Treating concussion, central pain and emotions

10 Treating concussion, central pain and emotions


The term concussion as used in this chapter refers to two quite different concepts of “concussion”. The first is the concept of a medically diagnosed concussion also called a traumatic brain injury (TBI) or closed head injury and is defined as an alteration in mental status, with or without loss of consciousness, accompanied by a brief period of amnesia after a blow to the head. The second, more subtle, concept means any shock or trauma to the system that has a direct or indirect impact on the medulla or brain stem.


A traumatic brain injury (TBI) is associated with loss of consciousness, post-traumatic amnesia in which the patient cannot remember the events leading up to the trauma for periods up to several days and focal neurological signs (de Kruijk 2002). A mild traumatic brain injury (mTBI), the most common form of concussion, is usually defined as one in which loss of consciousness (LOC) is less than 30 minutes and the Glasgow Coma Scale (GCS) score is more than 13 at the time of injury. A GCS score of 3 signifies deep coma and a GCS score of 15 signifies a fully alert and oriented patient spontaneously conversing and following commands. In an mTBI, the patient may have incomplete memory of the traumatic event and post-traumatic amnesia (PTA) of less than 24 hours and may have been dazed and confused at the scene without loss of consciousness. An example would be the driver of the target vehicle in a rear end accident who does not remember the sound of the impact or who does not remember anything between the time she saw the impact vehicle approaching and the time several minutes later when the police officer arrived at the car window (McCrea 2002, McAllister 2002, Ropper 2007, Ryan 2003).


Both TBI and mTBI are associated with post-concussive symptoms of cognitive, emotional and behavioral disturbances that can persist for months or years after the injury. These symptoms include headache, difficulties with attention, concentration and memory and the sequencing and processing of information, problems with mood including irritability, aggression and emotional lability, sleep disturbance, fatigue, dizziness and perhaps photophobia, hyperacussis or nausea although these tend to be more problematic immediately after the injury.



Incidence of traumatic brain injuries


There are 1.5 million traumatic brain injuries affecting 128 people per 100,000 in the United States every year and even though 85% are considered mild they result in significant disability and unemployment due to the cognitive, psychological and social dysfunction they cause (Ropper 2007). Sports and bicycle accidents account for the majority of cases among 5–14-year-olds and falls and motor vehicle accidents are the most common cause of concussion in adults. Post-concussive syndrome or post-concussive symptoms (PCS) refer to a constellation of signs and symptoms that may be reported after a TBI of any severity. Post-concussive symptoms affect up to 50% of mTBI patients at one month and 15–25% at one year. Some post-concussive patients never return to their pre-morbid function (Alves 1993, Middelboe 1992). Litigation and compensation factors involved in injuries sustained in the workplace or in auto accidents are thought to affect both symptom reporting and rates of recovery (Mooney 2005).


CT scans should be done to evaluate the need for neurosurgical intervention, even in the presence of a normal neurological examination, if the patient is under 16 or older than 65 years of age, has a GCS of less than 15 within 2 hours after the injury, two or more episodes of vomiting, retrograde amnesia for greater than 30 minutes prior to the trauma or is taking anticoagulants (Ropper 2007). CT and MRI scans while easily available and adequate to diagnose gross pathology such as hematoma, frank swelling or depressed skull fracture are not sensitive enough to show the subtle reductions in cortical perfusion, frontal and temporal hypometabolism and diffuse axonal injuries that have been demonstrated on PET or SPECT in mTBI patients with persistent PCS. Several studies have demonstrated abnormal frontal and temporal lobe activity with PET and SPECT scans in TBI/PCS patients whose CT and MRI scans were normal (Gross 1996, Ruff 1994, Humayun 1989, McCrea 2008).



Pathologies associated with TBI


Multifocal axonal injuries, increased permeability of the axonal membrane due to inflammation and activation of the glial system, disruption of axonal neurofilaments leading to disruption of axoplasmic flow and secondary axonal deafferentation in the areas of the brain served by the damaged axons have been observed after mild brain trauma in both human and animal studies (Oppenheimer 1968, Blumbergs 1994). Human postmortem studies have shown loss of cortical cholinergic afferents that would account for dysfunction in hippocampal cholinergic neurons and the resulting symptoms of memory loss and difficulty with information processing (Dixon 1994, Saija 1988, Murdoch 1998, Dewar 1996). Even mild brain injury has been shown to produce evidence of diffuse axonal injuries (Povlishock 1989, 1992, 1995). Sleep disturbances common in TBI patients are thought to be produced by injury to the reticular activating system that regulates sleep–wake cycles.


