Unmasking brain injury: Arts-based methods of communicating emotional experiences of ABI

Research Objectives: To understand common emotional themes of people living with acquired brain injuries (ABI) and how they connect to self-expression through art.

Design: Qualitative content analyses of text and art

Setting: public domain

Participants: Data were collected from the Unmasking Project Web platform. All mask art available as of 3/1/2023 was manually screened for inclusion. Masks that did not describe an ABI injury or have a narrative accompaniment that describes the art of the mask were not included in the analysis.

Interventions: NA

Main Outcome Measures: Interpretative phenomenological analysis (IPA; Smith, 2004) was used to evaluate how people with ABI used art to engage in self-expression.

Results: The mission of the Unmasking Project is to spread awareness of brain injury and advocate for the needs of people with ABI by creating masks. In total, 895 masks had narratives describing the visual components and meaning of their masks. Three major overlapping themes emerged that described the emotional experience of ABI: Divided, Pain/Loss, and Empowerment. Additionally, nearly half of the participants chose to express a literal depiction of themselves or their injury (n=335; 40%). People most often described and showed pain or loss (n=548; 61%), with codes such as feeling invisible or grieving. Also frequently displayed and expressed was Divided (n=331; 37%), symbolizing before/after TBI or the positive/negative effects of ABI. Finally, people portrayed feelings of Empowerment (n=268; 30%) in terms of being chosen or experiencing triumph in their recovery. Literal representations of ABI frequently used visual metaphors and the intentional use of different colors to depict their experience.

Conclusions: The narratives that accompany the masks verified how art was used for self-expression. In agreement with previous literature, participants experienced ABI as a disturbance in self-expression, often expressing it as loss or division. Furthermore, people expressed positive experiences from the injury. Arts-based research can be used in practice to provide a lens into patient experiences that might be difficult to articulate or evaluate through quantitative methods.

Author(s) Disclosures: The authors have no relevant financial or non-financial relationships to disclose.