and other reflections to avoid when chatting with someone recovering from a traumatic brain injury….

For a lot of us, the fact we sustained a TBI is invisible. We do not have stitches on our face or any visible sign we are injured. Yet, an injury to the brain is much more life altering than a broken bone. A brain that is not properly functioning can prevent us from engaging in activities of independent living and prevent us from working. There is a shyness and self-consciousness that over came me once I gained enough energy to leave the house- I became worried if I bumped into someone I knew they would not believe I had a TBI- how would I navigate that social interaction? Then, anxiety sets in. Navigating social circumstances is another challenge TBI survivors face…

Here are tips on how to make interacting with a TBI Survivor more caring and less uncomfortable.

• Be mindful at the pace in which you speak, slow down just a bit, that will help a lot
• Avoid ambiguous phrases
• Avoid acronyms, even if the acronym was commonly used prior to the injury, do not assume the TBI survivor will keep up with the use of acronyms
• Limit your visit to 30 minutes or less. A simple conversation can trigger complex areas of processing for the brain that is exhausting; especially if the visit is outside of a regular routine for someone healing from a TBI
• Avoid asking open ended questions- a question like “What would you like for dinner?” is so broad and vast (this question is difficult for people without a TBI right?). Instead try offering choices “Would you like chicken or beef for dinner?”
• Do not be surprised if your TBI survivor appears to be “over reacting.” TBI survivors tend to react differently to information/news compared to their pre-injury self
• Conversely, do not be surprised if your TBI survivor appears to lack empathy toward something you are experiencing or feeling. TBI survivors sometimes struggle with picking up on facial expressions and/or tone of voice. They are not intentionally withholding empathy, simply missed the moment where it was needed
• Be prepared for your TBI survivor to repeat themselves and not have awareness to this
• Avoid information overload- appreciate moments of silence, facilitate some calming music and simply just sipping on tea
• Practice mindfulness together
• If you feel comfortable, ask if you can help them with therapy homework- TBI survivors struggle with apathy and motivation
• Research TBI ahead of visiting with your TBI survivor that will mean a lot
• Be patient

In my day to day life prior to the accident, friends and family generally were not commenting on how fabulous I looked. So, making a point to let a brain injured person know how fabulous they look feels invalidating and may come across as though you do not understand the impairments and/or associated challenges a TBI survivor has. You probably really mean it when you say “You look fabulous!” however, the compliment  may unintentionally discredit all of the effort that went into a TBI survivor simply trying to look and feel normal for the day. At one point in my healing it took me 2 hours to get ready to leave the house, simple make up and hair only. That is the amount of time brides take to get hair and make-up done. My pre-injury routine took less than 15 minutes.

I could go on and on with tips, this list seemed like a good start. Please comment below and share tips you have for interactions with TBI Survivors!

-I am a therapist in Anchorage, Alaska. You can learn more about me at my website.