Imbalance, disequilibrium, particular problems with task sequencing, vision dependent balance and panic attacks during sleep or in visually complex settings may reflect damage to the endolymphatic system, eighth nerve or the vestibular apparatus in the inner ear. Damage to the inner ear can greatly confound and complicate PCS symptoms because some of the symptoms overlap but the diagnosis and successful treatments are completely different.


There are no universally effective treatments for post-concussive symptoms (Bazarian 2005). Tincture of time produces some recovery of function. Cognitive behavioral counseling for patients and their families at the time of the injury helps patients deal with the deficits, creates realistic expectations and reduces anxiety about symptoms. Medications and various strategies are used to modify post-concussive symptoms.


Complaints of sleep disturbance seen in 30–70% of TBI patients are particularly difficult to manage because medications for sleep disturbance such as the benzodiazepines and other sedative hypnotics mimic or exacerbate the post-concussive complaints of fatigue and cognitive dysfunction. But the sleep deprivation itself may exacerbate the post-concussive symptoms of cognitive dysfunction, fatigue, irritability and anxiety. Non-pharmacologic interventions such as the teaching and reinforcement of sleep hygiene and relaxation training promote functional recovery. The use of low dose anti-convulsant medication at night may be the best choice for medical management since it can address multiple symptoms of sleep disturbance, headache and chronic neck pain.


Dysfunction in the cholinergic, catecholaminergic and dopaminergic neurotransmitters may all contribute to cognitive impairment. It is clear that disruption in cortical cholinergic function is a primary source of cognitive dysfunction but some patients respond best to cholinesterase inhibitors and others to psychostimulants that increase catecholamine levels. Both classes of medications are intended to improve attention and working memory although it is advisable to start with low doses and titrate up in small increments (McAllister 2002).


In spite of these strategies symptoms from TBI persist for years following even mild head trauma and create significant disability. In 1999 the National Institutes of Health declared mTBI and post-concussive sequelae to be a major public health problem (NIH 1999).



Van Gelder’s concussion model


The second concept of concussion is particular to one physician, a Dutch osteopath and naturopath from Australia who trained in England in the 1930s and came to practice in Vancouver, British Columbia in 1946 (Van Gelder 1985, 1989). Harry Van Gelder was mentioned in Chapter 1 of this text and it is he who bought the practice that came with the 1920s machine that came with the list of frequencies that allowed him to treat a multitude of physical conditions and complaints successfully using electromagnetic resonance along with other therapies. Although somewhat eccentric, Harry Van Gelder was beloved and acknowledged by those he treated as being superbly effective and skilled as a diagnostician and healer. He developed a more subtle concept of “concussion” to mean any shock or trauma to the system that had an impact on the medulla or brain stem. Van Gelder’s skill, reputation and clinical outcomes lead to the consideration of this more subtle condition as a treatment focus.



Functions of the medulla


The medulla is located at the base of the brain and carries the ascending and descending tracts that connect the brain with the spinal cord. The medulla also gives rise to cranial nerve X, the vagus nerve. The vagus influences every vegetative function including, but not limited to, respiration and bronchodilation, heart rate and blood pressure and digestion through its regulation of the esophagus, stomach, small intestine, gall bladder, and the secretions of the pancreas and stomach. It contributes to immune system regulation by regulating secretions in the thymus. It supplies the motor parasympathetic functions of all of the viscera except the adrenal glands.


In Van Gelder’s model of injury and illness, trauma to the medulla made it function inefficiently and created dysfunction in all of the vegetative systems including the immune system, the cardiovascular system and the digestive system. The trauma to the medulla also created dysfunction in the pituitary and the endocrine organs it regulates by changing regulatory impulses in the fibers that connect the medulla to the pituitary.


The trauma to the medulla could be physical and caused by a fall, a blow to the head or any sort of physical injury that stretched or stressed the neck and brainstem. The trauma could be from emotional shock producing a flood of impulses from the viscera pouring into the medulla via the vagus. The medulla effectively becomes overloaded by overwhelming input rather like a circuit breaker that switches off during a power surge causing the system to function less effectively. The trauma could be from “chill” or any sort of event such as infection, exhaustion or toxic exposure that shocks the viscera creating a flood of impulses from the viscera through the vagus to the medulla causing it to “switch” into something like a “safe mode”. The vagus and the medulla simply function less effectively than they did prior to the trauma. The analogy between a computer or power system and the medulla moving into a less effective but “safe mode” is an apt one. The “safe mode” preserves the most important critical functions and allows for repair and recovery at some later time.


