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

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.

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.

Jeffrey Kreutzer

Jeffrey Kreutzer, PhD is the Rosa Schwarz Cifu Professor of Physical Medicine and Rehabilitation at Virginia Commonwealth University, Medical College of Virginia Campus, and professor of Neurosurgery and Psychiatry. He is director of Virginia's Traumatic Brain Injury Model System.

Posted on BrainLine July 30, 2012

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


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.

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