“Fragments that define my shape”: a qualitative study of self-identity on social media after an acquired brain injury

PURPOSE: Self-identity is disrupted when encountering significant life changes such as an acquired brain injury (ABI). Use of social media can facilitate self-expression, providing an opportunity for identity exploration. For people living with other neurological conditions, online self-expression has been described as being beneficial for sense of self, advocacy, and connection. We aimed to learn more about online self-identity after an ABI to inform rehabilitation approaches. MATERIALS AND METHODS: In this qualitative study, we interviewed 11 people with ABI and used reflexive thematic analysis to explore their self-expression on social media platforms and factors that influenced this. RESULTS: Individuals described how they used social media for belonging, support, and visibility. Some people revealed their ABI in their online identity, whilst others concealed this due to perceived stigma. Social media was used as a way to control their self-narrative in varying ways, sharing only fragments of their identity, often to appear more positive, resilient, and capable. CONCLUSIONS: Online self-identity is complex and multifaceted, with people often employing a 'balancing act' as they navigate reconstruction of self after their brain injury. Social media has potential to be used during rehabilitation for self-discovery and to showcase self-narrative, supporting people in their recovery journey.