Types of Relationships after TBI

This article will continue with the idea of a person having multiple “circles of friends” as presented in the previous posting.

In the previous article, I suggested five categories into which relationships can be divided.  Again, this is NOT intended as any sort of definitive list, but as a tool to help generalize relationships into a recognizable manner that is easer to discuss.

These five categories are:

Immediate Family
Close Friendships
Casual Friendships
Acquaintances
Strangers

First, I must eliminate the final two categories as unimportant for this article.  These are - 4) Acquaintances and 5) Strangers - and are people who were not strongly affected by my accident.  Living in a small town, some people I would group into these categories may have been aware of pieces of the drama, but it had no recognizable impact upon their lives - we will not discuss these categories for this entry.  Also, in the last posting I spent a long time explaining how my relationship with “close friends” was affected after my accident, so in the first we will not focus on the specifics of this of sort of relationship except as a point of comparison.

That leaves two other relationship types - 1) Immediate Family and 3) Casual Friendships - this article looks at how these relationships differ from relationships of 2) Close Friendships and then goes on to suggest that these Close Friendships are the relationships most affected by brain injury and why this is so.

Let’s start by looking at category 1) Immediate Family.  This was the group with which I was most involved on a daily basis - specifically, my parents and my sister.  I am fortunate to have a loving, supportive, proactive family that has always made a conscious effort to provide the support and guidance I need - in all aspects of life as well as the time of my accident - yet the extremities of emotion that grew from my recovery made even these relationships tense.  My parents, however, took on the responsibility of continuing to find ways to work with me through the hardships.  This was due, in part, to the living situation.  Please note, I recognize that my parents went far beyond providing any minimal support in my recovery, and I am deeply grateful for their dedication to helping me heal, but that said - the close quarters and immediacy of the living situation encouraged my parents to be active in my recovery - it is a lot harder to exclude someone from social interaction when he lives under your roof.  My sister is a slightly different story - and I will present more of her story in an upcoming posting - but she also, in part due to the living conditions, was forced to deal with me on a near daily basis.

With this living situation as the setting, combined with a commitment to helping me heal, my “immediate family” took a direct role in my recovery - actively seeking therapies, adjusting schedules to make time for doctor’s appointments, confronting my anger and helping find new ways to express frustration.  While close friends could step away from the “Lethan drama” of the moment, my family had to find a way to adapt life to the needs at the time.

Not to diminish the extensive extra work my parents - and my sister - did as part of my recovery process, but they were encouraged by social responsibility and societal expectations to take up the mantel of assisting in my recovery.  My close friends, however, did not have the same set of social and familial pressures.

Now, to category 3) Casual friendships.  These are people that I have a friendly relationship with, but we do not often go out of our way to interact - friends I pass in school, people involved in similar activities (sports, chorus, theatre, etc…), friends of the family I know through my parents.  These are people who casually care about me and my family, but usually make no attempt to be involved in our family affairs.

I make it a point to highlight this group of friendships because - at the time of my early recovery - many people from this category quickly became more active in the lives of my family and sought ways to support the recovery process - yet I separate them from the category of “Close Friends” because they were not involved in day to day interactions that caused them to witness the process of my recovery - news of my progress would get out and these “Casual Friendships” could be appropriately happy or sad while - for the large part - remaining unaffected by and/or unaware of the emotional confusion I demonstrated with closer relationships.

To quickly summarize the parameters of social interaction for these categories - Immediate Family relationships were required to deal with me because of the living situation, while Casual Friendships - being further removed from daily interaction - were not often affected by the social confusion that grew as part of my recovery.  That leaves Close Friendships stuck between the other two in a strange social neither-zone - the changes and social difficulties that come as a part of recovery are apparent and DO affect the lives of these close friends, but by most standards they are not socially obligated to deal with this uncomfortable behavior.  It can leave these friends saying uncomfortable phrases, such as - “I mean, yeah, he’s a friend, but he’s acting really weird now, let’s…I guess…not invite him.”  Close friends want to help, but they also have to worry about their own lives.

Dr. Mariann Young speaks very clearly about this on the “Brainline” YouTube channel - How to Deal with Friends Falling Away After a Brain Injury.  In this video, she suggests that it is important to educate friends about the changes that will likely occur as the brain injury survivor is returning to the community - it is important to recognize that the survivor has changed and there will be a new set of challenges - Dr. Young doesn’t use the word “storytelling” - as I suggested in the previous entry - but I believe the intent is the same.  By hearing stories of recovery from survivors and caregivers, healing supporters who are new the experience can be better educated and more fully psychologically prepare for any changes that occur in the survivor.

Retaining former friendships after brain injury is not an easy task.  It requires commitment by both the survivor and the friends - I will even suggest that “Close Friendships” are the hardest relationships to retain after an injury because they exist in that strange in the in-between-neither-zone described above, and there’s the rub.  Pulling from my experience, I remember trying to hold onto these friendships as one of the most important things after my accident - and therefore, as some of these friendships drifted away, these became some of the most difficult loses.  Recognize, this is MY experience, and I do not claim to speak for other survivors, but these friendships came to represent - in a very personal manner - the progress of my recovery - a fantasy scale that measured how well I was doing.  I felt that if I could retain these close friendships - or forge a new, similarly close group of friends - that would prove that I had recovered successfully and was still the same person - that some core social aspect of me remained constant.  Was this just me?  Do other survivors place the same sense of the importance in former friends?

Friendships come and go, yet the sudden nature of brain trauma clearly highlights this inevitable change - and so, this is another example of the difficult job a survivor has of acknowledging the pains of change in all its slow and sudden forms.

Having shared those thoughts, I’m eager to read your ideas.  The reaction of close friends after brain injury is a topic I’m interested in, and I would love any leads to readings about this.  So far, most of what I have found discusses the survivor’s perspective of losing friends and how to accept and prepare for these changes - understanding the survivors story is important, but I’m curious to find any information from the perspective of the friends - why do they feel the urge to pull away from a survivor?  How do friends see their role during a survivor’s recovery process?  Any leads you can pass my way will be greatly appreciated.

Chat soon.