Supports Necessary for Brain Injury

Supports Necessary After TBI

Relationships can change after traumatic brain injury. It is important that the survivor and the family has supports for as long as they need them. (Flickr / Creative Commons / David Martinez)

Author Janelle Breese-Biagioni wrote that 90 percent of marriages could be saved after brain injury with proper support for families after the injury. She says in her blog stated that 90 percent of marriages end in divorce after brain injury. She boldly declared that all of these marriages could be saved if the family receives the supports they need for as long as they need them. While we are skeptical that any therapy could have 100% effectiveness ratio, we do agree that proper family support is key.

Breese-Biagioni holds a diploma in professional counseling and a certificate in death and grief studies. Her personal story is perhaps more intriguing than her education. Her husband, brother, and a dear friend died within 18 months of one another from brain injuries.

In relationships after TBI, people experience more stress, which will take a toll on the marriage. It’s necessary for the family to be understanding.

She created the acronym RAGE to detail the normal feelings of grief. The R stands for regret, or feelings of what could have or should have been done. The A is for anger, which she experienced when her husband died. It is a normal feeling and can be dealt with safely in the hands of a professional. G stands for guilt, which happened to her too. She felt guilty she was alive to experience her kids’ lives and her husband was not. People must work towards forgiveness to get over the guilt. E is for emotional roller coaster. Breese-Biagioni suggests to do the work of grieving. So that you may feel joy and enjoy life again.

Breese-Biagioni emphasized that supports must be available for however long they are needed. Time-limited supports can be problematic. No two brain injuries are alike, so no two treatments may be alike either. However, the threads of brain injury can be similar from family unit to unit. People can help each other through shared experiences. Some say there is no cure for brain injury, but there is hope for improvement. As Breese-Biagioni puts it, it’s not a death sentence. The brain can repair itself to a degree. We call this neuroplasticity. Breese-Biagioni also emphasized that no two of the same treatments may work for someone in the same time frame. Successful recovery comes from perseverance and getting the person to keep on working at it.

“What makes marriage so difficult after brain injury is ‘the family roles and responsibilities’ shift dramatically,” Breese-Biagioni said in our interview with her. “For example, in my case, my husband was injured. We had been married for 14 years and suddenly he was unable to participate in our relationship in the way he had.” He became more child-like and inappropriate. He wasn’t able to father his children in the same way. His children became caretakers of their father.

In marriage, the partner sometimes has to take on the leadership role in the relationship. The changes after brain injury can be slight shifts of drastic changes. Communication may also take a hit. It’s important for the couple to work on communication. Therapy and support groups can help with recovery. It is also important to make sure the environment at home is positive.

From the book Neuropsychiatry of Brain Injury (1994 American Psychiatric Press):

“An equal adult partnership has been broken, and the uninjured spouse is often thrust into the role of caregiver — both for the injured partner and for the family when there are children. The result is often financial burden, loss of support, and isolation.”

“One of the biggest supports that is needed and rarely put into place is grief counselling,” Breese-Biagioni said in our interview. “And if it is, the funding is usually for the person with the brain injury and not given to the family as a whole. Each person in the family, including the survivor, must grieve the losses they are experiencing as individuals and as a family.”

We agree with Breese-Biagioni that treatment should not be limited to the six months following the injury. Treatment should be given to the person and their family for however long they need it. Only a commitment to a lifetime of recovery following brain injury, can deal with the challenges of this life shattering event.


Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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