In Van Gelder’s model, trauma leads to “paralysis” which leads to “allergy reaction” and reduction in secretions and vitality. “Paralysis” does not refer to a true medical paralysis or complete loss of function. Once again the analogy to the loss of function when a computer “locks up” and loses the ability to move to the next step is most apt. Computers move smoothly from one step to the next because of a continual flow of “do this – then do that” lines of instruction. The computer “locks up” because it has lost the line of code that tells it what to do next and becomes “paralyzed”. The frequency to remove “paralysis” is Van Gelder’s conceptual equivalent of the computer command “control–alt–delete” that reboots the computer system.


In Van Gelder’s system, as well as in our medical understanding of physiology, the body’s first response to any dysfunction is to release histamine as a way of starting the inflammatory cascade. The third problem, after “trauma” and “paralysis” that assails the medulla as it moves into “safe mode” is a histamine release or allergy reaction making the medulla less efficient by reducing both secretions and vitality and initiating inflammation as a means of repair and recovery. The loss of efficiency in the immune, digestive and endocrine systems caused by the malfunction in the medulla and vagus leads to a variety of allergy reactions and health issues while the system slowly initiates the repair process.



Treating the “constitutional factors”


Van Gelder became a physician at a time when the concept was developed that genetic factors could be turned off or turned on by life events or exposures predisposing the person to various illnesses. These genetic factors were called “constitutional factors” and probably correspond to what modern genetics calls single nucleotide polymorphisms or SNPs, places on the gene that are altered from the ideal or wild type. The constitutional factors had colorful descriptions that related them to susceptibility to the diseases of the day such as gonorrhea, syphilis and tuberculosis but they were effectively genetic predispositions to various ailments.


The practicing clinician will be familiar with the relationship between susceptibility to illness and patient family histories even if the concept of constitutional factors is not familiar. If every one of 100 people in a room is exposed to a certain bacterium only a certain percentage will contract the disease while some will fight it off successfully and a few seem not to even notice the exposure. Why is that? Van Gelder would say that the patients who fell ill had the genetic “constitution” that made them susceptible to the bacterium. Modern physicians trained in immunology and genetics would say that the immune systems of the patients who fell ill were less effective in fighting the bacterium because the minute receptors on the lymphocytes were less vigorous in defense. One interpretation of the event is more poetic and the other is more scientifically informed but different susceptibilities to illness are a known fact no matter how one chooses to interpret the causation.


The same patterns become apparent when interpreting patient family histories of illness. Physicians take a family history because it gives clues about what the individual’s risk is of contracting certain diseases. One patient will have a family history in which every adult over the age of 40 has diabetes as well as some primary relatives who have asthma and a few with multilevel disc disease and one with sarcoidosis. No one in the family suffers from alcoholism or psoriasis. The genes or SNPs would almost surely be related to inflammation and insulin regulation and the constitutional factor is related to the susceptibility to tuberculosis. Another patient will have a family history replete with stroke, heart disease, degenerative but not rheumatoid arthritis and hypertension but no one has diabetes, psoriasis or psychosis. Another will have psoriasis, eczema, irritable bowel as a personal diagnosis and in the family history but no family history of heart disease or diabetes. Another patient will have a family history replete with alcoholism and psychosis or other mental illnesses but no incidence of diabetes or heart attack. These patterns in family medical history are familiar to every practicing physician whether one chooses to interpret them in the light of modern genetics or in the light of turn of the century medical practice. Van Gelder’s device had one specific frequency that seemed to neutralize all of the constitutional factors.



Using Van Gelder’s model


Van Gelder’s model of restoring the patient to full function involved clearing “concussion” from the medulla, restoring secretions to the pituitary, turning off constitutional factors and the final step was to restore “vitality” to the system and “balance the energy centers.” This model is clearly not part of mainstream medical training or practice and it would be simpler not to teach it as part of an FSM pain treatment program taught to traditionally trained physicians.


