Perseveration After Brain Injury: How to Stop Repetitive Thoughts and Behaviors

When your loved one has a brain injury (TBI), you may notice repetitive thoughts and behaviors. It is important to know what perseveration is to understand what your loved one is experiencing. 

Perseveration is quite common after a brain injury. It is often seen in rehabilitation for brain injury

We all experience perseveration to some degree. We can have thoughts that seem to run through our minds repeatedly, causing anxiety and frustration. 

But these thoughts are appropriate. However, it is uncontrollable and challenging to pivot away from intrusive thoughts in brain injury patients. 

Perseveration is when a brain injury patient continuously repeats words, actions, or thoughts. The cause is due to changes in their brain that affect memory, attention, and cognition. 

You can do many things to support a loved one who experiences perseveation after a brain injury. 


What You Need to Know About Perseveration

If a patient with a TBI is experiencing perseveration, they may be unable to multitask. For example, they are unable to perform tasks and hold a conversation simultaneously.

It is caused by damage to the brain's frontal cortex, the part responsible for awareness and inhibition. When damaged, patients have difficulty stopping an action or switching from one task to another. 

Patients are not aware they have perseveration and cannot control the symptoms. This can be incredibly frustrating for both the patient and loved ones. It can have an incredible impact on the patient's life. 


What are the Different Types of Perseveration?

There are different types of perseveration seen in neuro rehabilitation. The three most common types are: 

  • Stuck-in-set: An uncontrolled or extended maintenance of thought or topic even when there has been a change in conversation or change in task
  • Recurrent Perseveration: An unintentional repetition of behavior. They are completing the same task over and over for no apparent reason. 
  • Continuous Perseveration: Uncontrolled repetition of a feeling, such as continuing to experience anger or frustration longer than appropriate

It is important to note that no two people experience perseveration to the same degree and can experience different types at the same time. 


How is perseveration Managed in Post Acute Rehabilitation?

In post-acute rehabilitation, a neuropsychologist evaluates and develops a comprehensive treatment plan. Occupational therapists help to work on coping skills to assist with perseveration symptoms. Other successful treatment options include: 

  • Cognitive-behavioral therapy
  • Group Therapy
  • Speech Therapy 
  • Medication

Patients may also learn a skill called thought stopping. Professionals use a visual cue or action that stops perseveration as it isis happening. One example is snapping a rubber band on their wrist when they notice they are perseverating. 


How Can You Support Your Loved One?

You can do things to help a loved one who is struggling with perseveration. Help them recognize when they are persevering and remind them to ask for help. Teach them to create a "stuck" signal when they are in the cycle of perseveration. 

It is helpful to give simple and clear instructions, such as helping them with getting dressed. Walk them through putting on socks, pants, their shirt, etc.

Also, consistently offer praise. If they are managing their perseveration, tell them! Reinforce the behavior with positivity. 

Allow some time for perseveration if it is appropriate. If your loved one is obsessing over a certain thought, schedule a time they are allowed to do so, but they have to stop once that time is up. You might want to set an alarm, so they know when it is time to stop. 

If you are struggling with supporting a loved one experiencing perseveration, seek help yourself. It can be very frustrating, and therapy can help you process your feelings. Setting boundaries for yourself and setting aside time for your self-care is essential. 


Getting Help for Your Loved One With a Brain Injury

Neulife is one of the largest brain injury rehabilitation centers located in Florida. Neulife rehab centers are experts in treating TBI patients, including catastrophic rehabilitation, traumatic brain injury rehabilitation, neuro rehab, post-acute rehab and more.

We use a patient-centered approach to help patients manage symptoms and accomplish their rehabilitation goals. 

We not only focus on the needs of our patients but also their families. We assist our patients by providing clinical evaluations, medical care, and therapeutic activities, including those that address perseveration.

The goal is always to develop a customized plan to transition the client back home with those they love. 

If you have any questions or would like to schedule a tour, please get in touch with us – we are looking forward to seeing you!

traumatic brain injury rehabilitation

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.



Dedicated to providing the highest caliber of care to individuals with brain injuries, NeuLife Rehabilitation is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).
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