Quick Facts
- Disinhibition and reduced behavioural control can be a problem after brain injury
- Individuals may be more impulsive and express their feelings, thoughts, and opinions without carefully considering the consequences
- Disinhibition is often associated with a loss of awareness and a lack of understanding that their behaviour is inappropriate
What does it
look like?
- Person says or does things that are inappropriate, embarrassing, or are not consistent with social norms (e.g. makes inappropriate sexual comments; talks too long or too much; laughs uncontrollably)
- Inability to self-monitor (e.g. may spend too much money)
- Disregard for safety and social rules
- Impulsive acts and speech
- Mood swings and irritability
Possible Causes and Complications
Possible causes:
- May result from decreased reasoning abilities and a lack of control
- May also be related to a decrease in self-awareness, a process that requires complex thinking skills which are often impaired after brain injury
Possible complications:
- Loss of relationships
- Safety concerns, and financial strain
What can we do?
- Provide direct feedback at the time of the unwelcomed behaviour
- Keep calm and do not overreact
- Provide positive reinforcement when possible
- Recognize and accept that the person may have this difficulty due to brain injury
- Encourage use of a “STOP THINK and GO” strategy that the person says to themselves before impulsively rushing into or doing something they regret
- Keep a record or diary to identify situations where the person has been disinhibited or inappropriate (are they more disinhibited in certain situations or with certain people? What are the triggers?)
- Eliminate or reduce any identified triggers
- Apologize and attempt to explain the difficulty to others
- Do not take these behaviours personally
- Distract and redirect the person to more appropriate behaviour
- Provide verbal and visual cues (i.e. hold hand palm out to signal stop)
- Provide clear expectations for desirable behaviour before social events
- Financial management may need to be supported
- Active ignoring of some non-threatening behaviour may reduce the incidence of a behaviour
Disclaimer: This information is not meant to replace advice from a medical doctor. Consult a health care provider regarding specific medical concerns or treatment.