Ask Kathy M. Archives
A Collection of Questions and Answers from TBI Advice Expert - Kathy Moeller

Topic: Social-Emotional - Emotional Control


Dear Kathy M.,

How come I get so angry all the time? My rehab. counselor tells me I suffer from "dyscontrol"? My brain injury was a year ago. What does this mean and what can I do about it? When I get angry I usually do things I regret later.


Kathy's Response:

Dear Jamie,

As far as I know, "dyscontrol" refers to a condition where a person has difficulty controlling their actions when they feel certain things. If you get angry, maybe you say something hurful or "inappropriate." If you feel "sexy" maybe you act out in a way you would not have prior to the injury. Other things too. It is a common problem following a brain injury.

When I was in brain injury rehab., a therapist explained it this way: "The normal brain has a natural "gatekeeper" that stops us from acting out in a way that has negative consequences. For example, when we get upset with a boss or a family member, instead of saying something hurtful, we would normally stop ourselves and do something that will have a more positive effect (than using hurtful language or throwing something). After a brain injury, the "gatekeeper" may not work terribly well, and we may impulsively say or do something we regret."

This explanation worked well. However, the important next question is, "What can I do to stop myself from doing or saying something with likely negative consequences, if indeed my 'gatekeeper' is busted?"

There are good strategies for dealing with a busted gatekeeper. The first step is awareness (some people call this "insight"). That is, knowing that our reactions feel very intense, but acting on the feelings impulsively, may not be in our best interests. This means we don't need to be short or abusive with salespeople in the grocery store. It means we don't have to flee a job, saying, "I quit" just because we're upset. And it means we don't have to swear just because a swear word is at the tip of our tongue!

We can consciously take a break from the situation and decide what we really want to do -- decide what action will have a better consequence than acting out how we feel at the moment.

Here are some strategies I use when I feel angry:

  1. Take a break from the situation to take time to think over alternatives for taking action
  2. Write in my Journal, until I feel I can deal with the situation
  3. If I'm angry with a person, write out a script for what I want to say and think about it
  4. Read the "Serenity Prayer": God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference (emphasis on the word "wisdom")
  5. Take a walk
  6. Listen to my relaxation tape
  7. Count to "10" before saying anything
  8. Call my counselor

There are others. I keep all of these written on a page called, "Strategies for feeling ANGRY" in a section of my planner (I used a "BRAIN BOOK"), called "UPSET." I turn to my UPSET section whenevery I'm feeling anything upsetting (frustrated, angy, confused, overwhelmed, whatever), and I have specific strategies for each upsetting feelings -- all are on separate pages. Heck, sometimes I distract myself by looking for the right page and I practically forget about what I was upset about (which can sometimes be a good thing). Looking over my strategies for a particular feeling (if I don't happen to forget about it), helps me take the time I need to work through the feeling, and that's a good thing too.

Hope this helps.

Kathy M.

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