You Did That on Purpose!
Misinterpretations and Anger after Brain Injury
By Dawn Neumann, Ph.D., FACRM
Imagine that you are waiting in line at the store and someone cuts in front of you.
A) Do you think the person cut in front of you on purpose or was trying to be mean?
B) Or do you think maybe he or she did not see you and it was an innocent mistake or there was some kind of emergency?
How you interpret this situation will affect how angry you will feel and how you will react to the situation. If you chose option A, it is likely you will be more irritated and angry than if you chose option B.
Irritability and anger are common side effects of traumatic brain injury (TBI). How we interpret others’ actions can lead us to feel irritated and angry toward those involved. Recent research suggests that one reason irritation and anger are more severe and common after TBI may be due to misinterpreting others’ harmless actions.
It is not always so obvious why people behave the way they do. So, it is normal to try to figure out the reasons behind others’ actions: What do they really want? Why did they do what they did? If we think someone did something to us on purpose, of course, we are going to get mad, and possibly even react. But for the most part, people without a brain injury
usually give others’ the benefit of the doubt and assume that others’ actions are not intentionally mean. For example, many people will assume the person who cut in front of you on line did not see you and it was an innocent mistake. As a result, it does not irritate or anger them that much. In contrast, it appears that more people with a brain injury assume others’ actions are intentionally mean. More people with a brain injury are likely to choose option A and feel more irritated or angrier.
What is the potential impact of this type of thinking?
- Socially inappropriate and/or violent behaviors towards others. Someone who thinks this way and gets angry is more likely to respond aggressively (yelling, pushing), especially after a brain injury when it is hard to stop the impulsive desire to do something about it. This behavior would not sit well with others.
- Legal troubles, criminal charges, and/or incarceration. This type of thinking could lead to violent and illegal behaviors.
- Strained relationships and stress among family and friends. Because family members do not see the
situation the way you do (They see Option B versus A), angry and aggressive responses to innocent situations are often unexpected, embarrassing, stressful, and scary. Family members and friends often say it is like having to walk on
eggshells around the person with the brain injury.
- Social isolation. Strained and stressed relationships can often push family and friends away.
- Decreased community participation. Because anger and aggression are not usually accepted or socially appropriate, people with these challenges may have a hard time being an active member of their community. This can also affect your work-related goals. Misinterpretations of your boss’s actions or that of your co-workers or a customer are going to make it a lot harder for you to get a job or keep a job.
Why are People with a Brain Injury More Likely to Think this Way?
First, it is important to note that not everyone with a brain injury thinks this way. People with higher level thinking difficulties, problems interpreting social cues, and those with anxiety are more prone than others to assume others’ actions are intentional or mean. Because these are common problems after brain injury, it makes them more likely to misinterpret others’ behaviors.
- Give people the benefit of the doubt. Most likely you do not have enough information to know for sure why someone did something. This means you cannot assume your interpretation is true. Remember that most of the time people are probably not even aware of how their actions affected you or they did not intend to cause you harm or lead to an unpleasant outcome for you.
- Think about alternatives. Come up with a few innocent reasons to explain the other person’s behavior.
- Perspective taking. Try to think of the situation from the other person’s perspective. If you were in their shoes, what might have prompted you to do what they did? Try to empathize with their situation. If it is hard to imagine, role play and pretend you are the other person.
- Don’t jump to conclusions. If you are not sure why someone did something, consider asking them why (in a nice way) instead of making assumptions.
- Consider counseling. Psychologists and Neuropsychologists specialize in helping you see and think about things differently.
Dawn Neumann, Ph.D., FACRM
Associate Professor and Research Director PM&R, Indiana University School of Medicine and Rehabilitation Hospital of Indiana Director, IU InterFACE Center at RHI (A Human Observation Lab)