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Case Reports
. 2021;48(2):231-242.
doi: 10.3233/NRE-208017.

In search of the 'self': Holistic rehabilitation in restoring cognition and recovering the 'self' following traumatic brain injury: A case report

Meenakshi Banerjee  1 , Shantala Hegde  1   2   3 , Harish Thippeswamy  4 , Girish B Kulkarni  5 , Narasinga Rao  6
Affiliations
Case Reports

In search of the 'self': Holistic rehabilitation in restoring cognition and recovering the 'self' following traumatic brain injury: A case report

Meenakshi Banerjee et al. NeuroRehabilitation. 2021.

Abstract

Background: Following mild-moderate traumatic brain injury (TBI), an individual experiences a range of emotional changes. It is often difficult for the patient to reconcile with their post-injury persona, and the memory of pre-injury personhood is particularly painful. Insight into one's cognitive deficits subsequent to injury can lead to an existential crisis and a sense of loss, including loss of self.

Objective: Restoration of cognitive functions and reconciliation with loss of pre-traumatic personhood employing a holistic method of neuropsychological rehabilitation in a patient suffering from TBI.

Methods: Ms. K.S, a 25-year-old female, presented with emotional disturbances following TBI. She reported both retrograde and anterograde amnesia. A multidimensional holistic rehabilitation was planned. Treatment addressed cognitive deficits through the basic functions approach. Cognitive behavioural methods for emotional regulation like diary writing helped reduce irritability and anger outbursts. Use of social media created new modes of memory activation and interactions. Compensatory strategies were used to recover lost skills, music-based attention training helped foster an individualised approach to the sense of one's body and self.

Results: As a result of these differing strategies, changes were reflected in neuro-psychological tests, depression score and the patient's self-evaluation. This helped generate a coherent self-narrative.

Conclusion: Treatment challenges in such cases are increased due to patient's actual deficits caused by neuronal/biochemical changes. Innovative and multi-pronged rehabilitation strategies which involve everyday activities provided an answer to some of these problems. This method of rehabilitation may provide an optimistic context for future research.

Keywords: Traumatic brain injury; autobiographical memories; cognitive rehabilitation; holistic rehabilitation; music-based intervention; selfhood.

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Conflict of interest statement

Conflict of interest

The corresponding author Dr. Shantala Hegde is a recipient of Wellcome Trust DBT India Alliance Intermediate Clinical Fellowship (IA/CPHI/17/1/503348).

Figures

Fig. 1
Fig. 1. Neuropsychological functions pre- and post-intervention.
Fig. 2
Fig. 2. VAS scores pre- and post-intervention.
Fig. 3
Fig. 3. BDI scores pre- and post-intervention.
Fig. 4
Fig. 4. Multiple cognitive areas contributing to sense of ‘self’.
See this image and copyright information in PMC

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