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Story 5 - Putting up a door: The workshop cupboard doors

Severe brain injury after the acute stage of rehabilitation

In the previous section I talked about the fact that it is not helpful to see Barry’s life as a series of problems which require solving. The brain injury is just one aspect of himself that he has to learn to live with. When you are seven years out from any major trauma the only hope is to stop trying to change things which cannot be changed. This is not a counsel of despair, but one of hope. At this time this thesis was being written Barry was long past the acute stage of rehabilitation. Focussing on the tragedy of the change that has been wrought is not going to help anyone. In fact there comes a time when the only change that is going to happen is through moving on again, as the person that you now are. It is easy to say, but how can it be achieved? How can you even begin to know what the next step should be when the whole of your life script has been re-written.

Barry is living in an age when all of his cohort will be facing huge questions about their future. Every new generation has to find its way forward and there are some times when it is easier to be young than others. Massive student debt has limited choices for some young people of this generation, unemployment limits choices for others. Barry is part of a tiny subset of his cohort who is not struggling with either of these issues. At this moment in time he is protected by the compensation legislation and by a very supportive family. He does not have exactly the same things to struggle with right now, but he is in his 20s, which is a time of trying to sort out a direction and possibly a time to find a lifelong relationship. He shares these dilemmas with other 26 year olds.

In this age where we are told that anything is possible, and it is our own fault if we do not achieve everything, there are multitudes of plans and possible futures floating over people’s heads. Who has told us that we can achieve anything that we want, and given so much ground for disappointment as well as achievement? Our heads are stuffed with images from the media. Some people succeed in grounding these dreams in reality, but many do not. The reasons can be multitude for both success or failure: circumstances, ability, politics, socioeconomic status, health, support etc.

Lack of insight in brain injury is typical

It is useful to be able to make a realistic appraisal of yourself in the world if you are going to achieve your goals. Barry, with his brain injury, is forever reminded about his lack of insight and his unrealistic goals. There seems to be a mismatch which is obvious to us. But our own private dreams and those of our colleagues may be equally unrealistic, if they were to be brought to scrutiny in the light of day. We say that the brain injured suffer from a lack of insight, as though insight is the prerogative of the non-brain injured. I would counter that the mismatch between our dreams and reality is endemic in our culture, there is nothing ‘given’ about the future or our place in it. Choice, which is hailed as a blessing, is also a curse. Many people find their way without inflicting too much misery on themselves or on others, but Barry needed a little bit of help in finding his way.

The first point is that Barry was not starting from scratch. He was not born the day that he had his brain injury, rather, this was something that happened to a young adult with a history behind him. He was dreamy in school, but had a way of relating to people which made him popular at the same time. He had and still has a well developed sense of humour, and I would say that there was always a sense of integrity about Barry, since I experience it in him and I doubt that it has been produced by the brain injury. He did not like anything that smacked of work and was never cut out to be a farm boy. However, he always loved pottering and this is something that seemed to arise spontaneously in him, since he did not have a lot of example from his father, in terms of handyman skills. His family responded to this part of him by using the very first carer hours that they got to employ someone with whom he could potter around with in a shed.

This thread then got lost for a couple of years when he went off to polytechnic as a student. This was a response to his previous aptitude for art. The art and handyman threads have been woven back and forward without ever really meeting. Both are part of a recognition that Barry is good at doing things with his hands. Yet this thread had got lost at the time that I started to work with him. It was an obvious one to pick up again.

The previous story about the troll seemed to be about art, but it was also about doing the kinds of things that a handyman would do. We noted at that time that the fishpond needed to have some netting put over it. And in the story about putting up the lizard CD rack we had noted that it might be useful to put up doors along the wall in the workshop where there was access to the underfloor parts of the house. In each story there were the seeds of things that could be done in the future. By the end of this story Barry was able to say that he would like to do some of this handyman stuff for others. The art thread was gradually getting left behind and the handyman thread was coming to the fore.

Premorbid cognitive and personality factors are relevant to the outcome in brain injury.

There is really nothing more to it. The past becomes woven into the future through the uses we make of the present. Premorbid cognitive and personality factors are relevant to the outcome in brain injury. I helped Barry to pick up the handyman thread, because this is the one that seemed to present itself in the things that we did together. It feels quite inevitable once the thread has been followed for a while, but I am aware that if I was a different person with a different set of skills, this part of his story might have turned out somewhat differently. For instance, if I was an artist I may well have picked up the troll/art thread and brought him further along this line, encouraging him to build on his skills in ceramics and to create more wonderful creatures along the way. However, given the ground that we were both standing on, the handyman thread seemed to be the stronger at this time. It was, after all, something which had interested Barry before his injury.