A 6-week trial was done in which the “concussion protocol” was not performed on any of the week’s 90 patients in order to assess whether it was actually essential to the outcomes achieved. The patients but not the practitioners were blinded to the change in treatment protocol. Within a few weeks it became clear that outcomes, while not quantified, had declined and treatment results were less favorable even when every other therapy and protocol were applied as before. By the end of the 6-week trial the “concussion protocol” was again used on a regular basis and outcomes returned to their normal positive level in the week’s 90 patients. Subsequent shorter trials with both the patients and the practitioner blinded produced the same pattern of effect on outcomes.


Van Gelder’s reputation as a master physician and healer was the original reason for considering using and teaching his more subtle concussion model. The model continues to be used and taught because it produces results that cannot be achieved if it is not used. It is left to the reader to decide from personal experience whether treatment of this more subtle interpretation of concussion contributes to positive outcomes in pain management.



Concussion protocol treatment outcomes


Treatment for this mild form of “concussion” described by Van Gelder was among the first FSM protocols used in practice. Patients reported improvements in sleep, mood and general wellbeing that were both subtle and profound sometimes years after a mild head injury and even when they could recall no head trauma. Encouraged by these results, FSM was used in patients with post-concussive symptoms from brain trauma, including TBI, mTBI and stroke. One to four treatments produced consistent profound improvements in sleep, mood, cognitive function, information processing, emotional stability and fatigue in hundreds of case reports from over 1000 practitioners after 12 years of use. Only the headache has proven to be somewhat resistant to treatment. In seriously injured patients more than four treatments may be necessary and the improvements may never last for more than a few days if neural tissue has been lost. Significant objective and subjective improvements have been observed in multiple case reports from numerous clinical centers in the US and abroad.



Concussion protocol increases serotonin


The data acquired through micro-immunochromatography demonstrated that the concussion protocol produced a significant but probably temporary increase in serotonin levels. Serotonin decreased during the treatment that reduced pain in fibromyalgia patients (see Chapter 8). When the pain reached 0/10 VAS or had stopped decreasing the protocol was changed and for the next 30 minutes the patient was treated with the “concussion protocol”. The patient was blinded to the change in treatment. Serotonin levels dropped during the pain reducing portion of the treatment in every patient treated and rose with use of the concussion protocol from an average of 175.75ng/ml (± 40.20) to 244.34ng/ml (± 76.05) in each of 16 different patients whose samples were collected during the 2-month test period. The normal range for serotonin is 100–300ng/ml.


The average increase in serotonin in the 30 minutes from the zero VAS time point to the end of the concussion protocol was 68.59 ± 54.79 for a 39% increase. One patient’s serotonin level more than doubled increasing from 155.2 to 337.6ng/ml. The Wilcoxon Signed Ranks Test result was Z = −3.52 p<0.001.


These anecdotal reports give some basis to pursue an organized controlled trial including neuroimaging such as PET and SPECT scans to provide some objective evidence to validate the observed clinical improvement.



Diagnosing concussion


If the patient presents acutely after head trauma, the practitioner should perform whatever neurological examination is within their training and scope of practice. If the patient has not been evaluated in an emergency department, has focal neurological signs, is under 16 years of age or older than 65 years of age, had a GCS of less than 15 within 2 hours after the injury, had two or more episodes of vomiting after the injury, retrograde amnesia for greater than 30 minutes prior to the trauma or is taking anticoagulants, the practitioner should order a CT scan to rule out intracranial lesions or hemorrhage.


The acute signs of concussion may include headache, nausea, photophobia, sleepiness, irritability and mental confusion including problems with word finding, memory and orientation. The acute concussion protocol is described below and would be used in this patient if the CT scan were negative or if the injury was not severe enough to require a CT scan.


Unless the practitioner reading this text is a neurologist it is unlikely that the patient’s presenting complaint will be post-concussive symptoms. The PCS symptoms may be incidentally mentioned in passing or not mentioned at all in a patient that is some months or even years post head injury.


The systems engineer referred for treatment of chronic neck and shoulder pain provided a rambling, tangential and disorganized history of the auto accident that occurred 2 years previously but did not complain of having post-concussive symptoms. When asked she admitted that she was having trouble organizing projects at work, was fatigued and had trouble sleeping but attributed these problems to pain. A typical systems engineer without post-concussive symptoms provides an organized, sequential and detailed history often presented in writing. The brain MRI ordered after this patient’s visit showed a small focal lesion said to be unrelated to the trauma although no basis for this determination was provided.


