Today is


Story 4 - The Troll

'Not a problem'

Barry found it really hard to bring anything to completion. The troll was a case in point, it was sitting in his workshop for months waiting to be finished off and placed in position. The focus here was on helping him to connect with the things which needed to be done (like finishing off the troll). A number of things were taken into account when making this happen, for instance his terrible slowness, his suspiciousness, his lack of motivation and so on. All of these things were direct results of his head injury but I did not attempt here to see them here as problems needing to be solved. Rather they were factors which were taken into account and he was given support which allowed him to get on with the job. I found a sense of direction by focussing on the job that needed to be done, rather than on the problems which might or might not be solved.

There is only one problem that Barry and I have ever managed to reach agreement on. I once read to him the whole list of his problems, which cover just about everything that could happen to a frontal lobe and then a bit more. Out of all those problems the only one that he saw as a problem was motivation. I couldn't agree more. Motivation has to be the problem that he has got, it is intractable and insurmountable. In the words of his physiotherapist, 'it's not that his starting motor is faulty, it's that he hasn't got one'. Yet.......yet.....I wonder.


Towards the end of 1997 Barry began to work with Dot, an amateur ceramicist who specialises in producing fantastic creatures. She was the sister of one of the facilitators and I had visited her before setting this up as an activity for Barry. He used to travel out to her workshop in Roundwood once a week and over the course of 2 months made 'the troll', which owed something to the style of creatures that Dot tended to make, but which was also clearly stamped with an expression of Barry's creativity. These visits were sometimes fraught, because it was so difficult to get Barry anywhere on time. They did seem to enjoy their time together, but there was never any more contact after the troll was completed.

Barry was creative before his head injury and art was a subject which he got very good grades in. This troll was an expression of skill and imagination which he needed at this time. Making this troll connected him back to the old Barry and it was way of using his strengths in a constructive way. His creativity is a part of him and if you put him in a situation where he has the opportunity to express it, he does it to a high standard. Clearly Dot’s workshop provided just the right kind of stimulating environment for him. He was not simply copying, although he was guided by the ambience of the place where he was working. He could not have done it without access to everything that Dot has in her workshop, the atmosphere, the special techniques that she has developed to fire large objects. He could not have done it without finding Dot in the first place and without lots of support in getting to and from her workshop out in Roundwood.

The troll was finally fired and brought home in January and left sitting on the workshop bench. He had done small things to finish it, such as spraying it with several coats of polyurethane. I suggested that it should be put in place, assuming that it was just a matter of lifting it from its present position and putting it in the garden. It was a hot day and Barry felt pressured by me and said that he felt he 'got more done when he was on his own'. I retreated to the kitchen, leaving him in the workshop.

I was acting from the position where I recognised that the troll needed to be put into position in the garden, since this was the purpose for which it had been made. If he did not finish this task he would be left with the feelings that come from not completing a thing which has been started. The feeling would be those of uncompleteness, of things never getting finished, of it all being pointless anyway. He may not have articulated these feelings specifically around the troll, but they came out in other situations. If you accept that these feelings are a symptom of a deeper sense of disconnection, then you do things that first of all tackle that disconnection. If everything feels pointless (a favourite remark of Barry's), then you ensure that things are done in a way that does have a point. In this case, the troll has been started and so it must be finished, or there will be consequences.

The classic consequence is some form of depression and I wanted to avoid any thought of focussing on his depression. This had already been done year in and year out since his head injury occurred. It seemed to me that the less I focussed on depression the less of an issue it became.

He then proceeded to think about curtains for the windows, since he did not know how to go on. After a short while I came back and together we talked about what to do with the troll as we stood beside the pond. Now, in that pond were three enormous goldfishes and we talked about them, as we often did. The pond was uncovered and they were in imminent danger of their lives from the local feline population. Eventually it was covered, but not before a neighbour's cat had eaten one of the fish.

