Exploring Intimacy After Traumatic Brain Injury (TBI) for TBI Survivors and Their Partners

An exploratory qualitative study was conducted to examine the experience of intimacy following traumatic brain injury (TBI) for TBI survivors and their partners. This research study was informed by a social model of disability framework that encompasses the social as well as physiological aspects of the TBI experience. The research focused on capturing positive as well as challenging aspects of intimacy after TBI, thus departing from the emphasis on loss and burden in previous research. Multiple qualitative methods were utilized with thirteen couples in which one partner had sustained a TBI. Couples were diverse in terms of marital status, length of relationship, and time since injury. Initial in-depth semi-structured interviews and follow-up interviews six months later were conducted in an effort to understand the impact of TBI on intimacy and how the passage of time affected the intimate relationship. At the end of data collection, separate focus groups for survivors and partners were conducted to share preliminary themes with participants and to obtain their feedback and further insights. Results revealed that intimacy after TBI is a highly complex phenomenon that is not easily interpreted within the existing TBI and relationship literature. In this study, issues of relationship fragility were balanced against stability, especially as couples moved beyond the initial stages of injury. Relationship resilience was a common thread, but it was influenced by the quality and types of social support available to participants, by adequacy of communication, and by the psychological and relationship history of the couple. Also, factors such as societal misconceptions of TBI and comparisons to pre-injury selves threatened to thwart positive adaptation and relationship strength. Recommendations for future research include investigation of the relationship between pre-injury psychological coping skills and relationship well-being after TBI in order to identify high-risk couples in need of specialized intervention. Also, further study is needed to discern the potential of social peer support interventions to empower couples to reconstruct their relationships. Increased education for health care professionals and for society at large is needed to support ongoing awareness of intimacy and TBI as an important social issue.