‘Lonely in my head’: The experiences of loneliness in individuals with brain injury

Abstract

Primary objective. This paper reports on the personal experiences of loneliness for individuals living with brain injury.Research design. This is a qualitative research design, employing semi-structured interviews and subsequent contextualist thematic analysis.Methods and procedures. Eleven clients (two female and nine male, aged between 27 and 63 years) with brain injury participated in semi-structured interviews. Thematic analysis was employed in the interpretation of the data.Main outcomes and results. The interview data and subsequent analysis depicted three overarching themes in a healing process -'Internal Loneliness', 'Healing the Cracks', and 'Visible with Cracks'. Participants described five factors which contribute to their feeling of loneliness: trauma, social isolation, concealment, rejection of part of self, and invisibility of their disability. The participants' accounts also detailed the necessity of a therapeutic intervention and relationship to deal with and address some of these issues.Conclusions. This study highlights that processing the trauma, developing dialectical thinking, self-compassion, and a degree of self-acceptance assist in the movement of participants towards allowing themselves to be 'Visible with Cracks'. This allowance of self to be fully seen appears to serve an important function for reconnection with self and others. These results may help to inform brain injury rehabilitative care, through developing their understanding of the internal loneliness factors that may be influencing an individual's social isolation or social withdrawal. Statement of contributionWhat is already known on this subject?Individuals with brain injury continue to report significant problems developing social contacts and maintaining significant relationships years post-injury. Social needs often outweigh the physical and cognitive needs in ranking of importance by both individuals with brain injury themselves and their families.

Life after lockdown: loneliness, exclusion and the impact of hidden disability

“…These themes chronicle how these feelings changed and developed during lockdown and survivors' feelings regarding society returning to 'normal'. Many of the themes and subthemes described in this project, such as loss of identity or confidence 35 , feeling left behind 36 and the importance of peer support and technology 37 have been found in previous literature. However, the current findings place these themes in the context of stroke survivors' experiences in relation to the pandemic.…”

Loneliness and disability: A systematic review of loneliness conceptualization and intervention strategies

“…In particular, accessibility is considered by authors such as Olsen (2018) , to be a variable closely linked to stressors, such as barriers to access to public transports, and social or cultural events, etc. Other authors take this variable into consideration indirectly, indicating the degree of mobility of people with disabilities with whom they have worked ( Lowe et al, 2021 ); Cooper et al (2009) , or architectural adaptations for people with physical disabilities ( Tzonichaki and Kleftaras, 2002 ). The studies by Macdonald et al (2018) and Tough et al (2018) go further and propose that loneliness and social isolation in disability are not due to a pathological explanation, but rather environmental barriers related to the accessibility of physical spaces or leisure activities.…”

“…The environmental context is not a factor that has been taken into consideration in the 75 articles analyzed in their entirety. The study by Lowe et al (2021) states that seven participants live in the city and four in rural areas, but this is simply presented as demographic data for the sample. The same is true of work by Burholt et al (2017) or the work done by Pavri and Monda-Amaya (2001) .…”

“…When it comes to people who have suffered brain injury, Lowe et al (2021) recommend starting psychotherapeutic processes. In the case of the 11 participants in their study, they work on psychoeducation, emotion management, and dialectal thinking.…”

Uncovering the social determinants of brain injury rehabilitation

“…Therefore, brain injury has long-lasting ramifications on wellbeing and quality of life (Haley et al, 2011;Hawthorne et al, 2009) often in the form of chronic mental health issues such as anxiety and depression (Fleminger et al, 2003;Proctor and Best, 2019). Lowe et al (2021) have furthered understanding of this complex issue, highlighting the importance of therapeutic relationships in mediating reconnection and reintegration following brain injury and a focus on alleviating survivors' perceptions of feeling left behind to avoid negative mental health outcomes. However, since these findings were published, the UK was operating in some form of lockdown for over 6 months, experiencing three national lockdowns since March 2020.…”