I am not my self: Reconceiving identity in rehabilitation care

ProblemHow does someone altered by illness adjust their view of themselves and how could rehabilitation help?BackgroundRehabilitation is expanding its scope to become more holistic, beyond a preoccupation with physical functioning, which requires an understanding of the concept of personal identity. One currently employed approach defines the self as expressed through the physical.PhilosophySuch a view risks reifying the self into something owned. Instead, the change a person experiences with illness or injury is not a shift within themselves but reflects alterations in their interactions with the world. A person is not an internal self, mediated by the form of a body. Instead, a person is a body existing in and experiencing the world, particularly through interactions with others.ApplicationThis revised understanding is significant in rehabilitation because it increases conceptual clarity, removing the perceived challenge associated with defining the self or personal identity. Moreover, by moving towards an integrated view of self, our perspective shifts, such that when a person says, 'I have changed', what we can appreciate is 'things have changed', thus reducing the blame on them. Consequently, there is increased hopefulness and better acknowledgement of patients' social situations.ImplicationsThe purpose of this is not to police colloquial language but to heed against over-interpreting certain common expressions in ways that lead to increased alienation.ConclusionRehabilitation should understand that no self is lost or transformed, but that there is a social identity which changes with altered circumstances and challenges around a person, who remains themselves.