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What Is Disinhibition After Brain Injury and How Can Therapists Help?

What Is Disinhibition After Brain Injury and How Can Therapists Help?

Comments [3]


What is disinhibition after brain injury and how can therapists help?

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[Glenn Parkinson] Sometimes people have neurobehavioral sequelae, which can impact the way in which they behave. So, disinhibition is something that we hear a lot about, people talk a lot about following brain injury. People sort of—we talk about it as losing your filter— things that you would normally think but you don't actually say out loud. They get stuck in the filter. Well, when the filter is broken, it's cracked, or it's gone—"zhoop"—just kind of pops right out. So, that relates to all sorts of things. It relates to aggression. It relates to making inappropriate comments about not liking someone's jacket that they're wearing. It also can relate to issues around sexuality and noticing an attractive person on the street, and making a comment when your spouse is right there and not exactly open to hearing that—or even talking to providers. Sometimes in the hospital, if someone has more disinhibition, then they will make inappropriate comments to providers, to their PT, about what they are wearing, or going out to dinner, or that kind of thing. When you work in a rehab environment, that's diagnostic. That's really helpful. That helps you understand kind of what's going on with them. But, for someone socially, that can get them into a lot of trouble, if they lose a sense of kind of the boundaries of social norms, and what's appropriate to say, and what's not appropriate to say.

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Produced by Victoria Tilney McDonough and Erica Queen, BrainLine.

Glenn W. Parkinson, MSW, MAGlenn W. Parkinson, MSW, MA, Glenn Parkinson, MSW, MA works as the psychotherapist on the Traumatic Brain Injury service at Walter Reed National Military Medical Center. She works with active duty and retired military personnel and their families specializing in combat-related injuries.

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Comments [3]

After leaving hospital it became quickly apparent that I had lost my verbal brake and said precisely what I was thinking without a thought for how in/appropriate it was. My brother thought it funny in the beginning but it upset a lot of people and my managers at work definitely didn't appreciate it. I ended up taking ill health retirement after a further 2 years.

Sep 24th, 2014 4:08pm

My problem is I both tell people too much and am paranoid about certain situations and people.  I have a friend who is a book keeper helping with paying bills on time and major financial decisions.  We balance my checkbook together.  I make smaller financial decisions but anything over $500 we talk about first.   I have history of 4 TBIs, the last one moderate.   Each one, the symptoms were worse and recovery slower.

Sep 23rd, 2014 1:47pm

Following my Severe TBI, my family did everything they could to get me to keep my clothes on.  It was tolerated in rehab....However, I had problems when I started working....then it became an issue.

Dec 5th, 2013 12:56pm


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