Does being flexible, psychologically, help you recover from a concussion injury?
Injuries happen every day, affecting how we spend time with our friends and whanau, how we engage in work, how we get on with life. With a broken leg or arm, we can rest it and find adaptions to all these activities, pace it out but get it done. We can still have conversations, look at screens, and engage in non-physical hobbies to help get us through the boredom and frustration of the injury.
Concussion, on the other hand, impacts all aspects of our activities. It comes with all sorts of unpleasant symptoms – headaches, nausea, dizziness, and mood changes, just to name a few. These by themselves make us want to retreat into our cave and wait out the storm. Our brains are used for everything we do, meaning we can’t find work arounds. This is then worsened by the fact that our cave has to be dark, silent and alone to try to avoid our symptoms.
What we know, unfortunately, is the best way to recover from a concussion is not to hide away in our cave. In fact, this could make things much worse! Generally speaking, after the first 48 hours, full rest can actually lead to prolonged recovery times and so you feel worse for longer. That’s not to say that you just jump back into it after 48 hours. Rather working with a rehabilitation team to create a recovery and rehabilitation plan that takes a graded approach to returning to activity as well as tackling the other contributors to prolonged recovery, such as neck and balance issues, are the next stages of recovery
So, what do psychological factors have to do with your concussion, a physical injury?
It may surprise you to hear that psychological factors—like your mood, anxiety, personality traits and behaviours—have a lot to do with recovery from all physical injuries and conditions. Viewing the body as separate from the mind is outdated and can actually get in the way of healing, sometimes leading to longer recovery times or other challenges.
In the case of concussion, this connection is even more direct. A concussion is a brain injury, and the brain is what produces not just movement and memory, but also our emotions, thoughts, and behaviours. So when the brain is affected, it’s completely normal to notice changes across all of these areas—not just physically, but emotionally and cognitively too.
How we feel and think influences how we behave, and that can shape how we approach our recovery. But it goes deeper than that: because thoughts and feelings come from the brain, and the brain has been injured, they’re often directly impacted. This can affect things like energy, concentration, motivation, physical posture, how we cope with stress, what we notice or tune out, and how we respond to our body’s signals. These changes can influence everything from how quickly tissues (like nerves, muscles, or tendons) heal, to how clearly we can remember things or how overwhelmed we feel in everyday situations.
Concussion affects all parts of us—how we feel physically, how we think, how connected we feel to others, and how we experience the world. It’s no wonder that emotions like fear, frustration, sadness or anger are so common after a concussion. These reactions are part of the injury—not a sign of weakness—and they can take a lot of energy to manage when we’re already running on empty. When we’re desperate to feel better, it’s also understandable that we might push too hard or avoid things we need to face—both of which can slow recovery.
That might sound like bad news—but here’s the good news! These emotional and cognitive changes are temporary. Your brain has an incredible capacity to adapt, rewire, and recover. With the right support and strategies—psychological, physical, and lifestyle-based—things can and do get better. Recent research is helping us understand exactly how psychological factors interact with the brain and body, so we can target these areas and help you feel better, faster. Recovery isn’t always linear, but you’re not stuck—and you don’t have to go it alone.
Where does psychological flexibility come into it? And what does this actually mean?
We started this post with the question whether psychological flexibility helps you recover from a concussion. The answer to this: it could definitely help. Psychological flexibility is one of the factors coming out of the research as a key player in the concussion field. This term refers to a person’s ability to make space for difficult thoughts and emotions while doing what aligns with who they are and what matters most to them as a person and their long-term goals.
When it comes to concussion, this is especially relevant. It is completely natural for us to be worried about these symptoms. It’s also natural to want to avoid anything that makes symptoms worse—light, sound, busy places, or even exercise. But while that avoidance might feel protective in the short term, it can actually reinforce fear, reduce activity, and increase distress over time. This can lead to a longer and more complex recovery.
Psychological flexibility allows us to notice when we’re caught in unhelpful patterns—whether that’s avoiding activity out of fear, or pushing too hard in the hope of speeding up recovery. It helps us pause and gently step back from those automatic urges, so we can respond in a way that’s guided by our values, rather than discomfort or frustration. With psychological flexibility, we can focus on what we can control (our behaviour) while working toward gradual, sustainable progress. This might mean pacing ourselves, engaging in rehabilitation activities even when they’re challenging, and making space for difficult thoughts and feelings without letting them steer the ship. By keeping our long-term goals in view and accepting some short-term discomfort as part of the process, we support a more balanced and effective recovery.
This approach doesn’t mean pushing through blindly or ignoring the body’s limits. It means staying connected to what matters—whether that’s getting back to work, being present with family, or regaining independence—and taking small, values-based steps even when it’s hard.
The good news is that psychological flexibility is a skill that can be learned and strengthened. And as the brain heals (which it can and does), this process gets easier. By supporting both the mind and the brain in recovery, psychological flexibility offers a way forward that’s both compassionate and empowering.
So how do I get me some of this psychological flexibility?
Psychological flexibility is influenced by many factors, and a concussion can make us more psychologically rigid or inflexible as a part of the injury itself.
The exciting news is there are ways we can grow and build on our psychological flexibility. There are skills and strategies and treatment approaches that work on this directly, such as Acceptance and Commitment Therapy (ACT). And on top of that recent research has shown preliminary evidence that these are beneficial in the treatment of concussion specifically.
Some ways that you can start working towards increasing your psychological flexibility:
1. Notice, don’t fight, your thoughts and feelings
It’s normal to feel frustrated, anxious, or down. Instead of trying to push those feelings away, try saying to yourself: “This is hard, and it makes sense I feel this way.”
2. Ask yourself what matters most right now
When you’re stuck—either avoiding things or pushing too hard—pause and ask: “What do I care about in the long run?” Let that guide your next step.
3. Do one small thing that moves you forward
Choose a manageable task that supports your recovery (e.g. going for a short walk, doing a rehab exercise, connecting with someone you trust). Keep it small and doable.
4. Be kind to yourself on the tough days
Recovery isn’t linear. Progress includes ups and downs. Try speaking to yourself the way you would to a friend: “I’m doing the best I can today.”
If you are working with a Concussion Service, talk with your rehabilitation provider about engaging with a Psychologist as a part of your programme and they can support you to develop these skills.
Co-wrote by Dr Tamara Bejakovich and Stacey-Lee Esterhuizen
