Challenging and complex behaviours are common if there is damage to parts of the brain that control our impulses and regulate our emotions.
Behaviour that is considered acceptable is set by thousands of unwritten rules. Some examples include:
how close to stand to other people
when it is okay to interrupt another person
when and how to show emotions
how to interpret and respond to nonverbal communication
when and what parts of a person's body may be seen naked.
Behaviour that breaks these rules can lead to social exclusion, restriction of access to community services, family breakdown and in extreme circumstances prison.
What are complex behaviours?
A challenging behaviour is one that we find hard to accept; it literally challenges our ability to understand why it is happening - usually because it is breaking those unwritten social rules. A complex behaviour is one which makes it difficult to initially see the reasons for the behaviour. Examples of challenging & complex behaviours include:
Physical or verbal aggression
Self-injury
Property destruction
Dis-inhibited and impulsive behaviour
Hyper-sexuality
Impulsivity
Aggressive behaviour
Why not just say bad behaviour?
When we use negative and judgemental words our actions tend to follow suit, and the behaviour is likely to only deteriorate in response. Using terms like challenging or complex behaviour acknowledges what is happening and encourages us to be more objective in our thoughts and actions.
What causes challenging behaviours?
Challenging behaviour is often as a result of the parts of our brains involved with our emotions, our ability to control impulses, and our self-awareness and ability to monitor and change our behaviour, not working as well as they should. As we grow and mature toward adulthood, we learn these skills over many years. Many people with challenging behaviour may need to relearn many of these skills, and in some cases may be unable to do so if their self-awareness is affected severely.
What can I do about challenging behaviours?
If you can understand the circumstances that affect behaviour, then you can understand the messages behind each behaviour and develop positive responses. When you understand why a behaviour is occurring, you can respond positively, instead of just reacting negatively.
Ask for support from others such as family members, therapists, psychiatrists and psychologists. Here are some basic tips that can help to reduce the chances of challenging behaviours, or develop positive responses to them:
Provide as much structure and routine as possible
Communication should be clear, direct and frequent
Talk about issues, including the behaviour and what to do about it
Don't be vague - explain which behaviours you like and don't like
Have clear limits and rules - what you expect and what is appropriate
Give the person feedback and information about their behaviour
Be consistent in how you manage behaviour
Be positive - notice and encourage appropriate behaviour frequently
Take into account changes in thinking, understanding or memory
Use strategies that defuse behaviour and help a person calm down - talk it through, change the topic, change the task
Use redirection, distraction, and diversion to shift behaviour
Use humour to defuse things and reduce tension and stress
Get support for yourself and for the person with the brain injury
Don't take challenging behaviours personally
Usually the behaviour is not deliberately targeting you so try to not take it personally if the person is critical, argumentative or angry although this is usually difficult if the behaviour has upset you. Remind yourself that the person's ability to manage their own behaviour is limited and focus on positive responses to the behaviour - this reduces the powerlessness many feel when just reacting to challenging behaviours instead of responding.
Stress management for carers & family members
It is normal to feel upset and angry - where possible stay calm while responding to (or ignoring) the behaviour but talk later with other family members or your support group.
Get support from people around you - talk about ways to manage behaviour and cope better - talk to friends, family, or talk to a counsellor if available. Discuss ideas to make things work better. Take time for regular breaks. You need time out for relaxation, rest and restoring your energy. Keep in touch with your friends and keep up with your own hobbies and interests as much as you can.
Is there a 'cure' for behaviour problems?
There are no easy solutions or fixes for challenging behaviours as they are caused by many complex factors which may not change. However, the good news is that even when a person has very limited self-awareness, family members can often influence behaviours by responding consistently and positively with positive behaviour support.