Paradoxes in rehabilitation

Abstract

Paradoxical enhancement and paradoxical recovery of function after brain injury harmonize well with the concept of “ultrabilitation” and its focus on novel forms of flourishing in rehabilitation settings. I consider three sets of paradoxes which may impact on brain injury rehabilitation. Firstly, I consider post-traumatic growth after brain injury and its key determinants. Secondly, I review the role of illusions in rehabilitation and the paradox that some clinical conditions may be improved by invoking perceptual distortions. Thirdly, I consider paradoxical recovery profiles after brain injury, since knowledge of such paradoxical profiles may help inform attempts at rehabilitation of some patients. Finally, I consider how some of these paradoxes relate to components of ultrabilitation, and in addition to the nascent field of positive neuropsychology and the concept of resilience after brain injury.

Implications for rehabilitation

• Illusions can sometimes be harnessed as a therapeutic tool in rehabilitation.

• There may be spontaneous, positive outcomes of an injury or illness, in the form of “post-traumatic growth”, and these should be considered as part of a holistic therapeutic approach in rehabilitation.

• Some patients make an exceptional recovery from a severe brain insult, and lessons could be learned from such cases, such as disciplined use of compensatory strategies, which could have broader implications for neurorehabilitation.

Keywords:

• Ultrabilitation
• Paradoxes
• Rehabilitation
• Illusions
• Post-traumatic Growth
• Exceptional Recovery
• Positive Neuropsychology

Acknowledgements

I am grateful to Veronica Bradley, Barbara Wilson and Jon Evans for their helpful comments on this paper.

Disclosure statement

The author reports no declarations of interest.