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Psychological Flexibility: Does Mindset Matter After Concussion?

Niall McKeever, a writer, and entrepreneur describes psychological flexibility as a “superpower of mental health and wellbeing”. In its simplest terms, psychological flexibility refers to the ability of someone to adapt when life doesn’t always go as planned. Concussion or mild Traumatic Brain Injury (mTBI) is one of those life events that is never planned for, always a surprise, and can be quite stressful. Luckily, most concussions (70-80%) recover on their own in about 3-4 weeks. Even in this relatively short window of time, taking part in your usual daily activities can seem difficult at best due to the symptoms that can come after a concussion.

A concussion can affect the way your brain thinks and how you feel. It can cause temporary changes in memory, concentration, sleep, processing speed, and eye-tracking. These changes understandably can take a toll on the psychological and emotional functioning of everyone involved, from the patient to their friends and family. If concussion symptoms persist beyond the 3–4-week window of time, one is considered to have persistent concussion symptoms (PCS).

Girl with Persistent Concussion Symptoms

There are several different risk factors for why a person may experience PCS, some of them being:

  • History of prior concussion

  • Learning disorders

  • Migraine Headache

  • Family and social stressors

  • High level of pre-injury symptoms

In research conducted from New Zealand by Dr. Josh Faulkner and his colleagues, there is a hypothesis that psychological flexibility might influence recovery after concussion. This thinking was based on their findings that suggest there is a relationship between psychological flexibility and pre-injury psychological risk factors such as anxiety, stress, or other behavioral health issues. In everyday language, this means that if you are someone that lacks psychological flexibility (you get stressed out easily with change or you are anxious at baseline), you may likely experience PCS.

What does this mean for you?

If you have a concussion and want to prevent PCS or if you have PCS now, changing your mindset and being more psychologically flexible may help support your recovery.

Ways to enhance your Psychological Flexibility:

  • Acknowledge that recovery from concussion can be difficult and know that it’s ok to experience uncomfortable emotions. There are no “right” or “wrong” emotions. Even when emotions are uncomfortable, the emotions themselves don’t cause harm and it’s important to recognize there is a difference between emotions and how you feel versus your actions and what you do.

  • Change the dialogue about your injury. You don’t “have a concussion”, you are “recovering from a concussion”. You may not be where you want to be or where you thought you would be. Try and focus on recovery and the things you can do now that you couldn’t do when you first got your concussion.

  • Accept where you are right now in this moment. It may not be where you want to be or where you expected to be. A lot of this may be out of your control. But you can focus on what you do have control over to participate how you can in activities that are meaningful to you.

  • Engaging in activities that you enjoy doing and that you are cleared to do by your health care provider.

  • Find a strong support system that allows you to be yourself and express how you feel. This could be your friends, family, or even a support group. Connecting with your support system on a routine basis can help support you during times of stress.

  • Try mindfulness. Mindfulness, meditation, or relaxation breathing, are all very similar in nature and allow you to be less reactive to your emotions. There are plenty of places to find free apps to try some guided mindfulness.

If your recovery seems overwhelming to you, find a Behavioral Health Therapist that can provide you with emotional and psychological support. Here’s how to start:

How to Find a Therapist:

  • Check on the back of your insurance card. There is a phone number specifically for mental/behavioral health. They can provide a list of therapists that are in-network with your insurance and specialize in your specific needs.

  • Ask your school what resources may be available. Many schools contract with local agencies to provide in-school therapy services.

  • Ask your pediatrician or primary care provider for a recommendation. They often know of local resources and can provide a referral if needed.

  • Visit psychologytoday.com or findtreatment.samhsa.gov to search for providers by location and specialty.


Faulkner JW, Snell DL, Theadom A, Mahon S, Barker-Collo S. The role of psychological flexibility in recovery following mild traumatic brain injury. Rehabil Psychol. 2021 Nov;66(4):479-490. doi: 10.1037/rep0000406. Epub 2021 Sep 30. PMID: 34591526.

Faulkner JW, Theadom A, Mahon S, Snell DL, Barker-Collo S, Cunningham K. Psychological flexibility: A psychological mechanism that contributes to persistent symptoms following mild traumatic brain injury? Med Hypotheses. 2020 Oct;143:110141. doi: 10.1016/j.mehy.2020.110141. Epub 2020 Jul 30. PMID: 32759012.

Diane L. Whiting, Frank P. Deane, Grahame K. Simpson, Hamish J. McLeod & Joseph Ciarrochi (2017) Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review, Neuropsychological Rehabilitation, 27:2, 263-299, DOI: 10.1080/09602011.2015.1062115

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