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September 23, 2009 / onthemarkwriting

Frontal Lobes and Impulse Control

Main_brain_lobes_largeA psychiatrist once told me that the frontal lobes in a person’s brain were like the front brakes on a bicycle when it comes to controlling one’s impulses. Yes, it is possible to stop yourself, he told me, but it’s gonna take much more time and determination than if your frontal lobes were fully intact.

The issue of impulse control affects all aspects of our lives–or at least I look back and see where I could have used more impulse control and better judgment at times over the past 20 years. For instance, when hungry, most people eat until they aren’t hungry anymore. Not so with a traumatic brain injury (TBI) survivor. For me, I know that if I liked the taste of something I was eating, I kept eating. And eating. And eating, until I was on the verge of making myself sick.

When it came to control urges, like thirst or sexual, I tended to cross the line where most people would realize the actions were becoming inappropriate. I remember one of my female physical therapists tying my shoe while I was sitting in the wheelchair–unable to walk or talk yet. As she patiently tightened my high-tops, I glimpsed a bit of cleavage. Without a second though, I reached down with my right hand–since I didn’t have good control of my left–and grabbed her breast.

When she objected I removed my hand from her blouse, and she said, “You can only do that with your girlfriend, but don’t tell your mom I said that.” So when “Alicia” and her family talk about how she was not able to control many of her urges, I can relate.

This lack of inhibition caused by acquired brain injury causes many of the people who used to be friends to stay away from the survivor. The sense of isolation caused by the loss of friends causes many survivors to engage in self-destructive behavior like drinking, drug-use, tobacco use, and a variety of other addictions.

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