Reclaiming Intimacy After Brain Injury

Reclaiming Intimacy After Brain Injury

It was one of those quiet moments just before we both drifted off to sleep. The kind of quiet talk that almost never leaves the bedroom.

“No one ever seems to write about challenges with intimacy after a brain injury,” I said, sleepily.

“Then do it,” said Sarah. Her voice had a degree of conviction that almost kept me awake.


Talking about love, sex, and intimacy can be like unraveling a tangled web, even to those without a brain injury. Add a brain injury to the mix and these difficult to discuss subjects can look insurmountable.

Prior to my traumatic brain injury, Sarah and I were equals in every sense of the word. In fact, those who knew us before my brain injury often called us one of the most happily married couples they had met.

One of my fondest memories of life “before” was a question we used to get four, five, six or more times a year: “Are you two newlyweds?” Sarah and I have long been fond of living an immersive, present life. We have always loved to travel. And before my brain injury, we had more than a decade of walking through our days, hand in hand like newlyweds, experiencing so much that the world has to offer.

Always holding hands — her hand fits most perfectly inside mine — we apparently have the look of a couple of people who really like each other. So, up would come that question again: “Are you two newlyweds?” We’d walk into someplace small, quaint, and intimate. It might be asked at the Pink Pig Café in Sedona, or perhaps that little coffee shop on the edge of Moab, Utah, just outside of Arches National Park. I’ve lost count of how many times in 15 years that a random stranger pops us that question.

Such is the outward manifestation of the love we share inwardly. We are blessed to have found each other. Even more blessed to know what we have.

I share this so you can get a bit of a real-feel for who we were before my brain injury.

Professionally, I was a web developer and a blossoming writer. Sarah has a career in telecommunications. We were two successful, very independent people who found great joy in just being us.

You already know what’s coming next.

Then “it” happened. The driver who broad-sided me while I was cycling was only a child of 16.

And our life — all that we knew, all that was familiar, all that was intimate — was torn from us in two ticks of a clock in a mangled wreck of steel and broken glass.

A large part of the David that Sarah knew, the David that Sarah fell in love with and married, a large part of who “he” was and who was one half of “us” no longer existed.

From an equal, I became her ward. I was under her guardianship. And for a time, our status as equals was gone.

Relationships without a brain injury are complex enough. Add a brain injury to the mix and most everything is unpredictable.

Intimacy is most natural when two people love each other, body, mind, and soul.

Many years ago, I heard sex defined as “an outward manifestation of inner love.” It’s a definition I have come to love.

But brain injury is an intimacy game changer. The first dynamic affected comes from changing roles. During that first year, I became dependent on Sarah for so much. She became my caregiver, making sure that I took care of myself, ate, rested, and set limits based on my new disability. The list goes on.

To be able to simply jump into our old roles as equals after the lights went out was simply not possible. As many people with brain injury know all too well, mental exhaustion leads to physical weariness, which in turn leads to instant sleep when head hits pillow. Hardly a recipe for intimacy.

Add the complexity of changed relationships, and it’s easy to see why many marriages don’t survive the pressures of a brain injury.

At one point, Sarah said, “If we didn’t have as many years together as we did, we probably would not have made it.” At the time, it felt like a bomb dropping.

But made it we did. Thankfully, the hardest times are behind us.

Everything about me has changed. Yes, I look the same; I know you understand that. But under the hood, everything is quite different. I react more openly to life. I laugh more than I ever have. I cry at just about anything. I am a different husband, partner, lover, and hand-holder than I was before.

But, I know, too, that at the core of me, deep inside, I am still, and always will be, David.  Thankfully, Sarah sees and understands this, often even more perceptively than I do myself. She has the ability to see through my brain injury and see the person with whom she originally fell in love.

Life today is similar, but also significantly different.

We still hold hands most everywhere we go. Not because of some sense of obligation. Rather, it’s because we feel close with even a small bit of physical contact.

And those who know us as a couple, who really know us, know that it’s not been easy. But they see that love covers a lot of ground. And they see the look we have in our eyes as we gaze at each other.

Slowly, we are rebuilding a new “us” on the same foundation that worked the first time: mutual respect and a deep love for each other. We have found that open, sometimes raw, occasionally awkward conversations about love, sex, and intimacy are critical in helping us come to understand, embrace, and live in the “new normal” of our relationship.

