compulsive behavior in brain injury

Compulsive Behavior

Compulsive behavior is common among brain injury victims. In the outside world, we hear terms like OCD, Obsessive Compulsive Disorder. In our world, the world of brain injury, having obsessions or compulsions is quite "normal."

The Mayo Clinic, on its website, lists some common indicators of a person having compulsions.

  • Washing and cleaning
  • Counting
  • Checking
  • Demanding reassurances
  • Repeating actions over and over
  • Arranging and making items appear orderly
For a brain injured person with no short term memory, repeating actions over and over again may not indicate a compulsion; they may simply not remember having done it before.

When Beth first entered the Independent Living program at Timber Ridge Ranch, she certainly had a compulsion. She wrote about that day:

My first night in the apartment was frightening. I was glad I had been permitted to stay there rather than at the facility, but soon realized it was a strange place and not home. I was all alone for the first time in a very long time and realized I was now in control. That, alone, was frightening.

Although it had been cleaned before I moved in, all of a sudden I became a fanatic for cleanliness. I had to make it mine for a while and it could have no evidence that anyone else ever lived there.

I began late in the afternoon and made good use of the washer and dryer, washing most everything I could find. I cleaned the tub and shower, the kitchen, vacuumed, etc. until I was exhausted.

I never had an appetite the entire time I was there. I had to force myself to eat to keep up my strength. I had washed one plate, one bowl, one glass, one coffee cup, one set of eating utensils. After each use, I would immediately wash them again. I could not stand for anything to be dirty.

Courtney Martin Larson wrote in her book, I Can't Remember Me (see our Brain Injury Books page):

My present compulsive behavior is my biggest challenge. I nearly drive myself crazy with these confounding compulsions. I think a lot of it is that I, for some reason, do not want to make a mistake, and this fact itself is unusual for me. I just can't check something once and tell myself it's done right. I have to keep going back and checking and re-checking...

To answer the question, "what can I do about my compulsions," the Mayo Clinic recommends cognitive therapy. But let's take a moment and notice a similarity about Beth's compulsion and Courtney's compulsion.

Beth was frightened about being out on her on. She was the person in charge of her situation. She did not want to fail. She cleaned every room and washed everything to "make it mine."

Courtney is in charge of what she is doing. She does not want to fail. So she checks and re-checks and re-checks.

Brain injury victims yearn to be back in control of, at least, parts of their lives. DJ Fierce, in his book, Surviving Black Ice, talked about being in control. He wanted his doctors, therapists and family members to back off. Let me try. Let me fail. (You can also find DJ's book on the Brain Injury Books page.)

Confidence Therapy

A brain injured person and the family caregivers both need to know that confidence building will be a magic pill. While I am not a doctor or licensed therapist, I have over 17 years experience living with a brain injured person. I have corresponded with numerous brain injury victims who have achieved much more than anyone ever expected.

Their achievements have a common thread, and that thread is confidence. Confidence comes from knowledge. And, as Beth has said over and over again, knowledge is power to a brain injured person.

From my point of view, knowledge is power to a family caregiver as well. Confidence-building is the root of our book and this website. Our Wall Calendar featured inspirational slogans each month. Journals, to be written in every day, provide a way for each person affected by brain injury to track progress.

CBS anchorman Bob Woodruff suffered a brain injury in Iraq. One day he had a thought that he desperately wanted to remember so he quickly grabbed pen and paper and wrote and wrote and wrote. (Well, as quickly as someone with a brain injury can.)

The next day he looked at his notes, and he could not read a single word. It was all lines and markings that formed no words. Today, however, he can look back at that note and see how much progress he has made. That is the purpose of writing in a journal.

Family caregivers can write their thoughts. You can write what you and your loved one did today...and tomorrow...and the next day. Over time you will be able to look back and see the progress. (See our article about Journals.)

Throughout our book we mention the need for a planner that will include dozens of lists. Sample lists are in our book and full size copies can be downloaded from this website and used. The purpose of the lists is to remove doubt and fear...and to build ... confidence.

Recovering from brain injury is a bad choice of words, because you do not recover from brain injury - you overcome it. A brain injured person's life will not return to how it was prior to the injury. A new life is the only choice, and the choice is how you want to build that new life.

I was rather tickled reading DJ's book, Surviving Black Ice, when he mentioned working with his physical therapist. He was having problems walking and mentioned to his therapist that he had always walked pigeon-toed before.

The therapist suggested that he might progress faster if he tried to walk pigeon-toed. DJ told the therapist, "If I had to learn to walk all over again, this time I was going to do it right." DJ made a choice how he wanted to build his new life. He reports that one of the happiest days of his life was when the physical therapist told him there was nothing more she could do for him. He was physically ready to go out into the world.

We are continually making games and puzzles for visitors to this site. The purpose of those games is to build confidence. Confidence in being able to achieve. Confidence in being able to remember. Confidence in being able to do.

Developing confidence in something, anything, will seem like a magic pill because it shows that injured brain that it is still working and can be used productively.

Chart a new course and ... never give up!

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