The Conscious Brain — From Insight To Practice
A clinical reflection in light of “The Brain and Formation of Consciousness, Perception, Identity and the Embodied Self”
This case study explores the recovery from concussion through the lens of The Brain and Formation of Consciousness. It illustrates how trauma can disrupt the relationship between cognitive function and embodied awareness, and how therapeutic intervention may support a redistribution of consciousness to facilitate healing. The case highlights the role of rhythm, immune activation, and embodied integration in the restoration of both function and identity.
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Introduction
In my previous journal, The Brain and Formation of Consciousness, the brain is understood not as the source of the self, but as an organ that mediates consciousness in relationship to the world.
Through its neuronal pathways, the brain gives rise to what we might call the “named self”—a structured sense of identity formed through repeated patterns of perception, experience, and response. This aspect of self enables us to orientate, interpret, and engage with the world as a distinct individual.
Alongside this, there exists a deeper dimension of self that is not located in the brain, but arises from an embodied centre of being. This inner sense of self is expressed through the rhythms, processes, and inherent wisdom of the living body. It is intimately connected to the organism’s capacity for regulation, integration, and healing.
Unlike the constructed, “named” self, this dimension is not shaped by culture, identity, or personal history. Rather, it reflects a universal aspect of human experience—a shared, underlying intelligence present within all individuals. It is through this deeper, embodied sense of self that a more fundamental form of relating becomes possible: one that recognises the other not through categories or distinctions, but through a common ground of being.
In contrast, the named self differentiates and defines. It establishes identity through boundaries such as name, culture, and personal narrative. While essential for functioning in the world, it can also create separation when it becomes the primary basis of self-experience.
Over the course of a lifetime, these two aspects of self—the constructed, brain-mediated identity and the deeper embodied self—gradually come into relationship with one another. Their integration forms the basis of what may be experienced as an authentic sense of self: one that is both capable of meeting the world and rooted in an inner coherence.
Both dimensions are essential. If the brain-based, “named” self is underdeveloped or disrupted, the individual may lose the capacity to orientate, communicate, and participate meaningfully in everyday life. Equally, if consciousness becomes overly concentrated in this domain, the connection to the deeper embodied self—and its restorative capacities—may be diminished.
When these two dimensions of self begin to integrate, a more complete form of brain development can emerge. The brain is then no longer limited to reinforcing established patterns, but becomes capable of forming new pathways through which the world can be perceived differently.
Such development, however, depends upon a prior shift: the individual must come into relationship with their embodied centre of self.
From this grounding, it becomes possible to reshape the patterns of the “named” self—not through shame or a sense of being wrong, but through a quality of understanding, patience, and a gradual reorganisation of experience held within a more compassionate awareness.
In this process, previously conditioned responses can be met with a different quality of awareness, allowing them to transform and evolve. As these patterns soften, a renewed sense of confidence and coherence can arise, enabling a more authentic way of relating to the world and to others. In this way, the individual is no longer bound solely by past conditioning but becomes capable of perceiving and meeting the other with greater clarity and depth.
This case illustrates what can occur when, through trauma, this relationship is disrupted. When the brain can no longer reliably mediate the world, the individual may lose access to their familiar sense of self. In such moments, the process of healing calls for a reorganisation of consciousness—one in which a new, more embodied centre of self can emerge, allowing both recovery of function and the development of new patterns of being and perceiving.
Patient Profile
A 71-year-old woman presented with persistent vertigo, dizziness, short-term memory loss, and a profound sense of disorientation described as “not being herself,” following a traumatic fall six months prior. The injury involved a forward fall onto the face with significant head impact and whiplash. MRI imaging showed no haemorrhage or structural damage. A diagnosis of concussion was made.
Her medical history included hypothyroidism with goitre and hyperaldosteronism (Conn’s syndrome).
The Pre-Traumatic Organisation of Self
Prior to the injury, the patient’s identity was strongly organised through activity, clarity of thought, and outward engagement.
She was:
mentally sharp and decisive
physically active despite chronic pain
deeply oriented toward caring for others
Her sense of self was closely tied to her ability to remain capable, responsive, and in control. Consciousness, in her case, was predominantly mediated through the brain and sensory system—through thinking, doing, and anticipating.
Biographical Context: Formation of a Survival-Based Self
From early childhood, the patient experienced severe physical and verbal abuse. In response, she developed a mode of being characterised by resistance, defiance, and endurance. Rather than withdrawing, she formed a hardened sense of Self.
This can be understood as an adaptation in which the self is organised prematurely in response to threat. The nervous system becomes oriented toward vigilance, and the individual learns to maintain coherence through effort and control rather than through relational or rhythmic support.
