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One of the crucial elements in reforming relationships is forgiveness. If a brain-injury survivor was once cruel and mean-spirited, the injury may have turned him or her around into a caring and responsible individual. Family members and friends need to be able to forgive the past. There may also be the scenario in which a kind and gentle person has turned into an angry and pessimistic person. Try to forgive that as well. If you know it is not in their “nature,” perhaps there is a biological reason for the new behavior that they cannot control. Forgiveness may even need to come without an apology from the injured person, because he may not be aware of any prior or current offensive behaviors.

If a survivor has children, the issue of reforming relationships can be very complicated. Parents have their traditional roles, and children know this. When those roles change, such as when the parent is no longer able to serve as an authority figure, the children may rebel, retreat, or exhibit other harmful behaviors. If this is an issue in your family, we strongly urge you to get family counseling to help work this out.

Work relationships can also prove to be difficult to redefine. Whenever there is a hierarchical relationship that has changed, respect can become a big issue. If a survivor is returning to work in a reduced role, or even in the same role, coworkers and subordinates may not know how to behave appropriately. It may be helpful, on the first day back to work, for the survivor to provide an outline (verbal or written) of her new abilities, what the coworkers can expect, how she would like to be treated, and how they can expect to be treated.

Friendships may fade. At first, some friends will visit often, send cards and flowers, and call to say hi. But as time goes on, these people will carry on with their lives and not think about how difficult life is for someone else. Instead of dwelling on lost friendships, patients and caregivers should encourage formation of new friendships, perhaps with other survivors.

Reforming old relationships is a team effort. The survivor and his family, friends, and coworkers must work together to define and establish each person’s new role. These roles should be clearly outlined, agreed upon, respected and flexible.

Job Placement One of the most intimidating aspects of recovering for the brain-injury survivor is the prospect of going back to work. If the survivor can return to her prior


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