Many people talk about feeling a loss of self following a brain injury and have no idea why they feel the way they do.
As soon as the topic is raised it brings instant recognition to those people who feel an inexplainable emptiness inside. Many people describe this phenomenon as feeling as though there is a void inside of them – a hole where ‘they’ should be. Something is missing, but how do you put your finger on it when so much else is going awry?
These feelings can have a number of different causes at their core and sometimes these causes can overlap with other things that are happening because of cognitive dysfunction, neural and biological damage, and changes in the chemistry of the brain, which can affect the overall way the body works creating a vicious circle.
Ambiguous loss of self
That you are still present and continuing with life, albeit it a changed-from-before version of life, creates the ambiguity of being physically present and yet not ‘all’ there. The sense of confusion this can bring can wander through the dusty halls of the mind like a ghost looking for answers, and yet, there is nothing there to find.
People struggle with these feelings and often isolate themselves whilst they try and figure out what is missing, and why their perception of themselves no longer feels the way it did. They may wonder if other people can see what has been lost or may feel a kind of loneliness inside that is difficult to describe.
Loss of clear self-knowledge
These feelings are often linked to the loss of memories. In time new links are forged but, until then, the inner knowledge that people held about themselves can remain inadequate, whilst feedback from others can seem superficial.
It can feel as though it is impossible to connect with the ‘former’ self, and without these connections, how do you make decisions when you no longer know what you would have prioritised or chosen, or why you would have even have been motivated to make a decision at all.
Loss of self through comparison
Many people are able to remember things about the way they were quite clearly. They can remember how they used to be and will be aware of what motivated or drove them, what their preferences were, and what their thoughts and feeling were about their status in the community.
When a brain injury changes abilities and functionality it can change many other things as well – such as the ability to learn or remain at work. It is natural for people to make comparisons, however, sometimes this is detrimental to levels of self-esteem and self-confidence.
Both the internal dialogue and talking about this with family and friends can be very negative and have an impact on how people relate to themselves. By using the data in a positive way people can determine new goals for themselves.
Determining new goals
To do this you need to acknowledge that some things have changed at the surface that you cannot change. This is followed by acceptance and the setting of new goals. If you fall into self-pity you will push the boundaries of what is to come further away from yourself.
There does need to be a realisation that significant changes have happened and that these changes cause feelings of loss and grief. It is important to be realistic and whilst some people may be able to focus on recovery and get back to work or college, other people may need to come to the understanding that there is a new and different purpose out there now.
The most important thing is to recognise that no matter what is different you still have lots to get and are still valuable and loved. Who you are is still there, struggling beneath the surface to find its’ way back into the mainstream of your life.