As recovery progresses, additional issues pertaining
to sexuality may be observed. Although the patient's level of alertness and
responsiveness is generally increased, cognitive difficulties, such as
impairments in memory, orientation, insight, and judgment, continue to be
common. Responsiveness is sometimes characterized by impulsiveness - acting
before thinking through the consequences of behaviors - including the patient's
sexual responsiveness. As a result, normal sexual thoughts and feelings are
not censored or inhibited as in a non-injured person. This extends to remarks
and actions that reflect sexual thoughts and are inappropriate to the immediate
circumstances, such as touching and repeated sexual references.
In some cases, there are medical reasons for changes
in sexual function or behavior following TBI, but, for the most part, the
main problems involve socially inappropriate outward behavior. Thinking is
often quite concrete, and care should be exercised when addressing any matters
with sexual content. For example, never use sarcasm or joke about sexual
matters, because the individual with TBI will likely take your remarks literally.
Remember, as well, that the individual with TBI probably does not appreciate
the social effects of their behaviors on other people. The following guidelines
are therefore suggested:
-
Identify the inappropriate behavior for your family member. For example:
"What you are doing right now is …"
-
Explain why this behavior is not appropriate, emphasizing the effects on
others. For example: "This is not the correct way to behave because …"
-
Provide an alternative behavior to replace the inappropriate one. Fore example:
"What you should do/say instead, is …"
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