“Relating through sameness”: a qualitative study of friendship and social isolation in chronic traumatic brain injury

Abstract

Social isolation has been described as a common problem among traumatic brain injury (TBI) survivors during the chronic phase. Due to physical, cognitive and behavioural changes, survivors become less socially active and experience a marked decrease in the number of friends. The goal of this investigation is to explore TBI survivors' subjective account of the challenges encountered in sustaining friendships, as well as gaining insight into their particular understanding of such difficulties. Using a thematic analysis approach, 11 survivors of TBI were interviewed in relation to their experience of social isolation and friendship during the chronic stage. Four main themes emerged from the interviews: (1) The impact of long-term cognitive and behavioural problems on relationships; (2) Loss of old friends; (3) Difficulties making new friends, and (4) Relating to other survivors in order to fight social isolation (sameness). Clinical implications of these findings, as well as their relevance in the design of long-term rehabilitation programmes, are discussed. Particular emphasis is placed on the need to acknowledge the value of relating to other survivors, as a way of resisting cultural discourses about disability, and as a source of self-cohesion in the process of identity re-construction.

“Putting a new perspective on life”: a qualitative grounded theory of posttraumatic growth following acquired brain injury

“…This study conceptualized the development of PTG as a dynamic process within which the participants spoke of the benefits of being with others who shared similar injuries, difficulties, strengths and experiences. This resonates with recent research which describes the value of relating to others with a similar experience [40]. The participants in this study described learning and broadening their opportunities and developing as people who were less 'set in their ways' and more willing to try new and different things than they would have been previously.…”

“…The narrative synthesise adds to the existing literature on peer support (Sweet, Noreau, Leblond, & Martin Ginis, 2016) and the importance of family and friends following SCI (Beauregard & Noreau, 2009). The findings also support recent research into the importance of relating to other people with similar injuries (Salas, Casassus, Rowlands, Pimm, & Flanagan, 2016).…”

“…A changed sense within one's relationships can involve an experience of deepening relationships, increased compassion and sympathy for others, and greater ease at expressing emotions. Being visibly disabled is a qualitatively unique experience because of the direct impact that a visible disability has on social relations, body image and identity [40]. Research on the integration necessary for positive adjustment to physical disability shows that people must integrate into society, integrate with the disability community, internally integrate sameness and differentness, and integrate feelings and self-presentation [39].…”

The Things that Help, the Things that Get in the Way: Working Together to Improve Outcome Following Acquired Brain Injury

“…The post-injury experience of friendship for these participants reflected a post-injury downhill or deteriorating process that incorporated early loss of social connections (losing contact), ongoing lack of understanding (being misunderstood) with reduced opportunities to share (wanting to share) and just hanging on to a place in society. This experience of loss and social disconnection has been reported by participants in a number of studies (Jumisko, Lexell, & Soderberg, 2005;Levack et al, 2010;Mealings, Douglas, & Olver, 2017;Muenchberger, Kendall, & Neal, 2008;Salas, Casassus, Rowlands, Pimm, & Flanagan, 2016;Shorland & Douglas, 2010), as has more frequent contact with family when compared to little or no contact with friends (Douglas, 2017(Douglas, , 2010Douglas & Spellacy, 2000). Feeling misunderstood or stigmatised has also been revealed in previous work (Knox et al, 2017;Levack et al, 2010;Mealings et al, 2017;Nochi, 1998;Salas et al, 2016).…”

The Psychosocial Impact of Neurobehavioral Disability

“…In addition to close personal relationships, poor emotional perception, leading to a lack of emotional expression and an empathic response, may also help to explain why a high proportion of individuals with TBI experience deficiencies in social-interpersonal behavior that lead to a decline in social and leisure activities, diminishing social networks, poor community integration, and high levels of social isolation and loneliness (69)(70)(71)(72)(73). For instance, May et al (74) found that poor emotion recognition abilities post-injury were associated with poor social functioning and fewer independent social activities outside of the home (i.e., community integration).…”