Not being able to feel or to indicate boundaries

People with brain damage have to explore their world again, have to find a new form of life. They have to recognize their boundaries, guard them and observe them. Sometimes they even have to cross them consciously.

Every brain injury is different. It varies from person to person and where in the brain the injury is located. Add to this the fact that there are billions of connections, then there are also billions of possibilities for differences depending on which connection is broken.

It therefore also requires knowledge of the brain areas to be able to say something about what the person with brain injury should do with boundaries.
It also takes the right timing to talk about boundaries. We will come back to that later.


Left hemisphere vs. right hemisphere

In general, people with left brain damage may be more anxious about crossing boundaries or exploring new boundaries. People with damage to the right hemisphere may be slightly more overconfident. They often do not see the boundary. This may be due to a limited insight into the illness or a limited insight into one's own behavior and problems that arise from this. It remains important to emphasize that every person is different and every injury is different.


Frontal lobe

People with damage to the frontal lobe can be quite limitless, because the frontal lobe is responsible for impulse control, decision-making and managing behavior and emotions. The frontal lobe with reason and ratio develops until about 25 years of age and the assessment of danger is related to this. Young people therefore see less danger and if they have a brain injury they may want to push the boundaries of what is safe and responsible too far.



A completely different form of limitlessness is called perseveration. This also often occurs with frontal lobe injury. It comes from the word persevere, which literally means 'to continue'. In psychology, perseveration means continuing with one and the same word or comment, the same movement or even a certain feeling.
It can be compared to the phenomenon of a song that just won't leave your head. Sometimes that song even continues in your dreams.
Someone who perseveres due to brain damage can experience the same constant discomfort. People experience it as unpleasant.
For the person who is persevering, it is often not possible to stop this behavior, emotion or action, even if there are negative consequences. The person sees no way to stop it.

Read more on the perseveration page.


The midbrain

Injury in the midbrain (mesencephalon) has very different consequences. The midbrain has three circuits that influence each other. The circuits use each other's system. If something changes in one system, something will immediately change in the other.

The circuits are:

"thinking and associating", "motivation", "motor skills".
If something changes in motor skills (exercise more), mood, thinking and motivation may improve and vice versa. This sometimes allows people to push the boundaries.
Not everyone has the opportunity to start exercising again.
People who do not have this will experience the limits of inability closer.



People with brain damage use up their energy much faster than people without brain damage. Brain fatigue, organic fatigue and neurofatigue are some words used for this phenomenon.
On average, it takes five times more energy for each action for someone with a brain injury than a healthy person.
Anyone who was used to working hard and pushing beyond their own physical and mental limits before the injury has a greater chance of exhaustion or burnout. Read more on the neurofatigue page.
The day energy must be consciously planned with sufficient rest before, afterwards and in between. Anyone who ignores these boundaries risks a relapse or exhaustion.


This setback or exhaustion may also be caused by external factors.
Most circumstances are beyond one's control. Unforeseen concerns, a neighbor who starts doing work on his house causing nuisance, illness in the family or admission to hospital, old age that comes with defects, are all examples of where a possible overload lurks.


Excessive questioning of people with brain damage can lead to structural deterioration.
This can result in a NAH burnout. Some call it a NAH burn-up.
Many people burn out before they know they have suffered a brain injury.

Not every brain injury is recognized. These people try to fight back to an earlier level of what they could handle.

Until it turns out that they are burned out. A second opinion may then reveal that there was NAH.



Once you understand your own injury, you still have to explain to those around you, sometimes after years, that the boundaries really need to be respected. Learn to say 'No'. Do this for your own good.


Someone described intelligence as "The ability to say no and make the choice NOT to do something."


Many bystanders become injury-tired. This means that these people have insufficient insight into the chronic phase of brain injury and the fact that years after the injury, the person with brain injury can still encounter things and gain new insights about themselves and what they have to deal with. deal.
Precisely with respect for the boundaries of a person with brain injury, this person could function better.
Conversely... if bystanders have to explain the boundaries to the person with an injury, without this person recognizing the boundaries themselves, this can result in a lot of resistance.
So everything has to do with timing... how many times does someone have to have bumped into boundaries to recognize that there is a new boundary...?!

If there are unforeseen external circumstances that overload the person with brain injury, try to relieve the burden as a loved one where possible. It is not unwillingness but inability. The brain can no longer compensate.