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Intimate Relationships

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“She almost died. If she had, my life would have been easier. I would have grieved the loss, and gone back to whatever it was I was doing, somehow better for it all. In time, I would have found another love. … But she didn’t die, though the person who survived is someone else, someone other, who carries within haunting echoes of the lost one who was my wife.” In 1992, Tom Gallant “lost” the wife he knew and loved passionately when they were t-boned at a traffic intersection.

Why do relationships change after a Traumatic Brain Injury (TBI)?
Everyone needs to feel loved. To feel valued. Like Tom and his wife, we all need people to talk and laugh with, spend time with, share ideas, worries, and joys. But friendships and intimate relationships can often change drastically for both people after a TBI. Here are some statements people often share after they or a loved one has sustained a brain injury:

• Our friends don’t call or come by anymore.
• I am lonely all the time.
• I can’t relate to other people.
• Other people don’t want to be around me or my loved one.
• People seem to avoid me.
• Who am I now? How do we all fit together now as a family?
• No one understands me or what I’m going through.
• I feel abandoned, rejected, unworthy, different.

After an injury, family roles can change, sometimes jobs are lost, and finances can become a significant worry. And with all these changes come stresses on relationships. What can you do?

• Talk with people you trust. They may be able to help you figure out solutions to your problems, or talking to them may just make you realize you are not alone.
• Don’t isolate yourself. Friends and family want to help. Let them.
• Create a positive network of help and support. This can include friends and family; it can also include people from a support group who know what you are going through.
• Take care of yourself physically and emotionally. Some fresh air or a walk can often clear your mind and give you a renewed perspective.
• Consider finding a peer mentor. By establishing relationships with others who face similar challenges, you're able to learn about local support systems and the "ins and outs" of dealing with them. More importantly, you can develop a relationship with someone who can empathize with you emotionally.

What about sex?
Talking about sex is tricky for a lot of people, especially for people — and their partners — after a brain injury. There can be a variety of sexual problems associated with TBI including diminished drive, physical impairments, depression, and lack of self worth, among others. A change in roles within a couple can also impact a couple’s intimacy. Once an equal partnership, a couple, after one of the partners sustains a TBI, may feel more like a parent and a child, making intimacy far more challenging for both partners, the caregiver in particular.

If sexual problems don’t resolve themselves, seeking the help of a mental health professional who is familiar with TBI, who specializes in helping people cope with depression, and who is comfortable discussing sexual difficulties can help.

There are also various treatment options to consider:

• Medications for mood
• Medications for sexual dysfunction
• Individual and couples counseling
• Referral for endocrine workup

People with TBI can also be vulnerable to sexual assault.

You are not alone
There are many reasons why relationships are important to all of us. Take some time to think about the positive changes that may come about in your life when you have good relationships. Share your feelings with important people in your life and find ways to tell them how much they mean to you.