This art/handyman dichotomy illustrates that no matter what choices are made, some things have to be left aside, at least for a time. If one were to focus on what Barry had lost by not continuing to work as an artist, there would be a feeling of impoverishment in the middle of plenty. It would be foolish to do this, since Barry was beginning to be happier as he got stronger as a handyman. Yet that is precisely the unhappiness that inflicts many people in our culture. We do one thing and grieve for all this things that we are not doing. If we are not able to fully engage and commit ourselves in the present, we will tend to live in poverty in the midst of plenty. Barry stopped grieving for all his losses as he began to engage with this one thread of his life.




The workshop was added on to the house at some point and this means that it provides convenient access to the space afforded by the piles underneath. As frequently happens, the previous owner had left quite a lot of odds and ends stored underneath the house. One of the first things that I did with him was to have a good rummage through all of this. He didn’t seem to have done so himself. The access points are between the wall studs and some of these are filled in permanently, while others were not. Making doors, which would allow easy access while screening off the area under the house seemed like an obvious job and one that needed to be done. I suggested it and he agreed that it needed doing. We found a board that would fit the first gap, which was beside the stairs into the workshop. It needed a bit cut off it so that it would fit over a slight lip on the ground. We talked about it and how to measure it precisely. There was no measuring tape so we did a quick hunt for a ruler, which his flatmate was able to provide. Sensing a bit of nervousness I said that he could either do it now or later, but he replied “whoever says that I couldn't!?” He practiced with the jigsaw and then cut a line along the board, which was accurate for most of its length.

We then needed some hinges so, after a break of a couple of hours while Barry had lunch and chill time, we went off to DDS (demolition store) on my suggestion. There were few hinges, but the store itself was an eye opener to Barry and he commented, 'this is my kind of place.' Then when he was paying for the hinges he announced to the assistant, who looked a bit nonplussed, 'I am going home now to work with my power tools'.

Successful therapeutic input in brain injury.

It was easy enough to know when you got things right with Barry since there was that jolt of recognition that came when he was on the right track. It was as though the path was already there in him and it was my job to help him to have enough experience so that he could recognise his direction..

That evening he hung the first door by himself and while there was an uneven gap along the top, it fitted well enough for what was needed. I saw Barry again 5 days later and he had not got any further than that.

My work with Barry seemed to be succeeding because I was so firmly focussed on the end product, success was not optional - it was all that mattered. One of the facilitators said at about this time: "it just gives us so much courage when we see someone like you coming in and managing to finish something with Barry". No one had been able to finish anything with him since he moved down to Rathnew, because the focus had been on pleasing him or changing him. Yet it was by focussing on the end product, knowing the things that were associated with it that I managed to induce him into completing things for the first time. I knew that Barry would want to finish what was started, if he was given the means to doing so.

It was easy to get him up, since he had gone to bed by midnight (which was pretty unusual) and he was ready to leave the house by 11am. Hardware Galore is one of his favourite places and we were going there together in his car, which increased the motivation. It took him about an hour to decide on which screws and hinges to get. We then went home for lunch and chill time and by 3pm he was up and keen to get on with his work. For once he did not want another cup of coffee and a smoke, which would normally take half an hour. He was able to make a second door after a brief discussion and at this point I looked superfluous, so he suggested I get a project of my own to do. It was becoming clear that the difficulty was not in the actual steps of the task, at least in a simple job like this.

I was back again after another 2 days and this time Barry was feeling depressed and slow. He was ready by 11am but he did not want to do any work until he got some cigarettes, so we walked down to the local dairy. The 3rd door posed a few extra problems about exactly where to put the hinges and how the door should open. He was slow to grasp ideas, but at the same time he wanted to get started and did not want to stop for lunch at midday. By 1pm he was exhausted and cooking 2 minute noodles for his lunch took him over half an hour and considerable effort and thought.

I called him from his chill-time before I left at 3pm and, when the facilitator arrived at 5pm, Barry said that he was 'bumming out with these doors.' The facilitator suggested some more alternatives for how do make it and was impressed by how determined Barry seemed to be to succeed. Barry ignored all these suggestions, but got back to the job. Unfortunately an hour later he hit his shoulder and there was a big cursing routine and a few bangs. By the end of the evening, however, he had managed to get the door finished. This completing of a task by himself was a first and it opened up new horizons about what was possible for and with Barry.

It would be very tempting to value the amount of perseverance that he was showing over the final end product, but the experiences are qualitatively different. I insist on his success because there is much more at stake when something is actually completed. The completed cupboard door will be there afterwards, long after the time that the trying took place.

Putting on those three doors was done over a period of about 10 days, which meant that he had kept at the job fairly consistently. This was the first time that he had kept going in any job by himself. When I came in the following Monday he suggested that I go through to the workshop to see the finished job. I was so proud of him. It felt like a breakthrough and, I am sure it was with this job in mind that Barry said to me a few days later he would 'like to do handyman stuff for others'.....


Next page: At work




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