– Insight & Awareness

An extremely important area of cognition, again associated with the frontal lobes, is awareness of self and others. After brain injury, many individuals are unaware of the effect their words and actions may have on others and so do not see the need to amend their behaviour.

There is also a lack of insight regarding difficulties. The type and degree of insight varies from person to person as time passes post-injury. For example, some people may have a good understanding of their physical problems but limited understanding of their cognitive deficits. Similarly, some are able to describe their difficulties but are unable to understand how these affect their everyday functioning.

Many people with a brain injury have a tacit understanding that they are not the people they used to be. They experience difficulties at work and in social situations but may have minimal insight into their own contribution to these, perhaps tending to blame external factors.

Lack of insight can cause problems for the family if the ABI survivor insists on trying to do things that they are now unable to do and which could prove potentially dangerous. It is, of course, important to remain aware of such situations, for example, driving or working with potentially dangerous machinery.

Again, the rehabilitation team will be able to advise on safety issues. It is also difficult in a rehabilitation context because someone lacking insight will not take onboard compensatory strategies that would help them function more efficiently. Insight usually develops over time but some people may never fully regain their awareness of self and others and may, as a result, continue to misread social and professional situations, displaying poor interpersonal and social skills.