Responding to individual needs
People with TBI
are as varied in their sexual knowledge and experience as are the
rest of the community. Some will have sound knowledge and broad experience
from before the injury that helps them deal with post-injury sexual
issues. Their confidence in their ability to have sexual relationships
is likely to be affected if they have lost some social sensitivity,
or have developed sexual dyscontrol as part of a general pattern
of disinhibition, or have suffered loss of self-esteem and changed
body image. In these circumstances they will need help to deal with
will have had very little information and less experience before
their head injury. If they are still young, they will need to be
given appropriate sex education in accordance with their family’s
values, as well as follow-up opportunities to develop psychosocial
and sexual skills.
All people, including
those with TBI, are entitled to have basic needs in human relationships
and sexuality met.
Development of self-awareness and self-esteem
- Sense of oneself
as a unique individual, who is an acceptable person, after a head
of personal beliefs and values.
- Awareness of
own feelings and an understanding that everyone has them (anger,
love, embarrassment, hate, confusion, loneliness, guilt, fear,
- Being able
to express feelings in acceptable ways and to change them if required.
of a positive body image after a head injury.
- Sense of ownership
of, right to, or control over, one’s body.
about how the body works, including sexual and reproductive parts.
Awareness of others
- Awareness of
others, including their difference and sameness to us.
- Awareness of
the way we affect others via our actions and feelings, and development
of responsibility for our own actions.
of what relationships are, different kinds of relationships, different
kinds of behaviour involved in them.
of, and skills involved in, making and maintaining relationships.
Awareness of social custom/rules/values
- What is considered
acceptable behaviour in the general community, and variations in
relation to particular communities where appropriate.
- Specific awareness
of appropriate physical touching in relationships and of one’s
about different values people hold, particularly in areas of sexual
confidence in interacting with others and asserting one’s
own views and needs. This results in:
– less vulnerability to exploitation
– less compliance
– greater responsibility for self
– problem-solving and negotiating skills
– understanding the consequence of one’s actions.
Awareness of self as a sexual being
that sexuality is a normal and healthy part of life and that we
have choices about its expression.
the differences between love and sexual desire (they are not the
same thing) and appropriate ways of expressing them.
- Accurate, non-judgmental
information about sex, including possible consequences, such as
pregnancy and sexually transmitted diseases including HIV.
- Issues of rights
and responsibilities and issues connected to sex and different
kinds of relationships.
Adapted from Sexuality:
Rights and Choices produced by Philomena Horsley and Sylvia Azzopardi
for the Family Planning Association of Victoria, 1990