Communication 101 Post Combat - or after any Trauma

Written by Julie Taylor

Communicating with Traumatic Brain Injury or PTSD (Post Traumatic Stress Disorder)

Post Combat, You Can Learn to Communicate Again - and Others Can Learn to Communicate With You, Just Fine

This article is written particularly for 'others' - 'normals' - who want to communicate with the head or brain injured.  But it's just as appropriate for 'grads' to read too: you may fear that you will never again be able to communicate the thoughts in your head after your brain injury?

Not so...  Hang in there.  Give yourself a chance...

Not everyone has experience of communicating with people with disabilities - and it can be quite different. Please remember that 'appropriate etiquette' is always based primarily upon consideration and respect - not just for the disabled but in every walk of life.

Below are some general suggestions for communication and things to keep in mind when interacting with those with combat-related injuries - such a traumatic brain injury (TBI) - and Post-Traumatic Stress Disorder (PTSD).

It is important to relax and treat the individual with dignity and respect. Be sure to listen to the individual and treat adults as adults - so many people 'talk down' to the disabled and this is infuriating from the point of view of the disabled. Do not be afraid to ask questions when you cannot understand or when you are unsure of what to do.

Communicating with people with TBI

Be prepared to repeat what you say (if asked) as some people may have short term memory deficits

Keep your sentences short.  If you don't, it's quite possible that we'll forget the beginning of your sentence by the time you get to the end.

'What I Mean Is...' a unique speech therapy workbook that will show you, step by step, how to put your language back together.  Language - words, speaking and writing - is icredibly important to me and I am grateful beyond words that I met Hilary Dibben, the author of this book.  I thought I was fine - at least as fine as possible - until I met her.  Her amazing and astute understanding of my communication problems enabled me to improve and get back to normal.

Pause for a few seconds between your 'thoughts' or sentences.  In time we learn new ways of learning: mine is with images.  I need for the person speaking to pause briefly after their sentences  so that I can reflect on it for a moment and commit it to another part of my memory - before I move on.

Be patient, and supportive. It may well take extra time to understand the individual; and to be sure they understand you. In fact in my counselling I find that 'normal' people often go so fast that their brains don't take in half of what they say or hear.  The result is feeling - and being - misunderstood.  And so not really 'getting' what your partner says to you.  Taking time is helpful to everyone in conversations, not just the disabled.

Try to avoid interrupting the person - it may take them a while to get out what they want to say and whilst they may not really mind if you finishe their sentences, you may not be 'quite right' and they are likely to forget whatever it was that was going to be their punchline or the end of their thought.

Likewise, they may interrupt you because a thought, perhaps related to what you're saying, flashes into their mind.  Let them know if this is disruptive for you.  They may have to learn not to interrupt and accept that they may forget their 'answers'. This is necessary re-learning for them and the best way to 'teach' it is to be candid about what works - and what is irritating - for you.

If you are in a busy public place consider moving to a quieter location as some people with TBI may have difficulty concentrating and focusing.  It can be harder or even impossible for them to sort out the background noise from the conversation they are actually having and so the quality of what they say may be severely compromised.

Focus on short term goals - to a certain extent.  On the other hand do discuss longer term goals too.  The brain injured may be very aware that they are having trouble thinking through long term goals and so feel patronized when you avoid the longer term.

Please remember: their intelligence is often exactly what it was. They still have exactly the same thoughts, just not in such a way that they are able to express them.  Your thoughts and words can be rather like prisoners, locked in your brain.

Respect is always key: in our 'fast' world, we often forget to pause and smell the roses!  Someone can be very different from you and still have very valuable things to contribute to your world.

One of the most important parts of my own ReBuilding was this book: Nonviolent Communication: A Language of Life (aka Compassionate Communication).  It helped me truly understand both my place in this 'new world' (as someone who had gone through trauma) and it helped me make sense of - and not be hurt by - the reactions of other people around me.  I have also used it with my clients and it has helped so many to both communicate kindly and 'precisely' and to hear others with new - less hurtful - ears. Available as a book (opposite) or in CD format (below)

Communicating with people with PTSD

This really is quite a different piece.   However, for me and for many people with brain injuries these two parts often go hand in hand.  It is very likely that the trauma which caused the brain injury was part of a very stressful chain of events - even if they all happened very close together.  In any case, these guidelines often apply equally to the brain injured and to PTSD (post trumatic stress disorder).

Try to minimize high pressure situations - peaceful, 'easy' environments are very much appreciated.  And we may not be able to cope with noisy and hectic environments for long periods.  Even classrooms which are brightly lit, full of noisy chatter and often quick movements - on top of learning new facts - are unbearable for any length of time.  When anyone is overwhelmed, they often lose patience and behave 'less than ideally' with those around them.  Multiply that by 10 or 30 for the brain injured or for those with PTSD.

Be patient and avoid interrupting the person. Embarking on the journey of trying to express a thought is rather like edging out on a tightrope: it's very easy to push (or just touch) them and they'll lose balance and fall...  Or be unable to complete their thought.  This is very frustrating.

Find out what makes the person most comfortable - it will often make you most comfortable too.  I've found that in today's fast-paced world we may well  'cope' - until we get PTSD or a brain injury.   Then - perhaps thankfully? - we have to take stock again and slow down. 'Coping', long term, seems to lead to stress?  For all of us?

In a nutshell?

1.  Slow down - not your actual speech so much as the environment around you and the pace of the conversation

2.  Respect - lack of respect is infuriating.  As I said, chances are they are every bit as intelligent as they were before.  Don't be patronizing.

3.  Find a quiet corner or more peaceful setting

4.  Try shorter sentences with a short pause between them.  Expect to be interrupted and patiently explain why this is also difficult for you.  Allow and help this person who is having to adapt to a new way of being to learn to socialize

Relax and enjoy - allow everyone you meet to share with you the riches of their personality and to contribute to your life.