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TBI SoS – Restoring a Sense of Self after Traumatic Brain Injury – What IS the Self?

Posted Jan 08 2011 12:00am

This is the second part in a multi-part exploration of sense of self and how it’s affected by traumatic brain injury. Read the first part here. More to come…

But what IS the “Self”?

Okay, since I like to start at the beginning, this is the first question.

I had a few ideas to start with, many of which were informed both by experts and folks who have commented at this blog. George Prigatano has studied anosognosia or not knowing that you don’t know as one of his specialties, and I was really intrigued by his writing when I first started my neuro rehab. It especially interested me, as I had been going along for years unaware of my issues and deficits, which were wreaking havoc with my life in serious ways. As for Self, though, there was more to it… and I came up with what I thought were some workable ideas.

I thought I was headed down the right road, then it occurred to me that I was getting all caught up in a whirlwind of ideas. I needed to look outside my own box for answers, so I used my noggin and looked it up. My handy Random House dictionary defines “Self” as:

1. a person or thing considered as a complete and separate individual
2. a person’s nature or character
3. self-interest

Hmmm… Interesting. It was kind of where I was coming from, but not exactly.

Then I googled “tbi + sense of self” and I found some interesting reading. Unfortunately, what I found had a lot to do with professional applications of official theory and what-not, and some of it seemed a bit narrowly focused on information from the outside looking in. I found some of what I read to be oversimplifications of what goes on inside our heads when we’ve sustained brain injuries, and some of it didn’t seem very respectful of our WHOLE selves it just wrote off the parts of us that had changed (and according to their reports wasn’t coming back) and focused on accepting the loss of those parts.

Ugh. How depressing. If I wasn’t depressed before, I was getting there rapidly. So, I decided to go back in time and consult some of the giants of psychology. (Note: This excludes Freud, because he originally believed that all the sexual dysfunctions of his female Viennese clients was due to sexual abuse and mistreatment, rather than some intricate complex, but his professional colleages shot him down and pressured him to come up with another explanation. He caved, so we got this convoluted “Oedipus Complex” business which has been a bane of our collective Western consciousness women’s AND men’s for way too long.)

So I did some reading in William James’ “Principles of Psychology (vol 1)” about “The Consciousness of Self”. Mr. James has always seemed like a nice enough chap to me. I had his book lying around from years ago (it was given to me, but I never actually read it), and lo and behold, there were about 100 pages of discussion about the Self from a historical and psychological perspective. Eureka! I was quite enthused.

But alas, the essay was so densely packed with ideas that go back to Locke and Latin phrases, that I suspended that reading after about 30 pages. Honestly, maybe they needed to use all those words back in the day, but Mr. James could have probably said as much with half the language. I flipped around a bit, but I got the impression that Mr. James was either in love with hearing himself talk in long, extended flowery phrases, or actually somewhat insecure about his ideas, so he needed to wrap them in all sorts of verbal gymnastics. (Note: I’m well aware others could say the same about me, at times.) Or maybe that’s how people back then just talked and wrote. Whatever the reason, I needed something more straightforward, less cluttered to get my head around.

So, I went back to the drawing board and worked on evolving my own definition of “Self” which is consistent with my experience and also makes sense to me.

To me, the “Self” is plain and simple – the part of us that keeps showing up. It’s the part of us that we recognize as uniquely us, which sets us apart from everyone else, and feels familiar and comfortable on a deep, fundamental level. Even when we’re doing things we know are wrong or we’re having experiences that are uncomfortable, disconcerting, or even painful for us, our reactions and interactions can be familiar enough to give us a foundation of deep-seated reassurance by telling us who we are. Self is our perspective, it’s our opinions, it’s the part of us that lets us interact with the rest of the world as distinct individuals with certain things in common with others.

Self is the part of us that gets things done. It’s the part of us which participates in life in its own special way, that makes decisions and takes action in ways that are ours alone. It’s the aspect of us that over time has developed in ways that make us different (sometimes “better”, sometimes “worse”) from just about anybody we know. Even those traits we have in common with others have a certain quality to them that is uniquely US. That’s the part of us that lets us both perceive ourselves as separate from others and also find some thread of commonality while participating in life and contributing to the world around us. Self gives us a sense of being whole, coherent human beings in a fragmented, often confusing world.

By its nature, I believe Self emerges from the repeated, habitual expression of specific feelings and thoughts and interests which combine into an expression of who we are and what we’re all about. It’s the part of us that reacts in the same unique way to similar circumstances often enough to give our life a flavor all its own. It’s the part of us that responds in a predictable way to the world around us. And each time we react or respond in ways that are consistent with who and what we think we are, we have our Self reinforced and strengthened.

In a very real sense, I believe we are what we do; our Selves arise directly from what we habitually do, what we habitually respond to. Repeated thoughts and actions fuse connections in our brains and inform the perspectives of our minds. The more we repeat thoughts and actions, the more firmly the connectiongs get reinforced, and the easier it becomes for us to think and feel those things. The things we do easily (even if those things are not very positive or productive), we tend to repeat even more, whether it’s because we enjoy it, or it’s just the easiest thing to do. It’s a self-perpetuating process, this creation of Self, and it’s as pragmatic a process as you can get.

When confronted by an angry parent over something we broke, we may lie and blame it on a sibling or a neighbor kid. Our parent believes us, we’re out of danger of being punished and rejected by this important person, and suddenly all is right in the world. We mess up again, and find we’re able to cover our ass again with yet another lie. Given enough time and repetition and “positive reinforcement”, we can turn from someone who lies, into a liar. Or, by chance one day, we pick up a pencil and start to doodle and discover we’re pretty good at drawing. People around us notice our talent and encourage us to do more. Again, given enough time and repetition and positive reinforcement, we can turn from someone who draws and doodles, into an artist.

We join a sports team because it seems like it could be fun, we find that we do enjoy it, and we practice like crazy. We learn to play well, and through our efforts the team has a winning season. In the space of a soccer season, and we go from being a kid who is interested in soccer, to being a Winner. We arrive in a new town as a total stranger, and we connect with people we like and who like us. We enjoy these new friends, and we build good relationships with people around us, and so we go from being a friendly stranger to being a pillar of our community and one of the most popular people around.

Even without positive reinforcement, if we have the same sorts of experiences over and over again, we can come to perceive those experiences as part of Us, part of our Self either resulting from our own actions or the cause for why we are how we are. A bully beats us up three times a week all during 5th grade, and we’re too small to fight back, too slow to run away. Through repeated beatings, failed attempts to avoid them, and lack of support or protection from parents and teachers, our behavior changes from outgoing and friendly to reserved and distrustful. In less than a year, we transform from a bright kid who is unfairly treated by bad people, to being a human punching bag who’s almost flunking out of school. A parent chews us out constantly over things we don’t realize we did wrong, and no matter what we do, we can’t seem to do anything right. Every time we turn around, we’re criticized and attacked for what we did or said or thought or felt. No matter what we try, we can’t seem to escape it, and so we go from being a kid who gets a little turned around sometimes, to being a victim of verbal abuse who “can’t do anything right.”

Ultimately, it seems to me, we become the product of actions we repeatedly take in response to our life experiences. In that repetition of responses, whether it’s positive or negative, the connections of our brain and our central nervous system and emotional/mental perspectives are created and reinforced. These continually define and redefine patterns and traits which we recognize as our “Self”. Throw in external reinforcement (from other people or (un)favorable circumstances that happen as a result) which validates our own perceptions, and you have the cement that holds the structure of our life and our Self in place… for better, or for worse.

< Read the first part

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