More on Communication after Brain Injury from:

https://erabi.ca/wp-content/uploads/2019/09/Ch2_Cognition-and-Cognitive-Communication-Post-ABI.pdf

 

Communication after a brain injury can be affected in many ways. It can be embarrassing or frustrating not to feel in control of how you communicate with others. Here are some common problems, and possible solutions:

 

Listen to yourself

It may take a long time to know how you are actually feeling. It’s hard to tell someone else how you feel if you don’t know yourself. Listen to yourself. Keep a journal. This is a good opportunity to get to know yourself better.

 

Communicating your symptoms to rehabilitation providers, professionals, relative, friends, and others

Before meetings, appointments or calls with family, make lists of what you would like to say/ask, and leave a space to write down answers, comments or suggestions you are given

Mention you might think of other questions later after the meeting. Be prepared to have to ask clarifying questions, repeat what someone said to be sure you understood, or to miss some of the conversation all together. 

 

Communicating your feelings

Its hard to communicate your thoughts and feelings in a measured way when you have a brain injury. Especially if you get emotional very quickly as those of us with brain injury often do. It might come out as crying, rage, frustration, etc.…That’s ok. You may overreact sometimes or under-react sometimes. All we can do is our best. With practice you will develop this skill and be able to communicate your feelings more evenly. Keep a feelings journal and the successful times you felt you responded well.

 

Understanding your feelings or other’s feelings

Keep a daily journal of activities/thoughts. If you have a hard time with this, try writing down just the moments that stand out for you.  Make a summary page of how you feel most often and what upsets you. This may change over time.

To understand others, repeat back what someone says to you, to make sure you have it right. Write down some things you would like to remember in the next conversation with that person (I remember last time you said your cat was sick. How are they now?).

 

Perception of what is reality

I always thought if I didn’t hear from someone, or I did but misinterpreted their tone, that they must be mad at me, or I did something wrong. The fact that you haven’t heard from them may have nothing to do with you at all. Brain injury survivors usually see themselves as the centre of all interactions. Try to be flexible in your thinking and try to come up with other reasons why you might not have heard from your friend.

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Difficulty talking with others for long periods of time, especially more than one person

Try to keep conversations with people short, and with as few people at a time to decrease the likelihood of bringing on overwhelming symptoms.

 

Participating in emotionally laden conversations

Think about your feelings before an emotional conversation so you can plan what to say in advance. Stick to this script. If the conversation gets off track and it gets heated, and you are worried you will respond impulsively (without thinking) say you have to go and you will catch up with the other(s) later. Try to communicate by email or text instead of phone so you have a chance to think before you speak.

 

Getting jokes

Ask for clarification if you don’t get a joke. “I don’t get it” is OK to admit. Or you can just let it go and know you are OK without getting every joke.

 

Following conversations

Ask questions about what you are talking about with others (e.g., did I hear that right, you are going to move?”). If you ask questions and repeat what others say, you are more likely to be able to follow the conversation because you are hearing it and repeating it verbally.

 

Social cueing, appropriateness

One time shortly after my accident my neighbour reminded me of her husband’s death, and I laughed. I realized much later that I had miscued because of my slow cognitive processing. This will happen. All you can do is to apologize and even make up an excuse (“I’m so sorry I thought you said something else”, or “I didn’t hear you correctly”) in order to save face. You can also describe your response as an effect from your brain injury symptoms.

 

Using language appropriately- “It’s hard to put lipstick on that train wreck”

Common sayings were hard for me to remember. I used the wrong words in the wrong phrases all the time. It’s OK if this happens. You might be embarrassed if you do this in front of others, but you are probably more sensitive about this than they are. When you feel like you can be less impulsive, think about what you want to say and the correct use of a saying before you say it. Or you can wonder aloud “what’s that saying about 2 birds and a bush?”

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Planning and pacing organizing

Book all appts and activities in advance to be sure their schedule is manageable for you

Use colour coding in a physical calendar to identify key dates

 

Flexible thinking

Try to think (and write down) of all possible options when asked a question, when trying to understand someone else’s behaviour, or when trying to make a decision. To understand different topics (www.do2learn.com), try mind or idea mapping.

Practice writing a list of words and then for each one, write a word that means the same thing for each (canine-dog; immediately-now; single-one).