(Re)Constructions of identity following traumatic brain injury: A discourse analysis
Traumatic brain injury (TBI) can cause a wide range of challenging and persistent difficulties, including disruption of normal cognitive, behavioural, emotional and physical functioning. TBI can also increase the risk of psychological and social problems. Personality disturbance, loss of sense-of-self and change in identity are key issues following brain injury and will constitute the main focus in this study. Eight individuals who acquired TBI between eight and 37 years prior to the study were interviewed. The text was analysed using two different theoretical approaches. Foucauldian discourse analysis (FDA) was used to explore how people with TBI (re)construct identity within their society and culture. The aim of using this perspective was to focus deeply on the social constructions of health, disability and illness, which have particular relevance for rehabilitation. The study also focused on the role of subjective experience of the individual and subject positionings within discourses. The analysis distinguished 33 discourses, which were conceptualised and integrated under five discourse themes: ‘identity in relation to disability and invisibility’, ‘identity as rebirth and ongoing development’, ‘identity as awareness and uncertainty’, ‘identity in relation to perceived normality and social belonging’ and ‘identity in relation to independence, acceptance and recovery’. A second reading applied Frank’s illness narratives (restitution, chaos and quest) to the text, in order to take the analysis and interpretive work in a different direction by placing the participants’ accounts of identity within a broader meaning-making process. The findings support the social constructionist view of identity as a fluid and multidimensional construct. The analysis suggests that while subject positionings of disempowerment and helplessness were common, the subject positioning of dependence has a shifting nature. The findings of this study may inform how clients with TBI adjust and accept ‘new’ identities following their brain injury. Clinical implications are discussed in terms of how psychologists could use psychological approaches to provide opportunities for clients to access alternative, more empowering discourses and subject positionings.
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