What Have you Done to My Husband?
“He almost died. If he had, my life would have been easier. I would have grieved the loss, and gone back to whatever it was I was doing. In time, perhaps I would have found another love. But he didn’t die, though the person who survived is someone else, a different person, who exists as a shell of the man who was my husband” (Spouse of a Brain Injured individual, 2012).
It is horribly sad to see the demise of many relationships and marriages when a brain injury happens, but for those who have stayed and worked hard at redefining their relationships, they are the ones who are truly blessed. Although this is not my personal story, it is one that holds true for many individuals that I have worked with over the years.
The Story:
You are at work and receive a phone call that your husband has been in a car accident and is being transported to the hospital. They inform you that he is still alive but has experienced some injuries. You drive to the hospital and although your husband is connected to many tubes and intimidating machines you are relieved to see that he is still breathing and he is fairly stable. The doctor reports that he has experienced a few broken bones, scratches, bruises, but the most concerning is that he also experienced a blow to the head during the accident. It is referred to as a closed head injury. You don’t know what this means but figure since he is going to be okay physically that everything will be alright.
After several days your husband opens his eyes and you are so happy and thrilled that he is going to be okay… and he doesn’t recognise you. You believe that he just needs some time to come to his senses although the doctor tells you that there is a very real chance that your husband may not be able to return to his former self. The head injury caused damage to parts of the brain (generalised brain injury) and that it is too soon to tell how it will affect him in the long term.
This is a story that will be all too familiar for many people reading this article.
An organisation called Headway has compiled the first dataset on all brain injury related hospital admissions in the United Kingdom and their results are astounding! There were approximately 956 admissions due to brain injury per day to UK hospitals in 2013-2014 or one every 90 seconds. The number of people admitted to the hospital in the UK with an acquired brain injury has increased by 10% since 2005-2006. Interestingly, in the UK men are still 1.6 times more likely to be admitted into a hospital for head injury, female head injury admissions have risen 24% since 2005-06. With the increase in the rate of brain injury, there has also been a higher demand for services. This increased demand for support is evidenced by almost two million page views of the Headway website in 2014, and a 60% increase in calls to the UK-wide helpline in the past five years alone.
So why, if traumatic brain injuries are so common, is there still a lack of readily available information out there? Are we talking about the issue enough?
Some Brain Injury Facts:
I have worked in the area of TBI for approximately 17 years and have helped countless couples come to terms with the changes that are about to happen in their lives. Traumatic Brain Injury (TBI) involves damage to the brain after a sudden and traumatic event. This can include injuries resulting from a fall, car accident, bike accident, drug overdose, or an assault. Effects from a brain injury can last anywhere from a short period of time to a permanent lifelong impairment depending on the severity of the injury. It can cause impairment in memory, problem solving, emotional difficulties (personality changes, depression), physical changes, or sensory impairments such as the loss of eyesight, hearing, or even smell.
Your brain is the engine that makes your body run. If the brain is not functioning properly then it can cause a multitude of problems for the rest of the body. Different parts of the brain control distinctive parts of the body or brain functioning. For example, the frontal lobe controls the executive functions such as impulse control, decision making, emotional regulation and judgment.
Famous Americans you may not realise have experienced a brain injury include President Abraham Lincoln, Barbara Mandrell, Bob Woodruff, Gary Busey and even heartthrob George Clooney. In the UK, Richard Hammond and James Cracknell are well known individuals who experienced a brain injury from their professions. James Cracknell, a gold medal Olympian, was hit by a vehicle in 2010 while riding his bike in Arizona for a TV show. This caused him to have to go through intensive rehabilitation, and although he has physically healed, James and his family had to work through the personality and psychological changes. James and his wife wrote a book titled “Touching Distance” which highlights the struggles that James and his family struggled – such as his quick temper, aggressiveness, memory problems, and epilepsy.
