takinxanax,

First, I hope you are not using xanax to help you deal with this struggle. But I digress.

On the communication struggle, he may struggle to process too many concepts in a sentence. This can be immediate memory related. It is better to ask questions with a single issue. For example, Can you go to the store and get me some flour and baking powder? This has three concepts. Instead, Can you go to the store for me ? he replies "yes" You follow up, I have a list of things for you to get. You give him a written list.

If he has to make too many decisions to answer the question or complete the task, he may overload and freeze up.

His lack of empathy is called 'flat affect.' It is not uncommon. It takes work to learn to express emotion when it does not flow naturally. The laughing at inappropriate times is called emotional lability. That part of the brain gets its wires crossed. I bet this happens most during stressful situations. It is very easy for the PCS brain to get its wires crossed during stressful situations.

His ability to work is due to it being an 'over-learned skill.' It has been memorized into so many different locations in the brain that he has access to those memories even without having to think. This is like a well trodden path through the woods. The ground has been so compacted for so many years that nothing grows there to hide the trail.

An example: I moved to Idaho in July 2000 and suffered my life changing concussion in Jan 2001. I had already memorized all of the main streets in 2 counties and was quite able to find my way about town by January 2001.

After the concussion, I lost all that memory. It was not amnesia. I just could not remember the order and placement of the streets. I could fly back to San Jose for work and know the streets there like the back of my hand. I still can. San Jose streets were an over-learned skill. The Idaho streets were not learned well enough.

He can still over-learn things but it will take repetition upon repetition.

He may have a verbal processing dysfunction. I have a verbal processing dysfunction. I can usually understand complex words but I can rarely recall them to use them as I speak. But, if someone is speaking in very complex sentences, I get lost very easily. So, it will be important to understand how his mind works so you can communicate in ways he will understand.

A family counselor taught us a simple skill. One person makes a comment and the listener has to repeat back what they heard. If you can get him to work with you on this, you may be able to learn how to better communicate. Most of the burden will likely fall on you since you have more adaptive skills. His adaptive skills are likely very limited.

btw, Congratulations on being married for 20 years, especially to someone with his history. I know what my wife and kids put up with before we understood what was going on in my brain. My injuries date back to childhood (1965) with many head injuries since then causing further struggles.

Please tell us more but help us by putting a double paragraph space every 5 lines. Some of us struggle to follow to the next line in long paragraphs.

So, I assume you two are in your late 40's or 50's. There are changes to an injured brain that start to manifest in the 40's. Think of it as menopause for the brain. Prior struggles tend to get magnified.

There are plenty of other symptoms you likely have not told us about. This is normal. Between the members here, we have seen it all.

My best to you.