Stuck in a Thought Tunnel: Rigidity after Brain Injury

Lined Tunnel. Rigidity after Brain injury

Flickr Image by David Rodriguez Martin

Imagine you can only ever think along one track. No changing tack, and no taking in new information.

Rigidity after Brain Injury is like this.

Others can think you are being deliberately obstructive, annoying or worse.

Not understanding rigidity after brain injury can cause frustration and distress in relationships with family and friends. It can also lead supporters to misunderstand or misread behaviour, and to take things personally.

It is helpful if each cognitive outcome, such as rigidity after Brain Injury, is carefully explained and understood by everyone involved. Seeking to understand as much as possible about rigidity is an important strategy for  supporters to help learn not to take things personally.

 

Flexibility vs Rigidity

For most of us there is some aspect of change during our life we will find difficult.

We might struggle to change familiar routines when events happen such as going to a new school, having a baby, moving to share a house with others.

We might have old habits we find difficult to break such as always travelling the same route to work, a nightly glass of wine.

We have ideas and thoughts they we hold on to long past their time. For me accepting that having a tattoo does not mean my children are gangsters!

We usually manage these changes ….eventually.

 

What is Rigidity after Brain Injury?

 

Bride blinkered by shutters. Rigidity after Brain injury

Flickr Image by Rienk Mebius

Imagine you wear blinkers that prevent you from seeing to either side of you.

This is what rigidity can look like – blinkers keep you following a line without being able to take in other information around you.

The difficulty with rigidity is that it is easily mistaken for more deliberate acts. It may be thought of as stubbornness, being obstructive, being stuck in a rut, or bloody-mindedness.

Inflexibility or Rigidity after brain injury, from any cause, means you are not able to adjust your thoughts or actions in response to changes that happen to you, or in your environment.

Rigidity after brain injury is not deliberate, it is an outcome of the damage to brain cells.

 

What Happens When a Person has Inflexible thinking / Rigidity?

As we have said above, while it might seem as though you are being stubborn, you are actually not able to change your train of thought, ideas or action even when new information is presented.

Most mornings ‘Jim’ would walk down to the local shops and purchase the newspaper, milk and bread for his family. Following a Stroke Jim continued this routine. Now no other circumstance or event could deter him from it. Jim’s wife ‘Sue’ found this difficult when they had other commitments in the morning.

Sometimes a person can become upset, appear confused or unable to cope because something has changed in the environment or daily routines.

Card with word RIGID Rigidity after brain injury

Flickr Image by Josh Clark

The outcome of this may mean a person will continue to do something, or persist with a course of action, even if they see it is not going to work. Even if it is detrimental to themselves or others.

Since a fall resulting in frontal lobe damage ‘Mary’ had limited funds and lived alone. She insisted on purchasing a large property despite advice it would cause her to become bankrupt. Mary could only see that she needed a large home in case family visited.

Rigidity after brain injury often occurs with damage to the frontal lobe of the brain.

 

 

Tips and Suggestions for Rigidity after Brain Injury

Before implementing any strategy remember:

  1. Discuss it with everyone involved, the living with brain injury, their family and support team to decide which might work better. Which are worth a try?
  2. Start with strategies and changes the person is interested in
  3. Do not try to change too much, all at once.
  • Seek information and understanding about rigidity after brain injury. Remember it is not stubbornness, or any other deliberate act, it is damage to the brain.
  • Support development of helpful responses and routines. Useful information and explanation about  assisting development of long term self regulation can be found on  Project Learnnet.
  • Talk about information that is needed to broaden ideas or make a change or decision, explain all the possibilities. Repeat as often as necessary.
  • Keep calm and take care not to become frustrated, remember the behaviour is not deliberate. Carefully explain changes that are going to occur ahead of time, gently and persistently give the information needed.
  • Gently and persistently continue to give the information that needs to be considered in decisions or ideas.
  • Take care of physical and mental well being as much as possible: adequate sleep, appropriate exercise, good nutrition can help build optimal and flexible thinking.
  • It may be better to remove yourself from a situation or change the topic rather than arguing. Carefully explain what you are doing, why you are leaving and that you will come back to the discussion at a later time.
  • When change is necessary:
  • It may help to write down all aspects of the change that is to occur, particularly if there are memory problems.
  • Give a reminder of changes ahead of time, and keep sudden changes to a minimum.
  • Discuss any upcoming changes with reminders of what will change, and what will remain the same.
  • Work together to find ways to make change more acceptable and to develop ways of managing it e.g. having something like a saying or something to do when a change needs to happen. “I may not like change but I will be OK”.

