Relationship Break-downs Following a Brain Injury - The Reasons for Them

In most relationships, it takes two people working together to make it a success. In the case where one has suffered a traumatic brain injury, this likely won't be the case because of cognitive impairments and deficits. When a relationship is unequal, it places an extra burden on the healthy partner.

Some of the problems that will have a bearing on the success or failure of the relationship will depend on the following:

- The length of the relationship at the time of the injury. Long-term relationships where a strong bond has already been firmly established, and one especially where they've raised children together, will have a better chance of survival.
- Whether it is a first or a second marriage. If it is a second marriage there may be other issues such as step-children and problems that have been brought into the relationship that could cause additional difficulties.
- The role of any step-children can make a very big difference. This is especially true if there has not been enough time to establish a good relationship between them and the caregiver or if they didn't have a good relationship with the parent.
- Whether or not there is friend and family support. If there is not, there is an additional burden on the caregiver which adds extra stress to the relationship. Often friends will not keep in contact after the initial injury.
- Is there community support? This is important to both the survivor and the caregiver. Brain injury survivors very often fall through the cracks in obtaining required support. Also in many communities, very little is offered for the survivors of brain injury.
- If outside social support is not available and leisure activities have become fewer, the family becomes isolated. This is hard on a relationship especially if the couple had originally been socially active. This may be even more difficult for the healthy partner than for the survivor.
- Role changes will be difficult for both partners but probably more difficult for the caregiver. In all liklihood the caregiver will carry most of the work load and responsibility that had previously been shared.
- If the relationship becomes a dependency/co-dependency one, it will make neither partner happy and eventually there will be resentment on both sides.
- Substance abuse can create severe problems in a relationship. It will be important to try to get help by possibly joining an Alcoholics Anonymous group and/or Al-Anon.
- Stress, as a result of changes in both the survivor and the caregiver's life, can cause many problems. As well, there may be stress as a result of depression.

If counseling is available in the area and both are agreeable to attending sessions, a counselor could help the brain injured survivor with cognitive impairments that may be impacting the relationship. Some of these might be denial issues; help with problems of self-awareness; lack of empathy; the inability to assess the difference between right and wrong, and to give encouragement to the injured person to work on his own behalf towards recovery.

Counseling can also help the caregiver understand the difficulties the survivor is experiencing and to learn strategies to help him/her with his rehabilitation. A good counselor can also help if there have been sexual problems since the injury.

However, even with knowledge, awareness and effort, relationship break-downs following a brain injury do happen.