Treatment with FSM and nutritional supplements helped reduce the symptoms. The diagnosis was based on observation and questioning when the quality of the history did not match the patient’s job description and presumed premorbid level of function. The basic concussion protocol included in this chapter was used on this patient in addition to more advanced protocols for chronic concussion in other areas of the brain and her symptoms were significantly improved.


There were frequencies for five general sections of the brain on the list of frequencies acquired from Van Gelder – the forebrain, midbrain, hindbrain, medulla, pineal and pituitary. The midbrain is the site of the thalamus. Concussion and post-concussive symptoms can affect any or all brain areas and questions should be asked that query the functions of each part of the brain so it can be determined which areas are most in need of treatment. Treating these areas of the brain requires a level of understanding of neurology and an appreciation of the profound effects that can be produced by FSM on nervous system tissue that are not generally available to students reading a basic level FSM text in pain management. There are protocols for treatment of acute brain injuries and chronic brain conditions taught in the FSM Core and Advanced seminars and the student who has an interest in treating these conditions would find these courses useful.



• History: Directed questioning may reveal symptoms the patient does not associate with the injury. Be aware that the patient may not be an accurate historian or may simply lack the self awareness to assess their own performance and cognitive function. When there is any doubt the patient’s family should be consulted.


• Memory and decision making problems: Are you having any problems with being forgetful? Are you having any unusual problems with memory for numbers, names, facts or words? Is decision making any more of a problem for you now than it was before the accident?


• Task sequencing: Is it difficult for you to accomplish projects that require multiple steps? Are you having problems performing errands in sequence, getting a meal on the table, or planning multistep projects?


• Sleep disturbance: Are you having any problems with getting to sleep or staying asleep?


• Fatigue: Are you more fatigued than you were before the injury? Do you fatigue more easily than you did before the injury?


• Mood: Are you more anxious, irritable, or depressed than you used to be? Do your moods shift more easily than they used to? Do you find yourself yelling or losing your temper more often than is normal for you?


• Balance and co-ordination: Do you have any new problems with balance? Can you walk around your home when you get up at night in the dark or do you need a light on? Do you fall or bump into things more often than usual?


• Hormones: Are you having any menstrual cycle irregularities (progesterone and estrogen balance)? Are you having any prostate symptoms (testosterone and estrogen balance)? When did you start having problems with acne (testosterone excess)? Have you had any weight gain since the trauma (insulin and blood sugar regulation)? Has your libido changed from what is normal for you (testosterone)? Do you awaken with hot flashes or have episodes of sweating since the accident (cortisol, estrogen)? Are you more fatigued than seems normal? Do you have difficulty performing or recovering from exercise? Are you depressed for no apparent reason (growth hormone)?


• Imaging: Unless the patient has severe symptoms or meets the criteria that require a CT scan acutely it is not necessary to order routine diagnostic imaging. MRI, PET and SPECT scanning are more revealing in chronic mTBI and the practitioner is encouraged to find a neurologist specializing in brain injuries as a referral resource.



Treating concussion – the concussion protocols




image Hydration




• The patient must be hydrated to benefit from microcurrent treatment.


• Hydrated means 1 to 2 quarts of water consumed in the 2 to 4 hours preceding treatment.


• Athletes and patients with more muscle mass seem to need more water than the average patient.


• The elderly tend to be chronically dehydrated and may need to hydrate for several days prior to treatment in addition to the water consumed on the day of treatment.


• DO NOT accept the statement, “I drink lots of water”.


• ASK “How much water, and in what form, did you drink today before you came in?”.


• Coffee, caffeinated tea, carbonated cola beverages do not count as water.


• Water may be flavored with juice or decaffeinated tea.



Frequencies



Channel A/condition frequencies


The frequencies, listed in the usual order of use, are thought to remove or neutralize the condition for which they are listed except for 81, 49 / which are thought to increase secretions and vitality respectively













































• Emotional component

 970 /


• Remove trauma

 94 /


• Restore function

 321 /


• Remove Histamine

 9 /


• Inflammation

 40 /


• Chronic Inflammation

 284 /


• Support secretions

 81 /


• Vitality

 49 /


• Stop bleeding

 18 / 62


• Fibrosis

 51 /


• Sclerosis

 3 /


• Calcium influx

 91 /


• Remove opiates

 19, 43, 46


A / B Pairs




6.8 / 38



• Remove or reset constitutional factors.


