TLDR;
Your expectations influence concussion recovery much more than you think. They impact how you experience your recovery and how your body responds to treatment.
No, this doesn’t mean its all in your head!
Expectations are not fixed. Small, repeated experiences can shape them.
Start by asking: “What am I expecting to happen after I do this?”
If you are asking “why won’t my concussion heal,” or your concussion symptoms are not going away, you are probably doing a lot right. You are engaged. You are trying things. And you still feel lost, or like you are not making progress.
Here is something that rarely gets talked about.
Your expectations play a reallllly big role in recovery.
That might feel heavy to hear. But it is actually within your control. This is not toxic positivity. It is about how your brain works, and how you can work with it.
What are expectations?
First off off, your brains #1 job is to keep you safe. One way it does this is by setting expectations.
Expectations are the predictions your brain makes to keep you safe (this is called predictive processing, which means your brain guesses what is coming before it happens). They shape how your body responds and how your brain interprets information.
And this matters much more than we may think.
Alia Crum, a top researcher in this field did a study using milkshakes. People drank the same milkshake on two different days. One day it was described as indulgent. The other day it was described as a light, healthy shake. When they believed it was indulgent, their bodies responded as if they had eaten more! Researchers could measure the hormonal change in their blood.
Expectations shape our inner experience and our bodies' response to events.
A common example that many have heard of is the placebo effect; when you expect something to work, and it does). There is also the nocebo effect; when we don’t expect something to work, it can reduce the effect that treatment has.
Why won’t my concussion heal? Where expectations fit
Concussion is an incredibly complex and misunderstood injury. Even the top researchers and practitioners in this field don't always fully understand how or why our brain/body responds. We are all still learning what works.
So it's common to have tried things and not noticed a benefit. It’s called the Hope & Despair Cycle.
You want to try something new, but you’re sick of the dread, the disappointment, or the weight that shows up when your symptoms still show up.
Most people who have experienced persistent symptoms after a concussion know this feeling.
I am not saying you have to be hopeful 100% of your time (that's just not human or healthy, especially when navigating concussion recovery). I am, however, suggesting to stay open.
I’m also not saying that “this is all in your head”. It's not. This is a complex process involving neuroscience and cognition.
What I am saying is that expectations influence recovery. They do not cause it.
Going into something thinking “this isn’t going to work” can shape how it goes. That is why checking our expectations before we start matters.
And if you feel doubtful or negative right now, you are not doomed. Doubt is a normal response to a hard injury. Expectations can change, and you get many chances to update them.
How Expectations Change
I’ll shout this from the rooftops: a key approach to concussion recovery is “consistency over intensity”.
Expectations are not fixed, we can shape them! They are shaped by past experience, what you’ve been told / education, body sensations, stress and mood and beliefs.
Think of your brain as a weather forecaster. Every day it predicts what is coming so your body can get ready. A good forecaster does not rewrite the forecast after one rainy afternoon. It learns from patterns over time.
Our brain learns through repetition, and it's the same for our expectations. That is why small, repeated steps matter more than one big one.
Forecast: Your brain predicts how the day will feel (ex. “a trip to the store will wipe me out”)
Try: Test the forecast with one small step (ex. go for 10 minutes at a less busy times)
Notice: Look at what the weather was really like (ex. It was tiring, and you recovered within an hour)
Update: Adjust the next forecast a little (ex “a short shop will likely be okay”)
Repeat: Forecasters learn from many days, not one (concussion are complex so use info from a few shops, not just one)
The good news is that each round gives your brain new information. Small, repeated steps add up.
Shifting Your Expectation
Identify It: Ask: “What am I expecting to happen after I do this?” (NOTE: if you tend to hyper fixate on symptoms and sensations, only try asking this before doing something new or seeing a new provider)
Reality Check: Pick a small test and after you try, kindly ask yourself “what actually happened”
Start from accurate information. Watch trusted education first, like the webinars from the Concussion Legacy Foundation and the Canadian Concussion Centre.
Next step
If you feel stuck and want support shaping expectations that help your recovery, book a discovery call.
