Break Free From Loneliness After a Brain Injury

Michael Cerreto, MS, CPCRT, CSC, LDR, Edu-K

Over the years, you woke up each morning with the certainty that your life would remain relatively stable. Then one day, you have a bad accident. When you wakeup after the accident, you are surrounded by nurses, tubes, beeping monitors, and the shock that something serious occurred but you can’t remember what. You find it hard to speak, remember, and move. You are staring down a future of doctors, rehabilitation, and uncertainty.

But time and resilience march on. After being diagnosed with a traumatic brain injury, you receive wonderful support and treatment and get a little better each month. You are encouraged by your progress but still think about the job you can no longer do and the friends who stopped calling. You feel guilty about how your family has been effected, and powerless to care for them as before.




The desire to make your life better is rooted in two basic human needs that guide your thinking, instincts, and behaviors: The need to be loved and to love others (feel connected) and the need to be constructive in life (contribute to others). These are powerful needs that can propel you to create a better life.

As you recover from your TBI, you begin to want more out of life. You may, however, feel constrained by your inability to follow conversations, remember, and do physical activities that once were effortless.

You feel lonely but reluctant to journey out of the house. So you withdraw into your own world of TV, reading, eating, and doctor’s appointments. Greater isolation and loneliness set in. Your basic need to feel appreciated by others goes unmet.

As humans, we try hard to avoid isolation and loneliness by creating expansive lives through school, friendships, sports, art, religion, and family. After a brain injury, your world shrinks. You can quickly withdraw into isolation and loneliness, which are shackles that constrain recovery.



You can break free from loneliness and expand your world again. Having a life of meaning and achievement can help you feel worthwhile and productive after a brain injury. You can have a renewed sense of mastery and control over your life, which are important to recovery.

First, you need to learn how to create relationships from scratch. When you were a kid, you probably had a larger variety of friends because you were around a lot of people your age each day. You had classmates, teammates, and neighborhood kids next door. These are called relationships of proximity. These relationships are quick to develop because you saw the same friends each day. You didn’t have to seek out people in unfamiliar places. Your friends were at your doorstep.

If you lose connection to work, school, and other groups after a TBI, you need to learn how to find places to meet people. In general, many people complain that they have fewer friends as they get older and question why. It is because, like a TBI survivor, they lose the daily proximity to people to form friendships over the years. So, you need to learn how to “find friends” on your own by getting involved in different groups. The Breaking Free From Loneliness Discussion Questions at the end of this article can help you get started.


Be More Accepting Of Yourself

As a brain injury survivor, you may hesitate exploring new activities and people because you have trouble following conversations, physically getting around, or finding the right words. You may worry about what others think about you. The likelihood is that many people are more understanding than you think. You also may be more critical of yourself than others are of you. Keep in mind that people will connect to your character, kindness, and interests regardless of how well you remember names and faces, and speak. Like you, they too have a need to connect and feel appreciated.


Preview Social Situations

If you find yourself hesitant to seek new opportunities to meet people, you can use a method called previewing.

For example, let’s say that you are invited to a party at a neighbor’s house and worry about feeling overwhelmed by the noise and conversations. Before the party, you should sit quietly and imagine the faces of the people attending. Select a few people who you want to speak with and what you want to discuss. Imagine having each conversation. When you go to the party, you should have those conversations, then decide if you want to stay or leave.

Previewing helps you imagine how to make a socially overwhelming situation more enjoyable because you prepare for it ahead of time.


Plan How To Expand Your Life

As a TBI survivor, you can work with a friend or family member to answer the Breaking Free From Loneliness questions below to determine how you want to expand your world. I discuss these questions with my patients and the discussion helps them determine how to escape from loneliness. So, find someone you trust and discuss these questions for yourself.

Whatever you choose to do outside the home to rebuild your life, make sure the activities are scheduled routines each week. For instance, every Monday you are at the gym exercising from 11:00am to 1:00pm; Tuesday you are taking a painting class from 4:00pm to 5:00pm, and so on. By making your activities set routines each week, you are more likely to followthrough and be consistent.


Breaking Free From Loneliness Discussion Questions


Step 1: Before your brain injury, what did you enjoy doing in the following areas:

Family activities:


Socializing with friends:





Sports and recreation:



Step 2: What other activities or interests do you have now that you did not have before your brain injury?


Step 3: Based on the lists above, select the top three activities that you want to consistently do with others outside the home at this time.


Step 4: How can you get involved with those activities outside the home each week on a regular, consistent basis?


Step 5: List the steps you need to take to get started (such as calling, emailing, or signup).



While many things may change after your brain injury, your needs to connect with others and contribute to their lives still remain. Fulfilling these needs can help you break free from loneliness, expand your life, and share yourself with the world.