Challenging Behaviours after Brain Injury

Posted by Jasmine

31st October 2019

Behavioural changes are very common after brain injury; however the changes can present themselves in many different ways. For example, they could be an exaggeration of existing personality traits, it could be a complete ‘out of character’ response, it could be mild, subtle changes or there could be no change at all. Unfortunately, these changes are highly dependent upon the individual’s pre-injury personality, the severity of their injury and their existing coping techniques.

The behaviour changes that are an exaggeration or a complete out of character response can be described as “challenging behaviours”

It is important to be sensitive and to recognise these sorts of changes as it could be an indicator of the development of mental illness.

Typical challenging behaviours include:

Disinhibition – lack of control over behaviour, resulting in socially inappropriate behaviour.
Impulsiveness – inability to act or speak logically or rationally, upsetting others.
Obsessiveness – particular fixation on thoughts or behaviour.
Irritability – feelings of impatience and intolerance to others.
Egocentricity – lack of consideration of others’ feelings or needs or becoming self-centred.
Loss of initiative – appearing passive and unresponsive, may be interested but lacking organisation or competency.
Risky behaviours – partaking in behaviours that previously would not be considered, i.e., drug or alcohol misuse.

A total reversal of behavioural change is not always probable; however, improvement is possible with successful support and strategies. Similarly, a loss of identity for the individual can be incredibly frightening providing even more reason for suitable support and coping strategies.

Common strategies include:

Anger management – identification, acceptance and management of angry/aggressive tendencies and behaviours.
Talking therapies – understanding of symptoms, identification and coping techniques e.g., CBT
Developing Trusting Relationships – important to gain support from others to provide feedback when adapting to change.

These changes in personality and behaviour can also affect the family. Sometimes, an individual can feel as if the person who they once loved has been lost, which can be very difficult to cope with. Therefore, the experience of a loved one changing so drastically can be likened to the process of bereavement, i.e., grief, denial, anger, acceptance and then resolution which undoubtedly takes a huge amount of time. It is also important that the family are able to cope and deal with these changes.

To learn more about challenging behaviours and how to manage and support your client to cope with these, designed for a wide range of working professional including case teams, case managers and solicitors, sign up now to: