HBOT as a Multidomain Intervention: Biological, Behavioral, and Ritualized Mechanisms in TBI Recovery

The AQUASS Lab currently runs the University of South Florida Hyperbaric oxygen therapy (HBOT) for traumatic brain injury (TBI) substudy. Anthropology is well equipped as a discipline to explain the influences that culture may have on TBI outcomes by drawing on theories and frameworks described below. HBOT is typically understood as a biological intervention aimed at improving cerebral metabolism, reducing inflammation, and promoting neuroplasticity following traumatic brain injury (TBI). Yet patients frequently describe changes that extend beyond standard clinical metrics, including early emotional regulation, increased motivation, improved adherence, and a restored sense of self.

This talk proposes a complementary framework for understanding these outcomes by examining HBOT as a ritualized clinical system. Drawing on medical anthropology and social theory, it synthesizes three perspectives: (1) Hinton and Kirmayer’s (2013) model of trauma as a multidomain regulatory loop, (2) Lende’s work on ritualized behavioral cycles and affect regulation, and (3) Collins’ (2014) theory of interaction ritual chains and emotional energy. Together, these models highlight how structured repetition, embodied sequencing, and patterned social interaction within HBOT may shape emotional regulation, engagement, and sustained participation over time.

Rather than treating ritual effects as symbolic or placebo-based, the presentation frames them as testable mechanisms, in which scheduling regularity, bodily preparation, the contained chamber environment, and repeated interactions with technicians operate alongside biological repair. This positions HBOT as a multidomain intervention in which biology, repetition, relationship, and motivation dynamically co-produce recovery.

View the full video here.