Following a brain injury, dynamics change. The relationship is no longer equal - you are no longer partners in the same sense you were before the injury. Initially it becomes almost like a parent-child relationship where the survivor becomes dependent upon their healthy partner. A new balance must be achieved and the new status must be dealt with if it is to work. Many brain injury survivors cannot accept what they are left with and find it difficult to move on with living. In many cases, they have lost the life they once led and the person they once were. Even if they can't verbalize this realization, they are aware that something is very different.
An international brain injury support organization states that relationship breakdowns run as high as 78%. They are often a result of the survivor's lack of empathy which can place a significant strain on relationships. Also damage can be done over time to the relationship by the survivor's inability to adapt to the brain injury and their resultant deficits.
It is through our brains that we experience ourselves and our environments. It is what makes us who we are. Brain injuries dimish self-awareness which results in an inability to recognize personal changes. Although brain injury strikes an individual, the entire family lives with the impact of the injury.
In order to attempt to alleviate potential problems, it may be necessary to avoid exchanges that may lead to misunderstandings - even a suggestion of doing something other than their way can cause swift mood changes.
As with children, reminders are often necessary. Have you taken your pills is a common reminder for us. Resentment becomes a companion to their anger and frustration when they are seemingly treated like a child. But when memory is an issue, these reminders become a necessary part of living.
Many survivors are self-centered and consumed with their own loss. In their concern for what they have lost, they are unable to realize that the loss is not one-sided. For their partners, even with the knowledge that the behavior is unintentional, the hurt still exists. Although we, as the healthy partner, have been told not to take things personally, it is difficult to remain immune to the hurt.
Are there answers? In general the relationship will depend mostly upon the healthy partner. It is recommended that the healthy partner not disagree with the brain injured person; not challenge or confront him; remain calm; be willing to ignore bad behavior; show support and affection; offer positive reinforcement and to be patient.
However, the relationship is unlikely to be what it was before the brain injury happened. Dreams have changed; new dreams and new strengths must be developed, if possible. The ability of the non-injured partner to cope is of prime importance. Some caregivers find that sharing their feels with others can help them through difficult times. Others use humor to focus on solutions instead of problems. But most importantly, remaining positive will be the best coping strategy of all.
I used to say that it takes two people to work at a relationship; one can't do it alone. This line of thinking cannot exist in such a situation. In most cases, there will only be one person working at it. The success will depend largely upon that partner's willingness to continue to work alone.
