I love my brother a lot, though he has always been a sarcastic and a bit difficult. Since his concussion 5 years ago due to an accident in a cycling race, those qualities seem to have been amplified to the point of hurtful name calling and instances of anger/rage directed toward me for reasons he hasn't made clear. i have suspicions about incidents in the past that may have been triggers for the anger, but they don't rise to the level of the temper he shows.
It has been very hard for me, talking about it endlessly in therapy and constant circular thoughts about what I should say/do, and then my own anger at him for the things he's said.
I have been patient and non-reactive toward him, and he has generally acted like nothing happened and carries on inviting me to casual social activities that I now have no desire to join him on because of my hurt feelings.
Compounding this is that within our family it's been me whose borne the brunt of his mood and the rest of my family (parents, two sisters) haven't been solicitous or supportive of me despite being aware of these incidents. It's like "every man for himself". The dynamics between the family members on this are complex for me to grasp and basically add up to their own problem.
He doesn't feel his concussion is impacting his behavior. Could it be, 5 years out? Will it ever change? Does anyone have any thoughts of how I can communicate best with him? Or do as my therapist suggests, and don't attempt to resolve this with him, but rather deal with my emotions internally ...
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mrtall
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Hello Mr Tall, I haven't logged in here forever, and your post caught my eye. Just going to say Hello and, although I do not have a TBI myself in my experience you are correct in the way you are going about things. Sadly I don't think your brother is aware of the true impact of his TBI, therefore unless, or until there comes a point where he is able to, you are likely to always have this complex situation. It is not necessarily that he has chosen to ignore or not understand, it is more likely part of the actual injury that makes him unlikely to grasp an understanding of his own behaviour.
All that to say, safeguard yourself without adding to the issues. I would also say that the 'family' part doesnt help you either, and rather adds to the complexity, but again, unless people have a realisation for themself it seems no amount of explaining gets through to them. Been there done that.
As I was re-reading this, I recall that The Stroke Association used to have Factsheets which covered various topics and I am quite sure one addressed Family in the sense of how the brain injured person may have changed in the family setting.
However, this is just one response from one point of view. I am hoping that there is someone out there who can respond from another point of view (I have an Acquired Brain Injury), and that might help you understand a little more of what is possibly going on in your brother's head too. Welcome to the Community though and I would encourage you to read through the posts, as someone will have been down the same route before you. Know what you can take on, and leave what is not for you to take onto yourself.
Dealing with your emotions internally is surely a known recipe for resentment and lasting hurt ? Although anger issues are common after brain injury, it's questionable whether your brother's anger issue results from a concussion 5 years ago. But even if that were the case, it seems he has sufficient awareness to single you out.
If there's no accounting for the acrimony then perhaps it's an escalating personality clash which can only be resolved by in-depth discussion or counselling. But if your brother won't accept there's a problem then maybe your best option is to stay away from him.
That might cause more discord in the short term, but stating clearly that his hostility towards you is too upsetting, so best to keep apart, might be food for thought for him in whether he values your relationship enough to moderate his behaviour towards you.
Uncontrollable anger is a problem for me. I flare up so easily when let down by lack of dexterity, or word-finding when trying to express an idea or describe something. And excess stimulus can cause meltdown! But the anger is only ever directed against myself, not others.
I really hope you'll find a way through this Mrtall. Discord between siblings must have collateral fallout but a pity other family members can't/won't help.
Five years of feeling this way is no way to live now, and I know I will personally never recover coming out of this on going living trauma, reason I have ten foot pole with any mention of counselling (personal opinion, everyone different).
Last night I forced myself to run (treadmill) then did dance to some old skool feel good music like no one watching, found myself laughing at this new approach I'm trying from feeling like poop constantly and reading a new book I discovered.
You will always be there for your brother, you have nothing and no one to prove, look after yourself, you are priority, this approach takes weeks, months to figure out how to go about, I'm just discovering.
