Listening may be very taxing and very tiring for a person with a brain injury.

In an undamaged brain, multiple brain areas are already used to:

• understand what is being said
  
• remember subordinate clauses in the storyline
  
• show a non-verbal response at the right time
  
• respond empathetically
  
• suppress one's own judgments or emotions
  
• summarize and ask further questions
  
• understand where a speaker is going with the story
  
• add memory aids to the story
  
• see associations/connections and store them in working memory while listening until they are useful
  
• recognize the speaker's undertone (humor, ambiguity, cynicism, sarcasm, happiness, exuberance, suppressed anger, concern or sadness)

With brain damage, all of this can be more difficult.

The person with brain damage has to put their own emotions and thoughts on hold for a while, but she or he also has to remember the storyline of what you want to say. She or he has to try to understand the explanation, filter what is important to remember and what is not, try to foresee the consequences and try to show empathy at the right time.

When there is background noise, for example, many people can no longer follow a conversation.

Much depends on working memory, social cognition, correct emotion recognition, attention and concentration and on the so-called executive functions, language disorder, taking language literally or not, receptive aphasia, but also on physical circumstances (tired? pain? full bladder? hyperacusis? hearing impaired? overstimulated?) and where in the brain the injury is located.

Incidentally, many people with brain damage (sometimes unconsciously) use a trick that they themselves do more talking than the other person, so that they do not have to listen so intently.

See paragraph on verbosity.

Delay in thinking

In most cases, the speaker's speaking speed is higher than the thinking speed that a person with a brain injury can handle. The thinking speed can increase again in some people over time after the injury, but for important conversations the brain slows down to stay focused on thinking.
Everything requires the brain to switch quickly and multiple brain areas are used at the same time. This will somehow pass by the 'damaged' brain area, causing a delay.

Non-verbal reactions
You can often see from the eyes and the eyebrows of the person with brain injury whether listening is going well or whether the person has dropped of.
You can observe that this person is already busy with another task in the brain or is still thinking about something you just said.
The eyes may wander, blink and squint, frown, become bigger. The eyebrows may frown, be raised to either grasp everything you say or try to hold on to their own thought or try to maintain concentration.

It is also possible that the person is already thinking about the answer.

Verbosity, talking too much

A behavior of talking too much and for too long, using too many words, being too detailed can occur after brain injury.

Some people simply cannot speak in shorter sentences and others have a less good self-assessment and judgment of what is socially appropriate.

It may be a case of:

• a form of self-protection because listening is so stressful. When you are talking yourself, you do not have to listen to the other person. It is a form of having control over a situation where too much is coming at you.
  
• especially when stressed or tired, someone can keep talking. That person can (almost) no longer stop talking and cannot find an end to the story.
  
• talking too much can also be caused by the person trying to create an overview of their own thinking while talking. The person cannot get to the core and essence. He or she elaborates and even deviates from the core message.
• in case of a word finding problem, give the description and then continue talking while searching for the word.
  
• a form of perseveration (go on and on and on). Getting stuck in a thought, emotion or action.
  
• a form of 'Logorrhea'. This is derived from the Ancient Greek words for words and flows. Logorrhea or Logorrhea are concepts from medicine and psychology, when someone, due to a disturbed language comprehension, links all kinds of words and parts of sentences together at a fast pace, with normal intonation, without seeing any connection in them. Excessive talking. This often occurs in people with receptive (or sensory) aphasia. Also called Wernicke's aphasia.
• a form of verbosity, wanting to be extremely detailed, wanting to be precise, using a lot of words.
  
• a form of impaired judgment of what is socially appropriate; when to talk and when to stop or when to listen.

Quote:
"I often fear that I've talked too long, or that I've given too much information with too many details, or that someone got tired of my talking or really didn't want to listen to so much text. I do want to say sorry and hope that people will kindly slow me down."

Problems with numbers

If the working memory for numbers is damaged, it can be difficult for a person to remember numbers that are listed or shown. If a number of more than three digits is named, on average only two are remembered.
This means that as a conversation partner you have to speak slowly if you want to list numbers for someone with a brain injury. For the person with a brain injury, it means that much more has to be noted down.
Nowadays, you often only get digital access through a code via text message or a letter code when logging in with DigID. This can be a huge stumbling block for people with a brain injury to gain access to the digital world.

Disharmonic profile

People may be verbally strong and still have language problems. They may practically 'talk your ear off', but may take language, proverbs literally and think in pictures, which may lead to misunderstandings.
For example, people cannot quickly see the consequences of what is said. Read more on our page about disharmonic profile.

Tips for the speaker

Ask if you should speak more slowly. Limit your words. Do not use subordinate clauses.
Keep the storyline clear. Ask in advance if a short summary is desired afterwards, or if someone wants a written report, or wants keywords written down.
Be unambiguous and clear. Make sure that there is no double meaning or an expectation is created. If necessary, name your emotion, but do not let your conversation partner guess about your suppressed emotions. Sarcasm, cynicism, proverbs or humor are not always understood and can be taken literally.
Observe whether your conversation partner can still follow you, has dropped out or is trying to suppress their own associations.
Realize that someone can respond less empathetically, but is not necessarily less empathetic. It just takes too much of the brain.