Identity changes after brain injury


Brain injury has a life changing impact upon the individual. People face a long recovery with no guarantees that they will function as they did before the injury. Their deficits and struggles may mean that they are unable to work in their previous profession, partake in leisure activities or hobbies they once enjoyed, or meet with friends for support and a laugh. As a consequence, their personal identity is blown to pieces and they are left with the question  – ‘who am I and where do I belong’. Many of our clients have reported to us that they feel a strong sense of loss after a brain injury, a loss of everything they feel makes them who they are.

Group life is crucial in the formation of identity. When we are asked to describe ourselves, we often use the groups we belong to in order to portray the person we are. We have identified that the loss of group membership after brain injury (i.e. work, hobbies, clubs, meets), has a devastating impact upon the individual’s psychological wellbeing. Most of our clients disclose that in some way, the consequences of brain injury make it hard for them to maintain group memberships and friendships they had before for various reasons. Because of this, they become socially excluded and struggle daily with no sense of purpose, peer interaction or meaning to their life. It is also commonly reported to us that with this sense of social exclusion and isolation, many psychological struggles such as depression and anxiety become apparent.

Everyone needs a certain minimum quantity of regular, satisfying social interactions to be happy and an inability to meet this need results in loneliness, mental distress, and a strong desire to form new relationships. Belongingness is the human emotional need to be an accepted member of a group. Whether it is by family, friends, co-workers, or even a sports team, humans tend to have an inherent ‘desire’ to belong and to be an important part of something greater than themselves.

Brain injury can impact on many different areas which make social interaction difficult. Issues with speech and language, information processing, and poor memory can all have an undesirable impact on a brain injury survivor’s social life. This can lead to many people giving up on trying to stay connected to their various social groups.

Group memberships form the basis of both our social and personal identity. They also have positive implications for our well-being and play an important role in helping individuals adjust to the transitions they experience throughout life. Change always creates a certain amount of stress for people, however regular social interaction can mitigate the effects of the stress. A positive transition that may involve moving to a higher-status group (e.g. a promotion, or moving home to a more desirable area) and the positive implications of this for self-esteem can help counteract any adverse consequences of the change itself.

On the contrary, negative life changes often involve a loss of such memberships or movement into a less attractive group, which has the opposite effect and can result in problems of uncertainty and challenge. Many life transitions impact negatively on well-being, at least in the short-term.  These negative life transitions are particularly apparent where the transition itself entails total loss of, sometimes multiple group memberships, combined with a loss of cognitive function and a deterioration in cognitive and/or physical ability — as is the case when individuals suffer from a traumatic brain injury. Such an unplanned transition requires significant adjustment and if not managed appropriately in the early days, can severely compromise a person’s well-being and plunge them into experiencing feelings of isolation, loneliness and despair.

Due to our understanding of the complexity of brain injury and how difficult these life transitions are, at Chrysalis we support individuals along their journey and help them to embrace their change. In the early days it is a struggle to accept the ‘loss’ of their former self. Naturally a person changes throughout the course of their life, but because brain injury happens in an instant and is a change that is thrust upon the individual and not a change that was a choice, it is hard to accept.

After brain injury, acquiring new group memberships helps individuals to build their sense of self.  Our aim is to be pro-active and help our clients to discover new hobbies, activities, educational and vocational interests within their local community, in order to formulate new friendship groups and thus begin to rebuild a new identity.

We have established a ‘FITBIT’ walking group to connect our clients using digital technology, as many were keen to improve their activity/fitness levels. A Fitbit is a pedometer which is worn on the wrist. It also has a sleep tracker, records mileage, heart rate and calories burned. An app is downloaded to the client’s smartphone, which logs activity and sleep. A great feature of the Fitbit, is that it enables people to connect by being ‘friends’ in the app and therefore you can see how many steps your ‘friends’ have taken, send messages and also ‘cheers’ and ‘taunts’.

The group has been a great success, providing a talking point, an interest and enabling members to connect to each other and participate in both personal and group challenges. In addition, we have reported physical benefits- such as weight loss- and also improved wellbeing amongst our clients. The group members feel more positive and are doing a fantastic job of providing support and encouragement to each other. We have seen clients form strong social connections, which is leading to them reporting feelings of confidence and independence.

Re-establishing positive social group-membership is a key priority at Chrysalis , as well as promoting healthy lifestyle choices.