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Managing Changes in Self-Identity After a Serious Injury or Medical Condition

Posted By Kristin Wiggs, PhD


Self-identity is defined as how someone perceives their life roles and abilities. After a serious injury or medical condition, people’s self-identities — as employees or students, parents, spouses and children, or athletes — can change in ways that can be distressing.

What Is Self-Identity?


After an injury, self-identity changes can result from physical changes (e.g., from loss of function, impairment, pain or fatigue), emotional changes (e.g., anxiety or depression), cognitive difficulties (e.g., forgetfulness or communication challenges), or some combination of all three. The stress of a change in self-identity arises from comparing the “old” self-identity to the “new” one. For instance, this could be the case for someone who is unable to engage in an activity they previously enjoyed, due to new limitations or because they do not feel comfortable in the activity any longer.

Issues with changes in self-identity are often not able to be concretely observed or measured. For some patients, these changes are obvious, while for others these changes can be more subtle. Patients often state, “I’m just not myself,” even after their recovery process and return to normal activities, which cannot be overtly viewed or understood by others. Patients can feel triggered with comments such as “you look great” and “you seem back to normal,” when internally things don’t feel right.

If you are struggling with changes in identity, use the four strategies below to assist with coping.

Four Strategies to Manage Changes in Self-Identity


Find Substitutes for Valued Activities
If you are unable to complete an activity due to limitations after an injury or medical condition, think about what you value about this activity. Then, find a different activity that still allows you to fulfill this value. For example, if you are no longer able to run, maybe you are missing the time you spent outdoors. You could add spending time sitting outside on a porch or going for walks.

Practice Thought Labeling
When distressing thoughts arise, name the type of thought, followed by redirecting back to the present moment to prevent getting stuck in negative thoughts. For example, if you have the thought of “I can’t go for walks like I used to,” put this thought into a category, such as “a criticizing thought, comparison to old self thought, or ruminating,” and then direct your attention back to the activity you were focused on in that moment instead of getting carried away in your thought patterns.

Return to Normalcy as Much as Possible
Engage in activities that remind you of your old self. For example, within your limitations, go to your favorite restaurant, park or coffeeshop, watch your favorite television show, and spend time with your social network. The more you participate in activities that you did pre-injury or medical condition, the more you will feel like yourself.

Practice Mindfulness
It is easy to feel consumed by ruminations on what you used to be capable of doing, and worry about what you will be able to do in the future. Unfortunately, this directly and negatively impacts the ability to be in the present moment. Mindfulness allows you to observe thoughts, emotions and physical sensations without judgment. For an introduction to mindfulness exercises, I recommend smartphone apps like Headspace, Calm and Mindfulness Coach.

Kristin Wiggs, PhD, is a licensed clinical psychologist at Shirley Ryan AbilityLab, providing rehabilitation psychology services for inpatient rehabilitation and the Pain Management Center.

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