Barry had been brought up on a farm and his relationship with animals was affectionate and responsible. At this time he only had these goldfish to look after. Life gets its momentum by the way that we recognise new needs, even as we are meeting the original need. There are always things to be done, once you start doing things. We had now recognised one of the next things to be done, even as we were just standing and talking about the troll. If we had not stood in just that position, fully engaging in the task on hand, it is unlikely that we would have recognised the need to cover the pond, which makes the point that it is only by fully engaging that you can begin to recognise what needs to be done. The person who is disconnected from the job on hand will simply not see what needs to be done next or how to go about it. One way of bring about this disconnection is to see the person you are working with as presenting a series of problems that need to be solved, before you can get to do anything. Covering the pond provides an illustration of this conundrum between solving a problem and meeting a need.

The pond obviously had to get covered up, Barry could see that and so could I. But he needed support to make it happen. I did not have the time or the knowledge to do the job with him and so I asked among the facilitators for someone who would undertake to do the job with him. One of them said that she had carpentry skills would do it with him, but then was not able to get him to do it. It was easy to see it as Barry's problem, she kept asking him if he wanted to do it, but he could not 'initiate' or 'plan', he was not 'motivated' and he could not relate 'appropriately' to the facilitator. We could have worked endlessly on these problems, but what we did not talk about was the fact that she had volunteered for something which she did not have the skills to do. In fact there was no problem once we employed a facilitator who was a carpenter. He did not ask Barry if he wanted to do it. Instead, they arrived together at a much simpler solution than the one originally posed, and the job got done.

There were some similarities between Barry and this student facilitator. Having said that he could do more on his own, he then proceeded to do nothing. He did not recognise what he was and was not able to do. He could make a plan but then not know how to put in into action. He has since shown that he can do jobs when he is left to do them on his own, but they cannot involve more than a few steps and the starting point must be obvious. It was my job to hold him to the task and help him to stay with it for long enough to see the possibilities. He was not going to get very far in his thinking about the troll as long as he stood staring at the pile of curtains. It was my job to make the job a success and I was there to take responsiblity for making it happen, in a way which allowed him to own the end results. Barry had the vision, but he needed someone who had judgement and experience to make it happen.

In Barry's eyes, the obvious place to put the troll seemed to be where a romantic looking female statue was already firmly concreted into place. Removing it would involve smashing the statue and Barry was reluctant to do this. He could not get any further in his thinking than this and so he wanted to retreat. We talked about alternatives. As we talked we noticed a space at the other side of the pond that looked as though it might work.

The problem solving mode can be very useful when it is applied to a technical process. It is a way of thinking which belongs properly to situations where 'things' are being worked with and an objective stance is perfectly appropriate here. It is not appropriate to see a person in the same way, as a problem to be solved.

He imagined the troll raised into full view on a stone platform. He wanted to concrete it into position, and I asked him why, since I would have wanted to try it out in several positions before making a final decision. He said that it was to prevent it being stolen. This seemed reasonable enough; given how much work he had put into it and how splendid it was in its grotesque, garden gnomish way.

You can see here some examples of rigid, suspicious, damaged frontal lobe, kind of thinking, if you choose to look closely under a particular light. But we are choosing not to and it should be understood that Barry is living in an area which is very densely occupied by students. There is a fashion among students to play pranks with garden gnomes and he was being wise in protecting this troll that he had already invested so much energy in. It could be used as an illustration of one of those frontal lobe manifestations of suspiciousness, but in fact I find that Barry's reasoning is soundly based and is a fairly typical response to threat. We live in a society that provokes us into expressions of caution, which would have appeared ludicrous in New Zealand society of 30 years ago.

The next day, which was another beautiful one, we headed off to Glenealy to look for the stones to use as a platform. We took my car. Barry would have undoubtedly made a fuss if his car was driven on unsealed roads and his boot loaded with dirty stones and this could have meant that we would not succeed in our mission. He always loves driving around in his own car, but I was unnerved by the inevitable criticisms of my driving. It is not that his criticisms are not justified, it is just that it can really ruin my day to be reminded of my shortcomings in this way.

