Theory of Mind
You may notice that a person with RHD does not seem to be as “connected” to others as they once were. In other words, they don’t seem to be able to take another person’s perspective or point of view in the same way they used to. This is known as “theory of mind” (TOM). Examples of difficulties with TOM include trouble understanding humor or sarcasm, or appearing rude, indifferent, uninterested, or insensitive to another person’s mood, feelings, needs, or ideas. It is important to remember that it is not that they no longer care about others or that they are trying to be selfish or inconsiderate. Rather, the damage to the right side of their brain has caused them to be less able to relate to or understand a situation from another’s point of view. Similar to the strategies for coping with changes in prosody (above), the best approach to managing this is to rely on the person with RHD’s ability to use language. Explain a joke to them or a funny scene on a TV program. Tell them how you feel. Be direct and clear about your perspective. Help them understand the subtleties of interactions that were once obvious to them. These approaches can help ease the challenges with impairments in TOM for both the people with RHD and the people who care for them.
What you can do
A useful approach for managing this difficulty is to be very direct – explicitly state your perspective, emotion, or if you’re joking or being serious. Ask questions when you are not sure how to interpret what they say. Help them to identify how what a person said - the words used - could help interpret what the person meant. These approaches can help ease the challenges with impairments in theory of mind for both the person with RHD and the people who care for them.