Brain injury is often described as a hidden disability – there may be no physical signs of a brain injury, though if sustained as a result of a traumatic accident, additional physical injury may have been suffered.
This is never more true than with a subtle brain injury, when it may only be close family and friends who notice changes to the persons behaviour, personality and cognitive functions.
What is disinhibition?
Disinhibition is defined as the inability to withhold a prepotent response or supress an inappropriate or unwanted behaviour – effectively it is the loss of control over ones behaviour, resulting in comments or behaviours that may be considered socially inappropriate.
Whilst we may all at times do or say something without thinking and instantly regret our words or actions, generally we have an internal filter which stops us acting inappropriately. However for those who have sustained a brain injury, this may not be the case and they may speak or act without realising that their words or actions will be considered inappropriate by others.
Why does disinhibition occur?
The frontal lobe is the part of our brain that monitors our behaviour and responses. Disinhibition usually occurs when there has been damage to this part of our brain either by suffering trauma to the head, stroke, dementia, motor neurone disease or a tumour. Diagnosis of a frontal lobe injury is by the use of screening tests, neurological testing or recognition of the typical clinical signs.
Common signs of disinhibition
Disinhibition can present itself in a range of ways, but typical behaviour may include:
- Commenting in a way which is hurtful or upsetting to others, often by saying the first thing that springs to mind, without thought to how this may make others feel;
- Breaking confidences by sharing secrets which were shared in confidence;
- Freely divulging personal information, including to casual acquaintances and being overly familiar with those people;
- Being unable to hide emotions, overreacting or responding aggressively towards others;
- The use of inappropriate sexual remarks or unwelcomed advances.
This type of behaviour can put relationships under enormous strain and can be confusing not only for the person on the receiving end of such comments and behaviour who may not fully understand how a brain injury has affected the person, but also for the injured party themselves. They may not understand why a friend or relation has taken offence to a comment they have made as they do not understand that it was socially unacceptable or hurtful.
How can disinhibition be managed, if the person who has sustained a brain injury does not understand that their behaviour is inappropriate? Following some research via their social media, the charity Headway, the Brain Injury Association, suggests the following:
- Surround yourself with people who understand – whilst this may not always be possible, there are inevitably times when we cannot be surrounded purely by people who know us well, those who knew the individual prior to their brain injury will likely be those who have the most understanding that the inappropriate behaviour or comments is as a result of the brain injury.
- Develop coping strategies – disinhibition can be difficult to predict, so it’s not always easy to manage, but seeking help from a cognitive behavioural therapist or neuropsychologist could assist with developing coping strategies tailored for the individual.
- Apologise and move on – this can assist in circumstances where the individual realises after the event that their words or behaviour was hurtful or inappropriate – a simple apology, perhaps explaining that a brain injury to the frontal lobe has been sustained could explain the actions or words. Headway produce a brain injury identity card which is personalised to help the card holder explain the effects of their brain injury.
About Brain Injury Group
Brain Injury Group was set up in 2011 to provide people affected by brain injury with a focal point to find people with specialist knowledge of brain injuries to assist them with legal, financial and welfare advice.
In addition to our legal and welfare advice service, our popular website features an A-Z of services and goods specifically of interest to those affected by brain injury, their families and the professionals who support them.
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How can we help?
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