Over time, this became her way of being in the world—functional, strong, but physiologically costly. Such a sustained pattern places continuous demand on the body’s regulatory systems, particularly the adrenal and thyroid axes.
This dynamic is also reflected in the patient’s medical history. The adrenal glands appear to have adapted through increased aldosterone secretion, contributing to the presentation of Conn’s syndrome, while the thyroid developed a goitre, likely in response to prolonged stimulation. Over time, thyroid function may have reduced, lowering metabolic drive in an apparent attempt to conserve energy within an already demanding physiological state.
Trauma and the Loss of Orientation
Following the concussion, the patient experienced:
severe dizziness and spatial disorientation
short-term memory impairment
inability to engage coherently with her surroundings
a deep and distressing loss of self-experience
What was lost was not only cognitive clarity, but the very means through which she located herself in the world.
The brain could no longer adequately mediate clear, awake consciousness. The world was no longer coherently perceived, and therefore the self—previously stabilised through this relationship—began to fragment.
Osteopathic Findings
The patient’s body reflected a state of unresolved survival:
rigidity of the upper thorax
collapse within the thoraco-lumbar relationship
a breathing pattern fixed in inspiration
a global lack of rhythmic fluidity
This presentation suggests a physiology organised around holding and defence, with limited access to the exhalatory, releasing, and restorative phases necessary for healing.
Clinical Understanding: Displacement of Consciousness
A central insight in this case was recognising that the patient’s sense of self was heavily dependent on brain-based processes of orientation and control.
Following trauma:
These processes were impaired
Yet her consciousness remained “located” there
This created a state in which:
The brain was overburdened
Healing processes and coherence of inner rhythm were compromised
Therapeutic Orientation: Supporting the Embodied Self
The therapeutic aim was therefore to support a redistribution of consciousness—away from exclusive reliance on the brain, and toward a more embodied experience of self.
This included:
Holding the adrenal-nervous system to feel safe and supported to let go
facilitating awareness of the body beyond cognitive effort
Guiding awareness into the area of the heart and the limbs
supporting breathing to move out of a fixed inspiratory state
restoring rhythmic processes within the thorax and whole system
creating conditions in which the patient could be, rather than continually doing or controlling
In doing so, the work sought to re-establish a centre of self that was not dependent on the brain’s immediate performance.
A Threshold Moment in Later Life
This trauma represented a profound threshold.
For perhaps the first time, the patient could not rely on the adaptive strategies that had sustained her throughout life. The hardened, driven self—organised through vigilance and control was no longer sufficient.
While deeply destabilising, this also opened the possibility for a different organisation:
one less rooted in survival
less dependent on constant mental activity
and more supported by embodied presence and internal rhythm
Such a change is challenging at any stage of life, and particularly in later years. Yet the organism still carries the capacity for reorganisation when the right conditions are supported.
Therapeutic Intervention
The initial focus of treatment was to establish a sense of safety and trust within the patient’s nervous system, which remained in a heightened post-traumatic state. This was approached through supportive hands-on contact, with particular attention to the region of the kidneys and the sympathetic chains. The intention was not to impose change, but to offer a quality of holding through which the system could begin to feel supported rather than threatened.
As trust gradually developed over the first few sessions, the treatment evolved to introduce subtle rhythmic support. This aimed to encourage the nervous system to shift out of sustained sympathetic activation, allowing for a softening of vascular tone and an improvement in circulatory dynamics. Through this, the organism was better able to enter a state in which processing and repair could begin.
A key area of focus was the liver. From a therapeutic perspective, the liver was approached as an organ central to processes of “digestion”—not only in a metabolic sense, but also in relation to the integration of lived experience. In this case, there appeared to be a significant accumulation of unresolved experiences extending back to early life.
Rather than attempting to directly treat the liver, the approach was to create the conditions in which its inherent capacity for regulation and integration could emerge. This involved supporting systemic rhythm, reducing overall physiological tension, and ensuring that the patient felt sufficiently safe for deeper processes to unfold.
Further exploration of the liver’s role in therapeutic processes can be found in my previous work, including The Living Liver: The Inner Human Ocean, The Living Liver: From Insight to Practice, and the accompanying webinar.
To further support this integrative process—and to reduce the patient’s reliance on cognitive control—treatment is also oriented toward helping her establish a more embodied centre of consciousness.
Particular attention was given to the region of the heart, understood here as a functional mediator between the more conscious processes of the head and the more unconscious processes of the body. By bringing awareness to this middle ground, the patient was gradually able to experience both inner bodily states and outer orientation without becoming overwhelmed by either.
From this centre, she began to develop the capacity to:
sense and respond to the needs of her body
remain present to her environment when required
move between inner and outer experience with greater ease
Establishing this “middle point” of consciousness became a central aspect of the therapeutic process. Over time, this supported a reorganisation of her overall system, allowing the brain to reduce its compensatory overactivity and participate more effectively in recovery.
