By Jacob W. Gent, Attorney at Law
A traumatic brain injury can have far reaching consequences. The impact of a traumatic brain injury affects not just the injured person, but also the survivor’s family and friends. The adage in the brain trauma rehabilitation community that “when one person has a brain injury, the whole family has a brain injury” is true in many ways and levels as the roles of family members change. The recovery process following a traumatic brain injury can be a long and difficult process. It is essential for the survivor to have a strong support network to aid in adjusting to life after a brain injury.
Much research has been performed examining the psychological difficulties experienced by survivors of TBI, and to a lesser extent, their relatives. A 2006 study conducted at the University of Quebec, examining the adjustment process from the perspective of the TBI individual and the survivor’s spouse, sought to identify the personal characteristics associated with greater marital satisfaction during the couple’s post-acute phase of recovery following TBI. The study sample was comprised of 140 French-Canadian individuals. The 70 target group couples (where one spouse had sustained a TBI) were recruited from various rehabilitation centers throughout Quebec. Test subjects were asked to complete questionnaires which measured five variables: (i) perception of communication skills; (ii) coping and social problem-solving skills; (iii) levels of anxiety and depression; (iv) general well-being; and (v) marital satisfaction.
The first goal of the study was to identify the personal characteristics of each couple that promoted psychological adjustment and marital satisfaction. The study found that positive coping strategies and problem-solving skills were important to effective adjustments during the recovery process. Moreover, individuals with a positive attitude in general tended to have a more positive outlook in times of challenge. Conversely, people with a negative outlook reported more worry and psychological stress. The use of avoidance, e.g., not dealing with issues and problems, and not using social support-seeking strategies limited or impaired the psychological adjustment of the affected couple.
The study also found that individuals with TBI frequently adopt an ineffective attitude toward problems and often avoid challenges. The behavioral and cognitive dysfunction caused by TBI can impair the injured individual’s ability to reach optimal results when problem solving. Over time, TBI survivors tend to believe they have no significant control over their environment and feel powerless in the face of challenges. This can cascade into developing a negative outlook towards problem solving and begin to employ avoidance as a coping strategy. The study concluded that individuals with ineffective attitudes tend to view problems as a menace to an individual’s well-being; doubt their own ability to solve problems successfully; become easily frustrated and distressed when confronted with problems of day-to-day life; and maintain a pessimistic outlook in general.
The second goal of the study was to determine whether there was any significant interaction between the personal characteristics of one partner and the psychological adjustment and marital satisfaction of the other partner. The researchers found that effective use of problem-solving strategies, a positive perception of one’s own communication skills, and infrequent use of avoidance strategies by the care giving spouse were shown to produce a high level of marital satisfaction for the injured spouse. In addition, couples with a positive perception of their spouse’s communication skills reported a higher degree of marital satisfaction. Other variables associated with positive psychological adjustment and greater marital satisfaction included an individual’s positive perception of the communication skills of both their spouse and themselves, as well as minimal use of avoidance coping strategies.
Results of the study suggest that effective attitudes towards problems, infrequent use of avoidance coping strategies, and the perception that one’s spouse possesses good communication skills are traits which promote a higher degree of marital satisfaction following a traumatic brain injury. The authors recommend that TBI rehabilitation efforts look into placing TBI survivors in situations where they could successfully test and enhance their problem-solving skills to promote self-confidence and decrease the use of avoidance as a coping strategy; help the TBI survivor come to terms with their limitations and learn to accept the “new normal” may enable their ability to cope with challenging situations involving social interaction; and assist couples in improving their communication skills.