Self Matters To Brain Injury Survivors


Everywhere I look, it seems I encounter people who are struggling with understanding who they are in this dynamically changing world, what place they have in their re-organized, increasingly global workplaces. They search for who they are now, as they recover from life-threatening illness. They wonder what will become of them, as their friends downsize, pick up, and move on. They cannot help but doubt what their future holds as they go through life stage and career changes, lose loved-ones to sudden, unexpected death, and otherwise grow and develop as people.

Everyone, without exception, goes through that kind of dark period, when they no longer recognize the person they once were. They’ve changed. And it takes time to catch up with the changes and re-orient yourself to the new you who’s suddenly replaced the old.

A stable Sense-Of-Self is an important part of that orienting process. Having a clear Sense of who you are, deep down inside, despite all the changes life throws your way, allows you to roll with the changes and grow with challenges. A strong Sense of identity, of knowing who the person in your skin is, and what that person is all about, actually allows your Self to change. Because even as you go through the inevitable shifts in your life, you still have a Sense of identity which remains stable through all the twists and turns in life. Indeed, a solid Sense-Of-Self is that stable foundation to your Self which allows you to go through radical transformations and still be sure of who you are and your individual place in the wider world.

For those dealing with TBI, especially, a stable Sense-Of-Self is a critical ingredient — especially in recovery. Unfortunately, it’s often one of the greatest – and hardest to remedy – losses one can experience when the brain is changed.

Of course, when it comes to surviving an injury to your brain, there are fundamental life-and-death considerations to take on. Even with mild TBI / concussion, the logistics of getting through the day may so completely exhaust you that philosophical / phenomenological rumination is far beyond reach. So why concern ourselves with talking about Self? Isn’t it best to put the Self aside, and focus on what needs to be done, one day at a time? Isn’t thinking about yourself and your identity a hurdle to buckling down or sucking it up, and doing the hard work of getting functional again?

A Sense-Of-Self might seem like a luxury, when you’re focused on the process of learning to walk and talk or just get through your day without melting down and screwing everything up. But the Self and your Sense-Of-Self are actually crucial pieces in the puzzle that is the processes of rebuilding a life – whether you’re learning to walk and talk, or trying to just get through your day without melting down and screwing everything up.

In the great LEARNet brain injury tutorial What Is Sense Of Self?1 , the authors explain:

Identities contribute to intrinsic motivation. For example, an adolescent who considers herself a good athlete – a “Mia Hamm kind of person” – will not need artificial motivators to exercise intensely and practice her sport several hours per week. Effort and practice go with being a Mia Hamm kind of person. Similarly, individuals who tie their identity to religious beliefs and religious role models will not need extrinsic motivation to extend themselves by helping others. Helping others simply goes with being the kind of person they take themselves to be. Students whose identity includes intelligence and academic success will not need a promise of rewards, like money, in order to study hard; rather, they study just because “that’s the kind of person I am; that’s me; I’m a conscientious student – and I know I need to study to do well!” Even hard work can be easy and satisfying if it flows from a person’s sense of “who I am.”

Knowing “who you are” and “what you are about” provides much-needed motivation, especially when it comes to performing the harder tasks of life. Knowing that you are a certain kind of person makes it logical that you should do such-and-such a thing, even if that thing is unpleasant, even painful.

Additionally, knowing who you are gives you a point of reference from which to interact with the rest of the world. Someone who knows themself to be a strong and courageous person will step up in times of trouble to assist others, possibly at their own peril. Someone who is invested in being a good person isn’t going to need a lot of convincing to take certain actions that are difficult but consistent with their view of what it takes to be a good person. Knowing your own mind, makes it possible to interact with others in meaningful ways – whether as friend, passing stranger, or foe. Each interaction with others reinforces your understanding of who you are, with plenty of comparisons and contrasts happening just beneath the surface of the give-and-take.

We all do it. Whenever we have an exchange with another person, we get to know ourSelf a little better. We get a refresher course in who is going to show up when we have certain types of experiences. We get to know the other person, too. And the learning is reciprocal – they learn something about themSelf, as well.

And what about Sense-Of-Self? That is the ongoing flow of unconscious knowledge we have about ourselves, based on our many experiences, and how we saw ourselves act and react under different conditions. Our Sense-Of-Self is vitally important, because it’s the initial expectations we have of ourselves ahead of time, that allows us to enter into new situations without having all the details up front.

Let’s say you’re the kind of person who holds doors open for others when you’re going in and out of buildings. Through countless instances of either pausing to hold a door open for someone coming behind you, or dashing to open a door for someone whose arms are full of boxes, or making way for a line of people in a hurry to get somewhere important, you’ve come to know yourself as the kind of person who does that. You hold doors open for others. Your Sense isn’t just of someone who holds doors open; it’s bigger than that. It’s of someone who is considerate, kind, and who will step up to assist others when they are in need.

That Sense-Of-Self then generalizes into others areas of life. It spills into other areas, as that Sense gets applied in different situations. You pull your neighbors’ trash barrels off their driveway on a snowy, windy day, so they can get in their garage without having to get out of their car. You tell a co-worker their tag is sticking out of the back of their shirt on a day when they have an important meeting. You pick up a lost dog running loose along a busy highway and you call the owner whose name and number is on the tags. You do any number of things that draw from – and reinforce – your understanding of who you believe yourSelf to be.

And that Sense-Of-Self makes it possible for you to take action without even thinking about it. Little gestures that “make you who you are” come naturally to you, without planning, without conscious initiation. And every time your system kicks in (having long since become “wired” for these small but significant things), it not reminds you, yet again, of who you are. And it reminds everyone around you, who you are. And so your place in your own life is reinforced and secured.

When we don’t know what matters to us… what we think and feel and believe… we cannot help but feel cut loose from our moorings. Because we are. If we don’t know “who will show up” in different situations, we are unsettled, destabilized. We have no way of knowing if we’ll be able to perform the way we want to – or have to. We have no way of anticipating whether we’ll be successful at what we try, or what we’ll do if we fail. When we don’t have a way of predicting our own performance in life, we have no way of planning or discerning any larger plan we can be a part of. Life becomes chaotic, confusing, meaningless. Because we have no clear Sense of who our Self truly is.

The Sense that we have of the Self we know to be who we are, is the guiding beacon that can show us the path ahead. If, that is, it is still intact.

1Mark Ylvisaker, Ph.D. with the assistance of Mary Hibbard, Ph.D. and Timothy Feeney, Ph.D. Project LEARNet – WHAT IS SENSE OF SELF? http://www.projectlearnet.org/tutorials/sense_of_self_personal_identity.html

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