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Brain Injury and Behavioral Issues: How to Get Back Control of Your Life

understanding brain injury and behavioral issues

What is the connection between brain injury and behavioral issues? And are there any ways to fix them?

That’s what we’re covering in today’s article.

Brain Injury and Behavioral Issues

The behavior changes that follow brain injury can lead to problems in your family and social life. They can even put you at risk for repeat injury.

But you don’t have to live with these issues forever! There are lots of great interventions you can take to regain control over your behavior.

But before we discuss those, let’s look at what causes behavioral problems after brain injury.

Causes of Behavior Changes After Brain Injury

Brain injury and behavioral issues tend to go together.

That’s because many of the changes associated with brain injury all affect behavior.

  • The cognitive effects damage a person’s ability to process information and understand others.
  • The physical effects make it harder, if not impossible, to do activities the person once enjoyed.
  • And the emotional problems after TBI cause a person to have trouble controlling their feelings.

Put all three of these together, and behavioral issues will arise, unless the survivor can learn effective ways to cope.

Before we dig into the coping mechanisms, let’s look at the different ways behavior changes might manifest after TBI.

Types of Behavior Changes After Brain Injury

The following are some of the most common behavioral issues that brain injury patients experience.

1. Impulsivity

This behavior change mostly happens early on in recovery, when the patient is just waking up and is suffering from post-traumatic amnesia.

People with this effect will display inappropriate behavior, from sharing personal information too freely, to making crude remarks.

The vast majority of people with brain injury will regain control of their most serious impulses as their brain heals.

Even if the person can control most of their impulses though, there will always be some areas they struggle with.

For example, they will probably still struggle with not saying things that might hurt someone’s feelings or with making rash decisions.

2. Inflexibility and Obsessive Behavior

Inflexibility is a common behavioral issue after brain injury

Some people with a brain injury can get fixated on certain thoughts or actions.

For example, they might get scared, angry or confused when their routine changes or they might get stuck on a topic during conversation and refuse to change the subject.

They might also have certain quirky behaviors that they can’t break free of, like keeping all the food on their plate separated.

3. Irritability and Aggression

This is perhaps the most common behavioral issue after brain injury. Some studies have shown that nearly 70% of TBI survivors struggle with irritability and anger.

Part of the problem is caused by:

  • increased sensitivity to noise and pain.
  • damage to the emotional control center of the brain
  • their frustration at the brain injury itself

These elements all combine to make the person’s temper on a short fuse. Loud noises will quickly overwhelm them, and they will often explode in anger over seemingly small things.

Family members should try to be patient when angry outbursts occur. At the same time, TBI survivors need to know how their actions affect their loved ones and apologize once the anger has passed.

4. Apathy

Behavioral issues after brain injury can cause apathy

On the other hand, some brain injury patients experience the opposite problem. Instead of reacting angrily, they might appear indifferent or unresponsive.

People with this effect usually have a form of  executive dysfunction after brain injury, which makes it difficult to initiate actions.

They also might have something called “flat affect.” This condition causes someone to lose all their emotions.

In both cases, it can seem like the person doesn’t care about anything, which is not true. People with these problems do in fact care; they just can’t express themselves.

5. Egocentricity

Some people become self-centered and inconsiderate of others after brain injury. They’re usually not intentionally cruel, they just do and say things that can come across as selfish.

Again though, this doesn’t mean they really are selfish. Some cognitive impairments make them oblivious to another person’s feelings and points of view.

With that said, it’s still possible to relearn empathy after brain injury, if you find the right therapy.

Treatment for Behavioral Issues After Brain Injury

Even though many of the behavioral issues listed above may feel outside of your control, what you do about them IS within your control.

You will probably always struggle with some of these problems; however, they don’t have to always dictate your behavior.

There are several approaches you can take to help you overcome behavioral issues. Some work better on certain issues than others, and you may need to use more than one to gain control over your actions again.

Insight-Oriented Psychotherapy (IOP)

insight-oriented psychotherapy can help you understand and overcome your behavioral issues after TBI

This therapy is best suited for TBI survivors who don’t have severe cognitive difficulties but still have trouble controlling their behavior.

The goal of insight-oriented therapy is to help a person understand their actions and find out what triggers them.

For example, maybe you tend to get stuck on negative thoughts and emotions, and this leads you to get more easily upset with your family. Or maybe it’s something as simple as hunger that triggers your anger.

Whatever it is, once you identify your triggers, the therapist will work with you to discover ways to either avoid it or cope with it in a healthy way.

Cognitive-Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is similar to IOP, but instead of focusing on triggers, it focuses on negative beliefs.

The beliefs CBT addresses aren’t necessarily conscious, but they shape how you see the world and as a result, they affect your behavior.

For example, a CBT therapist might help you discover that you believe people don’t like you because you have a brain injury, which makes you more hostile to others, or afraid to make new friends.

After you discover these beliefs, the therapist will teach you ways to retrain your brain to replace negative thoughts with positive ones.

Social Skills Training

social skills training is great for people struggling with brain injury and behavioral issues

For people who struggle with interacting with others, social skills training programs can help you get better at your interpersonal communication.

They also help you learn which behaviors are appropriate by role-playing different situations that let you practice in a safe environment.

Behavior Therapy

This therapy is aimed at patients who have too many cognitive difficulties to let them participate in CBT or insight-oriented therapy.

Behavioral therapists focus more on external triggers and try to teach the person how to avoid them.

They also use positive reinforcement to encourage good behavior.

For the best results, behavior therapy requires the involvement of a person’s family and friends.

Brain Injury and Behavioral Issues: There is Always Hope for Improvement

We hope this article has shown you that there is still hope for recovery from the behavioral issues of brain injury.

It will take a lot of hard work, but with the right approach, your behaviors will get easier to manage.

After enough time, you won’t feel like the passenger in your own body anymore, doing whatever your emotions want. You’ll finally be the pilot again.

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