When a person suffers a brain injury, the change does not happen all at once. It takes time to understand what exactly has changed. Both the person and those around them struggle to grasp what has shifted—what qualities remain, and what will never be the same again.
What characterizes this period is silence. It is hard to talk about the implications of a brain injury. It is difficult to understand, and even harder to explain. Often, this silence surrounds not only the injured person but also those closest to them—spouses, children, parents, or friends—who are forced to deal with a new and complex reality.
To illustrate this, I will share a true story. It happened many years ago, when I was a young woman at the start of my journey. This story has stayed with me, and today I want to give it a voice.
The Story of Clara
My dear mother had a cousin named Clara. They were like sisters, deeply connected, as neither had siblings at the time. Every Saturday morning, they would talk on the phone for an hour. They spoke Yiddish, and as a child, I could not understand their words, but I saw the closeness and love between them.
Clara was married to Carl, a tall man with a deep bass voice. Carl was an accountant who ran the household with a firm hand, while Clara, a gentle, smiling, and shy woman, fulfilled the role of his devoted wife. They were a loving couple, but childless, with no close family.
When Carl passed away, Clara moved into a nursing home. There, a new caregiver appeared in her life—she seemed very devoted, perhaps too devoted. Gradually, Clara’s connection with my mother began to fade. The calls stopped, the visits became rare, until one day Clara told my mother that her caregiver had suggested she stop receiving visitors.“It’s not good for me,” she said. “I need quiet.”
This rejection was incomprehensible. Clara, who had been so close to my mother for decades, suddenly saw her as a threat. The closeness turned into suspicion, and the trust that had been between them vanished.
When the Brain Is Injured: Trust and Suspicion
The brain has its own logic. When it is injured, a person’s behavior can change dramatically. What was once clear and understood—becomes uncertain.
Trust and suspicion are fundamental parts of our lives. From a young age, we learn to distinguish between whom to trust and whom to be cautious of. This ability develops over the years through experiences, social learning, and complex emotional processes.
When a brain injury occurs, this ability is damaged. This happens primarily due to changes in the frontal lobe, the part of the brain responsible for judgment, emotional processing, and recognizing the intentions of others (1).
How Does It Manifest?
Misjudging intentions: People who were once close and trusted may suddenly be perceived as suspicious. On the other hand, strangers or new figures might be seen as trustworthy.
Loss of social intuition: The person struggles to recognize who truly has their best interests in mind and who does not.
Emotional dependency and blind trust: Out of a need for security and support, many injured individuals cling to new people who enter their lives, even if their intentions are not pure.
The Neurological Perspective
The frontal lobe regulates our interaction with the environment. When it is damaged, connections to deeper brain structures like the amygdala, which is responsible for emotions like fear, are disrupted. As a result, the individual begins to interpret reality incorrectly (2):
What should seem threatening may be perceived as beneficial.
What once felt safe and secure can become suspicious.
A person who once intuitively understood who cared for them and who did not may now struggle. The sense of security they once had becomes fragile, and in its place arises a heightened suspicion.
Suspicion That Becomes a Barrier
In Clara’s case, the close bond with her cousin turned into suspicion, while the caregiver became the central figure in her life. This was not a conscious choice on Clara’s part. A brain injury altered how she experienced the world.
These changes affect not only the injured individual but also those around them. Loved ones find themselves facing a person who has changed:
The pain of losing a relationship that once was.
The frustration of misunderstanding and rejection.
The hope that the relationship might return to what it was.
The disappointment when it becomes clear that the change runs much deeper.
It is a turbulent journey of closeness and distance, of hope and disappointment.
Summary
A brain injury transforms not only the individual but also their relationships with those around them. It undermines trust, fosters suspicion, and leaves loved ones feeling confused and helpless. In Clara's case, the love and trust that had existed for years gave way to a new dependency, leading to a painful disconnection. Of course, this is just one example, and an extreme one, where someone intentionally influenced a very elderly and lonely woman—a woman who, even at her best, had grown accustomed to her husband managing her life. This created fertile ground for a new figure to fill the void left behind. Most cases are not as extreme, but the sense of shaken trust and the intrusion of suspicion into relationships can still cause pain and damage, even to a much lesser extent.
Alongside understanding the neurological mechanisms at play, it is equally important to acknowledge the emotions of hope and disappointment—feelings that accompany this journey for both the injured individual and their loved ones.
Bibliography
Kolb, B., & Whishaw, I. Q. (2015). Fundamentals of Human Neuropsychology. Worth Publishers.
Rolls, E. T. (2019). The Brain, Emotion, and Decision Making. Oxford University Press.
McDonald, S. (2013). Impairments in social cognition following severe traumatic brain injury. Journal of the International Neuropsychological Society.
Stuss, D. T., & Knight, R. T. (2002). Principles of Frontal Lobe Function. Oxford University Press.
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