'Lonely in my head': The experiences of loneliness in individuals with brain injury.

PRIMARY OBJECTIVE: This paper reports on the personal experiences of loneliness for individuals living with brain injury. RESEARCH DESIGN: This is a qualitative research design, employing semi-structured interviews and subsequent contextualist thematic analysis. METHODS AND PROCEDURES: Eleven clients (two female and nine male, aged between 27 and 63 years) with brain injury participated in semi-structured interviews. Thematic analysis was employed in the interpretation of the data. MAIN OUTCOMES AND RESULTS: The interview data and subsequent analysis depicted three overarching themes in a healing process - 'Internal Loneliness', 'Healing the Cracks', and 'Visible with Cracks'. Participants described five factors which contribute to their feeling of loneliness: trauma, social isolation, concealment, rejection of part of self, and invisibility of their disability. The participants' accounts also detailed the necessity of a therapeutic intervention and relationship to deal with and address some of these issues. CONCLUSIONS: This study highlights that processing the trauma, developing dialectical thinking, self-compassion, and a degree of self-acceptance assist in the movement of participants towards allowing themselves to be 'Visible with Cracks'. This allowance of self to be fully seen appears to serve an important function for reconnection with self and others. These results may help to inform brain injury rehabilitative care, through developing their understanding of the internal loneliness factors that may be influencing an individual's social isolation or social withdrawal.

The man who used to shrug - one man's lived experience of TBI.

BACKGROUND: Stress is common to the experience of TBI. Stressors challenge physical and psychological coping abilities and undermine wellbeing. Brain injury constitutes a specific chronic stressor. An issue that hinders the usefulness of a stress-based approach to brain injury is a lack of semantic clarity attaching to the term stress. A more precise conceptualisation of stress that embraces experienced uncertainty is allostasis. OBJECTIVE: An emerging body of research, collectively identifiable as 'the social cure' literature, shows that the groups that people belong to can promote adjustment, coping, and well-being amongst individuals confronted with injuries, illnesses, traumas, and stressors. The idea is deceptively simple, yet extraordinarily useful: the sense of self that individuals derive from belonging to social groups plays a key role in determining health and well-being. The objective of this research was to apply a social cure perspective to a consideration of an individual's lived experience of TBI. METHODS: In a novel application of interpretative phenomenological analysis (IPA) this research has investigated one person's lived experience in a single case study of traumatic brain injury. RESULTS: Paradox, shifting perspectives and self under stress, linked by uncertainty, were the themes identified. CONCLUSIONS: A relational approach must be key to TBI rehabilitation.