The Rage...Am I Safe?
- Luke Bohnenberger
- Dec 5, 2025
- 3 min read
Caregivers rarely talk about the moment when anger after a brain injury no longer feels like frustration, but more like like rage. The moment a raised voice isn’t just loud it feels unpredictable. The moment you find yourself asking a question you never imagined having to ask about someone you love...
“Am I safe?”
Aggression after traumatic brain injury is not uncommon. In one study of first-time TBI survivors 28.4% displayed aggression within the first three months, most often verbal outbursts and emotional volatility. Longer-term research shows that 50–60% of people with moderate to severe TBI experience persistent behavioral dysregulation, which may include irritability, aggression or disinhibition years after the initial injury. This means if you are seeing anger or aggression, you are not alone and the presence of rage does not mean the person you care for is choosing it. It may be part of the brain injury itself.
When Anger Stops Making Sense
To the caregiver, the anger often feels “out of nowhere.” The reaction doesn’t match the moment. A simple question becomes a confrontation, a small change becomes a threat, or silence becomes tension. As a brain injury survivor, I felt this a lot and as a brain injury coach I have witnessed this.
From a neurological perspective this disconnect has a cause. Injury to the prefrontal cortex weakens impulse control and emotional regulation, while regions like the amygdala may remain hyper-sensitive and reactive. The brain shifts into survival mode quicker, louder and more intensely and here is the part that’s hardest to understand when you’re on the receiving end:
The brain’s survival system cares more about protection than connection.
Happiness is optional. Safety is not, so the brain reacts even if the threat isn’t real.
When Awareness Is Missing
Many caregivers have asked me, “How do I help them if they don’t believe it’s happening?” and the answer is complicated, because insight is a brain function too. The part of the brain required to recognize the problem may be the part impacted by the injury. That isn’t denial, it’s damage.
Trying to reason with someone in fight-or-flight is like trying to have a thoughtful conversation with a smoke alarm, logic isn’t available during alarm mode. So here is two important things to consider.
Calm must come first. Reflection comes later.
Safety...for both of you
Caregivers often hesitate to talk about their own safety physically, emotionally and psychologically, but your safety matters. Creating distance during escalation is not weakness, it’s the right move. Setting boundaries is not abandonment, it’s protection and most importantly asking for help is not break of love, it’s necessary.
The nervous system cannot learn calm in chaos. Small, intentional practices like breathwork, routines, grounding, exercise, journaling all help rebuild self-regulation over time. Neuroplasticity means there is always potential for growth, even years after injury. This is not my opinion, these are facts. It is vital to understand that you cannot be the only tool, the only outlet, the only emotional shield.
To the One Who Loves a Survivor with Rage
If fear and love coexist in the same room for you, your feelings are valid.
If you are grieving the person before the injury, you are not doing anything wrong.
If you feel guilty setting boundaries remind yourself: boundaries protect connection, they don’t destroy it.
Anger after brain injury is not simply “attitude” or “personality.” It can be the brain doing what it believes it must do, even when it’s wrong. Please remember this...
There is hope.
There is help.
There is a path forward, not always fast, rarely easy but real and you deserve to walk that path safely.
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