In this article, I will be focusing on challenges in relationships after brain injury, specifically spousal relationships. I will be writing other articles on this topic because there are so many aspects to cover.
As brain injured survivors and their spouses can tell you, there are many complex dynamics in the brain that impact significantly on functioning after injury. One area that is commonly affected is the connection between emotions and rational thinking.
According to the manual Rebuilding Relationships After Brain Injury(developed by Prince George Brain Injured Society, 2019), the imbalance of emotions and rational thinking can be most impactful on a relationship.
The limbic system, located in the middle of the brain is known as the "child brain." The limbic system does not think or reason and does not mature past the age of a young child. The purpose of the limbic system is survival and to express raw emotions such as happiness and fear. The "me," "I want,” "I don't want" is the survival aspect seeking relief and avoiding pain.
In the frontal lobes of the brain exists rational thinking also known as the "adult brain.” The frontal lobes filter out emotions and are the home base for thinking, reasoning and logic, sending out messages such as "I should,” "be fair" and "do what is right.”
In a healthy adult brain, the limbic system and frontal lobes communicate and work with each other to maintain a responsible and balanced response to internal and external stimuli.
After injury, the relationship between the limbic system and frontal lobes becomes fractured. The frontal lobes are slower to respond and the limbic system takes over. As a result, there is no balance or filtering ability and the raw emotions come spilling out. The injured partner is not able to think before they talk and/or act. There is also an opposite extreme. The injured partner may not feel emotions and presents as flat and empty.
In my case, my emotions are flat. The assumption that this is better than being explosive is far from accurate. Trust me when I say that being emotionally flat is not a blessing. Not being able to express emotions angers and annoys people just as much as an unfiltered child brain response. Appearing like I don't care or have no empathy has brought the people in my circle and me much grief because this is not who I was before injury.
There are factors that can make the imbalance between rational and emotional worse. Pain, fatigue, unexpected events, frustration, anxiety, depression and fear can tip the overloaded plate. To make matters even worse, the uninjured partner can become unbalanced in their child and adult brains as well. Both the injured partner and their spouse have needs they want met. How they achieve this is an individual and ongoing process that requires communication and incredible patience and self discipline.
In my previous column, I wrote about flooding. In some instances, flooding can prevent an outburst if the survivor is aware of what their triggers are. To flood or shut down can be a strategy to avoid an unpleasant scene. Although flooding can be damaging to the injured brain, under some circumstances, survivors resort to this to prevent further damage to their relationships. This is one example of how complex the dynamics can be when faced with a dilemma and having to make a trade off to achieve some form of balance in a strained relationship.
