Identity Development, Traumatic Brain Injury, and Substance Abuse

Liza Colby (2009)

This dissertation project is a conceptual exploration of substance dependence, identity development, and traumatic brain injury (TBI). It was designed to create an underlying framework for therapeutic interventions for clients with traumatic brain injuries. The project was informed by the assumption that clients who begin to develop substance dependence before reaching adulthood may not have completed appropriate developmental tasks that lead to identity formation prior to sustaining TBIs. Identity formation is dependent on the ability to learn from caregivers about cause and effect. This foundation leads to the capacity to imagine for oneself possible outcomes of behavior. This skill is crucial for making decisions that influence what one experiences throughout life. These experiences create a sense of self. Substance dependence and TBIs change the brain in ways that impair the development of the decision making process and the development of the sense of self. This dissertation explored these changes and their consequences. It specifically integrated material from four areas: substance dependence, unawareness of deficit, human change processes, and identity development. The integration was developed using a qualitative research technique called bricolage, which combines previously unrelated materials in an effort to create something new. In this case the intent of the project was to learn about the potential for change in clients who develop substance dependence disorders prior to sustaining TBIs. The bricolage provided hope that change is possible. Clients may be able to develop increased self-awareness and the sense of self.