Many specialists will wade in on this issue with confusing double talk that might explain it but could simply confuse the hell out of you and leave you more enraged. I made issue with the show “Golden Girls” and Stella back in my signs and symptoms section for a reason. It is now common knowledge amongst the scholars that the last part of the brain to develop and often the first part of the brain to go as we age, is located in the frontal region. This part is responsible for many things, behavior being one and another is planning. We often wonder why our children act brain dead and take such dangerous risks that could kill them and the reason is that the wires have not fully developed where they start to take stock in the right and wrong of any given situation. An example is staying out late on the dangerous streets at night because it is cool or skate boarding without helmets and making the bold statement that it’s my body and if I want to do it then I will. They do not factor in that if they fall on their head and become incapacitated then society, the distraught parents pay the ultimate price by having to care for them forever. They do not factor in the cost to their parents, of possibly wiping out their savings and retirement all for the selfish reason of it’s my body and I’ll do with it what I want. This is normal behavior and fortunately it too does pass and as parents we give a big sigh of relief if they along with us survive until those neurons finally connect and a decent young adult emerges.
Now think about this for a moment. If you were to meet me I would look like an average guy. There are no telltale signs that I am brain injured. Most psychologists would aptly diagnose my anger as easily managed with some basic coping skills. If he was not aware of my previous brain injury he would apply the same treatment on me as he would a non-brain injured individual and that would be his first mistake.
My anger is not an issue that comes from the norm of a bad upbringing where I was beaten but rather because the pathways that once led to my frontal brain have been altered or completely severed. Many problems are happening simultaneously to a brain injured person and the caregiver needs to fully appreciate this. Those coping skills of life have to be re-introduced and rewired in many cases. The time it takes a non-injured person to learn new coping skills will be shorter than that of a brain injured. It is a Pandora’s Box of emotions from crying, to depression, to despair, to elation and of course anger. All of which need to be addressed and it is no easy task. One cannot separate anger from the rest of the issues. Anger is a result of the many internal problems that a brain injured is facing. He/she is angry because they recognize that they cannot speak properly, can’t find the words quickly enough, forget constantly, their balance is lost and the list goes on. The caregiver has no coping skills to deal with this scenario and may accidentally remark, why can’t you remember and that triggers an anger outburst the likes you’ve never seen before.
My point is this, the brain injury and anger is very complex. One cannot separate anger without identifying all the triggers that bring on the outburst in the first place. This will take months of testing and rehabilitation. We have to rebuild the pathways and re-educate the brain injured so that he/she has an understanding of what the triggers are and how to better deal with them. It is imperative that the care giver learn as much about the brain injury as possible if they are to survive this ordeal in tact. You will employ the same techniques for dealing with the brain injured as for the non-injured however if the instructor is not familiar with brain injury he or she may alienate the TBI patient. Remember the TBI survivor may be dealing with memory issues or permanent damage to the frontal lobe. The anger may not be easily controlled as a result and therapy may take many months and not just a weekend retreat that might be prescribed for non injured counterparts.