Loss of Relationships After a TBI Is Often the Most Devastating Outcome

Friendships often fall apart after someone has a TBI because people don't understand what that person is going through; they might even think he is faking. And in turn, the injured person doesn't understand why his friends have suddenly abandoned him. Loss of relationships and loneliness can be devastating after a brain injury.

One of the situations that comes up is you have a person, for example who is injured at work. And all of their colleagues, they see what happens— the person was crushed by some falling lumbar. And their colleagues are like "Oh my gosh, you know we'll be there for you forever." But, what happens over time is—3 months after the injury the person looks fine. So, the friends come to visit, and the friends have— they bring the message back to other people at work, and they say "Hey, I've seen John." "He was hurt at the worksite, and he looked bad the first couple of weeks, but he's looking pretty good right now." "But, you know what, John says that his doctor tells him that he's got really bad memory problems, and he's not coordinated, and he can't multitask anymore, and—but when I looked at him he looked really normal to me." "I couldn't actually tell that there was anything wrong with him, but he's saying that he is so bad off because he had this brain injury— he's so bad off that he can't work anymore." And, so then what happens is the guys at work start thinking "Oh my gosh, he's kind of figured out how to beat the system." "We'd all like to get paid, and we'd all like to collect money for doing nothing." In the meantime, here's this person who has been hurt, who is following his doctor's directions not to go back to work because if he goes back to work he's going to have another pile of lumbar fall on him, or get hit by a fork truck that is backing up and he can't— doesn't have the coordination to get out of the way. So, here's his friends thinking he's got an easy life, and he's living off the system, and they don't want to talk to him because they wish they were in his situation where they cold get paid for doing nothing. And here he is thinking "These people—I worked with these guys for 5 or 10 years they don't—they said they were going to come visit me— they came a couple times and now they won't return my phone calls." And that's when people start to think "Nobody cares about me." And when people think "Nobody cares about me" they begin to think they're worthless. And when people begin to think they're worthless, they get really depressed. And that, to some extent, is the root of some depresion that people face. Imagine if tomorrow—let's say you have 5 or 10 or 15 really good friends— imagine if all of a sudden tomorrow—you as a person who didn't have a brain injury— people just stopped returning your calls. People you text once or twice, or 4 or 5 or 10 times a day— they stop replying to your text messages The people you called and spoke with once or twice a day, or once or twice a week— they stopped returning your phone calls. You would begin to wonder what happened or what you did or what was wrong with you because nobody wants to talk to you. And if nobody wants to talk to you, nobody cares about you. And it's really a difficult situation. And it really takes people a while to figure out and understand what's happened. Because if all of your friends stopped returning your texts, and they stopped returning your phone calls, you tend to take it personally. "There is something really wrong with me." And, it's bad enough that people have a brain injury, but then they start thinking that you know, they are socially undesirable, they're outcasts, they are not worthy of anybody's friendship. And you hear people talk about self esteem— that's the other damage that occurs with this. It causes a horrible devastation to people's self esteem. And what this is about is the loss of relationships.
Posted on BrainLine July 30, 2012.

About the author: Jeffrey Kreutzer, PhD

Jeffrey Kreutzer, PhD a Professor of Physical Medicine and Rehabilitation, Neurosurgery, and Psychiatry at VCU. He serves as Director of Virginia's TBI Model System, a position he has held since 1987. He also coordinates VCU Health System outpatient services for families and persons with brain injury.

Dr. Jeffrey Kreutzer

Produced by Victoria Tilney McDonough, Justin Rhodes, and Ashley Gilleland, BrainLine.

Comments (6)

