Grieving Without End


People who are living with a brain injury and their loved ones are confronted with the impact of psychological loss. NeuroNotes has published a number of blogs on the subject of loss and the consequences of the loss experience. I have examined the loss phenomena in my work about the Loss of Self and most recently, in looking at Resilience. The term “Ambiguous Loss” was first used by Pauline Boss, PhD where she defined the concept of grieving over the loss of the attributes and personality of the person prior to their injury. The concepts associated with Ambiguous Loss include recognizing that the person is physically present, but psychologically absent.

In a video interview in, Jeffrey Kreutzer, PhD, discusses the implications of Ambiguous Loss for the person and their loved ones. Dr. Kreutzer, the Rosa Schwartz Cifu Professor of Physical Medicine and Rehabilitation at Virginia Commonwealth University and the Director of the Model TBI System, talks about the subject with great understanding in the attached video. Dr. Kreutzer discusses the response of women married to men with brain injuries referring to “(being) married to a stranger” or “married, but without my husband”. The person living with a brain injury also experiences loss of self and can view themselves as “not the same”. That loss can be profound and be a factor in severe depression and cause other psychological problems.

As we think about brain injury it is important to consider that the injury not only affects the person, but those around them. The Loss of Self which the person experiences and the Ambiguous Loss felt by their loved ones are aspects of brain injury which need to be addressed during the rehabilitation process and, in many cases, long after rehabilitation is over.

Click here to watch the video with Dr. Kreutzer.

About Rolf Gainer Ph.D.

Dr. Rolf Gainer is the founder of the Neurologic Rehabilitation Institute at Brookhaven Hospital in Tulsa, Oklahoma as well as the Neurological Rehabilitation Institute of Ontario, in Toronto, Canada. Dr. Gainer is a psychologist with more than twenty-five years of experience in the treatment and rehabilitation of individuals with brain injuries and a dual diagnosis. Dr. Gainer has designed and operated innovative rehabilitation programs in the United States and Canada for individuals who have been regarded as difficult to serve. He is currently involved in conducting two outcome studies related to the long-term issues faced by individuals with brain injuries and a dual diagnosis. He has presented papers throughout the United States and Canada in many professional conferences and educational forums.

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