) prioritizing the things you need to get done; and b) on that basis, then deciding the order in which to do them (sequencing). An effective planning and organizational doesn’t just allow you to keep track of appointments. It also enables you to get a handle on all the things you want to do— including your longer-term projects and your self-care— and then follow through on them.
It helps you get started on things when you’re feeling overwhelmed by all that you have to do. It enables you to break down the things you have to do into smaller and smaller pieces. That, in turn, makes tasks feel less overwhelming and more doable— which, in turn, makes it more likely for you to get started on them.
It helps you get started on things when you’re feeling frozen because you can’t decide what to do next. Besides helping you break things down into smaller pieces, an effective planning and organizational system enables you to make decisions about your priorities and to sequence the things you want to do. Thus, it gives you a simplified blueprint for the week, or the day— and having that blueprint removes the indecision that can sometimes paralyze you from taking any action. There’s an added bonus here, too: your blueprint will help you make better decisions, informed by what you decide are your needs and priorities.
It helps you deal with the curveballs and temporary setbacks you experience. By having a list of what you want to do and in which order, you also have the flexibility to shift things if a curveball comes your way— or if you simply just have an ‘off day’ or two.
It enables you to pace yourself and budget your energy— which will also helps you deal with multitasking pressures. With all the information in front of you— in terms of your obligations and projects— you can plan in a way that more effectively manages your energy. For example, you can schedule your most cognitively challenging tasks during your brain’s peak performance time. You also can create breaks in your schedule to help you budget your cognitive energy.
Thus, an effective planning and organizational system addresses the common problems with Executive Function stemming from PCS/mTBI and other brain injuries.
But what about other major non-physical issues, such as fatigue, irritability and anger, anxiety, and depression?
An effective planning and organization system can help with those issues, too. Here are 4 ways it does that:
It reduces fatigue. An effective planning and organization system reduces cognitive fatigue because it lowers your cognitive load. You don’t have to reinvent the wheel every time and figure out what to do, multiple times a day. You’re not constantly having to try to remember what you might be forgetting. It gives you the flexibility and framework to easily recover from an unexpected event that comes your way. And perhaps most importantly, by being able to pace yourself according to how your brain now works, it gives you a larger pool of cognitive energy to draw from.
It reduces anger episodes and irritability. In my experience, fatigue usually sets the stage for rapidly escalating anger episodes that individuals with PCS and TBI experience. Also, there is a tendency for fatigue to cause irritability in individuals— whether they’ve experienced head trauma or not. By reducing cognitive fatigue, you’re reducing your irritability and potential for outsized bouts of anger.
It reduces anxiety. An effective planning and organization system makes you feel calmer and less anxious. That’s because it really helps you reduce that feeling of having forgotten something— or of feeling like there are unaccounted for things you need/want to do that are floating somewhere in the ether.
It can help improve your mood. Depressive symptoms are not unusual for individuals who have persistent PCS, mTBI and other TBIs. Individuals experiencing these symptoms often report feeling less able, less useful, and less successful in achieving their goals. An effective planning and organizational system sets you up to successfully fulfill these goals. That, in turn, makes you feel more competent, able to execute purposeful actions, and more successful in what you do. And, in my experience, that often makes a big difference in changing the way you feel.
So what should you look for in a planning and organization system, and how can you use it to create an effective one for yourself? What are some good planning and organization systems that I would recommend?
These topics will be the subjects of future posts of mine in the weeks to come.