Understanding the rebuilding the self following TBI: Through the lens of Jungian analytical psychology
By Rebekah Dawson, MSc Psychodynamics of Human Development, Birkbeck, University of London and assistant support manager, Brain Injury Service, Sweettree Homecare Services
After a traumatic brain injury (TBI), many people describe feeling a profound loss of their sense of self. This study explores how individuals rebuild their sense of self after brain injury, through the lens of Jungian analytical psychology.
In Jung’s view, the Self represents the totality of who we are, including both the conscious and the unconscious aspects of ourselves.
Jung’s concept of individuation is the process of moving towards becoming one’s true, whole self, through the integration of the unconscious and conscious aspects of the psyche.
These concepts are applied to offer an alternative perspective to understanding what people may experience in relation to their sense of self after a TBI.
Within this study subjective experiences were explored through biographical stories, narrated by people who have experienced TBI. Thematic analysis was used to discover 2 main common themes which relate to the loss of self and the rebuilding of the self.
Direct quotes from their personal narratives are used to highlight their experiences.
Loss of the Pre-Injury Self
“But it was the loss of self that was most devastating. It felt like I was someone else living in a familiar body. I wanted to be me again.” Says one narrator when describing his experience.
Following TBI, people often describe grief for the person they were before their injury.
The change in their abilities and self-perception can lead to a painful sense of disconnection and alienation.
One narrator recalled, “I felt like an old woman because I couldn’t get out of bed to go to the bathroom. It was disgusting!”
These accounts reflect not just physical loss, but the emotional and psychological impact altered abilities have on people and their self-perceptions.
Through the lens of Jungian analytical psychology, this can be thought of as a disruption to the psyche which can contribute to a sense of fragmentation, emotional instability and an incoherent sense of self.
Current UK rehabilitation after a TBI addresses cognitive, physical, emotional and behavioural symptoms.
These aspects of rehabilitation are incredibly important, however, the deeper question of who a person feels and perceives themselves to be after such a drastic change to their reality and often their overall identity, can sometimes remain unaddressed.
As Jennings (2006) warns, “The real tragedy of TBI occurs when and if we allow the physical damage to objectify persons, reducing them to their impaired body and altered behaviour.”
Rebuilding the Self: Acceptance of a New Reality
Many narrators describe a turning point, noted as a shift from striving to return to the pre-injury self, toward accepting who they are now.
One narrator writes “I have yet to get back to the person who I was. And today that is just fine.” and another says “I redefined recovery. Recovery today begins with acceptance of who I am and what I have.”
This demonstrates a movement towards acceptance and from fragmentation towards coherence.
Many individuals describe redefining what success and purpose means to them, saying “I now believe success isn’t how far you’ve gotten, but the distance you’ve travelled from where you’ve started.”
For another narrator, they discovered new meaning through being able to help others “I feel very, very privileged to have the platform I have now to inspire thousands, hopefully millions, of people.”
Although many individuals may never be exactly the same as they were prior to a TBI, and remain with physical and psychological symptoms, these stories demonstrate the profound sense of loss that is felt, and how through grieving, acceptance and discovering new purpose, individuals can begin to adapt to life after TBI and rebuild their sense of self, in a way which is meaningful to them.
This process can be understood through Jung’s concept of individuation, whereby the realisation and integration of various aspects of the self, new and old, conscious and unconscious, contribute to creating a more whole and coherent sense of self.
The Role of Relationships
Adapting to life following a TBI is not a solitary act. The people who surround these individuals such as friends, family, therapists, and peers, all play an integral role.
Narrators said, “My mom brought me a box of chocolates… even though I couldn’t taste them, it made me feel a little better.” and “A turning point came when I met my then- partner whose outlook I found inspiring.” These phrases provide insights into the impact that those around us have on how we feel.
In Jungian terms, relationships provide the relational container where fragments of the self can be held, recognised, and integrated.
As Edlow and Kahn (2023) suggest, the “therapeutic alliance”, which is the collaborative relationship between professional and client that can foster curiosity and creativity, supports individuals to come to terms with, and adapt to, their new realities.
This does not always have to be a working professional; friends, family and anyone in close relationship could provide this.
These narratives reveal how self-identity and relational dimensions may be central to meaningful adaption to life after TBI, and how the integration of Jungian and psychotherapeutic concepts, could provide further understanding and frameworks which support the rebuilding of the self, following TBI.
Reference list
Edlow, M., & Kahn, C. (2023). Reparative adaptation after brain injury facilitated by psychoanalytic psychotherapy. Neuropsychoanalysis, 25(1), 53–66.
https://doi.org/10.1080/15294145.2023.2196998
Jennings, B. (2006). The ordeal of reminding: Traumatic brain injury and the goals of care. Hastings Center Report, 36(2), 29–37. https://doi.org/10.1353/hcr.2006.0026
Salas, C. E., & Yuen, K. S. L. (2016). Revisiting the left convexity hypothesis: Changes in the mental apparatus after left dorso-medial prefrontal damage. Neuropsychoanalysis, 18(2), 85–100. https://doi.org/10.1080/15294145.2016.1219937
