Disinhibition: Losing Social Filters after Brain Injury

January 17, 2020

Posted by: Kate O'Brien


It’s not always obvious that someone has a brain injury. While some brain injuries can be physically evident, many are more subtle. Often, only close family and friends will notice the cognitive and behavioural changes in a person.  One such change that is common in those with a subtle brain injury is disinhibition.

What is disinhibition? 

Disinhibition is a loss of control over behaviour, resulting in behaviour that may be considered socially inappropriate.  Another way of describing it is “losing filters”.

We can all think of times when we have done or said something suddenly and without thinking and then wished we could go back in time or take it back.  For most of us, we have a voice in our heads that tells us what is appropriate to do or say.  For a person with a brain injury, this internal filter may not exist.

Disinhibition after brain injury usually occurs where there has been damage to the frontal lobe.  This is the part of the brain that monitors our behaviour and responses.  Damage to this area of the brain can occur regardless of the cause or mechanism of the injury.  This means that people with a range of conditions including head trauma, tumour, stroke, dementia and motor neurone disease can suffer impairment of the frontal lobe.

Impairment of this part of the brain can be diagnosed through the use of simple screening tests, specialist neurological testing and by recognising typical clinical signs.

Disinhibition can present itself in a range of ways, including:

  • Making comments that are hurtful or upsetting to others
  • Divulging secrets that were told in confidence
  • Not following social rules
  • Blurting out the first thing that comes to mind without thinking
  • Divulging personal information too freely
  • Being over-familiar towards others
  • Overreacting or responding aggressively to others
  • Making inappropriate sexual remarks or advances (being disinhibited sexually)
  • Not being able to hide emotions or making tactless remarks
  • Laughing inappropriately

While it can certainly be refreshing to meet someone who just says what they feel, and calls it as they see it – it’s not always easy for family and friends or those who do not understand a person’s injury.  Words can be hurtful and uncensored remarks in particular can be damaging to personal relationships.  It can also be confusing and distressing for the injured person, who may not understand why somebody has taken offence to something they’ve said.

How to manage disinhibition

Headway, The Brain Injury Association have published stories from some of their followers on social media on how disinhibition has affected them following brain injury, together with guidance on how to manage it.  This includes:

  • Surrounding yourself with family and friends who understand your condition.  This can really help when an inappropriate moment strikes.
  • Developing coping strategies. Seeing a specialist (such as a neuropsychologist or cognitive behavioural therapist) who can help you to identify techniques to increase awareness and thought before acting.
  • Simply apologising when any offence has been caused and moving on.  It might be helpful to explain that you have frontal lobe damage or to show your Headway Brain Injury Identity Card to explain your symptoms.

If you are suffering from disinhibition following brain injury and would like further advice or support, you can contact Headway directly by phone on 0808 800 2244 or by email helpline@headway.org.uk.

How a legal claim can help

At Bolt Burdon Kemp, we recognise that a brain injury can affect people in many different ways and to varying degrees.  We have a dedicated team of lawyers who only specialise in legal claims for people who have suffered brain injury.  We assess each client’s needs and seek interim payments whilst the claim is ongoing to cover the costs of these (including treatments and therapies).  If your employment has been affected due to your injury, we can also claim for your lost earnings, providing you with financial security for the future.

Kate O’Brien is a senior solicitor in the Adult Brain Injury team at Bolt Burdon Kemp.  If you feel you may have a claim or are enquiring on behalf of a loved one, contact Kate free of charge and in confidence on 020 7288 4814 or at kateo’brien@boltburdonkemp.co.uk.  Alternatively, complete this form and one of the solicitors in the Adult Brain Injury team will contact you.  Find out more about the Adult Brain Injury team.

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Posted by: Kate O'Brien

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