Research Department of Clinical Psychology, University College London, London, UK.
Imperial College Healthcare NHS Trust, London, UK.
Disabil Rehabil. 2020 Jun;42(11):1495-1502. doi: 10.1080/09638288.2019.1572795. Epub 2019 Feb 11.
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 rehabilitationIllusions 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.
脑损伤后的功能反常增强和反常恢复与“超康复”的概念及其对康复环境中新的繁荣形式的关注非常吻合。我考虑了三组可能影响脑损伤康复的悖论。首先，我考虑了脑损伤后的创伤后成长及其关键决定因素。其次，我回顾了幻觉在康复中的作用以及某些临床情况可以通过引起感知扭曲来改善的悖论。第三，我考虑了脑损伤后的反常恢复模式，因为了解这些反常模式可能有助于为某些患者的康复尝试提供信息。最后，我考虑了这些悖论中的一些如何与超康复的组成部分相关，以及积极神经心理学领域和脑损伤后的恢复力概念。对康复的启示幻觉有时可以作为康复治疗中的一种治疗工具加以利用。在受伤或患病的形式下，可能会出现自发性的积极结果，即“创伤后成长”，并且应该将其视为康复整体治疗方法的一部分。一些患者在严重的脑损伤后会有异常的恢复，从这些病例中可以吸取教训，例如使用补偿策略的自律性，这可能对神经康复具有更广泛的意义。