An accident in a cycling race could result in quite a nasty 'mild' traumatic brain injury - which is what a concussion actually is (the 'mild' is a bit of a misnomer - just means you weren't going to die basically). My concussion /MTBI was an accident in the home three years ago, and I've still got problems managing fatigue and insomnia, and some difficulties handling conversations, and noisy and busy environments. It's a huge effort handling brain-related fatigue everyday, it's really sinking in for me that this rather arduous balancing act is for life now - not a happy thought.
A constant complaint here is that even our nearest and dearest don't understand what we're coping with. Have you tried finding out what impact your brother's concussion has on him? ( Perhaps just start by finding out what is was really like for him straight after the accident and go from there).
We also talk about 'old me' and 'new me' on here a lot - and grieve for our lost 'old selves'. As his brother you are probably a big reminder of how he could be now, if he hadn't had his brain injury. How hard have you tried to find out what he needs now? My (very loved) sister has certainly said some pretty crass things to me without thinking, over the last couple of years since my injury - which, when you are vulnerable, does hurt a great deal. I think we have quite a drive to be understood intuitively by our siblings, which is possibly harder to achieve as we get older - siblings are the people we've known longer than anyone else after all.
Plus sibling rivalry is also a thing, and seeing your siblings achieving when you are 'on the bench' of a TBI, is also pretty painful. I feel like I've aged about fifteen years in the three since my accident, and of course my sister hasn't. I try to be glad for her that her career is rocketing away, and mine has gone - but you know, that's a pretty hard thing to do.
And still everyone says things like 'well, you look okay' - which is mind-blowingly ghastly to be on the receiving end of.
So y'know, he just might be really angry. It's one way of dealing with very difficult emotions, even if it's not ideal. Plus we can be a little emotionally disinhibited post TBI, which would make it easier to let rip. I don't think my temper is worse, but I live on my own, so it's hard to tell, and I think anger after a BI sometimes depends on which bit of the brain was hurt in the first place..
Has he had any help since his brain injury or was he left by the NHS to just get on with it, like so many of us on here? Did you help him to access treatment options at the time? Or did you think, like so many people ( I'm sure I did before mine) that 'it's just a concussion, it's no big thing - after all, they just go away in their own, don't they? ' Incidentally, how old was he when he had the accident?
It might be worth you talking to the Headway helpline for more info on 0808 800 2244 and possibly both gently seeing if he might want to engage with them also, and on here in this forum too - we know anger is something that happens after a BI.
You may well still need therapy to handle your own issues, but perhaps you might consider helping him to afford some neuropsychology too? You talk about your own anger, so I wonder if anger is a way that your family historically tends to deal with emotion? I'm sure that's a tendency in my own family.
Well done for coming on here anyway. Let us know how you get on - hope you can get to a helpful resolution for both of you.
Thank you for this very thoughtful reply, it was invaluable to hear about things from the perspective of one who has suffered a concussion. Your and other responses to my post have actually been instrumental in helping me feel that it's "not me" and draw some lines between me and my brother's emotions!
Glad it's helped. The other thing post brain injury is that we can lack self awareness, which gets in the way of getting good help and then acting on it.
If you want to gain more understanding of living with a brain injury (and despite the title of the book, not just a stroke) try reading 'Mindfulness and stroke - a personal story of managing brain injury ' by Jody Mardula, and Frances Vaughan - a neuropsychologist who writes clear and easy to read explanations in the second half of the book, on what is essentially Mardula's diary of her strokes, as well as some notes on each section. I found it very useful to read.
thanks! interesting about lacking self awareness, that'll be interesting to ponder. kind of goes along with the "not remembering being angry piece". will check the book out.
Yes self awareness can come back pretty slowly actually - initially I was convinced I was capable of getting back to work in a couple of months.
Interestingly, Frances Vaughan mentions at one point that returning self awareness is often coupled with onset of depression, which makes sense to me as well.
The whole book is useful, but I thought the whole second section by Frances Vaughan was very succinctly written about the different possible impacts of brain injury - and enlightening. I thought it was really useful for families of people with BI.
It's not a mindfulness book per se, by the way, it's just that Jody Mardula was senior at Bangor University in that area when she had her stroke, and she diaried when she used her training to cope with the strange effects of her brain injury caused by her stroke.
