Personality Changes - Communication Difficulties Following a Brain Injury

There are many deficits following a brain injury that can cause personality changes. One of these problematic changes is in how a person communicates with others. Communication, for many reasons, often becomes difficult particularly in group conversations.

Pragmatic communication impairment causes problems in relationship as well as in work environments. Because of this, if severe, it will determine their success in employment situations and possibly within their social networks. With lack of communication skills often these social networks will gradually fade into the background.

A high percentage of those with brain injuries have communication difficulties. They very often have problems initiating conversation or in continuing with one. They will disassociate and be unable to interact with others either verbally or non-verbally, even if they know the people well. These difficulties seem to be enhanced when in large groups.
Over time their communication skills can either increase or decrease depending on the positive or negative results they get from their efforts.

When in conversation with others, it is common that they will rarely ask questions. The reason for this may be that in many cases, those who have suffered from a brain injury will tend to be self-centered and as a result, they have little interest in what someone else is saying. Another reason is they often have memory problems so may hesitate to ask because they don't remember if they've already been told before.

Some of the reasons for communication difficulties are:

- too much background noise can be confusing;
- it can be difficult to concentrate if the person is tired or anxious;
- they may have difficulty explaining their thoughts;
- pain can make communication more difficult because it may limit concentration;
- moods and fatigue can affect communication;
- long sentences can sound confusing as can complex conversations;
- alcohol can increase communication problems;
- over-stimulation;
- large groups;
- inability to take cues from others when in conversations;
- inattentiveness to conversation and/or lack of interest.

Ways of helping someone who is having difficulty with communication:

- keep sentences short;
- do not interrupt;
- be positive;
- have person avoid, when possible, large groups;
- when in groups encourage topics that the brain injured person may feel comfortable discussing;
- discourage, if possible, the use of alcohol;
- give emotional support.

Because of communication difficulties, especially in groups, many of those who have suffered from a brain injury tend to feel lonely. Over time it may be one of the most difficult deficits they will have to deal with.