Impulsive Choices

Written by Julie Taylor

Making the wrong - and impulsive - choices is typical of brain injury.  It's also typical of those with a brain that works slightly differently to most people - ie those with ADD or Attention Deficit Disorder and many similar learning disorders.  Behaving on an impulse that quickly 'comes over you' and is not within your conscious control is so easily done… This is especially difficult when you look OK...  It's even easy to fool yourself into believing that you don't need emotional rebuilding because nothing's wrong...  That is very hard on everyone around you too.  As, of couse, is ADD - because parents and other responsible adults need to help the child build in an appropriate way, rather than rebuild.

Your reactions and actions may well be incongruent with your thoughts and feelings.  Integrity depends in congruency between the various parts of our psyche, so this is very difficult.  Brain injury - sometimes known as ABI or Actual Brain Injury - is often invisible to all intents and purposes.  This being the case, no-one knows to cut you any slack or tries to be understanding when you ‘blurt out’ something inappropriate.

The same applies to those with various learning disorders which are often hard to detect too.  To keep explaining yourself is frustrating -  because invariably people respond immediately by telling you that your behaviour is quite normal – despite what you’re trying to say to them.  They tell you that everyone has the same difficulties. Of course, that doesn’t help because you want them to understand that the behaviour that just happened is not normal – and perhaps not acceptable – to you.

It took me over 10 years to get to the point where I could just about reign in my impulses and thoughts – almost all the time – but it was a real effort. On a light (but still very annoying!) note, I still – frequently – forget to buy something I really need and have to go back to the store or go without.  This happens to everyone sometimes and in fact I was slightly impulsive before my head injury.  But to someone with ABI or ADD it can happen ten times more often.  Imagine living with that? (Depend on lists) Or I may spend money I don’t have on the spur-of-the-moment crazy, useless things I neither like nor need! (Always make sure of return policies for everything - you never know till hours later if something really was impulsive...)  Or say out loud something that I don't mean to say (have rules about ever speaking out loud until you've thought over something).

How to handle impulsivity...

The first step is knowing that this is a problem for you.  Just knowing - academically - that this is something you need to watch out for and talking about this problem with others who don't have it is really important.

The second step is noticing when you behave impulsively.  Again, it helps to have feedback from someone 'normal' so that you can be sure when this happens.  Becoming very aware of your own thoughts, feelings and behaviours is more important than ever.

The third step is being able to anticipate when you are going to behave impulsively.  Play previous actions over and over in your head and notice what lead up to them and how you might 'catch yourself' before they happen.

The fourth and final step is being able to control your behaviour so that no-one else notices when you may have odd, impulsive thoughts.  It's unlikely that you will stop having impulsive thoughts but you can learn to keep those thoughts to yourself.  You can discuss with a therapist or worker other - more acceptable - ways in which you might express them.  This is where you learn strategies to cope with the changes that your injury has brought.

Sometimes a behaviour slips by or perhaps is more serious.  For example about 15 years after my injury I remember standing with my husband in our office while there were major renovations going on. An extra large piece of drywall suddenly fell from the ceiling, where it had only been tacked in place. It fell on his head, really hurting him and before I knew what was happening, I laughed. I have no idea to this day where that reaction came from - or why - and within a few seconds I changed it to concern. Remembering back though I cannot work out what emotion I was actually feeling at the time… Why that would be, I really can’t say. I loved my husband. Now, in the cold light of day, I am horrified by what could have happened. Interestingly my husband’s reaction was anger (at my laughing - as he saw it 'at him') and relief that his strong head had taken the fall and not mine… Thank you Nick.

The point is that even though I had a tight reign and over 15 years experience (then) on my expressions, every now and then a ‘peculiar’ blurt happens. When it does happen, I advise you always to give a short and to-the-point explanation - if you know, recognize or even realize at the time and acknowledge what has happened. Never try and ignore it – which I have done several times and which has always left me feeling ten times more uncomfortable. In fact it can be like one of those lies which starts out as a fairly harmless ‘white’ lie that grows and grows, and spirals down and down, as you try to dig your way out of the quicksand you find yourself in.  Friends and caregivers need to understand that this is something - a behaviour - that may possibly happen now and then and 'allow' it...  Allow you not to 'be' that behaviour but to recognize it - possibly later - and forgive it.

Hang in there... It's so easy to forget that these things are very real symptoms of brain injury and not just rotten behaviour... Although it's easy to believe - even as the person with the head injury (who should know better?) – that you are somehow ‘inadequate’ because your self esteem gets eroded, bit by bit, with every job and relationship failure - and every ‘odd reaction’ - every day. Try and deal with it 'practically' and put it straight out of your mind.

People often get mislabeled and are misunderstood.  Sometimes on purpose...  This applies to teenagers who are a difficult phase of their development anyway, particularly if they also have ADD or an ABI.  Here's the sad truth: it's often easier on the psyche to think 'I'm a bad ass' - rather than a wounded individual who could possibly use some more rehab... We may even end up not recognizing – or liking - ourselves…

Behaving with impulsivity is such an 'invisible' wound - to everyone, including your partner. Please be kind – and forgiving - to yourself. And to your loved ones. Emotional ReBuilding, like brain injury, is invisible too…

It's so important to remember that despite my injury or disorder, you are absolutely not the behaviour.  Maybe like my mild impulsivity that existed before my injury - which was perhaps less forgiveable - you need to understand and accept that this current behaviour now is actually quite separate.  And very difficult to change.  As I say, it is NOT 'who you are'.  It's just a piece of totally unreflective behaviour.