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When Words Hurt: Talking to Someone with TBI

Lance Cpl. William Taylor practices the speaker-listener technique during a Prevention Relationship Enhancement Program class where couples learn new communication techniques and ways to keep negativity out of their communication
Lance Cpl. William Taylor practices the speaker-listener technique during a relationship class where couples learn new communication techniques and ways to keep negativity out of their communication. (U.S. Marine Corps photo by Lance Cpl. Raquel Barraza)

Family and friends play an important role in the care and rehabilitation of individuals with traumatic brain injuries. A traumatic brain injury (TBI) is a complex injury with a broad range of symptoms including cognitive, emotional and physical disabilities. Further, the effects vary greatly from person to person. It’s natural for those who love and care for individuals with TBI to be confused and unsure at times of what to say to them or more importantly, what not to say. That’s what makes this article we found on titled, “9 Things Not to Say to Someone with a Brain Injury,” so meaningful.


Here’s an abbreviated look at the author’s suggestions on what not to say:


1. You seem fine to me.

Your loved one may look “all better” because he or she has no visible injuries, but that doesn’t mean they’re not experiencing symptoms of TBI that aren’t so obvious, such as memory and concentration problems, fatigue, insomnia, chronic pain, depression or anxiety.


2. Maybe you’re just not trying hard enough (you’re lazy).

Is your loved one really being lazy? There’s a chance they are suffering from apathy (lack of interest, motivation or emotion), which is a disorder common after a brain injury. If not recognized and treated, apathy can often get in the way of a person’s rehabilitation and recovery.


3. You’re such a grump!

Irritability is one of the most common symptoms of a brain injury.


4. How many times do I have to tell you?

Having to repeat yourself multiple times is frustrating. But, not remembering doesn’t mean they don’t care about what you said or asked them to do. It’s common for individuals to experience some memory problems, even memory loss, after a brain injury.


5. Do you have any idea how much I do for you?

Yes, your loved one is probably aware of how much you do and feels incredibly guilty about it.


6. Your problem is all the medications you take.

Prescription drugs can cause all kinds of side effects that your loved one may be sensitive to. But, if you blame everything on the effects of drugs, you might be encouraging your loved one to stop taking an important drug prematurely and be overlooking a genuine sign of brain injury.


7. Let me do that for you.

Encouraging your loved one to do things on their own will help promote self-esteem, confidence and quality of living.


8. Try to think positively.

Instead of telling your loved one to stop thinking about a certain negative thought, find a task that’s especially enjoyable for them. It will help redirect their negative thinking with more encouraging, positive thoughts.


9. You’re lucky to be alive.

Instead of calling it “luck” because someone with a brain injury may not feel very lucky to be alive, talk about how strong, persistent or heroic he or she is for getting through their ordeal.


Be sure to read the article for more information, and share it with others.


Visit or (specifically for military members) to learn about brain injury symptoms and treatment, rehabilitation, and family issues associated with TBI care and recovery.


Comments (10)

  • mary 07 Mar

    Excellent list, thanks.


    As a “S/P TBI” survivor from an 82mm mortar blast next to me (MFW into shoulder/neck/head/brain) – and years of OT – I find these recommendations simply outstanding! I was very fortunate to have a brain injury team (neuro-surgeon, neurologist, neuro clinical psychologist, neuro OT, neuro PT, neuro nurses, neuro clinical social workers, etc.) who encouraged me constantly – telling me that I can “Do it” That is just takes time, so (to me) be patient and do not ever give up! That “We” are here with and for you. They and their outlook/attitude towards me made all the difference! My (then) wife left me and rest of family did not understand.

  • DCoE Blog Editor 07 Mar

    @Mary, We’re glad you agree. Thanks for your comment!

  • DCoE Blog Editor 07 Mar

    @Jonathan, Glad you had a strong medical team to support your recovery. Thanks for sharing your experience with us!

  • Darlene 07 Mar

    Really good list! I'm a Marine Mom who was the primary caregiver for my son who was blasted out of his Humvee in Afgn. #7 on the list - what I did with him was gave him choices so that he felt he had some control in every situation. For instance - Would you like to do this? or would you like me to call so and so? or go somewhere, or get something? or would you rather do that? His choice. He decides, I only help. It worked for us. #5 Just Be Patient and Loving - Be available so they know they are not alone. After 4 years of healing, my son has thanked his Dad and me for all that we did for him, and told us how much he appreciated us being there for him.
  • DCoE Blog Editor 08 Mar

    @Darlene, Thank you for taking the time to share your feedback. This is great and will certainly be helpful for others. And we extend a big “thank you” to your son and your family for your service to our country.

  • Di' 09 Mar

    These recommendations are really right on. My daughter has been recovering from a TBI since 2009.

    It's really amazing the hurtful things that people say. Most times it's unintentional but sometimes people are looking for the right things to say, or trying to joke about it to help themselves feel more comfortable.

    The most hurtful was by her own dad who called it "dramatic brain injury" OMG I could have died!

    She has NEVER forgotten this comment. This is just not a subject that I think is good to joke about or underestimate. Peace and wellness to all of our fellow TBI survivors.

  • DCoE Blog Editor 11 Mar

    @Di, Thanks for sharing your experience with us.

  • RCR 12 Mar

    Very good article and as a TBI patient, it hurts when there are still those (my ex-spouse) who will constantly remind me or tell other people of my cognitive, emotional and physical disabilities when it is not their business to know about my injuries. Also how she used my TBI to the point I was ridiculed during divorce proceedings and used my TBI in an attempt to obtain full custody. There should be laws to prevent and warn individuals for minimizing you because of your disabilities.

  • DCoE Blog Editor 12 Mar

    @RCR, Education on this subject is so important. Thanks for your comment.

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