Differences in Expressing Emotion After Brain Injury

Not everyone deals with his or her emotions the same way.

Oftentimes patients that have had a traumatic brain injury and some psychological injuries actually too, they feel in some ways that they're not who they used to be, that somehow their sense of self is lost. And also family members, especially those closest to them, will make comments, "Well, he's not who I married." or, "He's different now." It's important, on one hand, to acknowledge that this is the same person; however, the way of relating to him or her is different. There is a loss in that, and so validating that sense of loss and helping them really work through some of the grief that comes with that, but recognizing the essence of the person or the love that you have with them, it doesn't get broken because there has been an injury. It may be harder or different to access or connect with, and that we can help families and couples deal with, about how to connect now, given-- so, for example, I can think of a patient whose affect-- which is basically our emotional expression--not our feelings, but how someone outside of you can tell what you're feeling. One consequence of brain injury can be what we call flat affect, which there's basically--it's hard to tell what someone is feeling, so it kind of looks like they're not feeling anything. And so we rely on all of those clues from each other, especially the ones of people who are intimate and close with us. We know their glances. We know kind of if it's a look, if something is on their mind or something is not quite right. With someone who has had a brain injury, sometimes those cues are different now. And so just because in this example the patient may not look like he or she is feeling anything, it doesn't mean he isn't. I was working with a couple where the patient's wife would say, "You know--he doesn't seem to love me, doesn't seem to-- but if you were to ask him if he loved his wife, he loved her as much or as more as ever. But because it doesn't look the same, the wife wasn't sure in the same way. That caused her own sense of, of course, worry and loss, until we were able to talk about it. They could find some new ways of trying to relate and connect and develop perhaps some of those new intimacies, if you will, about that closeness that doesn't have to be gone. It may be different, but it's not gone. Love doesn't necessarily exist in the brain. Now, I'm sure there could be others who will argue that point, that everything sort of exists in the brain. However, I have observed time and time again that that love, that connection, that sort of biological connection, especially--I'd have to say, I've witnessed it even stronger in parents and children than even with a spouse-- that that doesn't get broken because there has been an injury.
Posted on BrainLine March 4, 2009.

Comments (4)

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My husband and I have been married for 16 years. He recently was diagnosed with a craniopharyngioma, which was mostly removed with surgery and radiation. He had many temper/anger issues in the beginning of our relationship and had many emotional problems and was very disconnected about 3 years before diagnosis. I haven't had any help or support on what to expect from him now or what emotional things are tumor related if any. He seems to only have issues (memory lapse, problems speaking, not loving etc) with myself and my daughter. He acts completely normal every where else and he had a nueromaping that shows his memory, intelligence, and brain function as above normal. I do not know what to do, but am trying to be supportive and understanding without compromising my daughter and my well being. He is a lot more passive (due to his now lower testosterone levels) but the emotional disconnect and the toll all this is taking on me is horrible. There is absolutely no support for the family of the patient, and iall the work/stress affected my health. I had to deal with my own illness without any care or support from him, yet when other family members or co-workers experience any hardship, he knows and tries to help. Your video felt like you were talking right to me, on how he expressed love with words but nothing else. What puzzles me is that this isn't always the case with others. Please any advice/help or resources?

My husband was recently diagnosed with a craniopharyngioma. He has a permanent VP shunt and the tumor was mostly removed with surgery and then radiation. We have been married for 16 years, and he had many temper/anger issues sin

Ive had 2 brain surgeries and one being a tumor removed and second was a fatal oil field accident crushing left side of my head same side as the first brain surgery. I have the hardest time expressing myself. I had a man come into my home threatning my wife and children and it has taken a toll on me and my wife feels i am suppose to be ok but it was very devistating for me because i just stood there but never acted and i know part was because my children was right there and was scared for their lives. So i just stood there when my wife jumped up out of instinct to protect her children. She stood between the aggressor and us. That has made me feel unworthy and unsecure. This is so hard for me.

You did what you needed to. Your wife did what she needed to in this situation. Your brain will reacted different now and may always be diffrent. I know this because I have been living with a husband who is a TBI patient. He has never regained his reading and emotionally childish. We have to have things the same as much as possible or he has fits. When someone came into your space is hard before a trams but now it makes those emotions confusing. You both need to help each other and praise the fact you and your family is still alive. Celibrate what you have not what you don't or didn't do.
Thank you
Patricia Livingston