Mild traumatic brain injury: Impact on identity and ambiguous loss in the family.

Abstract

Research has revealed that almost half of relationships will end in divorce or separation when one member experiences a head injury. Many patients are not diagnosed initially, or for several months or years after their injury. Persons dealing with the numerous long-term cognitive and physical problems accompanying mild traumatic brain injury (MTBI) may develop a profound sense of "loss of self." This loss of self, manifest as identity ambiguity on the part of the MTBI subject may be strongly correlated with perceptions of boundary ambiguity on the part of the subject and family resulting from the situation of ambiguous loss. Early recognition and intervention may prevent relational and marital breakdown as well as unnecessary distress to family members. This article discusses the theoretical foundations of our research, preliminary findings of our ongoing qualitative study, and implications for future research and clinical intervention.

Adjusting to persistent post-concussive symptoms following mild traumatic brain injury and subsequent psycho-educational intervention: A qualitative analysis in military personnel

“…This resonates with much of the existing qualitative literature on the experiences of TBI patients, within which are discussions of a 'loss of self' [43], 'identity ambiguity' [64] and 'identity transition' [65]. Together these findings support the notion of a continual adjustment process; one that evolves in response to fresh challenges, newly recognized limitations and modified coping mechanisms.…”

Relationships after TBI: A grounded research study

“…In a 2005 review of the literature on marital adjustment to injury, Blais and Boisvert [7] note the 'lack of the clear definition of the adaptation construct' (p 1231) or, in other words, the dearth of exploration into what it is that defines the coupled experience. Since the time of this 2005 review, two studies have emerged that are each grounded in an experiential exploration of the relational experience [35,36]. While Kean [35] presents findings related to the whole-family response to brain injury, Landau and Hissett [36] focus on the process of coupled adjustment after TBI.…”

“…Since the time of this 2005 review, two studies have emerged that are each grounded in an experiential exploration of the relational experience [35,36]. While Kean [35] presents findings related to the whole-family response to brain injury, Landau and Hissett [36] focus on the process of coupled adjustment after TBI.…”

“…The process of engaging in healing was connected to resolution of these individual and relational ambiguous losses and was driven by couples' engagement in the themes of 'Collaboration and Integrated Care' and 'Identity Reconstruction'. Landau and Hissett [36] found that relational healing following TBI was dependent upon finding a shared view of approaching treatment and the process of finding a new and acceptable relationship identity.…”

“…Due to the acute nature of the study, Kean [35] did not integrate survivor experiences nor long-term aspects of familial healing into the emergent theory of 'Mapping the Future'. Landau and Hissett [36] more directly investigated the couple's experience after injury, using qualitative methodology to explore the adjustment process undertaken by three couples following TBI. The study intentionally situated itself within the concept of Ambiguous Loss, and sought to determine the impact of individually experienced ambiguous losses and relationally experienced ambiguous losses and to uncover any relationship between Ambiguous Loss and coupled healing.…”