sexual disinhibition in brain injury

Sexual Disinhibition After Brain Injury

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sexual disinhibition can add considerable stress to relationshipsSexual disinhibition is a result of brain injury, and it is one that is not discussed fully with brain injury victims. Why? Prevailing attitudes about sexual activities have not changed much since Victorian England or Puritan America.

Talking about sex, or even teaching about sex, is quite controversial.

Think for a moment about the Radical Religious Right in America today. These people have determined in their minds the definition of proper sexual activity. More than that, however, they have determined that anyone who does not agree with their position is evil.

"Proper sexual activity" can only happen between a properly married husband and wife. From this attitude, we have seen schools teach abstinence-only sex education classes which have been proven not to work. We have seen a proposed amendment to the United States Constitution to forbid marriage to couples who are both male or both female.

We have seen boycotts of businesses who provide health benefits to same-sex couples of equal value to those offered to heterosexual couples. We have seen the bombing of medical facilities in which a woman can receive an abortion. This sort of thing is a hindrance to proper, intelligent discussion of sexual actitity.

Failure to openly discuss sex can harm a person suffering from brain injury and, yet, so many people who should be discussing it are afraid to discuss it.

Disinhibition is defined as (1) Loss of inhibition, as through the influence of external stimuli such as drugs or alcohol, or as a result of brain damage; (2) Unrestrained behavior resulting from a lessening or loss of inhibitions or a disregard of cultural constraints.

In our book, Brain Injury Survivor's Guide, Beth and I mentioned how emotions are filtered by the front of the brain. We pointed out that brain injury causes those filters to fail from time to time. In other words, those emotions come out unfiltered.

Cursing is one sign. But it can also be seen as crying or laughing: any emotion that is unfiltered will be seen as a "super emotion."

Sexual desire is an emotion. Sexual activity is a physical expression of that emotion. Sexual or suggestive talk would also be emotional expressions. Sexual desire can also be expressed in the clothing one wears or the "signals" that pass between persons.

Think of that definition again. Disinhibition can be unrestrained behavior resulting from a brain injury. Many people think of Mardi Gras and Spring Break as periods of unrestrained behavior, and, for some people, they might very well be.

Dr. Glen Johnson, neuropsychologist, says in his book, Traumatic Brain Injury Survival Guide:

"Deep in the middle of the brain are sections that control emotions. They're very primitive emotions that deal with hunger, aggression, and sexual drive. These areas send messages to other parts of the brain to DO SOMETHING. If you're mad, hit something or someone. If you're hungry, grab something and eat it."

Both caregivers and medical professionals have reported being "hit on" by brain injury patients. This does not happen because the brain injured person has become an evil person; it's because those primitive emotions are screaming DO SOMETHING.

The brain's frontal lobe filter is taking a break from its usually non-stop activity of raising a STOP sign, and DO SOMETHING very well may escalate to DONE SOMETHING.

I can think of no better example of sexual disinhibition than George Gosling's book, TBI HELL: A Traumatic Brain Injury Really Sucks. We put a warning in our book that people who are offended by salty language should not buy Gosling's book, and we used the word "salty" quite generously. He wrote:

"I could not contemplate what was going on. I was in shock. My whole world was shaken and stirred. ... Did I miss something? I must be really @%#&* stupid to miss that. Am I that ugly? I must be a repulsive freak for a girl to call the cops on me."

The girl who called the cops was his physical therapy assistant. It is an interesting story among many in his book You can even see evidence of George's brain injury on the back cover of his book. On the back of our book, Beth and I put, "Never Give Up!" George put, "Don't trust anyone."

Open, honest communication is the key to helping a brain injured person along the road to developing a successful lifestyle. And that openness and honesty must include discussions about sex.

Primary caregivers may feel uneasy having those discussions. Or, more to the point, they may feel they cannot have such a discussion.

This is another reason finding a support group or support site such as this one is virtually imperative. Brain injury affects families. The whole family must deal with the medical and psychological effects. Find someone else who has gone through this situation. Ask them what they did. Ask them for guidance.

Are you THE SPOUSE?

Sexual disinhibition can ruin your marriage if you do not recognize it for what it is. Remember the definition: unrestrained behavior. That sexual emotion becomes unrestrained behavior because of a brain malfunction, not because your spouse no longer loves you or has taken up a life of cheating.

Legal systems will not find a person guilty of a crime if the person was unable to realize at the time of the crime that they were actually doing something illegal. The primitive emotion that moved your spouse to DO SOMETHING was not filtered by anything. In essence, your spouse did not know at the time that he or she was doing anything wrong.

I know that sounds pretty ridiculous to those of us who do not have an injured brain. We can think clearly; we can organize numerous sources of information into a related string of thoughts and make a decision based upon that thought string.

The frontal lobe of the brain that contains that big emotion filter also contains planning and organization "modules" that are used to sequence information and make decisions.

Now think again about the situation: primitive emotion says DO SOMETHING. It enters the organization stage as Step A. The brain misfires; there is no Step B and no Step C. The only brain activity to be organized is DO SOMETHING.

It passes from organization to planning where a decision will be prepared. DO SOMETHING is the only brain impulse flowing through the injured brain from planning to preparation to decision. Now it goes to the filter where the decision is lessened from its primitive state to a state that meets society's expectations.

But the filter allows it to pass without modification. Is is the brain injured person's fault their brain failed to act properly at a moment in time when it really needed to perform properly? No, it's not.

So, the question is this. Are you prepared to love and live with a spouse who may become much more flirtatious, who may dress much more provocatively and who may actually follow that primitive emotion with primal action?

You, the spouse, are the only person on earth who can answer that question. You are the only one who knows your innermost feelings. Beth and I were fortunate to have an excellent social worker who clearly and plainly laid out to me much of what you have read in this article.

According to neuropsychologist Dr. Glen Johnson, approximately 75% of brain injury victims will never receive formal brain injury rehabilitation like Beth and I did.

Never forget that family members are in need of rehabilitation as much as the person who suffered the brain injury. The brain injured person may not recognize their behavior has changed. Loved ones, though, will know. And loved ones are the people who must deal with this new person.

I don't guess anyone said it better than Judy Martin-Urban and her daughter, Courtney Larson, in their book I Can't Remember Me. Courtney wrote:

"My husband tells me that I am different now, but 'I can't remember me.' Mom says that my personality is changed, but I don't remember my other personality."

Beth and I pointed out in our book about her personality change. The Beth I was married to for twenty years is not the same Beth I have been married to for the past seventeen years.

The good news is that Beth's filter works much, much better now than it did the first few years following her injury. And, yes, she has a body piercing...and, yes, she has a tattoo. There is nothing in the world wrong with either of those, but the "former" Beth would not have done it.

Your loved one has changed from the person you knew. He or she will exhibit new traits and new behaviors. How do you feel about that?

You can find a related article at this link: Sexual Dysfunction and Sexual Performance.

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