More individuals within the U.S. suffer from traumatic brain injuries (TBI) than breast cancer or HIV/aids and is one of the leading causes of disability. Due to the prevalence and severity of TBIs, it is essential for couple, marriage, and family therapists to understand TBIs common symptoms and treatment options for couples struggling with intimacy post diagnosis. Despite the need for further discussion and guidance, minimal literature presently exists incorporating a systemic approach for couples where one partner has encountered a TBI. In an effort to address this gap, the present article aims to provide, (1) awareness and contextual understanding on how TBI’s shape couples experiences and (2) a suggested approach for treating couples to enhance their intimacy through a narrative lens. Those who experience a TBI can face many symptoms including increased impulsivity, disinhibition, aggression, lack of communication, depression, and sexual dysfunction. Narrative therapy may be uniquely equipped to assist couples experiencing these symptoms from a TBI by allowing couples to externalize the problem, create new experiences around this problem, and strengthen their new experiences. This suggested approach is delineated, applied to a clinical example, and discussed.