Emotional Issues Associated with BI
Sibling Issues
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The brothers and sisters of individuals who have acquired brain injury are often overlooked in the process of recovery and rehabilitation. This is a mistake that even experienced therapists and professionals working with families frequently make. The obvious impact of brain injury affects everyone in the family and may well be viewed as a “family affair” (Lezak, 1978).
Because of the age and maturity differences among siblings, no two individuals will react similarly to the effects of brain injury. Moreover, reactions to the family member with the brain injury will change over time. Therefore, the skilled therapists must carefully assess every family member’s reactions and anticipate changes over time.
Some common reactions among siblings are:
- Guilt
- Role Changes
- Regression
- Resentment
- Anger
- Worry
- Embarrassment
- Feeling Neglected
- Confusion
- Blame
- Withdrawal
Family members will typically experience a grieving process in response to the members injury. This process involves shock, grief, guilt, anger, depression and eventually coming to terms with differences in the person. Accepting the brain injured person’s deficits and responding to them in a fashion that enhances both personal and family functioning is a major goal of this process.
What families can do…(from the Brain Injury Survivor/Caregiver Manual, 2001)
- Provide education and reassurance.
- Take into account the age and maturity level of each family member and appropriately address their questions and fears.
- Include children in the rehabilitation setting when appropriate.
- Encourage writing or journaling their own story of the accident and questions that arise during exercise.
- Encourage counseling at an individual and family level and consider having the whole family present during the early, middle and later stages of recovery.
- Maintain honesty and adopt a direct attitude about what to expect for the brain injury survivor when s/he returns home.
- Anticipate that the family will go through periods of anger, denial, and depression before accepting the full ramifications of the brain injury and changes that have occurred.
- Siblings may act out as results of changes in the family. This is to be expected, and issues such as anger, resentment, jealousy, role changes, etc. should be addressed.
John Sass is a clinical neuropsychologist specializing in the diagnosis and treatment of individuals and family members who have sustained acquired brain injuries. He is the consulting neuropsychologist for the Restore Neurobehavioral Program in Roswell, Ga and maintains a private practice at the Center for Cognitive Rehabilitation in Dacatur, Ga.
References: Marcus, J. & Irvin, E (2001) Brain Injury Survivor and Caregiver Educational Manual: Aspen Publication, Gaithersburg, MD.