"Feeling part of things": personal construction of self after brain injury.

There is a growing body of literature on the nature of subjective changes experienced following brain injury. This study employs personal construct and qualitative research methods to address the question of how people make sense of, or construe, themselves after brain injury. Thirty-two individuals who had experienced acquired brain injury engaged in small group exercises based on a personal construct approach. Bipolar constructs were elicited through systematic comparison of pre-injury, current and ideal selves. The constructs elicited in this way were subjected to a thematic analysis. Nine themes were derived and an acceptable level of reliability of the definitions of these themes achieved. The highest proportion of constructs fell into the theme "experience of self in the world", followed by "basic skills" (cognitive, sensory, physical, social) and "experience of self in relation to self". It is concluded that following brain injury, people make sense of themselves in terms of the meanings and felt experiences of social and practical activity. This is consistent with social identity theory and stands in contrast to traditional neuropsychological sense making in terms of impairments and abilities alone, or activity or social participation alone. The implications of these findings for future research and rehabilitation are briefly considered.