Awareness and the emotional experience of acquired brain injury

Across three papers, this thesis explores emotional adjustment and its relation to selfawareness following an acquired brain injury (ABI). The first paper, a literature review, discusses the findings of studies that have investigated the relationship between selfawareness and emotional distress following an ABI. Some of the studies demonstrated an association between the two variables, whilst others did not. Three variables, namely; time since injury, injury severity and the influence of rehabilitation were found to exert some influence on findings. The second paper presents findings from an empirical study that explores the lived experience of emotional adjustment following an ABI, in individuals who participated in an Emotional Management therapeutic group. The study was undertaken according to the principles of interpretative phenomenological analysis (IPA), with semi structured interviews being conducted with six individuals aged between 58-69 years. Distinct aspects of experience emerged, forming three overarching super-ordinate themes: biographical disruption, adjustment and post-traumatic growth. Biographical disruption described the instant and devastating onset of an ABI which imposes significant change and loss. Pre-injury personality, self-awareness and societal perceptions were discussed in regards to their influence on self-appraisals. Adjustment outlined a process of adaptation to the ABI, which appeared to be facilitated by meeting others who had also sustained an ABI. Posttraumatic growth explored how participants acquired new insights and meaning to life, whereby they discussed enjoying richer relationships and worrying less. The third paper discusses implications for theory and clinical practice that emerged from the first two papers. It outlines a range of factors and patient characteristics that may contribute to the development of emotional adjustment disorders following ABI, thereby drawing attention to how clinical interventions should be designed to minimise their impact. In addition, it explores areas for development and further research. A personal reflection of the research process and outcomes is included