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Changes in Personality, Behavior, and Thinking:

Strategies for Coping & Adjustment after Brain Injury

Kristine Cichowski, MS, Director

Judson Paschen, Brain Injury Peer Mentor

Rehabilitation Institute of Chicago - LIFE Center

Community Life Skills TrainingMidwest Regional Traumatic Brain Injury Model System at the Rehabilitation Institute of Chicago - 2009

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Brain Injury – What does it mean?

Damage to the body’s command center – Central Nervous System

Impaired messages– Movement– Thinking– Speech– Behavior– Personality

http://www.infovisual.info/03/038_en.html

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How does the Brain work?

Left side controls Right Right side controls Left Each section (lobe) of the Brain

controls specific functions

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Understanding your Injury

Changes & Challenges Thinking Behavior Personality

Changes are different for each individual.

Think of your brain as your own

personal “finger print”

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“Thinking” Changes & Challenges (Examples)

Memory, Attention & Concentration, Planning & Organizing, Problem Solving, Processing Information, Fatigue

Tips: – Develop a schedule - consistency is key– Use a memory book or daily planner– Minimize distractions

• One topic or task at a time

– Structure activities - gradually extend complexity• Break down activities in small steps

• Practice attention & memory skills - games

• Take breaks – allow for more time

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“Behavior” Changes & Challenges (Examples)

Impulsive, Short Temper, Mood Swings, Inappropriate Language, Social Skills, Sensitive to Time

Tips: – Get a good Coach

• Be open to supportive feedback and make a conscious effort to adjust behavior

– Develop a signal that family and friends can use to help you know when you are out of line

• Be “fair” – no nagging

– Work at being more flexible, open to change• Try not to take things personally

– Practice and think ahead to help develop your problem solving and reactions to others / situations

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“Personality” Changes & Challenges (Examples)

Mannerisms Conversation Skills Body language Interests Motivation

Work towards embracing

who you are now rather

than constantly seeking the

person prior to injury.

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“Personality” Changes & Challenges

Tips:– Pay attention to personal appearance

• Neat & Clean – look in the mirror

– Pay attention to how you present yourself to others

• Friendly – SMILE • Positive Body Language• Eye Contact – Listening Skills• Pleasant Tone of Voice• Respect Personal Space of Others

– Get Out and Be Involved• Begin to redefine your relationships or build

new friendships• Create experiences so you can talk about

something other than your brain injury

– Help others understand what a brain injury is and what it is not

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Tips for Family & Friends Be a helpful Coach Be true to your word Be time sensitive Speak slowly and clearly, but not

demeaning. Use meaningful examples

Focus conversations - one person, one topic, one task at a time

Minimize distractions – it can be hard work to interact with others

Be mindful of fatigue and how it affects thinking, behavior – brain and physical stamina

Verify that information is understood Write down information for recall at

another time Use visuals to simplify / clarify Reinforce use of a to do list or

memory book

Take time to get to know each other

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Tips for Family & Friends Identify and communicate to the Coach As you observe behavior, give

supportive feedback Establish a signal to help a person “stop

& think” – use the signal in a fair way Rehearse answers to questions - Keep

it simple and positive. Use tips to help with communication and interactions.

Reach out to others to help them stay connected with you and your loved one

Clarify misinformation and misunderstandings – nurture relationships

Embrace the person for who they are now – refrain from comparisons to the old self

Practice forgiveness

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Knowledge is Power!

LIFE Centerhttp://lifecenter.ric.org

ORwww.ric.org ~ “Quick Links”- LIFE Center

Phone: (312) 238-LIFE(5433)Fax: (312) 238-2860

eMail: lifecenter@ric.org

This program is supported in part by a grant from theNational Institute on Disability and Rehabilitation Research (NIDRR)

and is part of the Midwest Regional Traumatic Brain Injury Model System at the Rehabilitation Institute of Chicago.

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References:

Behavioral management strategies for working with persons with brain injury. (1998). Chicago: Rehabilitation Institute of Chicago Academy.

Brain Damadj’d… Take II (film). (2006). Paul Nadler, Writer and Producer. Toronto: Apartment 11 Productions; dist: Films for the Humanities.

Brain Injury Association of America, Model Systems Knowledge Translation System. TBI Model System Consumer Information. (2009). Cognitive Problems after Traumatic Brain Injury; Emotional Problems after Traumatic Brain Injury. Washington, DC: Brain Injury Assoc.

Brain Injury Association of Maryland. (1995). Why Did it Happen on a School Day? Washington, DC: Brain Injury Association.

Brain Injury Circle of Caring – A family discussion guide. (2004). Chicago: Rehabilitation Institute of Chicago.

Brain Injury Program: Patient and Family Resource Guide. (2009). Chicago: Rehabilitation Institute of Chicago LIFE Center.

Burgard, Jodi. (Jan 2009). Brain Injury: Why does my loved one act out? A family guide to emotional and behavioral changes after a brain injury. Chicago: Rehabilitation Institute of Chicago.

Rehabilitation Institute of Chicago Brain Injury Team. (Jan 2008). Brain Injury: An Overview – What is it and what does it affect? Chicago: Rehabilitation Institute of Chicago.