Experiences of the Process of Adjustment to a Brain Injury: An Interpretative Phenomenological Analysis

Abstract

Aims: Acquired Brain Injury (ABI) is often researched from a reductionist perspective, focusing on pathology and dysfunction (Olney & Kim, 2001). More recently there has been a call towards taking a person-centred, global approach; questioning old ‘assumptions’ about what is currently known, and incorporating the views of the patient (Hill, 1999). This qualitative research study aimed to make a further contribution to the evidence-base by investigating the experience of adjusting to life after ABI. Method: Six participants, (two female, four male) aged 26-49, who had experienced a severe ABI an average of 31 months previously, were interviewed using a semistructured schedule. Interpretative Phenomenological Analysis (IPA) was employed to analyse the transcripts. Results: Five master themes emerged from the participants’ accounts: Experiencing a loss of control; Observed changes as a threat to identity; Being displaced by the injury: Feeling unchanged in a changed world; Attempts at managing a threatened identity, and Enable me don’t disable me: The role of support in recovery. Implications: Clinical implications were considered within Bronfenbrenner’s (1979, 2004) Ecological Systems Theoretical Framework. Within the Microsystems (the individual’s immediate systems such as their body, home and work) participants described a struggle to make sense of their perceived loss of control of their body and brain. They described the importance of making sense of these changes. Clinically there is a potential role for professionals to facilitate how people make sense of their experiences, perhaps moving away from reductionist explanations, which appeared to prevent participants from having hope to influence change. From a Macrosystemic level (the individual’s social, cultural and political systems) the participants felt they were less valued and as a result, judged by society and by political systems. Participants’ accounts suggested that they wanted to continue to contribute and be valuable in society. An implication therefore is for professionals involved to take more a political stance in influencing how we currently conceptualise people after brain injury, focusing on enablement rather than disablement.