Starting or Nourishing Romantic Relationships After Brain Injury


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.


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.

Comments (107)

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.

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