The cognitive process of identity reconstruction after the onset of a neurological disability

Abstract

Purpose: Rehabilitation professionals and researchers underscore the impact of an acquired disability on identity. However, the cognitive process by which identity is transformed is understudied. The present study aims to explore the cognitive process by which personal identity is reconstructed following disability onset. Methods: A template organizing style of interpretation was used to perform a qualitative analysis based on the Cognitive-Developmental Model of Social Identity Integration (CDMSII) using interview data from 10 participants with traumatic brain injury or traumatic spinal cord injury. Results: As suggested by the CDMSII, following the accident, participants initially tend to emphasize distinctions between their pre- and post-injury conditions. Eventually, individuals are able to create cognitive connections between pre-injury self-knowledge and how they understand their new condition. Finally, in the last stage of the identity integration process, the various identity components are recognized as part of the self. Organizing data based on the three stages of this theory was found to resonate with participants and aided the comprehension of how every stage in the identity reconstruction process is intertwined with the need for continuity through life. Conclusions: The CDMSII offers a useful heuristic for understanding long-term identity reconstruction and the present research emphasizes the importance of a sense of continuity following disability onset.

Implications for Rehabilitation

• A central concern in the adjustment process following disability onset is identity reconstruction. The Cognitive-Developmental Model of Social Identity Integration is useful to understand this process.

• This study highlights the importance of a sense of continuity throughout the identity reconstruction process following disability onset.

• Therapists should first help to identify core pre-injury identity characteristics in order to sustain a sense of continuity. Subsequently, the patient can be helped with the creation of meaningful links between significant pre-injury characteristics and the post-injury circumstances.

• The process of identity reconstruction following disability onset spans many years, therapists need to address this issue in a long-term perspective.

• Identity
• spinal cord injury
• temporal continuity
• traumatic brain injury

Acknowledgements

The authors would like to thank Valérie Lamontagne, Sonia Marcone, Miriam Roussel-Bergeron and Anda Vintiloiu for their collaboration to the first steps of this project, as well as Christine Gros and Matt Davidson for revising the English.