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Coping with Behaviours

Personal Stories

Coping with Behaviours

Managing the challenging behaviours that can arise after a brain injury can be very stressful for families or partners. Nathan's family is one that demonstrates the patience, consistency and willingness to develop strategies that can manage Nathan's behaviour.

This was not one of Nathan's better days. He was more irritable than usual this morning and his parents exchanged their usual glances of frustrated affection when he was not looking. He constantly interrupted his parents in mid sentence. He sulked when he was told to wait. He threw his spoon to the floor before they even finished their sentence.
At four years of age Nathan had a well developed wail he unleashed every time he failed to get his way. It echoed around the room when he was not allowed to steal his sister's toast. He resented being told he must stop calling her a fat head. In his frustration he tried to hit her and screamed when he was restrained.
Minutes later all this was forgotten as he happily played a game on the computer. Every time his parents told him to get dressed he said okay then ignored them. There was some more yelling as the computer was shut down then he was taken through every step of getting dressed which he resisted as much as he can. More than usual, Nathan was unable to focus on getting ready to school and was distracted by a bird outside, his sister's singing and the unused computer.

Through all of this Nathan's parents demonstrated the hallmarks of good parents worldwide- patience, firmness, consistency, understanding and affection. While they did not understand the physiology of Nathan's brain, they did know that at five years of age he was only beginning to learn a range of cognitive abilities. Considering the needs of those around him.
Compromising with others. Restraining his impulses. Prioritising and sequencing a range of tasks. Controlling his emotions.

The frontal lobe
The vast majority of these cognitive processes took place in Nathan's frontal lobe, which would not fully mature until his mid twenties. Until then his parents knew that he would gradually acquire these skills if they continued to patiently model good behaviour, provide feedback on his behaviour, and provide consistent boundaries with affection.
Ironically it is in his mid twenties that Nathan damages the frontal lobe of his brain. A particularly hard tackle in football leaves him unconscious for three hours in the local hospital. The scans do not reveal any brain trauma so Nathan's family feel he has survived yet another accident of his sport oriented life.

Resentment within families
In the following months his family gradually realise that Nathan has changed. The only way they can describe it is that in many ways Nathan is five years old again. He can not take into account other people's needs and interrupts his parents in mid sentence constantly. He sulks or yells when his demands are not met instantly. His moods vary wildly, particularly when he is fired for inappropriate behaviour in the workplace.
Nathan has trouble with his household chores and financial management. Initially his family try to help out but he is easily distracted and inclined to outbursts when asked come back to the task at hand.
Resentment builds up in the family and comes to a head when his sister refuses to see him after he threatened to hit her. Their local GP recommends a neuropsychological assessment which indicates that Nathan has acquired a mild brain injury. She explains to the family how the trauma to Nathan's frontal lobe has led to his current problems.

The need for understanding
As the family comes to understand Nathan's brain injury more fully, they realise that he does not control over much of his behaviour - much as he didn't as a child when his frontal lobe was not fully developed. With this understanding they begin to exercise the patience, firmness, consistency and affection that will slowly help Nathan relearn some if his lost abilities - emotional control, seeing others' points of views, curbing his anger and social skills. While he may never fully regain lost abilities it is the support of his loved ones that will provide the best environment to recover as much as possible.


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