Prior to my brain injury I would say I had a considered approach to life. Even when shopping for a new outfit, I might find something I was immediately drawn to. But instead of just buying it, it would resist such impulsiveness. I would still visit all the other shops, as I hated the chance that there could be a better option out there. After traipsing around for a couple of hours I might not have seen anything better. So I would return to purchase the original one that caught my eye. Some people would see this as a waste of time and effort. Say that you should just follow your gut. I don’t necessarily disagree, but I was following my brain.
After my brain injury I hated visiting the shops, I would give in to impulsiveness.
The world of online shopping has encouraged impulsiveness. You are able to browse items that have been difficult to access in the physical world. Online shopping meant I couldn’t try items on before buying them. Maybe they would look better on and so I could be missing a gem if I didn’t give it a go. I was following my impulsiveness in hope to feel as good as people thought I should be. Coupled with my unreliable memory, I bought more than I should have done. But even when some things clearly didn’t fit or just weren’t as good as I’d hoped for, I didn’t bother sending them back. The impulsiveness was over, or ready to move on to the next aim.
I could be obsessed about completing an exercise without being able to think through the consequences of my actions.
One day, in the height of the hottest summer Britain had experienced in decades, I decided to remove the weeds from our drive. Wearing shorts and t-shirt, I sat on the drive which had been neglected since my accident 8 months before, and started pulling out the weeds. I didn’t put on any gloves, which was stupid, as any gardener will tell you. But worse than that, I didn’t put on any sunscreen. I was, at that time, still finding that the temperatures my body registered were considerably colder than reality.
As I wasn’t quick at anything then, it took me hours. But I didn’t notice I was hot, apart from there was sweat dripping down my face. My neighbour saw me and stopped for a chat. She remarked on the extreme heat, and she I looked hot, and advised I should give myself a break. There was concern etched into her friendly face, so I decided I should go get some water. As I passed a mirror on my way to the kitchen, I realised I had sunburn. I’d been so focused on the idea of completing the task I’d set myself, I hadn’t stop to consider how to plan and execute my mission whilst looking after myself.
Even though James would try to tell me not to do silly things on a whim, I just saw it as him telling me I needed permission first. The Irish woman in me rebelled.
Once James had gone to work I would be doing stupid things because a compulsion had come over me. And because I thought I could do it, and would show him! Despite the fact that I had a pronounced limp, and was still pretty weak, I would be trying to move heavy things, just to prove I could do it. But even if I did achieve what I’d set out to do, I would be left exhausted and in pain. Which is probably what he was trying to warn me of. Why wouldn’t I listen? I’m sure I frustrated him, but also worried him half to death. Even before my accident I had fallen down the stairs many times, so he was constantly worried in my clumsy state, how he would find me.
After a brain injury your ideas can be unshakeable, and compulsions urgent. But plans might not be well thought through or adhered to. I know that can make us a bit of a risk, and make you feel like you might have a heart attack. But at the time we just can’t see that. And telling us no can make us grind our heels in even more. My suggestion is to tell us how another, simpler, less risky idea we had before is brilliant. Don’t say that’s why you are backing it, but draw on it’s other good points. Then we might see your positive attitude towards us as encouraging, which is better than always telling us what we can’t do.
8 replies on “Impulsiveness after brain injury”
I am a licensed clinical social worker in NJ and am currently working with a young woman who was in a carnival ride accident about 2 years ago and subsequently incurred a TBI. I did not know her before her accident, but since she has told me numerous stories about her poor decision capabilities. She seems to lack the ability to discern between showing good judgment and poor judgment in her decisions. Purchases of big ticket items, trusting the wrong people, loaning money to folks she barely knows, and she is currently dating a man twice her age. We have been talking about how to put off making decisions and to ask the question, “Is this something that will help me or could it potentially wind up hurting me?” After reviewing a number of situations where she made poor decisions, she realized, after the fact, that her decisions wound up hurting her. I am not an expert in the area of TBI, but this article prompted me put down in words what I have experienced in the therapy sessions.
Thanks Robert for sharing your experience, and I hope you and your client continue to move forward with her therapy.
Yes I totally relate to all three of your examples! Thanks for sharing. I thought that was just me. I think because there are many things I can’t do now, so sometimes when I get an idea in my head I can latch on and not let go until it’s done… for better or often worse to my personal health. So helpful to think through!
I guess we only learn the hard way that sometimes what we mistake for instincts or principles need to be adapted to our new situation – but that takes time.
My sister had a massive stroke that affected her frontal lobes. We had to take her phone away as there were a number of times when she was planning to take steps which would wreck her stability. She’d planned to retire, purchase and travel before she had her stroke…afterwards she wanted to purchase the RV from her funds in her 401K account. Another time she was planning to change her name on all of her accounts, and another she was planning to change all her passwards.
As she hadn’t purchased long term care insurance because she was in decent health, we needed to conserve her assets. It was hard for her not to be in control of her money but we felt it was best.
It’s difficult when someone has fluctuating competence because when we are in a good place you want to be allowed to make our own decisions, but then the moments when we make unwise ones comes along and messes everything up. I had to take over my dad finances as he started to succumb to Alzheimer’s, but he was more than happy for me to do that. I did take away his passport at one point because he was talking about flying to the other side of the world. It was less than 2 years after my own TBI and hadn’t recovered much, plus I had PTSD so no way could I escort him. I felt bad about it but it was fir his own safety.
Hindsight can be a “kick in the Ass” but when it is enabled by many types of accidents, meds and or recovery it becomes harder to quantify to oneself.
Hyper-hyper no fun!
Yes I hate that moment of realisation when I ask myself “Why did I think that was a good idea?!”