Stories of Impulsivity after Brain Injury
The following are stories of real life survivors of brain injury. Clicking on the titles will take you to their actual story.
Betty, like most severely brain injured survivors has issues with impulsivity and impolitic speech. She just doesn’t know quite when not to express exactly what is on her mind. She gives the example of how, at least from her perception, she ruined Christmas. Betty states;”My husband and I went to his ex-wife’s Christmas morning to open up Christmas gifts and she handed me a gift and I opened it up and it was a plastic popcorn popper. I looked at it and I kinda made a smirk and I said, “you gave us this last year.”
Alcohol, not knowing who to trust and impulsivity made dating unproductive.
“Nobody ever said that this could happen. You might have some impulsive words coming out, I mean, which is pretty common. I mean, that would be the first thing I’d tell somebody, that’s kind of normal. Nobody ever told my wife this is going to happen. I mean, knowledge is really power. I mean, just knowing that this could happen, it don’t fix it but it helps.”
Craig talks about his therapies: “It was the first thing that helped the impulsivity and actually timed my brain to, to for my body to be able to control it.” How did your wife miss the spasticity?: “I sent her running pretty quick, with my impulsive behavior. I was downright mean. I would just say some of the meanest things and so within a few weeks I did a good job of alienating her.”
Explain how the metronome works.: “Well, metronome is a device, it’s computerized. You have devices on your hands, your feet, and there’s other devices. Basically you’re using your auditorial, your vision and your body and you’re timing it to a metronome, you’re timing it to that beat. So by training your brain to keep time it actually helps impulsivity. Since then I’ve used that on kids with ADHD and they’re not taking any medicine so you’re able to control themselves. It’s an amazing process.”
So one of the areas in which you were different at work was the inhibition; you were more open and frank, too frank perhaps in the way you interacted. What about your own behavioral issues?: “Oh, yeah, the impulsivity was still (an issue.) I would get angry and I was never one to rile, but, the first couple of years anger would happen. And most people get angry at some things, but I don’t think that was the issue. It’s the perception change, from working for the company rather than working for the people because I truly was a company person. My boss said something, it was like, “yes, ma’am.” It got done and I had no bones over doing it.”
When asked if she had problems with impulsivity she states; “I want more control, more than the impulse it’s I need to plan out this is what I’m doing at this time, this is, this is where I’m going, this is how long I plan on staying. My big thing is if something goes awry or something doesn’t work out the way I had it planned, then I have more problems. As far as just picking up and saying no, I’m going to do this or I’m yeah, doing things unexpected, I’m not saying it never happened, but no that’s not a problem. No.”
Gordon Johnson: Does he have problems with impulsivity?Mom: Do things impulsively you mean? Gordon Johnson: Yeah. Act first, think later.Mom: Yeah. He does. Because I had something I say why’d you do that. And then later on he’ll say I wish I wouldn’t have done that. Well did you think about it first? No just went ahead and did it. It’s not anything tangible sometimes. It’s just he gets up and walks away and you’re going okay.
When it comes to money you have poor impulse control?: “Yes.” What kind of things do you have trouble with on an impulse? What is it that you can’t resist that you should?: “Going and sitting. I mean, gasoline is what’s been so expensive. Right now, I’m going back to school to become a certified nurse’s assistant; so, and I’m working PRN, so I drive my patients home, and he’s an hour from here. And instead of, instead of staying there when I’m not on duty, just to hang out before I go to school, I may either drive back here or I may drive to somewhere else just to, to get out of that environment, of caregiver,for a short period of time. And then I’ll drive somewhere else and have to drive back an hour here to go to school at night. I’m in school four nights a week. Well then, that costs money to put more gasoline in the tank to get me on home, which is an hour from where I work and school.”
One of the areas that’s most affected by brain injury is the disconnection between a physical response and an intimate response. There is also a very strong impulsivity issue that impacts sexuality. We first learn the word inhibited in the context of sexuality, and in that context, it is often easier to understand the flip side of that, disinhibition. Now you mentioned that you needed to feel desired and you were desired by the other man. But was it also a very impulsive type of interaction?: “Yeah. The way that that relationship began was because I forced myself. Mm hmm. I tried to force myself upon that person. I made, I kind of just said here I am and I want this to happen and that person said okay. And so that was very impulsive. However, at the time I didn’t feel that it was impulsive. I, I, I kind of felt like – if it’s a good analogy – I kind of felt like I was an actress and that I was trying to act out the person that I should be and the woman that I should be and the sexual being that I should be. So it still doesn’t seem real to me but I know.”
You mentioned that when your mania gets to be a problem, you go through money quickly?: “Yes.” Does the medication help with that?: “I would say, I still at least once a month I will have that problem but it can help at times. Usually what will happen is nowadays I will sleep when I am going through a, well that is a depression state. I will stay up all night when I am in a manic mood. The last thing I had was for three days.” What happens at the end of the three days?: “I conk out for at least 12 hours. And during this, stage Becky knows (to keep) all the credit cards, all the debit cards, anything I can use she will keep them on her person.”
You think it’s accurate to say that you have a fairly flat mood, meaning your energy levels aren’t high and that you speak impulsiveness and saying the wrong thing. It’s not “socially acceptable” I think is the word that we’re looking for earlier.”