Primary and Secondary Losses

Brain Injury Blog by Janelle Breese Biagioni

March 14, 2011

Primary and Secondary Losses

After a loss – death, divorce, separation, or other painful transition – the person encounters primary and secondary losses. Catastrophic injuries are also ways to encounter primary and secondary losses.

Primary Loss

Primary losses result from the “event” or the “call.” In this instance, a brain injury is the event and the survivor experiences primary loss(es) due to the impact of their injury. The primary loss can include changes in personality, and cognitive and physical deficits. The impact of brain injury on the survivor’s life can be staggering and the day-to-day challenges from these life-altering changes can be overwhelming for everyone.

Secondary Loss

A secondary loss spirals from the primary loss.  So for an individual living with the outcome of a brain injury, because of cognitive and/or physical challenges, they may not be able to return to work. This could result in a change in income for them. If the change in income is significant, there could be a change in lifestyle. This could mean they can no longer afford to take a vacation, go out to eat in a restaurant, or continue with their favourite hobby. These are secondary losses.

Others in the family will share in some of the losses with the survivor, but they may also have their own secondary losses to work through.  For example, a husband or wife may have to leave their job to provide care to their spouse. Children may have to forgo participating in community activities due to financial constraints or because the parents are not able to get them to and from events.  These are secondary losses.

A significant secondary loss comes with changes in roles and relationships. A spouse is often assuming the role of caregiver and children may be asked to take on more responsibility than they should. The interaction between family members may have changed drastically and they no longer have the same relationship.

Each person needs to explore their losses and find appropriate and safe ways to express their feelings of grief.

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One response to “Primary and Secondary Losses”

  1. Marie G. Cooney says:

    I wish my family better understood the primary and secondary losses of TBI. Maybe in time. Thanks for your thoughts on this subject. I am finally reclaiming my life: a partial combination of who I was, who I am, and who I am becoming. Time will tell if friends and family will follow suit.

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