Abstract
Deficits in awareness are a common problem after traumatic brain injury (TBI), often compromising the process of emotional adjustment, including mourning. Unfortunately, there is little understanding of how the specific profile of cognitive impairment and emotional change often presented by individuals with TBI influences awareness and mourning. Concrete behavior has been often described as a feature of TBI, with a difficulty detaching from immediate experience (both internal and external) as its signature. From a self-psychology perspective, concrete behavior can be understood as a change in the cohesion and structure of the self, where temporal and representational domains are modified. This paper offers a novel approach to problems of awareness and mourning after TBI, by considering how temporal and representational changes in the phenomenology of the self alter individuals' emotional landscape. More specifically, it describes how concreteness modifies several aspects of emotional life that are central to awareness and mourning, such as emotional reactivity, emotional regulation, emotional understanding, and signal anxiety. The impact that concreteness has in awareness and mourning is also discussed in detail throughout the paper, as well as the technical challenges implied. Finally, some general guidelines to address changes in the phenomenology of the self in a therapeutic context are briefly described.
Published Version
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