Page Utilities
Harvey Jacobs, PhD, Brain Injury Professional magazine (page 1 of 3) Page 1 of 3
Behavior is generally recognized as the most common yet most misunderstood aspect of the human condition. To some people behavior is inferred when somebody is acting out, or responding in a manner that is not acceptable to others. Is it possible to mis-behave if there is nobody else around to observe or experience its effects? And just what constitutes mis-behavior? Some people will identify absolute moral codes to behavior while others note the relative nature of its effects. Is it always wrong to kill? Is it always right to indicate acceptance and affection of another? Just what the heck does “appropriate” mean anyways?
To others, the concept of behavior constitutes super-human feats or note-worthy abilities. We honor those who behaved unexpectedly or who placed themselves in harm’s way while doing the right thing for others. Sports heroes are honored for breaking old records. Writers, singers, artists and others gain acclaim for breaking new venues and new barriers.
But what about the average guy? You know, the one who gets up every morning, does what he is supposed to do, goes about his business without “inappropriately” bothering others. Does this constitute behavior? Of course it does. In fact everything we do constitutes behavior. Taken from no less of an authorative source than the American Heritage Dictionary, behavior constitutes: The actions or reactions of a person [or animal] in response to external or internal stimuli.1
For too many years the field of brain injury rehabilitation maintained dubious disciplinary distinctions regarding cognition and behavior. There have been vociferous debates and arguments regarding cognitive vs. behavioral approaches; as if a forced dichotomy existed. Effective behavioral change strategies were seen as temporary or “not real treatment” by some people because the behavior of focus would change when the strategy or developed supports in one’s life stopped. Cognitive strategies were disdained by functional empiricists because of their conceptual rather than functional nature and difficulties generalizing across environments. Things that did not fit into an ABC template were suspect. Some viewed learning as the province of cognitive strategies whereas stopping “bad behavior” as the domain of behavioral approaches. In lighter moments there were the jokes that “Behaviorists can’t think” and “Cognitivists think they can!” In the process, people were missing the forest for the trees and often arguing about the same difference!
Conceptualizing Behavior
Behavior constitutes the individuality and the sum of our actions, especially as they are represented to others. It is the dynamic product of the complex interactions from within and around us, and much like life it is constantly changing. How do I infer that you are “thinking?” Most likely because you answer a question, produce a paper on a topic, choose one of several offered choices, etc. I don’t actually see you think, but I see (or can infer) the product of your thinking by your behavior. Observing and documenting behavior is an ongoing process because our behavior is always changing. What you were doing just before you began reading this article is different than what you are doing now and will be different from what you will be doing several minutes, even several seconds from now.
So what causes behavior? Many things – probably more than you can or may want to consider. We can start with environmental factors such as the antecedents (cues) that precede behavior, the consequences that follow behavior, the overall environmental circumstances in which the behavior is occurring; and the contingencies between these three elements. Is it noisy or quiet, familiar or unfamiliar, supportive or hostile, static or changing, crowded or abandoned; and what about all the shades of gray in between?
Neurological impairments and their corresponding cognitive and perceptual disabilities clearly host a wide range of salient factors that effect behavior. We are all aware of the challenges that changes in attention, concentration, awareness, memory, initiation, organization, abstraction, sequencing, stamina, vision, smell, taste, touch, and a multitude of other factors unique to the individual can proffer on behavior. Now add to this the interactive and integrative effects that these multiple factors can have on any instance of behavior, let alone across the continuing cadence of life. Remember, it is not how you experience the world through your “apparatus” that is important, but how the person of focus experiences the world through theirs.
Effects of physical impairments including mobility, paresis, paralysis, damage to other body parts, pain and physical fatigue all play their roles, as do pre-morbid conditions. Throw the effects of medications into the mix. Is it any wonder that each person and brain injury is unique?
Changes in daily routines, especially changes in ability or inability to work, go to school, or get around the community can have profound effects. What happens when a job that defined your life’s focus for so many years is lost; when going to the store for a gallon of milk now takes all day since you can’t drive and have to rely on public transportation – let alone the fact that you will probably forget why you were going to the store by the time you get there; or when good friends fade and no longer answer the phone?
It doesn’t take a rocket scientist to understand how one’s behavior will change under such conditions regardless of neurological impairment. People who lose jobs, retire when they are not ready to, lose loved ones, experience major environmental disasters, or a whole host of other calamities will also demonstrate significant behavior change in the absence of a brain injury because their lives and worlds have changed. This does not minimize the tremendous effects of a brain injury on behavior, but rather underscores the other collateral issues that are involved.
In every case, regardless of the person and circumstances, their behavior changed when circumstances and events within and around them changed. Clearly, they “ain’t misbehaving” but “simply” behaving differently, and in most situations BEHAVING reasonably to different circumstances. In fact, at the time such “inappropriate” behaviors may be very adaptive for the person engaging in them. You would probably do the same in the same situation and under the same circumstances.
From Brain Injury Professional, the official publication of the North American Brain Injury Society, Vol. 5, Issue 4. Copyright 2009. Reprinted with permission of NABIS and HDI Publishers. For more information or to subscribe, visit: www.nabis.org.
Brain Injury Professional is the largest professional circulation publication on the subject of brain injury and is the official publication of the North American Brain Injury Society. Brain Injury Professional is published jointly by NABIS and HDI Publishers. Members of NABIS receive a subscription to BIP as a benefit of NABIS membership. Click here to learn more about membership in NABIS.
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