Social Skills After Brain Injury: Understanding Changes and How to Improve

A traumatic brain injury can severely affect a person’s social skills and their ability to connect with others.

Without these skills, a person’s self-esteem can suffer. They might struggle to maintain friendships or make new ones. They may start to feel isolated and have a sense of failure, which can lead to depression.

That’s why re-learning social communication skills after brain injury is so crucial during recovery. Not only does it ward off negative feelings of isolation, it also helps improve overall quality of life.

Today you will learn what social skills are, how brain injury can affect them, and what steps you can take to recover them.

What are Social Communication Skills?

Communicating with others involves more than just speaking. It includes body language, facial expressions, tone of voice, and other actions.  To truly communicate, you must be able to share information with people in a way they can understand.

Effective communication skills require the use of several cognitive abilities, including:

• The ability to listen to and recall what the other person said
• Starting and ending conversations
• Taking turns speaking
• Managing your emotions
• Understanding non-literal language, such as humor
• Understanding social boundaries and expectations
• Awareness of the situation and the other person’s feelings
• Organizing your thoughts and sharing them in a way that makes sense

All of these skills comprise what psychologists call social pragmatics. After a brain injury, many of these abilities are lost or impaired, which makes socializing more difficult.

How Brain Injury Affects Social Skills

Damage to the frontal lobe can cause a lack of insight and awareness. This makes it more difficult for the person to monitor their behavior and understand how it comes across to others.

For example, a patient might not allow the other person much time to speak. This does not happen because they are selfish, but because they do not even realize how long they have been talking.

In addition, the orbitofrontal cortex helps regulate our impulses and prevents unwanted emotional outbursts. Therefore, if it becomes damaged, a person might say or do inappropriate things while speaking.  

Other effects of brain injury that can impair social skills include:

• Hearing loss, which can make it difficult to listen to others and pick up verbal cues.
• Attention problems, which impede a person’s ability to follow a conversation.
• Memory issues, which can make it hard to remember what the other person said.
• Lack of motivation, which can prevent a person from initiating activities, including conversations.

Mood swings and depression can also contribute to poor communication skills.

Signs of Poor Social Skills After TBI

Because brain injury often affects a person’s self-awareness, they may not realize how their social skills are impaired.

The following are some signs that a person struggles with social communication:

• They fixate on one topic and try to bring every conversation back to it
• They give too little or too much information
• Their responses might not make sense
• They ramble or repeat themselves
• They talk too fast or too slow
• The other person has to ask a lot of questions to keep a conversation going
• They struggle to read emotions   

 Fortunately, it is possible to regain social skills after brain injury with the help of a therapist.

How to Improve Social Skills After Brain Injury

Social communication skills can be improved in most people, even after brain injury. As with everything else you might want to learn, increasing your social competence will involve consistent practice.

Speech therapists, occupational therapists, and neuropsychologists are a few medical professionals who can help you relearn social skills. You might also consider trying group therapy for social communication. A group would allow you to practice role-playing conversations in a safe environment.

Even if there are no groups nearby, you can still improve your skills with a trusted friend or family member.

The following are a few helpful ways to boost your social confidence after brain injury.

1. Evaluate

The best way to improve social skills is to determine what you struggle most with. Some questions to ask yourself include:

• Do I listen and let the other person talk?
• Do I show interest in the other person by asking them questions and staying focused?
• Do I get to the point?
• Do I initiate conversations?
• Do I get too emotional or not show enough emotions?

Ask a person close to you how you do with these skills also, in case there are things that you miss. If they list other problems that they see, try not to get defensive. You can’t improve if you don’t know where your weak spots are.  

2. Set a goal

Pick the skills that you most want to improve and work on them one at a time. Start with the ones that you struggle the most with.

For example, you could set a goal to ask more questions during conversations. Have your family members teach you how to ask questions and practice with you.

Just remember to start small and slowly work your way up. The more manageable you make your goals, the more likely you are to achieve them.

3. Practice

Practice your skills in places where you have a chance to interact with people, such as at your doctor’s office or during recreational therapy. You can even try some volunteer work if you are able, which can open up some good opportunities for conversations.

To start a conversation, especially with someone new, here are a few ideas:

• Talk about things around you, such as the weather or the person’s dog.
• Ask open-ended questions, such as “what did you do over the weekend?”
• Take turns talking and listening.
• Pay attention to your body language. Make sure to smile and nod.

If your friend or family member is there to observe you making conversation with a stranger, ask them for honest feedback on how you did and where they think you still need to improve.  

Social Communication and Brain Injury

Social communication skills are critical for improving your quality of life after brain injury. Not only can they help you form and maintain relationships, they can also help you succeed at work, school, and every other area of your life.

While brain injury can make connecting with others more difficult, with enough practice and persistence, it is still possible to improve your social skills.

Just remember to be patient with yourself, and to take things one step at a time.