Educating Families About Behavioral Changes
With respect to behavioral changes, let's start with education about why the person may be behaving the way they are and to explore with the family around some of the situations that may trigger some of the anger or frustration. So for example, if the person is very overwhelmed, has difficulty filtering out lots of noise and lots of stimuli in the environment, just changing the environment and making things quieter may help to reduce that level of frustration. So that would be something fairly simple that families can do just purely through education and modifying the environment. Now sometimes we know that anger can come out of nowhere when someone's had a brain injury, and in those situations, it's really important to help families learn calming strategies, not to talk back, not to argue back, which will just escalate the anger, and instead, learn exit strategies, time out, learn ways of calming, stepping back, but then coming back to talk about things when things are calmer. Sometimes it may be just modifying the communication style. Because we know that people with brain injuries may have more difficulty processing information, families may need to learn how to be short and sweet in their messages, not to over talk, not to use complex long sentences, and to keep things simple, and that makes it a lot easier and less frustrating for the person with the brain injury. With respect to mood changes, we know that both the person with the brain injury as well as the family member, experiences a real sense of loss. So the person with the brain injury may be going through a grief reaction, and it's not uncommon for people to experience sadness, anger, despair, like the same kinds of reactions that people go through when they've lost a loved one, and the person with the brain injury also goes through those same kinds of feelings. And so that needs to be acknowledged by the family, by people around them, and sometimes family members in their good intent to be helpful try to pull the person with the brain injury away from those feelings rather than sit with them and support them and help them normalize that this is okay and giving permission to grieve. So that's an important component of dealing with some of the mood changes because it may be a grief reaction that they need permission to experience and to express and to go through. Now, we also know that after a brain injury, people are more vulnerable to experiencing mood changes such as depression. So it would be important to make sure that it's not a clinical depression and to assess for that and help the individual consider whether or not they want to engage in counseling to deal with the depressed mood.
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.