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Wow- this is so hard. About 8 years ago, I became very ill due to a rare autoimmune disease that I didn’t know I had. At the time, I was a normal 37 year old wife & mom, with a busy, full life. This disease attacked my autonomic nervous system, which affected me in a lot of ways, but primarily, I became unable to maintain my blood pressure while standing. It was gradual, one day while chatting with a friend, standing next to her desk, I remember feeling dizzy, then I fainted. Within 6 months, I could not maintain consciousness even sitting upright. It took about 6 years to recover, but within the first 2 years, I had so many fainting spells, that I ended up with more than 20 concussions, at least 5 of those were pretty severe. I am lucky. I recovered so much more than we ever thought would be possible. Even so, I lost 50% of my once 20/20 vision, now legally blind. Permanent damage to my pituitary gland, loss of certain cognitive function, and about 4 years of complete memory loss. I wasn’t in a coma, I didn’t have amnesia. My short term memory just didn’t work, so that time is lost. One day, my memory started working again, but I was stuck 4 years in the past. That was about 18 months ago. I’m trying to adjust, but it’s not easy.
I guess my personality was just completely different from my normal mild-mannered, good natured self. I became confrontational, and would easily become emotional. I spoke loudly and seemed aggressive I guess even when I didn’t feel that way. I did not comprehend how dangerous my condition was, and was constantly taking risks, therefore continuing to injure myself, incurring more head injuries.
I ended up spending about 6 weeks with family and friends back home, to give my husband a break, as he was caring for me full time. I live in the Midwest now with my husband & kids after moving here about 15 years ago. All of my family & close friends lived out west in Northern California. They were all so worried about me and wanting to help, so they arranged my trip and I was going to spend time with my 4 very close, lifelong friends, my brother and sister in law, my best friend, and my dad and stepmom.
Long story short, I came home 6 weeks later and absolutely no one was speaking to me. This was 6 years ago. I have absolutely no recollection of anything- I don’t know what happened. I’m fully aware that I was almost certainly completely to blame for whatever happened, but I don’t remember.
In the last 6 years, I’ve tried so many times to fix what I had done. Of course, because I do not know the specifics, I can only apologize for “whatever I may have done to hurt you”, to cause or create chaos, to inconvenience anyone, etc. I’ve asked each individual if we can talk about whatever it was that I did so that I can be properly remorseful, but with the exception of my parents, no one else will even speak to me about anything. For the most part, everyone just ignores my attempts to contact them. It’s like I just do not exist to them. The only explanation I’ve been given was by one close friend who told me that: “You just aren’t the same person, I don’t know you.”
I cannot move past this. Everyone seems to have turned away from me. I can’t seem to forgive myself for losing my lifelong friendships. My friendships in my new home have also faded, as often happens with major illnesses and injuries. I get that. But it’s so hard to accept that people who have known me for my entire life are content to live their lives without me in them. I’ve tried multiple times, and the rejection is soul crushing.
I think it’s preventing me from moving on and rebuilding my life, and making new friendships. I’m terrified of rejection and nothing makes any sense to me.

I have lost my best friend (of 38 years) and her beloved family because of a comment. If they really loved me they would have googled TBI.
I'm mad at her though for not having my back; them for not holding her accountable. This is the hardest thing that I am continuing to go through, who knows for how long, where is her compassion? Her family has been there when I reach out, but it was just too hard to continue coming around. I don't trust anything anymore. I can't keep up just talking with people about easy things sometimes and I can get easily confused; this is the scariest. It wasn't like this as much at the beginning, I don't think, All of my issues continually got worse. I've lost work because of it.

I think the biggest thing is getting the rest, proper nutrition, and exercise that your body needs and can tolerate. Take care of yourself and get counseling through free programs like celebrate recovery in your community. It will be helpful to be able to verbalize what you’re going through in a safe environment where people will listen and not judge you. Just work on yourself right now. It’s a good time to do so after this Covid virus thing goes away of course.

I have a TBI. I've had it really difficult with family relationships before TBI. Afterwards, I'm going through a divorce and hardly ever speaking to family. The good thing is that I'm close to my son. I get mad sometimes but it's more about pain and hurt than anything else.

Hi I too have a TBI. And my family also was not very good prior to the injury, but now I have absolutely no relationship with my family at all because of the TBI and my behavior. I had a good relationship with two of my sons, but one of those sons has chosen to completely push me out of his life recently and that has been devastating to me. I have a beautiful grandchild from him and he only wants to talk to me when he wants something from me. I think the TBI is only part of the problem, the rest of it is a dysfunctional fractured family life. I wish you well.

I too have lost relationships. My boyfriend of 10 years left me for another woman I lost my daughter after she reported sex abuse by her dad they said I made her lie and I've lost my job my home and most of my family and friends. I don't feel different just am different I guess. I had diffuse axonial sheer injury from being hit by a train. It hurts so much to be this new person no one likes or trusts I am the same person!