Richard Hammond experienced his brain injury in 2006 when he was filming an episode on Top Gear and lost control of the jet powered car he was driving. He experienced severe depression, difficulties with processing information, and problems with managing his emotions. He became defensive, quick tempered, and experienced memory loss. He did not initially recognise the issues he was experiencing which made it difficult when filming the hit TV show. Self-awareness for individuals with a brain injury can be extremely difficult for everyone involved since the individual is not able to recognise that they are doing anything wrong or different. Although Hammond does not speak about the effects of his injury and changes in personality had on his family, he admits that it has been hard for his two daughters and wife. Richard and his wife also wrote a book together titled “On the Edge: My Story” which goes into detail of his injury and how it has affected him.
Back to the story:
So going back to our hypothetical situation, there is a very real possibility that the husband in this story may never recognise his wife or if he does, his feelings and reactions towards her may have changed. These changes in a person’s personality or behaviours can cause the spouse of a TBI survivor to feel like they are “married to a stranger.”
Over time the husband may start to remember “who” his wife is but things may not the same. He may not like the things he used to, he may kiss differently, be more aggressive, more passive, he may become quick to anger, and yell due to frustrations. He may scare those around him and leave others feeling hopeless and angry over the situation. All of a sudden, this man is not the caring and loving man that the wife married. The wife may find herself taking on more of a caretaker or parental role rather than a partner.
As a spouse, you have to watch your loved one carefully and make sure that he does what he needs to do on a daily basis, make sure that he does not wander off, and ensure that he takes care of himself physically (medications, personal hygiene, and yes… sometimes that he has dressed himself properly).
The equal balance of the relationship has shifted in the other direction and the wife may find herself as the “breadwinner.”
Along with the more obvious relationship and personality changes there can also be intimacy changes. A person who experienced a brain injury can experience a diminished sex drive, or equally an over active sex drive, physical impairments, depression, and decrease in self-esteem. A husband that used to buy flowers or send cute text messages while at work is now silent unless he needs something.
How do you deal with this? What can you do when you feel like running away?
Relationship Research:
50% of marriages and primary relationships fail within 24 months’ post-injury. Research has also shown that wives of brain injured partners report that “men are more self-orientated and exhibit more childlike dependency after their brain injury.” The brain injured individual tends to be more inflexible, display inappropriate public behaviour, self-centeredness, and decreased self-control which can make sexual readjustment more difficult. Many wives report that they receive less expressions of affection after injury and they feel more alone. Not only has the wife “lost” her partner but friends and family tend to drift away when they realise they do not know how to deal with the changes.
How to Heal:
Knowing all of this can cause some to pack their bags and leave. This was ‘not a part of their marriage vows‘ and many struggle to deal with the changes. For those of you who are willing to try and make things work for better or worse there are some words of wisdom.
An important first step in working through the changes is to “take time to grieve for your old life and build a new one together… as a couple.” Grieving is a normal and natural process. The person who experienced the brain injury will need to morn their losses and the significant other has the right to do the same. You can be angry, yell and scream your frustrations (not to your partner of course), and you have the right to not feel ashamed that you want to leave sometimes or wish your partner had not survived. The following are also ways to help work through these difficulties:
- Learn to communicate in a way you can both understand.
- Remain loving and positive.
- Speak openly about sex and be willing to discuss what you like and don’t like.
- Seek out a therapist who is familiar with brain injury to help with personal/relationship issues.
- Maintain respect for the other person – don’t belittle them or make fun of some of their behaviours.
- Understand that there will be a “new normal” which could possibly be better than the “old normal.”
- Become a part of caregiver support groups to help you understand that you are not alone and that others may be experiencing similar situations and emotions.
- Educate yourself on brain injury to understand what your partner is going through.
- Talk about your expectations, fears, and feelings – be open and honest.
- Be willing to try new things and not expect things to return to “just the way that they were before”.
Each brain injury is different. Not only will changes vary based on what part of the brain was affected, but the type of person and their pre-injury personality will affect how they respond. Be willing to accept that it may not be able to be repaired and don’t put too much stress on yourself and your partner. If you are willing, the only thing you can do is learn to accept and move forward together.
(Note from The Editor: Many thanks again to Jennifer Adams for talking about such a tricky subject. Research for this article is accredited to the following sources. Headway.org (2016), Centre for Disease Control and Prevention (2016), Withy Kings LLC (2016), Peoria Illinois Brain Injury Group Foundation and Gainer (2004).
To read more from Jennifer check out her author page here or check out her blog KarmaBites here.)