Nothing beats the realization that you can get through just about anything with your best friend by your side. And at night, when all is quiet … well, we’ll just leave it at that. 

Comments (17)

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.

So understand this situation as I had a brain illness, not expected to live but am still improving 2.5 years later.

The article was interesting but not helpful. My husband has a TBI and we are struggling through the on going changes in personality. He looks like the man I feel in love with , but he is no longer that person. Once in awhile I get a glimpse of my husband, but normally I don’t know who he is or what new charges will happen. Sex has changed a lot. Gone is the man who gave before receiving. The love I used to feel now feels empty . His very being has shifted in such a way that he no longer “feels” like my husband and being an empath this is really hard for me . I was looking for something on the changes that others have or are going through with intimacy as well. His article was more about their love that has got them through.

I am going through this with my Fiance and I'm desperate to read about other couples who have struggled through this. I'm looking for hope I guess. I dont want to fall into that statistic of people who dont make it through this but we don't have many years behind us. We were just starting our family, with a baby at home and a new one on it's way. I'm terrified that we wont be strong enough to get through this. I'm devastated with the change in affection and intimacy. Could this come back in a month or a few or will it likely take years or is this a permanent change?


although you say you share  your most deepest issues post TBI I find you have not mentioned this most likely issue with sex and intimacy post TBI ie. Does the sexually equipment still function.  Mine doesn't and I too came off my push bike and have never been the same since.

how was it for you? are fortunate to have the love of your life...Three Months and Four Days before my accident in April of 2010 I lost the love of mine after 25 years of togetherness. Four plus years later being Windowed with a new brain is unexplainable to those who have no idea of what brain trauma really encapsulates. Love your blog sir.
David, Thank you for the article. I find it very helpful. I can appreciate the comment about the sexual equipment not working because mine is half numb and while it works adequately, it does not work as well as it did. My crash occurred 4/6/11 and left me with a body that was almost but not quite completely numb and no memory at all. Rehabilitation began with teaching me to speak again and walk again. I could barely think at all. Three and a half years later I have slowly recovered to the point where I am still half numb, am just beginning to feel my emotions and starting to understand that some things are too dangerous to do because thy will result in injury or death. Your story is inspiring. Many thanks, Bruce
I had a Traumatic Brain injury in '07. My Husband (ex now unfortunately) and I had a healthy and active sex life together. As many others know whom experienced a TBI, it can effect the 'sexual portion/part' of ones brain. Well while I was in the hospital, my husband began cheating on me with a woman whom I'm well aware of who she is. She was a Classmate of ours in High School! I believe that part of the reason for him cheating and throwing me out of our house was because he wasn't getting the intimacy as much as he was before my TBI. Even though he began cheating on me while I was literally fighting for my life in the hospital. He was/ is a very 'sexual' person, and instead of being there for me, he found his 'sexual needs/ wants' fulfilled by another woman. I can not help that I no longer have the sexual feelings/ desires that I once had. That portion of my head/ Brain was effected in my bleed. I wish people would truly understand how a TBI effects one life, and would be more understanding, and accepting of what one goes through, and how difficult it can be to live day by day with a TBI!

I had a TBI in '07. Before experiencing my injury, my husband (ex now) and I had a very healthy and active sex life. As many whom have suffered a TBI know, this part of ones life can be effected by this serious of an injury. We do not try to be this way, but that portion of ones Brain is many times effected, as mine was. My husband (ex now) began cheating on me while I was in the hospital literally fighting for my life!

I wish others would understand, or at least try to understand that we don't want to lose these feelings etc. it is not our fault! It is just part of a TBI in many cases as it was for me!!!

Reading this article is so inspiring and brings hope for my husband and I. I swear if I had not known better I was writing it myself because I can totally relate 100 percent. It is my husband that has the TBI and life has changed 100 percent. I love him unconditionally and we have been married 31 years (27 before his accident). We were once that couple that everyone talked about how are you two so happy all the time. I miss the intimacy we once shared. We have tried to get it back somehow it's lost it's way. I won't give up and I tell him all the time I will never forget the memories we once shared but we have to move on in order to have a future together so let's make new memories together and just do the best we can.

its been a long hard road for my husband and I since his brain injury five years ago. We still love each other and he is still the same person personality wise but he has lost sexual function and even with viagra, it's uncomfortable for him. Also he doesn't remember how to initiate those little things anymore like touching or even reaching out to hold my hand.

