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.