Brain Injury
Oral Presentation
Rolf Gainer, PhD
Founder and Principal
Rolf B. Gainer and Associates
Palm Springs, California
Nicholas Mehrnoosh, MS
Graduate Student
Eastern Washington University
Spokane, Washington
An individual's life can shift dramatically after sustaining a traumatic brain injury (TBI). The dynamics of life, from interpersonal relationships to professional goals, has the potential to fundamentally change the course of life due to the biological impact of the injury. At the core of these changes, is the paradigm of the self. Through case study research, we will explore the narrative of loss and reconciliation of the self as it pertains the recovery trajectory of those that sustain a TBI. Strategies to promote hope and positive outcomes during rehabilitation and long-term recovery will be identified and reviewed.
Life begins with ambiguity, with little drive nor purpose. As individuals develop, from youth to adulthood, the ambiguous nature of life is honed into clear decisive borders. Within those borders, individuals create, define, and interweave their paradigm of ‘the self’ through all aspects of their lives. Through this understanding, there exists a continuity of the self that has both consistent and ever-changing characteristics that are shaped by experiences, both good and bad. A traumatic brain injury (TBI) is but one of those experiences, which previous research has shown has the potential to fundamentally disrupt the continuity of the self leading to alterations in an individual’s functional abilities (Ben-Yishay et al., 1985; Wilson et al., 2009; Ylvisaker, McPherson, Kayes & Pellet, 2008). The importance of the self can be derived from the notion that human consciousness cannot exist without some form of the self to drive it, allowing individuals to shape the course of their lives (Feinberg & Keenan, 2004). Thus, the self enables personal agency over several platforms of life within our communities and the broader society. For this reason, among others, the essence of life is tremendously impacted by the thematic narrative of loss and reconstruction of the self that has been reported in the months to years following a TBI. These themes are accentuated by the continual manifestation of neurocognitive deficits, which are further influenced by the fundamental changes in social roles and statues, global functioning, and overall psychological resilience that facilitates a new ambiguity in life. The ambiguity created after a TBI requires a reconciliation process that hones the “new self”, which is uniquely person-centric. Any reconciliation will thus be complex and riddled by a paradoxical conflict within the self. Such a conflict arises as survivors of a TBI recollect upon their pre-injury view of self and the perception of themselves within the memories of others, yet are simultaneously grasping to understand their “new self”. The conflict can come to a potential resolution when the individual accepts themselves and adapts to their new lives, thus facilitating a resilience that can carry them forward throughout their life. Nurturing the development of such a process after a TBI can be difficult, yet it’s crucial for a successful reconciliation that is fundamentally tied to the thoughts of oneself and by interactions with other individuals or institutions throughout society. Thus for many individuals, life after a TBI is about finding hope in the darkest experiences of their lives. Through case study research, the following presentation will focus on describing the narrative of reconciliation, in order to provide strategies to enhance the rehabilitation and long-term recovery of individuals that sustain a TBI.
