Fatigue from Conversation – A Pronounced Problem after TBI

Fatigue from Conversation –  Post-Concussional Challenge

By Gordon Johnson

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Fatigue from Conversation is another major factor in understanding post-concussional deficits. Another area where fatigue comes on quickly is in crowded rooms, particularly in noisy environments where attention must be focused on multiple other people’s conversation. Just adding noise to the equation, makes the brain concentrated harder. Adding multiple speakers, means the brain not only has more to remember, but that it is going to have to focus more to keep straight who said what.

When we think about conversation, it is important to realize that keeping track of conversation requires a great deal of mental flexibility. This is increasingly true the more people who are participating in a conversation.  Obviously none of us listens to more than one person at a time speaking very well.  When three or four people are participating and mostly waiting their turns, that isn’t a challenging thing to keep up with. But while it is challenging, it is second nature to us.

But when you’re having difficulty with your attention, you start to get behind. You get behind in not only hearing and recording the words, but keeping track of who has said the what.  It also becomes harder to keep up if there are other things going on while you try to remember.

One of the phenomenon that I’ve noticed in my practice which I have not seen commented on by other writers about brain injury is that most of my clients and most of the people that we talk to on the phone giving general brain injury advice to are much better at concentrating in a conversation on a telephone than they are in person and I relate that to multiple attending demands.

When you’re on a telephone conversation and you have a clear connection the only thing you have to focus on is the voice that you’re hearing in your ear. You are only hearing a voice and a sound coming from one direction and one place. There are no visual phenomenon to have to record as well.  You don’t have to worry about body language, you don’t get distracted by how the person looks and you don’t get distracted how they smell.  It is only the voice that you hear. A face to face conversation, even with just one person, you now see that person.  You see the expressions on that person, you may notice when they I are not paying attention to you.  All of these things can become distracting.

When your brain is keeping up with its attentional demands those things are like our vestibular system running in the background and don’t require very much of our concentration.  But when we get behind or when we get anxious, or when we start worrying about our well being and the relation to the well being of our relationships, those things can be very distracting and can take large portions of the brain in order to attend.

The place where the fatigue first shows up is in memory.  When the brain gets behind, it only records part of the sensory input that a non-injured brain might.  Memory is the thing that gets blamed, but more often it is the attentional resources that are the culprit.

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Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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