Loss of self: A narrative study on people with traumatic brain injuries

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Counseling and Human Services


Douglas P. Biklen


brain injury

Subject Categories

Social Psychology


This study elucidated the meanings of "loss of self" represented in the self-narratives of people with traumatic brain injuries (TBI). Using a qualitative research method, I conducted participant observations of and interviews with ten TBI survivors. I also used first-hand accounts of other individuals with TBI, drawn from an email Listserve, TBI Support List, as well as from journal articles.

Qualitative analysis of the data revealed four interrelated categories of loss of self. The first category is "loss of single self-history." People with TBI are likely to have two contradictory views of their lives. One view says that the self-history is continuous despite TBI, whereas the other says that it is discontinuous because of TBI. The second category is the "opaque self." Many TBI survivors have lost clear self-knowledge and are uncertain of what they can do in society and in the future, as well as in their immediate environments. The third category is the "devalued self." TBI survivors tend to feel that their present selves are valueless when they compare themselves with pre-injury selves in terms of interpersonal relations, job capacities, senses of present time, and future possibilities. The fourth category is the "labeled self." People with TBI often sense that society presses upon them negative labels that contradict their own self-images.

The data also showed that TBI survivors devised many strategies to overcome their experiences of loss of self. They may clarify their functional changes by describing, explaining, and controlling their opacity. They may restore value of the self by keeping the hope of recovery, by making downward comparisons, and by re-interpreting their TBI experiences. Also, they may negotiate their self-images with society by distinguishing the self from negative connotations of TBI.

Thus, loss of self is not a monolithic concept but involves several aspects in the person's self-narratives, constructed in the person's interaction with self, environment, and society. For the intervention of loss of self, professionals should attend to self-narratives of people with TBI and underlying interactional processes, and assist them to change those narratives directly or indirectly.


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