• 6.8 / 38 is an A/B pair in which channel A is not a condition and channel B is not a tissue. The desired effect is created by the two frequencies delivered simultaneously in an interferential field. This frequency combination appears to neutralize all of the genetic factors described by Van Gelder and the physicians of the early 1900s and generally makes people feel more grounded and steadier.



35 / 102



• Balance the energy centers.


• / 102 was the frequency on Van Gelder’s list for the pineal gland which secretes melatonin and regulates sleep wake diurnal cycles. Melatonin is a powerful antioxidant and has some anti-tumorgenic activity in preventing breast cancer and other cancers. In Van Gelder’s understanding, this frequency also resonated with the energy center at the top of the head known as the “crown center” when combined with 35 / on channel A. If the practitioner’s belief system does not include the concept of energy centers, then the frequency can be used with the intention to simply address the physical structures. This frequency combination usually makes patients feel lighter and more relaxed. The affect of the frequency combination and the outcomes achieved do not appear to be affected by the practitioner’s belief system.



Channel / B tissue frequencies


There is some debate in the FSM community as to what anatomical brain structures are included in each area. The divisions are probably imprecise and somewhat arbitrary. Response to treatment helps to disclose what functions reside in which brain part in any particular patient.


image

Figure 10.1 • The frequencies for portions of the brain treated with the concussion protocol or treated to remove central pain are shown in the diagram above. / 94 is the frequency for the medulla. / 310 is the frequency for the anterior pituitary. / 89 is the frequency for the midbrain and is used for pain syndromes involving the thalamus.




Medulla: ___ / 94



• The medulla, brain stem, or myelencephalon includes the medulla oblongata and the medullary pyramids. The medulla contains the motor and sensory pathways to the body and the face and the vital centers regulating the cardiac, respiratory and vasomotor systems.



Midbrain: ___ / 89



• The “midbrain” is part of the mesencephalon and includes the tectum, the pretectum, the inferior and superior colliculi, the cerebral peduncle, the midbrain dorsal and ventral tegmental areas, the crus cerebri, the substantia nigra, and the cerebral aqueduct and may also include third ventricle, thalamus, hypothalamus, subthalamus, subcortical system, the amygdala (limbic system), hippocampus (limbic system). For the purposes of this chapter it has been found to successfully treat central pain and is assumed to address the thalamus and periventricular, responsible for central pain.



Anterior pituitary: ___ / 310



• The anterior pituitary regulates the hormonal body processes, sexual maturation, sexual function, physical maturation, growth height and form through its secretions of gonadal regulatory hormones.



Solar plexus: ___ /200



• The solar plexus is an archaic term for the celiac nerve plexus of the vagus nerve just below the sternum in the epigastric area of the abdomen. This frequency is thought to address both the nerve plexus and the energy center located in this area. If your belief system does not include the concept of energy centers then the protocols can be used simply to address the physical structures. The frequencies used and outcomes achieved will not change.



General concussion protocol



Channel A condition / Channel B tissue




94 / 200 – Nervous tension



• Literally translated this frequency removes “trauma” from the solar plexus but Van Gelder used it to reduce nervous tension. It is observed to have a calming effect and to begin increasing serotonin levels.


• Treatment time: Use this frequency for at least 1–2 minutes depending on clinic time demands and the patient’s condition. If the patient is very tense and time allows this frequency may be used for up to 5 or 10 minutes.



970 / 200 – Emotional tension



• Literally translated this frequency combination balances the emotional component or removes emotional stress from the “solar plexus” and Van Gelder described it as reducing emotional tension. It is observed to have a calming effect and begins increasing serotonin levels.


• Treatment time: Use this frequency for at least 1–2 minutes depending on clinic time demands and the patient’s condition. If the patient is very tense and time allows this frequency may be used for up to 5 or 10 minutes.



94 / 94



• Remove concussion from the medulla.


• If the memory of some recent trauma is replayed in slow motion in the mind’s eye it will become apparent that there are two parts to any trauma. The first is the pain of the physical injury. The second is the “fact” of the trauma and the surprise or shock to the system that it represents. It is the “fact” of trauma and the shock to the system that is thought to be removed by using 94 /.

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Jun 14, 2016 | Posted by in PAIN MEDICINE | Comments Off on Treating concussion, central pain and emotions

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