Behavior and Personality Changes After TBI
When someone's had a TBI, there's often quite significant personality behavioral changes. So for the families it's often as if they've lost the person, the loved one that they had and cherished and loved. And for spouses I often hear them talking as if the person that they married is like a stranger, no longer the same person. And for parents they often have to grieve the loss of the child that they remembered, or they might need to grieve the loss of dreams of the hope for future with their child. So loss issues are quite profound and cut across all cultures, cut across all families. And what makes the loss issues so difficult is that often the person with the brain injury may look the same, but their behavior, the way they act, it's as if they've lost that person. So the feelings for the families may be as if they've experienced a death, but there aren't the rituals and there isn't the acknowledgment that families experience as if they had lost a person from death. So it results in very complex grieving processes for these families. There's a term that we call ambiguous loss where you've lost a loved one but yet it's unrecognized, it's unacknowledged, people don't get the support that they would in other situations where there has been a loss, so it's very isolating for these families. So the loss issues are one of the things. Emotional and behavioral changes are common after a brain injury, and that's often tough for families, particularly if there are aggressive tendencies, anger control problems, impatience. And one of the things that we often have to do is to make sure that safety protocols are put in place and teach families ways of instituting calming strategies, ways of communicating with the injured person so that it doesn't escalate frustrations. And education is a big part of it because often family members initially may not understand why their loved one is behaving the way they are. And so if they're helped to understand that they may be impulsive or the things that they say may be related to injury to the front part of the brain which we call the frontal lobes, then they can learn strategies to accommodate for that. So educational intervention is really important as well as supporting families around learning strategies to deal with whether it be the behavioral changes or the cognitive changes after a brain injury.
Posted on BrainLine April 29, 2009. Reviewed January 16, 2018.
Produced by Victoria Tilney McDonough and Brian King.
Caron Gan is an Advanced Practice Nurse, Registered Psychotherapist, and Registered Marriage and Family Therapist with the Ontario and American Association for Marriage and Family Therapy (AAMFT). She has worked with clients with brain injury, providing psychotherapeutic intervention to youth, adults, couples, and families.