Preserving self: from victim, to patient, to disabled person.

Open-ended, unstructured interviews were conducted with patients who had survived serious traumatic injury, and their experiences from impact to recovery analysed using grounded theory. A four-stage process of 'vigilance', 'disruption', 'enduring the self', and 'striving to regain the self' was delineated. The basic social psychological process of 'preserving self' explained the strategies used in each stage, and required deliberate action, focused energy and tremendous effort and will. The strategies used to preserve self changed in each stage of the model. At the beginning, when physical survival was in jeopardy, the strategies were primarily physical. Protecting self was a process of 'taking time out' and of shutting down, in the stage of disruption. In the stage of enduring the self, it was passively learning to 'take it' and to bear the treatments. Finally, in the stage of striving to regain the self, preserving the self was the work of regaining and redefining the self as a disabled person.