Identity. The way we think about ourselves, the stories we tell which help define ourselves and who we are, concepts about what we do, the groups we belong to, how we operate in the world, our unique histories and cultural identities. All that comes together to create our identity or sense of self. This is me. It’s a strange thing, often sitting in the background until something happens which brings it to the fore. 

Traumatic Brain Injuries are potentially one of the most life changing events a person can experience, resulting in significant effects across a wide range of life from: cognitive, emotional, physical, social, vocational, perception of control over one’s life and more. It is often in the quiet moments that unseen, or perhaps un-thought of effects creep in, the grief and loss around who am I? Life, as previously known, often feels lost (Haynes, 1994).  

Research has shown that identity change following a traumatic brain injury is associated with depression, grief, negative self-esteem and sense of sense (Carroll & Coetezer, 2011; Desdentado et al, 2021). Who am I when I can’t do what I did yesterday? Who am I when my world feels smaller because I can’t manage the social interactions like I once did? When I no longer respond the same way I used to? When my body changes and can no longer support what I used to do? When I feel fine one minute then suddenly my chest is tight, my breath is fast, my body full of tension and anxiety washes over me because of something seemingly insignificant? When where I used to be, and where I want to be, feel so far removed from one another.  

Who am I?  

These are complex questions that often carry a sense of loss. When we experience loss, a person, a pet, a job, it is healthy and healing to go through a grief process. Yet when it comes to concussion and potential related losses there seems to be little space for grief or understanding.  

I feel a large part of the difficulty around identity grief is that it seems unseen. We cannot see a concussion or monitor its effects and healing in the same way as we can a knee that has split open after a fall. This ‘invisibility’ means others too cannot see it, leading to impacts in relationships and families we may not have been prepared for, adding another layer of complication to this identity grief.  

I myself remember questions from others which I couldn’t quite answer; “Why can you not come to work today when you were able to yesterday?” “You look fine.” “You said you would come to the barbeque today, you were fine this morning, how come you can’t come now?”. 

So how does one begin to face this?  

There is no easy answer, no one size fits all, no magic pill, but the first thing to keep in mind is your identity may never be the same as it was before your injury. Like so many things in life, and in grief, trying to get back to how things were or who we were ‘before’ is just not possible.  

Identity is never fixed and through this experience you will have changed. However, it is important to remember that different doesn't always mean bad! Sometimes the weight of our ideas around who we are supposed to be, what life is supposed to look like can trip us up. When life doesn’t align with that vision we can feel that no other vision will have us feeling a sense of well-being or accomplishment, but there will always be other things in life that bring a sense of purpose, passion, wholeness and contentment. Even if these things feel far away or unattainable now, these will slowly become a part of your life. 

I believe self-compassion is key. Self-compassion, the ability to be: 

Touched  by  and  open  to  one’s  own  suffering,  not  avoiding  or  disconnecting  from  it,  generating  the  desire  to  alleviate  one’s  suffering and  to  heal  oneself  with  kindness.  It  also  involves  offering  non-judgmental  understanding  to  one’s  pain,  inadequacies  and  failures, so  that  one’s  experience  is  seen  as  part  of  the  larger  human  experience (Neff, 2003, p. 87). 

Literature posits self-compassion may be a key self-construct after injury as it has been shown to be helpful in alleviating emotional suffering (MacBeth & Gumley, 2012; Zessin et al., 2015).  

How do we cultivate self-compassion?  

Try to be patient with yourself and show care. If you find it difficult to do this perhaps you can imagine a friend, family member, or pet and imagine how you would do this for them. How would you talk to a friend or a child who was struggling or experiencing feeling overwhelmed? Chances are you wouldn’t berate them or tell them to get over it, or that they were being stupid! Give yourself the grace you would give someone else. Allow yourself to have difficult feelings. 

Breathe.  

Our breath is one of the most powerful tools we have. Inhaling for six seconds and exhaling for six seconds for two minutes at a time will begin to settle your autonomic nervous system and allow you to be more present in the here and now. Practicing mindfulness is part of self-compassion as it allows us to centre ourselves in the moment. Do the things you can that bring you a sense of joy, contentment or wholeness. 

Reflect.  

Take time to reflect on changes whether it be through journaling, talking with a friend or counsellor, art, or other forms of expression. Try not to focus not just on losses, but on growth, gains and hopes you hold. You may hold new perspectives, new skills and formed closer relationships. Acknowledging and having space to grieve for the parts that may ever be the same is powerful, so too is bringing forward and celebrating the new pieces that have been built.  

The journey through head injury and healing is unique for everyone. We all come with unique histories, experiences, beliefs, and capacities. Remember, the person you were is still a part of you and will continue to be a part of you moving forward. 

-Sophia

 

References 

Carroll, E., Coetzer, R. (2011). Identity, grief and self-awareness after traumatic brain injury. Neuropsychological Rehabilitation, 21(3), 289-305. https://doi.org/10.1080/09602011.2011.555972 

Desdentado, L., Cebolla, A., Miragall, M., Llorens Rodríguez, R., Navarro, MD. & Baños, RM. (2021). Exploring the Role of Explicit and Implicit Self-Esteem and Self-Compassion in 

Anxious and Depressive Symptomatology Following Acquired Brain Injury. Mindfulness, 12(4):899-910. https://doi.org/10.1007/s12671-020-01553-w 

Haynes, S. D. (1994). The experience of grief in the head-injured adult. Archives of Clinical Neuropsychology, 9(4), 323–336. https://doi.org/10.1016/0887-6177(94)90020-5 

MacBeth, A., & Gumley, A. (2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. https://doi.org/10.1016/j.cpr.2012.06.003 

Neff, K. (2003). Self-Compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85-101. https://doi.org/10.1080/15298860309032 

Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.1205