I am skipping around again. There is a long list of effects which Bill still deals with to this day even though it has been 35 years since his accident. The rest of his section of the book discusses how those deficits still impact his daily life. As he ages some of them are on the increase, others remain as they have been. It is our hope that when others who struggle with brain injury of one kind or another read this, they can relate and not feel so alone.

Impulse control- the tendency to act on a whim; acting out behavior without thinking about the consequences of such behavior.

 I have trouble with impulse control and delaying gratification. In the early days after the accident, problems with  impulse control were evident in outbursts of anger or other feelings. I could not control my temper or my tears.  I felt things and they just came out all over whoever was nearest, usually my wife.  I didn’t realize how much my pre-injury brain helped me to be socially acceptable with my feelings.  It allowed me to hold them in or let them out appropriately.  Now I don’t have those kinds of outburst issues as much, unless I am tired or overwhelmed.  For me, the bigger issue currently is more external things I want for comfort but are not good for me.  I cannot seem to stop some things like eating junk food or sitting and watching too much TV. I lack what some people would call willpower. It is very hard to delay gratification and control impulses. 

Impulse control during a conversation is one of my more visible weaknesses.  I can’t hold back my thoughts, so I interrupt constantly, and even go in different directions in the conversation. I ask a million questions because I am curious.  I just follow the trail of my thoughts without control of them. It frustrates my family or people I am talking to, but because I don’t say everything that comes into my head (believe it or not), I think I am doing well.  I don’t always see the frustration on someone’s face or pick up on social cues, so I just keep talking.  My kids will tell me, or my wife will nudge me under the table, but I don’t see it myself really. I tend to think I have more control than I actually do.  

There are times when I jump off topic during a conversation because of my external environment and my inability to filter it out. If I am in a loud place, like a crowded restaurant it is overwhelming to me. I will interrupt a topic to talk about the guy at the next table, or the way someone parked their car outside the restaurant.  If my brain gets too overloaded I will stop talking altogether, because I cannot keep up with all the stuff around me and carry on a conversation too.  It tires me out, therefore when I leave, I need to rest my brain before I can think straight again.  When I am under stress I find it impossible to try to analyze things to gauge my behavior and if it is appropriate to the situation or not.  I get agitated when I have to deal with external stressors and I don’t always handle things well.  I have a lot of regrets about it once I look back at the situation.

Another frustration is that TBI symptoms are sporadic. Sometimes I can do things and other times, I cannot.  I hate these issues and behaviors because they have no solutions. How can an employer deal with me if I have these unnamed problems?  No wonder I keep losing jobs.  I have an invisible injury.  It would be so much easier if it was simple like needing hearing aids, or a cast for a broken bone. ADA laws cover adaptations for employees who have special circumstances. Those kinds of things are direct and easy to understand, if you have a wheelchair, you need a ramp, etc…  For me and my injury, sometimes I know the issues and other times I can’t even see them.  I don’t really advocate for myself because I cannot name a specific issue or how to help me. Much of it depends on external circumstances beyond my control, and it prevents me from showing what I can do.  I don’t even tell potential employers about my injury. Who would want to hire someone with all these invisible issues? No one. So I take my chances they will not notice. The injury is invisible, so I think I am pretending well, until I lose another job for, what seem to me, to be random reasons.

Here’s what it looks like in an example. I had a job interview once and I was in the lobby filling out some short answer type questions where I had to write.  There was a baby in the room and there was some confusion as to who was keeping the baby between the two adults there so one of them could leave. I couldn’t concentrate on what I was writing because of the distraction, but also because I was worried about the baby and the situation. Long after they had solved the issue I was worried about the baby being left with someone who was supposed to be having a supervised visit. (I was interviewing for a case worker job.) It’s like it got stuck in my brain. The assistant came to get me for my interview but my written questions were unfinished. It made me feel like I did something wrong. She said I could finish it later, but it kind of reminded me of being ushered into the principal’s office when I was a kid.

I went from the lobby, and my unfinished questions with my feelings of being inadequate, directly into a room with a panel of people. They were asking me about how I would handle all different kinds of hypothetical scenarios.  At the time, I thought the interview went great. However, now looking back at it, I can see I totally messed it up. My answers were not good because I could not think clearly. I talked too much, because I do that when I am stressed. I am sure they probably thought I can’t handle stressful situations. I kind of proved it to them, and a caseworker is a highly stressful job, so I pretty much showed them I wasn’t the guy they were looking for.  The panel didn’t think about how those little things, like a baby in a room while I am writing, affected me because they didn’t know my limitations. It’s another job I didn’t get.

These types of experiences increase my feelings of being rejected for something I cannot control.  I see my disability and it seems to make it easy for me to be critical of other people who look fine.  They don’t know what I am dealing with and I resent it. It is nearly impossible for me to look beyond myself to understand what pain others have from their own experiences.  Looking from outside I jump to conclusions, but then I think about it and realize I am doing the same thing to them that I hate when it is done to me.  

The times when I can slow my thinking down, I have compassion for people who are having trouble, like elderly or disabled people. My limitations have taught me patience and given me empathy, sometimes.  Back when I was taking care of my elderly father and I wanted him to feel his own autonomy in the small things. I could just pick some things for him when I was shopping, but I wanted him to feel he had some control over his life so I took him and let him pick. Sometimes he was like a child, with an advanced intellect. 

Because of my injury, I understood how that feels. I could guide while still letting him feel he was in control. No assumptions of what he wanted or needed on my part, instead I wanted to show empathy.  If he was angry and cranky, he didn’t have evil intent, he was just frustrated.  Often cranky old people are misunderstood, the problem is they are losing themselves and it makes them unhappy. I get that.  I say let them be who they are. Interesting people. I want someone to let me be who I am, too. I want people to give me that same kind of understanding.