Social Communication and TBI

Do you talk better than you communicate?

There is more to communicating than just talking. To actually "communicate" we also must share information with another person. There are things you should do, and things you should not do:

You need to be able to listen to and remember what you hear.

You need to take turns with the other person, and not interrupt.

You need to share the information you have accurately and without rambling.

What you say must be organized and make sense.

Your tone and emotions must fit the situation.

You must "give and take" with the other speaker. Don't make the other person do all the work.

You need to always be aware of how what you are saying is affecting the other person.

Communicating takes skill! It's something that is difficult for everyone. Often, it is made even more difficult by a traumatic brain injury (TBI).

What happens when these skills are not good?

If we combine all the things that we just listed above, they are part of something called "Social Communication." People with TBI can struggle with Social Communication right after their injuries, and for months and even years afterward. These are some of the things that can happen over time when TBI makes Social Communication difficult:

At first, it may just be a lot of work to know what to say and how to interact with others.

Then, some people may just stop trying. They may not want to get involved in conversations.

Others may not want to get involved in conversations with the person who has the TBI.

After awhile, it may be hard to make or keep friends; it may be hard to find a "girlfriend" or a "boyfriend."

It may be hard to keep a job.

Eventually, self-esteem may be affected. The person with the TBI may not feel very good about himself or herself. He or she might have a sense of failure.

As a result, some people may start to feel isolated. This feeling can continue many years after the injury.

Specific Signs and Symptoms

People who have trouble with Social Communication might have some or all of these characteristics:

Their communication is confusing to others.

When they talk, they may give too little or too much information.

They might be disorganized.

They might ramble and repeat themselves.

They might not catch and correct errors they make when talking.

They may not make sense.

They may not stay on the topic.

They may not give the listener enough detail.

What they say may not be interesting.

They may talk or process information too slowly.

The other person may have to ask a lot of questions and do more than his or her share of "the work" to keep the conversation going.

They may give more information than the other person wants to hear.

They may not know how to use "clues" or "hints" from the other person. This includes things like gestures, eye contact, and emotions.

They may not be able to tell if they are making the other person uncomfortable.

They may fail to read the other person's emotions. Is he sad? Is she angry? Is he in a hurry?

They may not know what the other person is driving at; they may not know what the intent is or where the other person is coming from. For example, if someone found out that his best friend had just lost a job, he would talk one way. If he learned that the same friend had won the lottery, he would talk in a different way. And, if he saw a friend at a party he might talk differently than if he saw the same friend in a library.

Re-learning Social Communication

If you, or someone you know, has some of these symptoms after a TBI, there is good news: Social Communication skills can be improved in many people. Training and practice help - especially when the practice is in real-life situations. One good way to work on your Social Communication skills is to join a treatment group of people who are working on the same thing. Groups usually have several people with TBI, and they are usually led by a psychotherapist or speech therapist who is experienced in social communications. But, if there are not any groups near you, you can still practice on your own with a partner, friend, or family members.

Here is what you can do:

Go back and look at these sections of the brochure again:

\ Do you talk better than you communicate?

Signs and Symptoms

Review the different problems and symptoms that are described. Make a list of the ones that you think are problems for you.

Work with a partner, friend, or a family member to get their ideas too. If they listed any different problems, add those to your list also.

Start with the things that are the biggest problems for you or that limit you the most.

Set a goal. Pick one problem that you want to work on. Think about things you can do, when talking, to help this problem.

Tell your partner or family member what your goal is. Ask them to give you feedback about how you are doing. If your goal is to not interrupt others, ask them to let you know when you have interrupted. This should be done in a way that does not embarrass you. For example, they could give you a "secret" signal if you are in public, or they could talk to you privately later on. You may want to have a time each week when you can get feedback on how you are doing with your goal.

Remember that getting feedback on how you are doing can be hard. You may not agree with what the other person is telling you. It may be frustrating. However, becoming aware of your strengths and weaknesses is the first step toward improving your social skills.

Keep practicing your communication skills and goals when you are out in public - when you are shopping, at school, or at a party. If your partner or family member is able to observe you while you are having a conversation with a stranger in the "real-world," check with them afterwards. Ask them for specific and honest feedback. Be sure to ask them about the particular problem area you were trying to focus on.

Some final tips to remember

Keep good eye contact

Get to the point, and stay on the topic

Take turns talking and listening

Remember to ask questions

Be friendly and relaxed

Be aware of body language - yours and the other person's

Practice, practice, practice, and then practice some more. It will almost certainly get easier if you do. Good luck!