Amey Welch, an Associate with, Brain Injury Group Member, Irwin Mitchell’s Serious Injury Team, discusses how a brain injury can impact relationships and provides some tips for those who have relationships with people with a brain injury.

As a personal injury lawyer representing individuals who have sustained an acquired brain injury, I have seen that the consequences of a brain injury can be far-reaching and have a significant effect on a wide range of relationships, including the relationship between couples, parents and children, the wider family, friends and working relationships.

This article will focus on the impact of moderate to severe traumatic brain injury on relationships in couples. It will consider how the relationship can be affected, provide tips for couples who are experiencing relationship difficulties, along with providing details of where further support might be available.

How can a couple’s relationship be affected?

Following a traumatic brain injury it is my experience that there is often an acute phase during which the brain injury survivor remains in hospital. During this time, they and their partner will be going through a number of changes. Both will be coming to terms with the injury and what it might mean in the longer-term. Quite often the future will be very uncertain at this time. It is likely that both the injured person and their partner will feel a range of emotions during this time and temporary measures will be put in place as families come together to compensate for the injured person’s reduction in income, ability to contribute to household chores and childcare where relevant. Once the injured person returns home, there is usually a lengthy period of recovery during which the focus will be on getting better and learning new skills. However, in some instances life will never return to exactly what it was before. This is particularly the case where someone has sustained a traumatic brain injury.

It is not uncommon for the full extent of a traumatic brain injury to become more apparent once an injured person has returned home and starts attempting to resume their life as it was before. At this stage, it may become clearer that the arrangements which were initially thought to be temporary are likely to be long-term and, in some cases, lifelong. This can be an extremely emotional time and can place great strain on a relationship. Whilst the symptoms of a traumatic brain injury will vary from person to person depending on the severity of the injury there are some common themes when it comes to the difficulties that can arise within relationships.

Common difficulties that arise, include:

Financial pressure

Financial pressure can be a cause of tension in any relationship and traumatic brain injury can provide the circumstances for such difficulties to arise.

For example, it may be that the individual who has sustained the traumatic brain injury may no longer be in a position to work and as a result the household goes from having two incomes to one. This can place a lot of responsibility on the partner who is working to make sure they keep money coming in whilst also impacting the injured person who may be finding it difficult to come to terms with the fact that they can no longer contribute in this way.

The general stress of struggling financially along with the emotions felt surrounding this can lead to arguments and tension between partners.

Change in roles and responsibilities

As previously identified, one of the main things which changes within a relationship following a traumatic brain injury is the roles and responsibilities carried out by each person in the relationships. Couples may have previously shared household responsibilities such as cooking, cleaning, laundry, gardening, financial management, diary management and looking after children. Following a traumatic brain injury, it is not uncommon for a partner to take on the lions share of these roles along with also providing personal care and support to the brain injury survivor. Whilst this can be challenging for the partner providing such support who will have less time to focus on other things, it can also be difficult for the injured person to come to terms with as they are more reliant on their partner than before. This can lead to a decreased sense of self-worth and increased frustration which again places more pressure on the relationship. The way in which the couple spend time together may also change and in turn this can leave to an increase in tension within the relationship.

Changes in communication

Another common issue arising in relationships following a traumatic brain injury is difficulties with communication which is key to maintaining healthy relationships.

As individuals we do not just rely on what people say when it comes to communication, but we also consider other elements such as facial expressions, tone of voice and body language. Following a traumatic brain injury, it can be difficult to pick up these social cues which can lead to information being misinterpreted or misunderstood. This can be confusing for both the brain injury survivor and their partner.

Changes in emotions, cognition, behaviour, and personality

A final common theme is the emotional, behavioural, and cognitive changes that may accompany a traumatic injury.

Depending on which part of the brain has been affected, someone with a traumatic brain injury might experience sudden and extreme mood swings, may act impulsively and in a way they would not have done before, may behave in a way which is considered socially inappropriate such as losing their temper and swearing in public, easily lose their temper over things which might seem trivial, have difficulties remembering important dates such as anniversaries and birthdays, difficulty remembering conversations that have already taken place and therefore requiring reminders, have difficulty concentrating, appear self-centred and lack empathy towards others.

They may also be completely unaware of the extent of their difficulties, their behaviour and what effect this has which is known as a lack of insight. This can be difficult for a partner to come to terms with and difficult to know how best to manage.

A common complaint of brain injury survivors is not feeling understood by their loved ones. For example, partners do not seem to understand or appreciate their difficulties and how they can help. Their partners may unintentionally do things or say things which are unhelpful, and this can be a cause for frustration.

Tips for relationships after a brain injury

Try to learn more about the common effects of a brain injury. Where a loved one remains under the care of medical professionals, a partner can ask to attend appointments to ask questions about how the brain injury survivor’s injury affects them and how they might be supported.

Try to increase communication; take some time to think about the challenges faced. As the partner of a loved one who has suffered a brain injury, you could ask questions in respect of where they see difficulties arising and how they feel you can best assist. Where talking in the first instance is difficult you could try writing a letter or both setting out some bullet points before talking.

Consider approaching a qualified relationship counsellor or therapist and ideally someone with experience in traumatic brain injury.

Try to make time for each other. It is not uncommon for the roles of carer and partner to become blurred following a traumatic brain injury which can easily become all consuming. As difficult as it might be, try and make it a priority to schedule a regular date night and spend time together reconnecting. This does not need to be anything grand but perhaps sitting down to have a cup of tea together, ordering in a takeaway and eating together without distractions, playing a game together or going for a short walk outside. These things may seem small, but they can help in providing a break away from the day to day and assist in reducing tension.

Seek further support from others:


Amey Welch of Irwin Mitchell

Amey Welch is an Associate in Irwin Mitchell’s London Serious Injury Team. She has been representing clients who have suffered life-changing injuries for a number of years and has a special interest in acquired brain injury, polytrauma and fatal accidents.

Irwin Mitchell are a national law firm whose solicitors work hard to make things easier for their clients and their family. Over the past 2 years they have helped clients recover more than £1 billion in compensation, but this is only part of the story, their solicitors also help clients access the rehabilitation, medical care and support needed to achieve the best recovery possible.

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