I suppose your brother could also have PTSD ? That can cause outbursts of anger as well I believe. Did he ever get proper neuropsychology support after his accident?
I don't know what kind of treatment he got - he's never been one to like being asked questions about himself I guess. as far as PTSD, I could see it - though how would you separate out those effects from the effects of concussion? especially from outside ...
So many people don't get any treatments or help after MTBI, they're just left to manage. I got some decent rehab on my health insurance after my recovery stalled after about 8 months - so had six months or so of great improvement after that until it slowed down - then had a lot of coaching from a neuropsychologist to handle fatigue, and my mental attitude to it all.
Yes, I suppose it's close to impossible to sort out PTSD from the effects of concussion - that's why it's so important to get to neuropsychologists and neuropsychiatrists rather than their non neuro counterparts.
It's a relatively recent discovery that soldiers suffer a particular pattern of brain damage from being in the vicinity of blasts for example, when in the past it was always variously attributed first to shell shock and then to PTSD. But of course there's nothing to stop both being present.
Do you think he would be able to ask his GP for support?
I don't know if he would or not. I don't know exactly how he perceives his own condition. I once asked him if he was still affected and he was dismissive - but used the phrase "I'm as good as I'm going to get" which seemed to suggest he believes he's still somewhat impacted but maybe pessimistic about the hopefulness of future treatment - or he believes it's not necessary. I do wish I could talk about it more freely with the rest of my family.
Yes, must be hard, families can be very good about ignoring mental health related outbursts in family members, I know how that goes. It's the old 'elephant in the room' thing, isn't it? I think the stigma around mental health is very unhelpful, but very real unfortunately.
Is it a thing in all areas of his life or does he just do it where he is 'safe' to do so? It may just be you're his safest person unfortunately. It is very difficult walking on tenterhooks around someone though.
Though to be fair 'somewhat impacted' doesn't really get near the hassles of handling fatigue and everything else that comes along with the aftermath of a brain injury.
Hope you find the book interesting.
Perhaps try a new post on here asking how people here wish their siblings would behave and what bugs them most. It seems very easy to get cut off from our families and friends.
I think he's always been a bit temperamental ... with everyone. I think you're right though, he probably does feel safe with me. he's had outbursts at other family members and one even stopped speaking to him for a few years ... but I'm currently the only sore thumb. thanks for your advice about the second posting, I'll give it some thought.
Mr Tall, I will look at this issue, and may even completely move away from the brain injury.
Family dynamics can be maladjusted. You talk about your brother, but you also mention that other members of the family unit appear to be almost complicit in how your brother acts.
Now, is it a case of you are loosing the plot, or is it that the rest of the world is mad? You are the only one that can judge the answer. If it is your problem, then continuing therapy may be of value, but if you consider that that your relationship with you brother and other family is destructive towards you, then distancing yourself may be uncomfortable, but for your own long term peace of mind, then that maybe the best case scenario.
Yes, I have a brain injury, but prior to this, many years ago I had to make a very similar choice. There is regret of missing much of the happy events, but I couldn't know until after, how things would play out. There are less pleasant events that I couldn't avoid, that I ended up having to stick my head above the parapet because I know others didn't have the strength or the knowledge to handle.
It is only time that has fallen, that other family have realised that I was actually the only one that was looking out for everyone, and juggling everyone else's weaknesses.
Time can be a great leveller, but every family is different, and I can't tell you how, or what is best to do.
Subsequent to my brain injury, family has, almost to distraction, made more of an effort. They still have little insight to many of their flaws, but instead of dismissing me, they have started to acknowledge me as the elder of the family, which is strange, because I am the youngest of my generation.
It has taken many years of holding others pain, it has taken many missed occasions.
You can't choose your family, but they are blood, and yes it can take a long time for the dynamics to shift. You cannot sacrifice your own sanity though, because, when needed, you won't be in a fit state to be there when it counts.
