Interview with Dr. Zender
Sofia: To start, could you introduce yourself and share a bit about your background and the work that you do?
Dr. Zender: Hi! Yes, thanks, glad to be here. So I’m a clinical and forensic psychologist. For the past, quite a few years, I’ve specialized in auto accident trauma as my primary focus in my practice. In dealing with survivors of severe auto accidents, I see a lot of cases of concussion, traumatic brain injuries, or closed-head injuries. There’s a lot of different names for the same kinds of symptoms, post-concussion syndrome, and it’s often a big challenge for people to recover from traumatic brain injuries because it can have big impacts in terms of functioning: Occupationally, socially, cognitively, emotionally, sexually, uh, in all areas of functioning. But the good news is that bodies heal, brains heal, and with time and the right conditions, there can be optimal recovery.
Sofia: Could you tell me about your experience writing your book? I’d also love to hear what led you to specialize in this field, and specifically what inspired your focus on auto accidents.
Dr. Zender: So I had been already working, specializing in auto accident trauma for quite a few years, and I attended a Harvard writer’s continuing education conference and decided at that time to write a book on auto accident recovery. Sort of a roadmap for people to follow who have been involved in serious car accidents to cover areas like traumatic brain injuries, dealing with the medical/legal paradigms, (which are often very, very challenging), and just to give all my tips and all the guidance I could about how to best recover.
Sofia: What advice would you offer to patients recovering from a car accident? And how can friends, family, and loved ones best support someone going through a concussion?
Dr. Zender: It’s very difficult for people to deal with traumatic brain injuries because we call it a silent injury. Usually, you don’t see that the person is injured, however, they can be severely compromised. Their memory, their concentration, their speech, all these things can be impacted to some degree or another, and the disruption to functioning can also be variable. There can be good times where the person is functioning pretty much normally, and then there can be times where there’s severe disruption to functioning. There’s a great book, written by a professor of Artificial Intelligence from Purdue who had a car accident. It’s called a ghost in my brain, and he talks about, you know, sometimes he could be functioning extremely well, give brilliant lectures, and then other times he would have to crawl out to his car, and he couldn’t find his car. And, you know, it was just like extremely impaired. So there’s this tremendous variability in functioning that we sometimes see, and stress can play a major component, but there’s also a major hormonal, neuroendocrine component to recovering from brain injuries, and it is often very poorly understood and recognized that these neural endocrine elements can be like a secondary injury that can unfold for months and years after the accident. So, finding a competent neural endocrinologist. It’s really, really difficult because there are very few, and when you do find one, the insurance industries often really fight their findings because it is a rather controversial field and there’s a lot of mixed opinions. So it’s very hard for people to get the neuroendocrine aspects of an injury addressed, but it’s worth trying.
Sofia: In your view, what is the connection between concussions and PTSD? How does PTSD influence the recovery process, especially in the context of car accidents?
Dr. Zender: There’s a great deal of crossover and correlation between the symptoms of traumatic brain injury and post-traumatic stress disorder. And we know that as stress goes up, the symptoms of traumatic brain injury can also greatly intensify. So, with post-traumatic stress, if the person is being triggered by traumatic reminders of the accident, then this can also severely impact cognitive, neurocognitive, and neuro-emotional functioning, but there is a great deal of overlap between the two conditions. And, there is even some thought that–a colleague of mine who’s a neuroendocrinologist, Dr. Mark Gordon, feels that post-traumatic stress disorder is actually a form of traumatic brain injury, and to look at them as not separate conditions, but as unified conditions.
Sofia: Based on your experience, what practices or approaches have you found to be the most effective in supporting healing after a concussion?
Dr. Zender: Well, there’s how do people best recover after a concussion? Number one is, I would say, self-care. That the person needs to recognize that they need to take responsibility and do everything they can to create what we call a neuropermissive environment for the brain to heal. That means not utilizing alcohol or drugs to cope with the emotional experiences they might be having. To get adequate sleep, to focus on a very healthy diet, rest is probably number one. Sleep is number one, and the sleep is also the one area of functioning that is often most impacted by both concussion and traumatic brain injury.
Sofia: If you could change one thing about how society views or approaches concussions, what would it be? And what do you most wish people understood about concussions?
Dr. Zender: If I could change one thing about how society approaches concussion, I would say, number one, people need to realize how vulnerable we are. How vulnerable our brains are to the impact of concussive forces, like car accidents or sports, and to do everything possible to minimize or to minimize the risk of injury to the brain. And then on top of that, to become better educated about what the symptoms of concussion are and what post-concussion syndrome looks like, and to learn ways to minimize those risks and to maximize things they can do to recover.