Starting or Nourishing Romantic Relationships After Brain Injury

Starting and Nourishing Romantic Relationships After Brain Injury
Question: 

Could a person with TBI start and have a healthy romantic relationship? My friend/boyfriend (who has a TBI) can go from bringing me flowers and telling me he loves me to other times thanking me for dinner like I’m just any friend of the family.

Answer: 

The answer to this question is — yes. Following brain injury, individuals can — and do — start and maintain healthy, loving, committed relationships. In fact, in studies investigating the stability of romantic relationships after brain injury, results have shown couples have less of a likelihood of separating than do couples in the general population¹,². However, this answer also comes with an asterisk.

In order for people with a TBI to maintain healthy, loving, romantic relationships, they will need support, encouragement, and understanding from their partner. While this sounds like a recipe for the success of any romantic relationship, there are specific ways in which people with brain injury will need to be supported. There are also commitments the people with brain injury will need to make to themselves, their partner, and the relationship, in order to sustain relational happiness and security over the long term.

The partners of people who has a TBI must first educate themselves about how brain injury impacts an individual. In addition to the frequently cited TBI challenges related to thinking such as memory, attention and concentration, and problem-solving, individuals with brain injury often experience changes in behavioral, social, and emotional functioning. In a relationship, partners often read the emotional and social cues of their partner in order to gauge the stability of the relationship. However, after TBI, some disruption in emotions and challenges with communication are to be expected. People who understand brain injury can learn to interpret changes in their partner’s mood and their partner’s willingness to interact socially in new, more accurate ways. Education can also help partners not to personalize behaviors that may be more related to brain injury than a reaction to or reflection of the relationship.

In addition to building a knowledge base about common symptoms of TBI, partners can learn strategies for new ways to de-escalate an argument, identify early signs of their partner’s stress or anger, and share their own needs for emotional response or connection with their partner. Again, while these may be important skills for any romantic relationship, the way in which a partner de-escalates an argument when their spouse has a TBI will be different from the approach used by couples where brain injury is not a concern. Reading information written for caregivers, attending family member support groups, and meeting with a therapist who has familiarity with brain injury are all solid ways to build an effective skill set.

Of course, maintenance of a healthy relationship always requires the dedication of both partners. People with brain injury can improve the likelihood that their relationship will succeed by attending therapy focused on emotional regulation and compensatory strategy development. Additionally, by focusing on building communication skills, asking for help, and focusing on the positive, survivors can enhance the emotional connection they have with their partner.

Finally, when a couple enters into a relationship after one person has had a brain injury, they may want to consider taking a proactive stance by attending counseling with a couples’ therapist who is familiar with TBI. Both emotional and physical intimacy can be impacted by brain injury. Couples counseling can assist both partners in developing strategies and coping skills that can enhance the intimate connection both individuals feel with one another.

Posted on BrainLine April 12, 2013. Reviewed July 26, 2018.

About the author: Emilie Godwin, PhD

Emilie Godwin, PhD, LPC, MFT is a faculty member and licensed clinician at Virginia Commonwealth University, with a specialty focus on couples and family counseling after brain injury. Currently, she serves as the Family Support Program Coordinator for the VCU TBI Model System projects.

Emilie Godwin

Comments (117)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

My son was born with a developmental disability. At the age of 20 he was in a crash that resulted with a TBI. He is on his 3rd relationship since the accident 3 years ago. His girlfriend manipulates him into spending enormous amounts of money on her ($800/weekend ). He is unable to recognize that she is using him. As the parent of this 22 year old child, what can I do?

I am in a newer relationship with a tbi.... it feels like a daily struggle lately. Because of his injury he gets depressed. ...then he drinks. Of course because of his injury he has no filter or shut off to stop. He claims he's not an alcoholic.... just drinks to numb the hatred for himself. ...I love him. But I have young boys to think about

I am having a hard time finding any information dealing with overprotective relatives "ie" sisters. They meddle into every crevice of our relationship. The are constantly making up and spreading bad rumors about me. They have set my fiance up with an astronomical amount of money. Then accuse me of being with her to take it from her. In reality when I met her I didn't even know she was set up with money I just fell in love with her. They are completely narcissistic in their accusations against me. I have spent every bit of my money to take care of my girl. I love her dearly and want to be hers forever but feel such an impact on my nerves I don't know how to handle these interfering relatives. Does anyone have any advice?

You love them...but how do you keep going?...when you love them and they cause is heartache...

My husband and I have been married for 13 years.  We are now separated.  He sustained a TBI in 1991 and I met him in 2001.  We married in 2002 because we were pregnant, and he really wanted to try and make it work because he said he had never loved anyone as much as he loved me.  During our 13 years, he frequently reminded me that we were in this for our child and that we were working toward our relationship becoming more complete.  This affected me over the years, but I chose to let it go.  At the end we were in counseling, but it was too late, he was no longer in love with me.  For the last 1.5 years, we have been pretty much platonic (a lot because I wasn't into the sexual side of things) which I blame myself for and being on Zoloft didn't help.  When I speak on the phone with him, it's as if he is a stranger.  He is now focused on only himself and doesn't have to answer to anyone and this is how he wants to be.

