Brain Injury, Social Skills, and the Holidays

Ask the Expert: Social Skills and the Holidays

My husband fell off a ladder almost a year ago now and sustained a brain injury. I've noticed that his communication and social skills tend to get worse at parties, especially during the holiday season. Why is this? And what can I do to help?


The holidays can be fraught with pitfalls for someone with a brain injury. The fact that your husband's communication and social skills worsen at parties is not unusual. For starters, routines are disrupted and there can be an increased number of social functions with less time to rest in between.

TBI related fatigue could cause a decline in social skills. Things can get even more challenging if alcohol is added to the mix. And for individuals prone to seizure activity, holiday lighting — particularly flashing lights — could increase the risk of a seizure.

A social setting, like a party with many people engaged in conversation, eating, and drinking, can easily become over-stimulating and even upsetting to a person with TBI. To help your husband deal with all these issues, you might try limiting the number of engagements during the holidays. And when in a social setting, help support your husband’s conversations by introducing easy topics, and repeating or rephrasing questions asked by others.

You know your husband better than anyone else, and when you hear him having difficulty using the right words, or even slurring his speech, it's time to go home. All the activity has probably tired him out. For someone with TBI, it can be exhausting trying to converse in crowds, with strangers, and in over-stimulating settings.

Posted on BrainLine December 16, 2008.

Comments (25)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Sometimes I think I confuse "getting used to it" with "getting better".

"Sometimes falling seems like flying...for a little while."

I love this..... Your words are so true. I can relate. Going down does feel like flying for a little while!

Don’t get mad at me because I’m STILL brain injured, still impacted by the effects of what happened. Believe me, NO ONE is madder than I am, and when you try, you just look stupid.

I’ve been suffering from an tbi for about a year does it get any better than this

I fell from a ladder in 2003, suffered Traumatic brain injury and amnesia. My nurse wife noticed every change in me. Time is my only cure and learning new ways to cope with the simple things in the life! Lotsa patience!!!

Perfectly stated answer! Very informative for those who do not understand brain injuries!

It is so awesome for me to read articles like this. I'm a TBI from 2009. I'm at a place where I have accepted my new self but it's especially at the holidays that I mourn the self I lost. I liken it to mourning my Grandparents because I learned so much from them about love, compassion, caring and acceptance. But my accident knocked those things right out me. Let's just hold on tight to each other and pray that we make it out with dignity.

For those looking for earplugs... Make an appointment with an audiologist for custom musician earplugs. They're a life saver and you can adjust the amount of dBAs you want blocked.

Sensory overload.

I Also agree; and with TBI from a car accident nearly 15 years ago, I do get stressed and fatigued after much activity such as parties or even shopping. My brain wants to get so much accomplished, my body is drained of energy.

Right on. As a person with a TBI I couldn't have said it better. I get overwhelmed and have to leave the occasion.

Thank you both, very helpful. I have a very social job. I am in desperate need of improving my skills. Step one is recognizing and admitting the problem.

Well done and thanks Carolyn Rocchio! I have to rest/sleep if I ever (so very rare now) go out in the evening. I also have trouble driving at night unless well-known and well-lit and am single. I find eating while I talk I get far less tired: talking and understanding conversation is extremely tiring and difficult for me but while eating and giving my brain constant energy I do far better so meals out far better than just drinks. And I feel bad just standing, OK if moving/walking.

Yes. Thank you ... it was interesting.

I have auditory processing issues due to an automobile accident injury. And my work is to ride on a school bus, it has been nearly impossible to do my job because of the noise on a full bus. Ear plugs have been my savior while my body heals. Thank you for the information in this article and in the comments, I have been helped.
Dealing with a TBI is always a problem for me. Parties are one of the worse things I have to deal with. It has been 5 years since my head injury and it gets frustrating avoiding social events and seeing my wife disappointed since we used to both be such social people. I go to events and wear ear plugs but after a while It just gets to be too much. I try to just go out and stay near by so that my wife can enjoy herself. It takes patience from all sides to deal with a TBI!!!
Thanks for sharing your tips, I too read my husbands body language and facial expressions to see when he has had enough of everything but i didnt think about ear plugs so that he doesnt think people are yelling at him all the time, its 2 years now and when you mention the \\\"sensiitive hearing\\\" everyone assumes someone is deaf not that everything is super loud!
where do they sell the ear plugs that look like hearing aids? Trish
I substained TBI while serving in the Gulf War. I find that large groups brings on the stress for several reasons. One, I do not have the ability to pronounce words when reading; and when in a group I switch the words for others that sound similar. (totally different meaning by accident). I, myself do not recognize that I have done that. I appreciate my friends that will correct the error, for it helps me realize my mistake. I agree fully with the lights and tiredness as being a problem with someone with TBI. Eighteen years and still learning. Cynthia
As a thirty one year old survivor of a TBI who has had numerous opportunities to enjoy the spirits of the holidays,I agree with the previous comments that you shouldn't try to please the entire party, rather you should concentrate on smaller groups so you can concentrate on more specific and personal topics.
I am recovering from an ABI, ruptured anneurysm, I also find parties and crowds difficult to deal with. For me its noise sensitivity and not being able to focus on conversations properly. It gives people the wrong impression, as I come across as unattentive and not interested, where in fact I find listening to conversations difficult with noise interference and background music. It does mean that I avoid parties and large gatherings. I wish anyone suffering from an ABI a speedy recovery and to remember that you go at your own pace not others. Best wishes!
I'm a 26 year old male who was an ABI. I was in a car accident. I used a lot of alcohol after my accident to numb the psychological pain of the crash. I have not had a drink in over 2 years now, 'one day at a time.' I find large gatherings of people tough and overwhelming especially when there is alcohol present. I also wear a hearing aid as a result of my accident. This makes it very hard to communicate with friends in loud envirnoments. I am looking forward to a quiet family Christmas but firstly getting my exams completed at university. I have learned that anything is possible when I apply myself.
I found this article very useful. I find it extremely hard to be in a room with more than 2 people at a time. I did not realize that this is another side to an ABI, and it makes me feel less "outside" knowing others have the same symptoms. Thank you. Bettyboop. a.ka Marie
An aid to dealing with social events is foam earplugs. The yellow one are best and less conspicuous that the pink bell shaped ear plugs. They will not change the ability to hear someone near but they will help block out the chaotic background sounds. My wife and I just tell people that I have an auditory processing disorder from a brain injury. A hearing aid clinic can custom fit "musician ear plugs" that look like hearing aids and blend in to the ear's color. Resting up before hand is also important. The companion also needs to be able to read the 'eyes' of the TBI patient. My wife can tell when I have had enough by the look in my eyes.
I am ABI survivour and the first three years of my brain injury I could not go into places with large crowds. I went to a Christmas party put on by my employeer and sat the whole night in tears. I had loved my job and could no longer work. I have never gone to a function in a party atosphere. Too much noise is stressful and I feel out of place. I do go to events put on by my local brain injury society and love the people, there is no alchol and we all have a great time, we all have a brain injury so we all feel safe together. Calliejay