Ok, let's bring it back to your brother. Yes concussion can be more of a brain injury than we would first think. It can cause behaviour to be disinhibited, how someone acts and can compound less desirable behaviours where there is little insight. Does it need to be tolerated? No, boundaries need to be set. Maybe ultimatums. These need to be clear, and acted on to try to modify how someone may act. There is no point being the proverbial punch bag just for the sake of maintaining the status quo.
Do I know the right answers, in relation to you, your family, and your brother? No.
Yes, this type of thing can still happen 5 years out and beyond. He may not be aware of have accepted it yet. So times this is because of the where the injury is and sometimes because people haven't done any programs where things have been explained fo them. Doing a program in a group can be good because it is easier to see in someone else than yourself, and also you build trust with others and if they say 'hey up! Do you know you do this?' The person likely will find it easier to see.
I have an ABI and sometimes run into people who have one, were treated for some sort of event or condition, but no medical person used the 'brain injury' term, so they think they don't have one. This is really sad as people can get really down and down on themselves. Acceptance only comes after awareness and it takes a long time.
Even if he won't seek help, or even if he is, check out some of the info for friends and family. Find a local group where they might be able to talk to you and give community references, or find one online.
I know I am not that easy to live with as I get irritable when overtired or my brain has had enough, I can not divide my attention and can only do one thing at a time - so for instance I can not talk to someone while looking for my car keys. I can say when I am irritated I am irritated and it has zero to do with the person who is around me... inside it feels something similar to a reaction to something like nails in a blackboard. In my family it helped some when they understood it was not them I was upset with. (They still don't like it and I still try to find ways to manage - in my case a tricky complication is someone in my family actually likes to provoke fights and wants to argue and so will try to trigger me to have a reason for a fight, and they are persistent.)
I don't think it is fair for you to bear the brunt of it. I also question why your therapist says not to say anything. How abi literate are they? I know some people just assume all people with brain injury are ragers and will get physical - this is far from true, but it may be true with your brother. (I know people in the community who report being completely unable to back down from anything they perceive as a challenge, to the point of getting physical. )
Is it possible for you to talk to his doctor? I know they can't discuss his case with you without permission. Maybe he would give it? Even if he doesn't give it, you could perhaps describe his behaviour to his doc so the doc is aware.
My concern for you, MrTall, is your need to look after your own mental health and peace of mind. You get full points for continuing to be around him, because a lot of people will just leave. On the other hand, you have to balance being around him with your own health and well being.
The other thing you may watch for is if it is worse when he has had any alcohol at all. Even a very small amount can trigger some (and they have no memory after).
If you can identify things about certain situations where he is worse, you may wish to avoid those.
It is also not uncommon for people to want to totally pretend they do not have an brain injury because they can not face the loss of identity, or because they think it means they are insane and they can not face that either. (I have met a few people who spent years being treated as if the brain injury was a mental health issue.)
I am starting to go all over the place, so I will stop.
The last thing I will say is something a nurse told me: "does this feel right? Yes, then keep going? Does this feel right? Keep asking yourself. When the answer is this does not feel right, look for another way to deal with it - may may another therapist or health care provider." It is up to you of course but it sounds like the direction you are getting from your therapist are not leading to any internal peace for you.
It is not easy.
(You may also want to check out EMDR which is a very effective way of removing triggers from traumatic events - can be small t trauma like the situation with your brother, it does not have to be big T Trauma as in events first responders and soldiers face. I have done some and it makes the event seem more like something you read about in a book - the emotional upset part is no longer there. There is one style where they use little paddles tou hold in your hands and one where you watch a finger move - I suggest the paddle based one.)
thank you so much for this i really feel heard and your thoughts and advice are very welcome. Yours and the other comments really helped me get through a week's close-quarters vacation with my brother, thankfully we were in separate cabins. I really tend to blame myself for his anger and these comments have helped me view whats happening as less about me. and also shut down the thinking a little of "what can i do or say to fix this conflict" vs more toward "let's figure out his triggers and avoid them, minimize contact and be civil for the rest of the family's sake". I think bringing up emotions and issues is a trigger area so dispense with that!
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5 and half years later
Can anyone who has had a TBI resulting in amnesia, explain to me how your memory came back?
Anger issues
Can you help me out? 
