Changes in Circles of Support After Brain Injury

A TBI can damage parts of a person's brain but it can also damage -- or at least change -- that person's circle of support.

There often is this emphasis on family members taking over after a person has experienced a brain injury. And then we start to talk about dysfunctional families, or families who are in denial, and families get a bad rap because, while a family is usually a very important part of a person's life, they're not the total part of that person's life and they never really have been. What happens with a brain injury is it may not only damage a person's brain, and there may be other associated injuries which effect cognition and emotions and perception and these other things that contribute to behavior, but it destroys their support circles. Everybody has a support circle. A support circle are the people that you depend on to get through life. There's the very center of that support circle, which is what you call the 'Intimacy Ring', which is your family and maybe your very closest, best friends in the world. Not just your best friends, but your 'bestest' friends. And then there's another ring, which are your other friends and maybe a ring of the people that you work with or you go to church with or you go golfing with. And then there's another ring of people that maybe you buy or purchase services from, whether it's the car mechanic, the butcher, the baker, or whoever. Well, after a brain injury, when you're no longer able to work, you're no longer able to interact with those people who provided supports. You may not have the same level of resources to purchase them. And as these people and supports fade away, you can't do it all on your own. So brain injury not only affects the individual who sustained the brain injury, but it affects other people--family members and other people in the support circles. And a lot of the work that we have to do to help people be successful is to try to find ways to reestablish these support circles. We see similar types of behavioral and emotional decompensation in other people who haven't had a brain injury, but who have experienced some other catastrophic loss. It can be some other medical or neurological problem. It can be that the only mill or factory and a small town closes down and people lose their jobs. So these are critical issues, and this goes back to very early on in our field where Muriel Lezak, a very well-noted neuropshychologist said, brain injury may start as a medical challenge, but far too often it ends up as a social catastrophe for so many because we forget about these things, and we don't help people put back together their lives.
Posted on BrainLine November 12, 2010.

Produced by Vicky Youcha and Brian King.