When the Family Needs to Change—Not the Survivor

After a brain injury, families often hope their loved one will “go back to how they were.” They wait for signs of the person they remember—their personality, independence, energy, or emotional steadiness. This hope is rooted in love, but it can unintentionally cause harm.

Here’s what I’ve learned from over 20 years of supporting brain injury survivors: the person has changed. Sometimes permanently. Often in invisible but profound ways. Recovery is not about “getting back to normal”—it’s about adapting to a new normal that includes the survivor’s current strengths, struggles, and identity.

Families are frequently focused on the survivor’s progress, but rarely do they realize that they are also being asked to change. To grieve. To adapt. To learn how to support the person who exists now, not the one they remember.

Sometimes this includes learning how to live with unfamiliar behaviors. After a brain injury, survivors may become impulsive, emotionally reactive, or unfiltered. These are neurological changes, not personal shortcomings. When families hold on to outdated expectations, both they and the survivor can become stuck, frustrated, heartbroken, and disconnected.

Research supports this. A 2010 study by Kreutzer et al. introduced the concept of ambiguous loss—the experience of grieving someone who is still physically present but psychologically changed. Families who don’t receive support in adjusting their expectations often report higher distress and strained relationships. But those who do receive education and therapeutic guidance show stronger emotional recovery and better family functioning.

This is why therapy isn’t just for the survivor.

Talking with a therapist who understands brain injury can be life-changing for family members and loved ones. Therapy can help them grieve, recalibrate expectations, and begin to reconnect in a healthier way. In many cases, this kind of support for the family is the most important ingredient in long-term healing.

Brain injury recovery is not a solo journey. But it’s also not a one-way street.

Families, you are not failing by struggling. You are not failing by needing help. But healing—real healing—often begins when you let go of who someone used to be and learn how to embrace who they are now.