It makes me sad but I hope it will return as other things have with time.

I met the love of my life in August of 2014. She was 6.5 hours away from me which was hard but we made it work. I had promised her I'd be down for an ASL walk for her father and a wedding. The morning I was supposed to leave everything was going wrong and I was so close to just staying home but I wanted to see her and I had made her a promise so I was not going to break that promise so I loaded everything up including my very young cat because I was going to be gone for a week or more. He was terrible the whole trip like he knew something was going to go terribly wrong. She told me just to turn around and take him back home. I said no I'm already 3 hours in I'm not turning around I was determined to get to her. About 15 Minutes later my life changed. I was very lucky to make it out alive a few times they almost lost me. So I somehow called my girlfriend even though I could not see. And told her what had happened the best I could in and out of consciousness. My skull was reconstructed and a titanium plate was put in about my eye. Less than a day later I was walking out of the hospital. So this is about a month after we met and she was now helping take care of me. Less than two weeks later I was helping her move in with me. Then less than a month later it was legal for us to get married so we did. We didn't want to wait because we had almost been Taken from each other already. We had a great sex life before the accident but now.the pain, frustration, and mental tiredness slowed that down. It wasn't that I was not attracted to her it was that my mind just couldn't. All of the stress just didn't allow it. We are still happily married a year and a half later things are getting more and more back to normal. But we are still very much in love. Thank you for this article.
My brain injury occurred less than three months after I was married. Things changed immediately and forever. Intimacy was difficult and infrequent due to either exhaustion or the emotion stunting effects of numerous different meds, without which I couldn't get out of bed. We worked with my doctor but my husband never told me how much he resented the change until the day - 7 years later- that he told me he wanted a divorce. I only wish he had the support system that I had to get through these times and make it work.
After 38 years of marriage, our sex life had cooled drastically, so after my husband's TBI, I didn't feel the loss of our sex life was a huge issue. I was so thankful that he not only survived a severe brain injury, but regained the vast majority of his abilities, that I felt guilty wishing for more. Now, 7 years later, I still feel the loss of our sex life, but even sadder, the intimacy we had shared. He still loves me, but the closeness we had is gone. Sometimes love remembered is enough to carry us through.

Me and my husband of 30 years were the perfect couples. People were amazed at our love for each other. Today has been two years since my husband had a motorcycle accident, suffered a tbi, and our lives were changed. We were as one before the accident now we are not. I have days where I feel like I can't do this anymore then I look at him and know the man I fell in love with, had children with, had a wonderful life with, is still there. I loved my husband before the tbi and I love my husband after the tbi. He will always have me as long as we live. It is hard to say but I will never give up on the man I love with all my heart soul and mind. TBI is the most horrible thing anyone can go through. But our love will see us through this.

My husband also had a motorcycle accident. It will be five years in September. We had been married 30 years. Five years later we are still together, but I am a caregiver more than a wife. I still love him and him me but the intimacy is gone. I miss our life as it was before the accident but feel fortunate for the support system we have. It’s so true that in an instant life can change forever! Good luck to you as you continue your journey.

My wife of 25 years at the time of her injury three years ago was and still is my world. Up until the injury our love life was phenomenal. Now being her caregiver I feel that is all I am. There is absolutely no intimacy at all. We were a very sexual couple and I now know that part of our lives is all but gone. I feel so selfish needing and wanting that physical part of love. I don’t know what to do or who to speak to about this. I love my wife dearly, but not sure what to do about the intimacy issue. It is so hard to be in this situation.

What a great article. I’ve had my TBI for 4-5 years...not really sure of the exact date. My wile strongly scolded me a few weeks ago for finding out I had been looking at dirty Web sites. I apologized, and I haven’t looked at them since. Tonight tWe were lying in bed and I reached over to touch/caress her, and she pulled away. ‘Why?” I asked. She said that I am no longer a husband to her. I don’t remember exactly what was said, but she basically said that she only sees me as a patient now.

Needless to say, I was shocked. We’ve been married for more than 10 years (agaiń, I don’t remember the actual number of years...blame it on my injury)

Any advice would be appreciated!