What not to say to someone with brain injury?

Communicating with someone who has sustained a brain injury requires empathy, patience, and an understanding of the often invisible challenges they face. Certain phrases, though sometimes well-intentioned, can be incredibly dismissive, hurtful, and unhelpful.

What Not to Say to Someone with Brain Injury?

When interacting with an individual living with a brain injury, it's essential to be mindful of your words. Phrases that minimize their experience, assume a full recovery, or suggest they should simply "move on" can be particularly damaging.

Phrases That Minimize Their Experience or Assume Full Recovery

One of the most common pitfalls is to assume that someone has fully recovered or that their struggles are no longer valid just because they may look outwardly 'fine.' Brain injuries, particularly traumatic brain injuries (TBIs), can have profound and lasting effects that are not always visible. Therefore, it is crucial to avoid comments that dismiss their ongoing experience or invalidate their current reality.

Here are specific phrases to avoid:

"It doesn't look like there's anything wrong with you." This comment ignores the internal struggles and invisible symptoms such as chronic fatigue, cognitive difficulties (memory, attention, processing speed), and emotional regulation challenges. Someone might appear physically recovered but still battle significant internal obstacles daily.
"But you're better now, aren't you?" This phrase often stems from a lack of understanding that recovery from brain injury is a complex, non-linear process, and many effects can be long-term or permanent. It can make the person feel pressured to pretend they are fine or that their ongoing struggles are not legitimate.
"Move on and stop dwelling on what happened." Telling someone to simply "get over it" or "move on" is highly unhelpful and dismissive of their real and ongoing challenges. It places the burden of emotional recovery solely on them without acknowledging the physical and cognitive barriers they might face, which prevent them from simply "moving on" as if nothing happened.
"Everyone forgets things sometimes." While true, this minimizes the specific and often severe memory deficits a brain injury survivor might face. It can make them feel that their genuine struggles are being trivialized.
"You just need to try harder" or "If you just focused more..." These comments imply a lack of effort or willpower, rather than acknowledging the neurological damage that affects their cognitive abilities.
"At least you're alive" or "It could have been worse." While intended to be positive, these statements can invalidate the person's current pain, grief, and challenges. Surviving a brain injury is a profound experience that comes with its own set of losses and difficulties.

Unsolicited Advice or Comparisons

Avoid offering unsolicited medical or recovery advice, or comparing their journey to others. Every brain injury is unique, and what worked for one person may not apply to another.

"My aunt's neighbor had a brain injury, and she fully recovered after trying [specific therapy/diet]." While well-intentioned, this can create unrealistic expectations and dismiss their individual experience.
"Have you tried [unproven remedy/fad diet]?" Unless you are their medical professional, it's best to refrain from offering specific medical advice.

Why These Phrases Are Harmful

These types of comments are harmful because they:

Invalidate their experience: They make the individual feel misunderstood, unheard, or that their struggles are not real.
Increase isolation: Feeling misunderstood can lead to withdrawal and loneliness.
Create pressure: They can feel pressured to "perform" wellness or hide their difficulties.
Lack empathy: They demonstrate a lack of understanding about the complex and lasting nature of brain injury.

What to Say Instead

Instead of phrases that minimize or dismiss, focus on empathy, patience, and support.

"How are you feeling today?" (Allowing for a genuine answer, even if it's not "great").
"I'm here for you, whatever you need."
"What's one thing I can do to help you right now?"
"I understand that some days are harder than others."
"Take your time." (Especially in situations requiring cognitive effort).
"I can only imagine how challenging this must be."

Understanding the Lingering Effects of Brain Injury

It's crucial to remember that recovery from brain injury is often a lifelong journey. Many individuals experience a range of lasting effects, including:

Cognitive changes: Difficulties with memory, concentration, problem-solving, and executive functions.
Emotional and behavioral changes: Irritability, anxiety, depression, mood swings, impulsivity.
Physical challenges: Fatigue, headaches, dizziness, balance issues, sensory sensitivities.

These "invisible disabilities" are real and can significantly impact daily life, even years after the initial injury. Approaching interactions with patience, respect, and a willingness to learn about their specific challenges will foster a more supportive environment.

Here's a table summarizing common unhelpful comments and more supportive alternatives:

What NOT to Say	Why It's Harmful	What TO Say Instead
"You look fine." / "It doesn't look like there's anything wrong."	Ignores invisible symptoms and invalidates their struggles.	"How are you truly feeling today?" / "I'm here to listen."
"But you're better now, aren't you?"	Assumes full recovery; dismisses ongoing challenges.	"I understand recovery is a journey. How are things for you now?"
"Just move on." / "Get over it."	Disregards the profound and lasting impact of the injury.	"This must be incredibly challenging. How can I support you?"
"Everyone forgets things."	Minimizes severe cognitive deficits specific to brain injury.	"I know memory can be tricky sometimes. What helps you remember?"
"You just need to try harder."	Implies lack of effort rather than neurological difficulty.	"What's feeling particularly challenging right now?"
"It could be worse."	Invalidates their current pain and grief.	"I can only imagine how difficult this must be for you."
"My friend had a TBI and is totally fine now."	Creates unrealistic expectations; dismisses individuality.	"Every recovery is unique. I'm focusing on you."

For more resources and information on supporting individuals with brain injuries, you can visit organizations like the Brain Injury Association of America or Headway – The Brain Injury Association.