“Relating through sameness”: a qualitative study of friendship and social isolation in chronic traumatic brain injury

ABSTRACT

Social isolation has been described as a common problem among traumatic brain injury (TBI) survivors during the chronic phase. Due to physical, cognitive and behavioural changes, survivors become less socially active and experience a marked decrease in the number of friends. The goal of this investigation is to explore TBI survivors’ subjective account of the challenges encountered in sustaining friendships, as well as gaining insight into their particular understanding of such difficulties. Using a thematic analysis approach, 11 survivors of TBI were interviewed in relation to their experience of social isolation and friendship during the chronic stage. Four main themes emerged from the interviews: (1) The impact of long-term cognitive and behavioural problems on relationships; (2) Loss of old friends; (3) Difficulties making new friends, and (4) Relating to other survivors in order to fight social isolation (sameness). Clinical implications of these findings, as well as their relevance in the design of long-term rehabilitation programmes, are discussed. Particular emphasis is placed on the need to acknowledge the value of relating to other survivors, as a way of resisting cultural discourses about disability, and as a source of self-cohesion in the process of identity re-construction.

KEYWORDS:

• Traumatic brain injury
• friendship
• social isolation
• neuropsychological rehabilitation
• identity

Acknowledgements

We would like to thank all attendees at the Head Forward Centre for their time, collaboration and feedback regarding this study. We are particularly grateful of Maggie Cottam for her support during the process of data collection and help editing final versions of the manuscript. We would also like to thank Dr Rudi Coetzer for his valuable comments and suggestions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 http://www.headforward.org

Additional information

Funding

The first author of this article was supported by a Post-Doc grant from CONICYT (Chile) as well as a young researcher grant from the Neuropsychoanalysis Foundation (New York, USA).