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Why does this happen?

Traumatic brain injuries often result in damage to the frontal lobe. This area of the brain used in reasoning, problem solving and controlling our more basic impulses and emotions such as anger. An individual who has sustained a brain injury has often lost these skills which can result in difficulty controlling responses to feelings of anger. In some cases, this can lead to violent outbursts with minimal provocation and little warning.

Brain injury also affects social judgement and the ability to know what is appropriate in different situations.

Examples include:

  • an adolescent who spits in his mother’s face when told he can’t go out
  • a grandfather who screams constantly at a niece he used to adore
  • a husband who hits his wife whenever he doesn’t get his way.

Because brain injury also affects self- awareness, a person may feel justified in saying others were responsible for provoking their anger.

Management techniques

While allowances need to be made for changes brought on by a brain injury, actual violence requires an immediate and consistent response and should never be tolerated.

Family members should respond to inappropriate behaviours as soon as they emerge. This will prevent a pattern of family abuse becoming established in the home. Ignoring angry outbursts and not setting limits can lead to a cycle of violence developing.

Positive behaviour support

There are a variety of strategies available for families to minimise the chances of domestic violence occurring. The strategies within the positive behaviour support approach include:

  • establish consistent rules remain calm and respond positively during an anger outburst
  • involve the injured person in discussing behavioural issues
  • recognise and manage the triggers for aggressive behaviour
  • give positive feedback for appropriate behaviour
  • make agreements about behaviour and set limits
  • give clear feedback on aggressive behaviour
  • ignore the behaviour when appropriate to do so have a safety plan.

Remember that because brain injury affects memory and self-awareness a person with brain injury may not remember past violent behaviour and their actions should not be taken personally. Try to find out what triggers the behaviour and avoid or minimise these in the future.

Families can respond to issues of anger and violence early by discussing and establishing ‘family rules’ before the person returns home.

Obtain specialist help

Behaviour specialists are available if rehabilitation has already finished. There are many strategies available such as:

  • working on communication skills
  • anger management
  • relaxation techniques to control aggressive behaviour with a positive behaviour support plan.

Holding a family meeting whereby all members are trained to treat aggressive behaviour consistently within a positive behaviour support plan.

Personal support

It is important for carers and family members to have support networks around them; people to talk to and people who understand. Joining a local support group is a great way for carers to connect with families who are in similar situations. Synapse runs a number of support groups, both in person and online – check out for details.

Safety plans

Carers need to remove themselves from a potentially violent situation the moment they no longer feel safe.

It is important to maintain a safe environment by removing potential weapons or dangerous objects. This includes objects that could be thrown or used to damage property. An easy- to-access list of emergency phone numbers should also be part of any safety plan.

The last resort?

Brain injury is never an excuse for domestic violence. If violence still occurs despite professional support and a positive behaviour support plan, the next option is to either contact police and report the abuse or request a restraining order.

Contact Synapse on 1800 673 074 for information about available support and advice.

This includes information on legal, emergency accommodation, restraining orders and appropriate support for the person with a brain injury.