While I was riding the exercise bike this morning, I read up on impulse control problems. According to the research, impulse control is managed by the brain’s executive function, is located in the frontal lobe, so when you have an injury there, it can really do a job on your mechanisms for deciding what you will and will not do, which impulses you will and will not follow. I’ve been in a number of accidents where my head was thrown forward really hard, then back again — car accidents, falls during sports games, etc.
Now, the injury you have doesn’t have to be only banging the front of your head against a fixed surface. You can also hit the back of your head against something, and have your brain “bounce” off the back and then slam into the front of your skull, as well. That’s called a “coup contrecoup” (front of head, back of head) injury. It can work both ways – you can get hit on the back of your head and have the brain fly forward. Either way, you have that pudding-like substance that sits in your skull ramming up against the rough inside of the bony case surrounding it. Two injuries for the price of one, which is probably why executive function problems — including impulse control — are so common with head injury.
Anyway, I’ve struggled with impulse control for decades. My first clear recollection of serious impulse control problems was after my TBI when I was eight years old and was hit on the head with a rock. All of a sudden, I noticed myself behaving in ways that were not unlike me. Not everyone is very self-aware when they’re eight years old, but I noticed very clearly that I was behaving in ways that I did not want to. I was an older sibling, and I took my role very seriously, to be a good role model for my siblings. It was a huge focus of my life – I was a very sincere kid, you see. All I wanted, was to be a responsible older sibling, especially since my family lived in an area that was somewhat dangerous, and all of us kids had to look out for each other.
After my TBI, I found myself saying and doing things with (and to) other kids that didn’t seem like me at all. I started teasing them and taunting them, trying to provoke them, being argumentative and aggressive. It was the weirdest thing – like I was watching myself in a bad movie, and I was unable to stop. I remember thinking many times, Why am I doing this? Why am I acting this way? I need to stop… but I can’t.
It was terrible. And I became convinced that there was something terribly wrong with me, that I was a bad person, and I was not to be trusted around others.
So I withdrew. And for most of the rest of my childhood, I stayed in my shell and did my utmost to not interact with other people. After all, I couldn’t be trusted.
Ironically, the thing that got me out of my shell was something pretty bad for me: I started to party when I was in high school. My sophomore year, I got into drinking (and some drugs), and I started hanging out with kids who didn’t give a damn about my grades or my clothes or whatever — so long as I would party with them. And so I did. But I digress…
The bottom line is, my impulse control issues — also, violent temper outbursts when I was a kid (not helped by parents who were combative and liked to bait and provoke me), problems with stealing, intense distractability issues, and problems with just blurting out things that I had no business saying — have wreaked havoc with my life, and they’re still a bit of a problem with me. On any given day, I can follow impulses that take me far from where I intended to go, when I got up in the morning. And then I need to play catch-up, which is exhausting and frustrating and demoralizing.
But at least now I know about it – at least now I’m aware that impulse control is a big issue for me, and I need to take steps to address it. I’m also aware that with my history of head injuries, the chances of me NOT having impulse control issues are a bit slim. So, I try to make the most of it.
First, I try to stay rested. I try to keep up with my sleep. My executive functioning (including impulse control) goes downhill when I’m fatigued, so I try to keep myself relatively rested. If I’m not well-rested (like right now – I had a long weekend, and I missed my afternoon nap yesterday) I can tell a difference in my thinking and my choices. So, I try to stay mindful of being a little bit impaired in the executive functioning area. I have to remember that my brain is tired, and it’s going to be prone to wandering around more than usual, so I have to keep an eye on it — like watching a toddler in a department store.
If I can’t stay rested, I try to stay relaxed. I don’t always keep up with my sleep, so I try to stay loose and relaxed. I make more of an effort to stretch and do my breathing exercises, to keep myself from tensing up. If I have less energy, due to fatigue, it means I need to be more judicious with energy I do have. Being tense just eats up even more of my energy and burns me out — kind of like driving down the highway in 2nd gear. It’s hard on my “vehicle” so I try to consciously relax throughout the course of the day. This helps me to not be as impulsive, because it cuts down on my agitation, which makes me more anxious and prone to just follow some impulse to do such-and-such, to relieve the pressure I’m feeling. Relaxing helps me manage my anxiety and agitation — and it gets my mind off the latest impulsive distraction I’m running off to indulge.
