The Quiet Shape of Hope

A different kind of peace...

When people speak of hope, they often mean the hope for peace - peace in the world and peace in relationships. But for those of us living with neurological injury, peace is not simply the absence of external conflict. It is the quieting of an inner war we didn't know we were fighting.

For me, hope was never a feeling. It has only recently begun to re-emerge in my awareness.

In the early years, it was a hidden structure, something I leaned against without knowing it was there. Now, it is something I hold gently, quietened by the fear of disappointment and the effort to remain present.

Who I am

I am a brain injury survivor. Twenty-five years ago, I sustained a traumatic brain injury that reshaped the architecture of my cognition, emotions, and sense of self.

I fall into the category of people who lost self-awareness. That means I had no insight into the extent of the neurological damage I had suffered. I could read about brain injury, even speak about it - but I couldn't feel it as mine. Understanding didn't land.

My recovery began without recognition of my inner world and with bafflement over the external one. I didn't know what I had lost, so I don't know what to hope for.

The absence of hope: early years post-injury

In the early years, hope was not absent, it was inaccessible. I lived in a state of cognitive disconnection, where my mind no longer supported insight. I couldn't grieve what I didn't know I'd lost. I couldn't name my challenges or imagine change.

This kind of awareness is often described clinically as "lack of insight", but that phrase doesn't capture the lived experience. It wasn't denial - I simply couldn't relate to the injury. I understood my brain worked differently, and as an eternal optimist, part of me accepted the experience as an interesting experiment.

   Emotionally, I wasn't numb; I felt everything. But the feelings erupted without context, like bubbles escaping a shaken bottle of sparkling water.   

There was no recognition of what triggered my emotions, no understanding of what they meant. I was flooded and adrift.

In this state, hope could not be consciously held. It was not a goal or belief. It lived beneath awareness, perhaps in the body, perhaps in the deeper layers of mind, but it had no name.

I could even observe progress, but still not name it as hope.

The spark of hope: working with an occupational therapist

Hope began to surface almost five years post-injury, when I started working with a neurological occupational therapist. I didn't know it was hope at the time, what I felt was longing - for someone to understand me, and to help me understand myself.

I knew I couldn't relate to the information being given to me. I could hear it, but I couldn't feel it. The idea of having a "translator", someone who could bridge the gap between knowledge and meaning, packed a punch I now recognise as hopefulness.

It wasn't about recovery, it was about relationship. The neurological occupational therapist didn't just offer strategies, she offered containment. She held space for my confusion, my eruptions, my silence. She didn't rush me towards insight but walked beside me until it began to emerge.

That was the beginning of hope, as a relational structure instead of a feeling. Someone else believed I could understand, and slowly, I began to believe it too.

Hope as a psychological need

Hope is often described as a feeling or mindset. But for those of us navigating brain injury, it is something more elemental. It is an unconscious psychological need.

In the absence of self-awareness, there is no recognition of loss. And without recognition, there's no grief, no longing, no hope. This awareness can protect us from distress, but it delays insight, and with it, the possibility of change.

   When awareness begins to return, hope arrives in its wake. Not as a solution, but as a question: Could things be different? Could I understand? Could someone help me make sense of this?   

For me, the foundations of hope were laid in the presence of a neurological occupational therapist. Her role was not just clinical, it was relational. She didn't offer hope as a promise - she offered it as a possibility.

And that possibility became a scaffold I could begin to build on.

Hope as structure, not sentiment

For me, hope has never been linear. It has returned in spirals - through relationships, reflection, and the slow reweaving of self. This year, it has returned through voice. Through the invitation to share. Through the recognition that survivor wisdom is foundational.

Hope is often spoken of as something warm or motivating. But for those of us navigating brain injury, it is rarely that simple. It is not a sentiment. It is a structure.

Hope is the scaffolding that holds us when cognition falters; it is not the absence of struggle, but the presence of structure. And for those of us still rebuilding, that structure makes all the difference. 

It is the relational architecture that allows insight to emerge slowly, safely, and without collapse. It is the quiet presence of someone who believes in your capacity to understand, even when you cannot yet feel it yourself.

   Occuaptional therapy, at its best, builds that structure. It protects the space where meaning can form. It walks beside recovery.   

What has given me hope this year

This year, hope has taken on a new shape. It has emerged not just in my own recovery, but in the act of sharing it. Being invited to write this article is part of that emergence. It signals that survivor wisdom is not just valid, but it is valued.

I have found hope in co-creation. In the quiet recognition that my experience can help others. In the possibility that my words might resonate with someone still searching for theirs.

I have also found hope in the work of occupational therapists. Their presence, their patience, their refusal to collapse complexity into simplicity, gives shape to hope in ways no textbook ever could.

Hope for me, is no longer hidden, It is something I hold gently, with awareness and care. It is not a guarantee, it is a companion.

Last updated: 8th December 2025