Great article, I have TBI and am in a relationship. I love everything in my relationship but sometimes it can get hard with my effects. Its hard to control my anger, emotions and thoughts. But its all about having an understanding partner who can try to put their feet in your shoes and realize you aren't the person you act out to be in situations and can't control it sometimes. I love reading the comments of others because it helps me too.

I just got into an argument with a woman I was dating who has a TBI. I knew nothing about TBI before I met her. I wish I had known more about it before we started dating. I've learned that what they are thinking isn't always easy for them to communicate. Be patient with them...it's nearly impossible for me not to try to put myself in her shoes when she's at her worst. The depression of my own life and the emotion I directed towards trying to help her...it wasn't healthy. I'm realizing for me it was more about trying to make her life better trying to make her happy taking on all these feelings that I shouldn't. It's not healthy to think that you're the reason why someone else is happy. My advice to anyone with a TBI or dating someone who has one is to spend the first part of your relationship learning about how a TBI affects someone. Without that I think it's nearly impossible. It's very hard for some of them to communicate what they are actually thinking and that can cause lots of problems. It's going to take me a little while to get over this

As someone with a TBI, i want to say thank you to those that understand and stick by their partners. I also want to apologize on their behalf and my own. We aren't trying to be difficult, and we hate that you suffer with our trauma. But thank you so much for being the support we so desperately need!

I recently started dating a man who was born a "forceps baby" and suffered a skull fracture from the doctor who delivered him. He is a decent man and I very much enjoy being with him, but I definitely want to learn more about his disability so I can be the partner he deserves. He told me about his last relationship which didn't end well. He got severely depressed and was suicidal. I'm definitely concerned that he will have difficulty should we argue or things don't work out. Any suggestions are welcome. Thank you!

I've been in a relationship with my bf for 16 years and last year he suffered a TBI. We were engaged before this and it is difficult. There are days when he is the man I fell in love with and others he is a cruel stranger. I read the comments and feel relief to know I am not alone. We have two kids and they are dealing with the loss of their father as well. He is constantly depressed due to the TBI and physical complications that came with his injury. It is a daily struggle and I have thought many times about walking out and giving up. But I love him so I stick by his side as I vowed to do when I said yes to marrying him. Although I must also say that the comments from people in "long distance" relationships with TBI ppl are appalling. To truly understand the daily struggle, you have to be there. I am with my guy from morning meds at 6am to bedtime meds at 11pm. The only time we are apart is when I go to work. My bf requires 24 care and there are two ppl who provide this...me and his brother. A person with a TBI needs constant contact, support and love daily.

Dating someone with TBI can be hard. My boyfriend's emotions are up and down and each day I'm not sure what sort of mood he will be in. Some days he's really good and he's funny and really shines. Other days it's hard to identify causes but he will be cross and easily frustrated. Feel like I'm continually on egg shells with him. Don't always voice my own opinion as it can often lead to conflict. It's a confusing situation for both of us, but I won't walk away. It's his TBI, not him. I'm hoping as time goes on the angry/frustrated days will become less frequent...

Interesting article and thread. I struggle with a new relationship with someone with a TBI. I feel like I am on an emotional roller coaster having questioned numerous times what is our relationship, friend, boy friend and girlfriend or something else. I too get from time to time a thank you for spending the day with him?? Odd behavior, rigid thinking.

I'm dating someone with TBI and where long distance as well and its been very tough because I feel like I have to watch everything I say without him feeling disrespected which causes a lot of fights . I'm very new to this and in trying to understand but is it normal for them to constantly crave attention ?

I am so glad to have found the comments. I am dating TBI fellow. Not only that, we are on long distance relationship. It is really tough. I feel the same way with all of you. My patience has been tested many times. I hope I can be more understanding after I read this article. And I hope many other people will comment so I can learn from them as well. 

I agree with the previous poster's question "how can I know if the behavior is due to the brain injury or just negative personality traits?" I really struggle with this with my husband. He suffered a TBI 12 years ago at age 15 and I knew about from the first day we met 6 years ago, but I feel like I really didn't know the full extent of it until after we were married. I really do love him and we have 2 children together, but I can't tell if some of his behavior is from the TBI or it's just who he is. I've tried coaching him over the years on proper social norms and encouraged him in different areas, but he is usually resistant. I feel like his short-term memory is getting worse and I am starting to lose my patience.

In terms of the difficulty people with a brain injury can have in fostering romantic relationships and the lack of consideration, how can I know if the behavior is due to the brain injury or just negative personality traits?

This is good advice. Wish I'd adhered to it some hours previously, prior to entertaining/ blindly walking into an argument with my TBI fiance! I've learned so much patience through loving him but sometimes it's just not quite enough. And the debates are always so unreasonable and one sided. The majority of the time I concede and allow him to get his own way (not wanting to upset him). Tonight I'm absolutely at my wits end and I feel so sad and guilty , like I've let him down. Fingers crossed tomorrow will be better

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