Casey Templeton for The New York Times
BEFORE AND AFTER Hugh and Rosemary Rawlins have put their lives back together since his 2002 brain injury, but their struggle has included her diagnosis of post-traumatic stress syndrome.
At a crowded vigil on Sunday night in Tucson, Representative Gabrielle Giffords held her husband?s hand as she stepped up to the lectern to recite the Pledge of Allegiance.
Casey Templeton for The New York Times
RECOVERY Hugh Rawlins has returned to surfing and biking since his bicycle accident.
It had been one year since a shooting at a Tucson supermarket killed six people, injured 12 others and left her with a severe brain injury. Ms. Giffords?s appearance was greeted by an enthusiastic crowd that applauded her remarkable progress toward recovery.
The man next to her, fighting tears, offered his own remarks. ?For the past year, we?ve had new realities to live with,? said her husband, the astronaut Mark E. Kelly. ?The reality and pain of letting go of the past.?
Captain Kelly was speaking of the survivors of the shooting. But his words echoed the sentiments of many brain injury survivors and their spouses as they grapple with interpersonal challenges that take much longer than a year to overcome.
Until recently, there had been little evidence-based research on how to rebuild marriages after such a tragedy. Indeed, doctors frequently warn uninjured spouses that the marriage may well be over, that the personality changes that can result from brain injury may do irreparable harm to the relationship.
Captain Kelly and Ms. Giffords largely have kept private their own experiences in this regard, and they declined to be interviewed for this article. Still, therapists are beginning to understand the obstacles that couples like them face, and what they are learning may lead to new counseling techniques to help restore the social links that give lives meaning.
Contrary to conventional wisdom, many relationships do survive after a spouse suffers a brain injury. Some studies find divorce rates well below the national average among these couples. A 2007 investigation found that the divorce rate was around 17 percent in couples followed for as long as 90 months after a spouse sustained a brain injury.
That is not to say these couples are always happy.
?Two or three years later, they want a whole lot more than simply to be alive,? said an author of the 2007 study, Jeffrey S. Kreutzer, a psychologist at Virginia Commonwealth University in Richmond. ?While people may technically be married, the quality of their relationship has been seriously diminished.?
Dr. Kreutzer and other psychologists at V.C.U. are among the few therapists in the country trying to develop marriage counseling techniques tailored to couples dealing with brain injuries. Traditional marriage counselors often hope to restore people and their relationships to their original luster. For Dr. Kreutzer and his team, recovery often means teaching uninjured spouses to forge a relationship with a profoundly changed person ? and helping injured spouses to accept that they are changed people.
The research is still in early stages, and in many ways the therapeutic toolbox is not much different from that of regular marriage counseling: Couples coping with a brain injury are taught to communicate better, to focus on positive developments and things they like about each other, and to set aside time to inject a little romance and fun into a life that can be consumed by doctors? appointments and paperwork.
But other traditional techniques can backfire with these couples, the researchers have learned. For example, said Emilie Godwin, another V.C.U. psychologist, encouraging partners to remember what sparked their love in the first place can mean ?highlighting the things that have probably been lost.?
?You?re asking people to just look forward, to not look back at all,? she said. ?To try to recreate a relationship.?
The Stranger in the Living Room
About a month after surgery to remove a brain tumor in 2006, Terry Curtis turned to his wife, Vicky, and offered her a divorce.
?I told her she was free to leave,? he said. ?I?m not the person you married.?
Mr. Curtis knew he had become cold, impulsive and incapable of focusing his attention. But it would be 18 months before doctors explained to the couple that complications from surgery had caused a brain injury.
Mrs. Curtis, 60, was once drawn to her husband?s ?sparkle,? she said. After the injury, he ?flat-lined? emotionally, and he suffers from depression, anxiety and a lack of motivation.
Source: http://feeds.nytimes.com/click.phdo?i=e1d7bb6d506ef7e44a0ec1bb7e5d610c
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