 

More information about rigidity after brain injury, particularly for children and students, can be found at Project Learnet “Flexibility vs Rigidity

 

And Finally

You might get sick of me talking about the amazing resources, people, and paths I find myself exploring in the course of writing these articles. Sorry if you do, but I hope it doesn’t stop!

This week while looking for resources about ‘rigidity’ – I did not find too many. I did come across a blog called ‘Broken Brain – Brilliant Mind’  . The article that lead me to this blog was entitled ‘Rigidity and chaos – mental illness after tbi’

The article raises fascinating discussion about rigidity versus chaos, and mental illness vs brain injury. While the discussion about ‘rigidity’ was not specifically about cognitive damage. The article includes some strategies that may be helpful such as the importance of getting adequate sleep.

I discovered ‘Broken Brain – Brilliant Mind’ provides a very generous supply of some great resources on the site including

I say “very generous” as I now have an inkling into how much time it takes to maintain even a small resource about brain injury, and the ones freely provided on ‘Broken Brain – Brilliant Mind’ must have taken extensive time and effort.

I will finish with a quote from Broken-Brain-Brilliant-Mind which has nothing to do with rigidity but a lot to do with a great strategy for life:

“What a mystery this all is. It’s fun for me to pick something to think about and imagine that I can figure it out, but ultimately, the real reward for me comes from the searching for answers, not the finding.”

 

Thank you everyone, see you next week and please feel free to Comment or send me an email HERE.

I would love to have your Comments about – well everything really!

7 Responses to Stuck in a Thought Tunnel: Rigidity after Brain Injury

  1. Madelaine May 6, 2015 at 10:54 am #

    It is also helpful to engage the person with a brain injury in understanding what they are experiencing with their rigidity. Sometimes just talking about it, or having a voice enables them to feel less absolute and supported. Even with frontal lobe damage a person can change their mind about something or alter their routines – but they may need to do it slower or may need to establish the parameters to feel more in control of the situation. They may remain rigid for a while and then slowly change their mind. Often the harder a family member or caregiver pushes the more resistant the person will be. In some ways rigidity may be a factor of the brain trying to manage the uncertainty and ambiguity of brain injury.

    • Melanie Atkins May 6, 2015 at 12:50 pm #

      Hi Madelaine, Yes this is great. Absolutely agree. With all aspects of living with brain injury it is so important to first discuss with and work alongside the person who has cognitive difficulty.Time and finding the right way is valuable. Also appreciate and wholeheartedly agree with your comment about the possibility of rigidity being a way of coping with all that is happening, I also wonder if the term “lack of insight” can also be a response to all that has occurred. Thankyou so much for this helpful additional information, much appreciated. Regards Melanie

      • Madelaine May 7, 2015 at 1:18 am #

        Lack of insight is a big problem – bigger I think than is referenced. However, even in this people can ‘relearn’ insight – or develop the tools to reflect more successfully. In truth I know a lot of folks without brain injury who lack self-reflection – but they have learned over the years, from childhood (where mistakes were accepted) what works and what doesn’t. The person with a brain injury has to redevelop (or simply develop) a skill that helps them self-observe – including asking ‘am i being rigid?’, ‘why do I feel this way?, am I uncertain about something? do I feel out of control of my situation? what can be done to make me feel more at ease with the changes?. I done a lot of work with organizational change and organizations are also very rigid and resistant to change so similar questions get asked in that set up.

        • Melanie Atkins May 7, 2015 at 1:46 pm #

          Thank you so much for this further information Madelaine I hope you don’t mind but I will also add this to on an earlier post about insight in brain injury.

Trackbacks/Pingbacks

  1. We Take Care Of Our Own. Or Do We? - Changed Lives, New Journeys - June 16, 2014

    […] and his community. Three brain injuries had left him with significant cognitive changes including rigidity and frontal lobe damage and behaviour changes. Sitting with his mum ‘Shirley’ one day, […]

  2. Great post on rigidity | Broken Brain – Brilliant Mind - May 6, 2015

    […] http://www.changedlivesnewjourneys.com/rigidity-after-brain-injury/ […]

  3. Always a “new normal” on the horizon | Broken Brain – Brilliant Mind - July 19, 2015

    […] hike this morning, it occurred to me that one of the things that makes this so difficult, is the rigidity that often comes with TBI. Check out Stuck in a Thought Tunnel: Rigidity after Brain Injury for a great discussion of this. […]