Second Chance to Live

Sharing Hope in the Face of Adversity — One Piece at a Time

Traumatic Brain Injury and the Identified Patient – Part 2

Posted by Second Chance to Live on November 17, 2007

In the event that you have not read Part 1 of this article, please do so at this time by clicking this link:  Part 1.

Hi, and welcome back to Second Chance to Live. In the first part of this series I spoke about displaced sadness, shame and the identified patient as these topics relate to family systems theory. After reading the first part, you may find yourself scratching your head and asking yourself how does this apply to me. I will seek to clarify and tie together those questions today. My experience has taught me that assigned or assumed family roles — such as the scapegoat, hero, mascot or lost child — seek to control and constrain parts of the individual that displease or disrupt the family system. In the process the individual is covertly or overtly expected to discard parts of themselves to maintain the system and contain the conflict, secret or unresolved loss. The roles become substitutes and the actors become reactors. The individuals within the system adopt a false self. The false self evolves out of the individual’s drive to comply in order to avoid being criticized, shamed and / or threatened with emotional or physical abandonment.

When the individual seeks to maintain their role or identity to avoid losing love / approval or to prevent being shamed, blamed and criticized they become hyper vigilant. Like a cat on a hot tin roof they seek to avoid conflict in order to maintain the role. In the process of complying the individual’s creative energy is redirected to enforce the unspoken code of the family. The individual’s creative energy is used to validate their role and to maintain denial. Denial is used to dismiss any need to address or process the conflict, secret or loss. When an individual with in the family system has or acquires an invisible disability, denial is used to dismiss the need to address the disability. Consequently the individual with the invisible disability internalizes their struggles. Such internalization sets the individual up to be blamed, shamed and made to be the problem with in the family. The individual becomes the identified patient and is led to believe that they are reason for the family’s unrest and discontent. In these circumstances the individual then takes on the responsibility for what is out of their control – their invisible disability for which they may be unaware of themselves – the irritability, restlessness and discontent of the family system.

When the individual leaves the nuclear family system, they take their role with them. The role once again becomes the vehicle that drives them as they interact with other people – beyond the family system. Consequently, life for them becomes a gauntlet as they attempt to fix and compensate for the restlessness, irritability and discontentment found within their relationships. Their overdeveloped sense of responsibility is mirrored through and in other interpersonal relationships. The identified patient or scapegoat consequently becomes hyper vigilant in their relationships as they attempt to repair or fix the restless, irritability and discontent to avoid being criticized, blamed, shamed or abandoned. As mentioned in part 1 of this series, these individuals become human doings rather than human beings. In the process of doing their creative energy is exploited to manage the unmanageable. As with other roles with in the family system, the identified patient trades their creative energy for a crusade that can not be won. In the event that the identified patient continues in that crusade their essence will slowly be drained and distracted.

In my experience, I had to begin to accept myself as a person with an invisible disability before I could begin to break free from the role as an identified patient. I had to learn how to accept myself as a person who has an invisible disability, rather than a person who is disabled. I had to realize that although I have deficits and limitations, I am not those deficits and limitations. I had to stop living the lie that I am responsible for other people’s irritability, restlessness and discontentment. Through identifying and accepting my reality — rather than buying into anyone’s denial system for me — I have been able to use my creative energy and learn from my experiences rather than internalizing my deficits and limitations through the eyes of shame. I sincerely believe that I became an identified patient because of a lack of information. No one is to blame and pointing the finger in anyone’s direction is of little value. My motivation in sharing the above is not to complain, but to use my experience to illustrate a reality. People with invisible disabilities many times are criticized, belittled, ostracized and shamed for matters that are out of their control.

The sad reality is that as an individual with an invisible or visible disability, you may have people in your life that want to make you the problem — identified patient. I have good news for you. You are not the problem. The problem exists because of a lack of willingness to understand and empower. In the event that you have people in your life, who for whatever reasons want you to live through their denial, I want you to know, you have a choice. You no longer need to buy into their denial system my friend. You are the solution. You are not your disability, your deficits or your limitations. You no longer need to live in the shadows of shame and contempt. You are a beautiful person who has an invisible disability. You are remarkable and resilient. Through accepting yourself as a person with a disability you will find a new vitality. You will learn to embrace yourself and fly like a bird that is set free from the cage that once limited the bird’s flight. You will discover your creative energy and you will use your gifts, talents and abilities. You will move in the direction of your dreams and you will fulfill your destiny. Please read my post, Following your bliss…regardless. Be encouraged my friend. More will be revealed!

If you have any questions or would like to make a comment please use my Contact Information Page.

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2 Responses to “Traumatic Brain Injury and the Identified Patient – Part 2”

  1. Great post(s)! I have recently “discovered” that I sustained a mild traumatic brain injury at the age of 8, about 35 years ago, and knowing this — as well as how it has affected me cognitively and behaviorally — now puts so much in perspective. I was also cast in the role of the scapegoat in my family, and having an invisible disability truly complicated things. Thank you for this post and this valuable information. It really shed much-needed light on something that’s very immediate for me now. Oh, by the way, I’ve added you to my Broken Brain – Brilliant Mind blogroll at


  2. Hi Brokenbrilliant,
    Thank you for your time and kindness. Thank you for leaving a comment. I appreciate the encouragement. I got back from a 13 day visit with my family. I am happy to be back at home in front of my desk. My brother seems to refuse to attribute difficulties that I have to injury done to my brain some 40 years ago. He blames me and continues to deny that my brain injury has anything to do with my disability and believes I throw the disability card when I run into difficulties. Very frustrating. I have written a 4 part series some time ago and then a 2 part series,

    You may find that these two series to be helpful. I also have a site map — — that has a list of the 208 posts I have written since I started Second Chance to Live on February 6, 2007. Not all of my posts have traumatic brain injury or living with a disability in their titles, however you may find the material that I present in those titles very helpful. I share from my experience, strength and hope.

    Thank you for adding Second Chance to Live to your blogroll. I read through your most recent post. You are a very talented writer. I have found that Second Chance to Live has helped me sort through my reality. Keep up the good work and God bless you.

    Please stay in touch and let your friends know about Second Chance to Live. God bless you!

    Have a simply amazing day!!!



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