Society for Medical Anthropology
Oral Presentation Session
Christine Melillo (Department of Veteran Affairs)
Karen Besterman-Dahan (Department of Veteran Affairs)
Bridget Hahm (Department of Veteran Affairs)
Gail Powell-Cope (Department of Veteran Affairs)
In the VHA (Veterans Health Administration), full community reintegration, which traditionally encompasses: 1) employment or other productive activity; 2) independent living; and 3) social activity, is considered the ultimate goal of rehabilitation for Veterans with Traumatic Brain Injury (TBI). This paper will discuss the results of a 4-year HSR&D longitudinal ethnography focused on understanding how Veterans with TBI experience community reintegration after discharge from acute and transitional VA rehabilitation. Specifically, we will explore liminality as a framework for understanding TBI experience in general, and further suggest that people with TBI are essentially liminal personae. We argue that the liminal nature of TBI, resulting from cognitive and physical impairment, often creates a discrepancy in ones’ sense of self-identity; thus, having significant implications on the milieu of work, daily living, and social interaction. We explore examples of precarity, struggle, and triumph in the everyday lives of Veterans with TBI and their caregivers. We contend that the "cruel optimism" of TBI is that "full community reintegration" is rarely, if ever, achievable; thus, leaving individuals with TBI to navigate their lives as liminal personae. Finally, we will discuss the link between liminality and trauma and ways to potentially breach the thresholds of TBI. We conclude by suggesting that art therapy can be used as a relevant and appropriate clinical intervention to facilitate self-identity reconstruction and community reintegration among Veterans.