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.
- Kreutzer, J. S., Marwitz, J. H., Hsu, N., Williams, K., & Riddick, A. (2007). Marital stability after brain injury: An investigation and analysis. NeuroRehabilitation, 22(1), 53-59.
- Godwin, E. E., Kreutzer, J. S., Arango-Lasprilla, J. C., & Lehan, T. J. (2011). Marriage after brain injury: Review, analysis, and research recommendations. The Journal of Head Trauma Rehabilitation, 26(1), 43.
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.