Antonio Damasio (1999) continued a long conceptual tradition within neurology when he described the brain as “a system of systems” (p. 331). We have extended this systemic view beyond the skull to situate neural systems within inter-personal, social, community and cultural systems, alongside systems and pattern transmissions of ideas and meaning. Our conceptual heritage and resource in this regard has been related to traditions of post-Milan systemic family therapy, second-order cybernetics, communication theory, social constructionism, post-structuralism, and narratology. Isolated individuals and their damaged brains disappear within this scheme, replaced by brain injury as a pattern, dynamic, and relationship. Interestingly, in applying systemic theory for this group of people we are continuing traditions within both brain injury and family therapy literatures. For example, although hidden behind broader labels such as chronic or physical illness, survivors of stroke can be found in the case examples of key family therapy publications such as the early work of John Rolland (1990) and even a contemporary of Gregory Bateson, Paul Walzlawick (Watzlawick & Coyne, 1980).