Response to Treatment and Outcome
Initially, the patient experienced difficulty in receiving treatment, reflecting a long-standing tendency toward self-reliance and control. Despite this, there was an underlying recognition of the need for support.
Early responses were characterised by a marked sense of fatigue, followed by periods of relaxation. Rather than attempting to regain strength through effort—as had been her lifelong pattern—the patient began to recognise that rest and letting go were essential to her recovery. As this shift occurred, previously held fears began to surface, reflecting the beginning of a deeper internal process.
The patient entered a phase of emotional and physiological “digestive” activity, in which both past experiences and the recent trauma began to be processed. For the first time in many years, she reported feelings of depression. At this stage, she sought additional support through talking therapy, which provided some benefit, although it remained primarily cognitive in nature.
A key development was the establishment of a simple, consistent daily rhythm. The repetition of familiar activities provided the nervous system with stability and predictability, reducing the demand for constant adaptation. This supported a gradual transition out of a chronic survival state.
As this rhythm became established, corresponding changes were observed within the body. Postural patterns associated with fatigue and sympathetic dominance began to soften. Breathing became less restricted, and a more coherent, expressive rhythm emerged throughout the system.
In parallel, the patient reported a reduction in vertigo and increasing clarity in both cognitive function and sensory perception.
A significant turning point occurred when the patient developed, for the first time in many years, an acute illness characterised by a cold and mild fever. This appeared to reflect a re-engagement of the immune system in a more integrated and responsive manner. Following this, the patient demonstrated a notable shift in her relationship to her past. She was able to reflect on earlier life experiences with increased understanding and compassion, including an emerging capacity to empathise with those involved. This shift coincided with further improvements in cognitive clarity and overall function.
As treatment progressed, it became evident that the patient was no longer operating solely from her previous pattern of endurance and control. Instead, she began to experience a more embodied sense of self, from which she could recognise and relate to her habitual coping mechanisms with greater awareness and acceptance.
This marked the beginning of a new phase of life.
During periods of stress or overwhelm, earlier patterns would still emerge. However, over time, the patient developed the capacity to recognise these responses without judgement. By returning to breath and bodily awareness, she was able to re-establish a centred perspective, allowing her to meet challenging situations with greater stability and clarity.
Clinical Implications and Discussion
This case highlights that the effects of concussion extend beyond structural or neurological impairment, involving a disruption in the relationship between brain, consciousness, and the embodied self. Where the brain is relied upon as the primary organiser of outward awake experience, injury may lead not only to cognitive dysfunction, but to a more fundamental loss of orientation and identity.
From a therapeutic perspective, this suggests that treatment should not be limited to symptom management or cognitive rehabilitation alone. Instead, there is value in supporting a redistribution of consciousness—away from exclusive reliance on the brain and toward a more embodied centre of regulation.
The progression observed in this case indicates that the restoration of rhythm within the organism plays a central role in recovery. The re-establishment of breathing dynamics, postural adaptability, and daily routine appeared to provide the physiological conditions necessary for both neural recovery and experiential integration.
The involvement of the liver, approached here as an organ of metabolic and experiential “digestion,” reflects the importance of supporting the organism’s capacity to process both recent trauma and unresolved past experiences. While such interpretations extend beyond conventional biomedical frameworks, they may offer a useful lens through which to understand complex, non-linear healing processes. Equally significant was the emergence of an acute immune response during the course of treatment. This may be understood as an indication that the organism had regained sufficient regulatory capacity to more actively engage with and integrate its internal environment.
From a physiological perspective, this phase may also reflect the role of immune signalling in supporting neural adaptation. Cytokines, which are capable of influencing central nervous system activity, may contribute to processes that facilitate the reorganisation of neuronal signalling pathways. In this way, the immune response can be viewed not only as a defence mechanism, but also as a potential participant in the restoration and adaptation of brain function.
The emphasis on establishing a centre of awareness within the region of the heart points toward the importance of mediating between cognitive and bodily processes. Supporting this integration appeared to reduce the burden on the brain, allowing it to recover while maintaining functional engagement with the world.
Overall, this case suggests that recovery from concussion may be enhanced by approaches that address not only neurological function, but the broader organisation of the human being. In particular, facilitating the integration of the “named” self with a deeper embodied sense of self may support both physiological healing and a more stable, resilient experience of identity.
Although this case focused on recovery following a significant concussion, it illustrates a broader principle of healing. The reorganisation of neuronal pathways, alongside the discovery of a more embodied centre of consciousness, offers an important perspective for clinical practice. Regardless of the presenting condition, supporting this integration may be fundamental to the healing process.