Traumatic brain injury and the construction of identity: a discursive approach

Using discourse analysis, this paper explores the co-construction of identity for individuals who have sustained a severe traumatic brain injury (TBI). An analysis of discourse, obtained through interviewing six adults with a TBI, each with one or two significant others, suggested four main interpretative repertoires which informed participants' co-construction of identity: "Medical model referencing", "dependence as intrinsic to TBI", "TBI as deficit" and "progression and productivity as key life-defining features". Medical model referencing is discussed in relation to the common, passive positioning of individuals with TBI, which often occurred in relation to memory loss. The construction of abandonment was also common, due to participants" dependence on the provision of specialist, expert services in the community. Clinical implications are discussed in terms of facilitating individuals in the co-constructing and re-authorship of more empowering and inclusive narratives and providing community services that promote meaningful social identities, separate from medical discourse.