I try to keep things simple. I pick and choose what I’m going to work on, and I try not to overwhelm myself with too many things. When I’m tired, I tend to load up all kinds of chores and tasks on myself to do — for some reason, my brain thinks that’s a good idea to pile more stuff on the list. It’s like there’s a part of me that knows I’m liable to overlook things, so if I throw as much stuff on my plate as possible, something is bound to get done. But the exact opposite happens. When I have so much going on, it overwhelms me, and I have that much more I have to think about, which tires me out even more. Keeping things simple and focusing on one task at a time, rather than 20 of them, helps me keep my sanity.
I use my own distractability to get things done. This is a little piece of brilliance that occurred to me about a year ago. I know I’m impulsive and prone to distraction, and I also know there are sometimes things I have to get done, no matter what. If I’m working on something in one room, I’ll often completely forget about what I need to do in another room, and I’ll be so caught up in doing what I’m doing, that some things won’t get done. So, I create distractions for myself that trigger my impulsive streak, to get me to take action on things that need to get done.
Case in point: Doing the laundry when my spouse was working yesterday. We tend to share this work between us, especially when one is working and we’ve got loads and loads of dirty clothes piling up in the hampers. My spouse will often remind me of things I need to do, so I don’t lose track. But yesterday I had a bunch of things I needed to do for work, and they were out, so I was on my own. The laundry had to get done, but I’m notorious for forgetting to start the washer, or switch the clothes to the dryer when they’re done washing. We’ve had to throw out perfectly good clothing because it soured and was ruined by sitting in a wet pile in the washer for days on end. I really didn’t want that to happen yesterday, so I created distractions for myself to catch my attention and get my action impulse going. To remind myself that I had to bring the clothes downstairs, I put a pair of shoes in the middle of the kitchen floor, where I would have to either walk around them, or put them on and go upstairs to get the clothes (I need to change out of my downstairs slippers, because our stairs are wooden –and very slippery — and the last thing I need is another fall down the stairs). I also put the laundry basket out in plain view where I would see it, so when I went in the kitchen to get something to eat or drink, I’d notice it and then check on the clothes. I also left the light on in the laundry room (we try to keep it turned off) so I could prompt myself to check on the clothes.
Everything worked – I got two loads of laundry washed, dried, folded, and put away — all in one afternoon/evening. It might not sound like that big of a deal, but it’s not the sort of thing I take for granted.
Whenever possible, I try to harness my impulsiveness. It’s a little like engineering my own success, using one of my most glaring weaknesses. I know I’m prone to perseverate and get stuck in a certain thinking/behaving track and not be able to get myself out. I also know that I tend to be quite rigid and set in my ways about how things ‘should’ be done. S0 if I need to remember something or do something important, I create interruptions for myself that not only catch my attention, but also trigger some impulse to DO something. I do things like putting stickie notes on the sliding glass door of the kitchen. They catch my attention because they don’t “belong” there, and I definitely take action to get them out of the way. Having stickie notes on the sliding glass door makes me a little nervous, for some reason, so if I harness that nervousness and my impulsiveness, I can actually get things done, remember to do things, etc. The more important someting is, the more disruptive the interruption I create. Like putting objects where they don’t “belong” — a pair of shoes in the middle of the floor, or a stickie note on the sliding glass door, or an empty bottle of shampoo in the bathroom sink — so I remember I need to do something about them. The more nervous something makes me, the more likely I am to impulsively do something about it, so if something is very important, I’ll use a nervous-making experience to prompt me to action.
Thinking about how I do this, part of me thinks that I’m kind of copping out. I should really be training myself to have improved executive function, think through what I’m doing, be clear on the choices and consequences, and have a more “evolved” approach. But when I’m really busy, and I need to switch gears quickly — go from answering emails for work, to checking the laundry, to bringing up another bottle of water from the basement, to making myself some lunch — I need to switch gears quickly and not over-think my choices. All too often, I get stuck in over-thinking things, and then I get waylaid by the opposite of impulsiveness — a combination of perseveration and rumination and slowed processing speed.
For what it’s worth, this works for me — creating distractions to harness my impulsiveness and get things done, even keep myself on track. It can be a little messy at times, but it works for me. And that’s the important thing.