Working with Couples in Crisis After Brain Injury

Dr. Kreutzer and Dr. Stejskal talk about their work with people with traumatic brain injury and their families.

Taryn and I have worked with a lot of couples together, and we saw a couple who was in a state of crisis, because the husband had a very serious injury and had ideas that his wife was being unfaithful to him, and he was really concerned that she was being unfaithful. And so we talked-- the great thing about both of them was they were very open about their feelings, they were very honest about what was going on and their concerns, and the husband said, "I'm really afraid that because I've changed, you may not like me anymore." And the wife very much insisted that she liked him--loved him as much as she ever did. We were very afraid for that couple, because we felt that the wife was working really, really hard, and was feeling very stressed out and was being very supportive. And here her husband was meeting her with-- I'm talking about how suspicious he was. And what happened was, we continued to meet with that couple over a period of several years. We basically--Dr. Stejskal and I basically said very firmly, "Your wife is not being unfaithful." "It would help your relationship much more if you would acknowledge the good things that she's doing to help you." And we also let him know that if we were concerned about his wife, that we would be open and honest with both of them. And so, over a period of time, he began to see that his ideas were not based in reality, they were more fears related to his concerns about his personal shortcomings. And the good thing about that is that we've worked with him over a period of years, they have done--he's gotten a little bit better, he's been physically more capable, more ambulatory, and they've planned trips together, they've had a lot of good experiences together. And so in looking back over that experience, we really thought that the intervention that we used was effective, because this was a couple that, maybe had they not sought out help, their marriage could have ended in disaster. And we would call that a successful intervention. And I think I would just add that related to that couple in particular, we also found some individual therapy for the wife. She didn't feel like she had any friends or family that really understood what she was going through, and so we were able to provide that for her so she had someone to talk to about her feelings and her experience, and someone to say, "You know, this is a really hard time for you." And she said some weeks it was good just to have someone tell her that she wasn't crazy, she wasn't nuts, she didn't have to be over it yet. And the second thing that I would add is that we like to think that we have a lot of good ideas for people and a lot of experience. But really, it's the couples that do the heavy lifting and the hard work, and then we try to be there as consultants or as guiding lights when they come in each week.
Posted on BrainLine May 27, 2009.
Produced by Victoria Tilney McDonough and Brian King.

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