Barry really does seem to have a problem here. He has had a beautiful sleek black Mazda funded by the insurance corporation who kindly recognised (after considerable persuasion) his need for transport. He is not allowed to drive it (his 'baby') in a world which has been built around the motor car. Every time someone drives him in it he is reminded of his loss and, he reminds the driver also, that this car is his and that there was once a Barry who could have driven much better than 'this'. He is the ultimate passenger seat driver and every driver recognises the feelings that this can evoke. Driving is such a complicated thing, such a fast, dangerous thing, that someone as damaged as Barry should never be allowed behind a wheel. Of course, there are plenty of other people in our society who should not be let behind a wheel, but we do not stop them.

His brain injury bars him from driving and this is an insuperable fact of life which must be accepted. His neighbours cannot afford a car, because they are poor, and this causes them grave problems. Poverty may contain the seeds of hope, if you live in a society which allows that, while brain injury is forever. Poverty and brain injury are different kinds of tragedies, they are both part of the human condition which is accepted in our society. The fact that something is posed as a 'problem' suggests that there is something ahead....a solution. If there is no solution on offer, then 'just getting' on, within the context of accepting the tragedy within our human condition, seems to be a more useful mode. This is all to say that Barry’s brain injury has become his context and that the most useful way to work with him is to accept that context and figure out how to get on with the rest of life.

Driving is part of the human condition in our culture. In our acceptance of, and our joy in, this mode of transport we implicitly accept the outcomes. We accept a way of life where space and time are compressed, where life is lived in the fast lane, where our earnings are poured into the fuel tank, where our environment is polluted by the exhaust fumes and where thousands of us are killed or damaged in the most brutal way every year. It was Barry's driving which brought about his brain injury. He is part of the human condition which we all take part in. To see his grief as 'his problem' is to take him out of that human context. It is our need for fast transport, together with an adherence to clocktime, which has become the problem. In a society which did not include the car, Barry would seem much less disabled. His predicament with space and time can be eased by bringing about a situation where he was chaufeurred in his own car. Taxis and buses came next, but there was always an issue about the fact that they relied on clock time.

We stopped on the outskirts of Glenealy where we saw a few suitable looking stones perched on a crumbling bank beside the road. I went to the nearby house to ask for permission to remove them, but when there was no answer I assumed that it would be okay and proceeded to load a few stones into my boot. Barry carefully dissociated himself from the procedure, clearly feeling uneasy about the legality of the operation and he refused to help me at first. I was feeling unusually light and gay and I enjoyed teasing him about his intrepidness. After a few minutes he joined in and helped me.

Conscience is a product of our culture which is often disturbed when there is brain injury, yet here was Barry expressing a finer sense of right and wrong than I was. My actions here caused Barry to dissociate himself from the activity, which was precisely the reaction which I did not want. My actions were therefore unethical, not for the reasons that he might have supposed, but because they had alienated him from the activity, when what I wanted to achieve was a sense of connection. It was not an altogether successful experience, and it taught me to respect the conscience of this person. He was disconnected both from getting the stones as a base for the trolls, but also, in his moral outrage, from a relationship with me. This was not something that brought us closer to together. I was having a great time, yet Barry was being perplexed. It was my need for engagement which was being met here. I knew enough about boundaries of acceptable behaviour to be able to play with them here. Barry was excluded from this playfulness, both because he had different values as someone who grew up on a farm, and because he was not ready to play with boundaries when they all seemed so uncertain to him. Play can only come about when there is certainty and this was missing for Barry in this situation.

There was another issue which this brought up which was the fact that, far from being certain about what I was doing, I actually had very little idea about where to pick up stones. My interest in stone walls had led me to notice that there were stone walls in this area, and I therefore supposed that stones would be in a good supply. When the stones did not immediately present themselves I short circuited the activity and picked up the stones off the ditch. In doing this I conscious of the kind of distress that Barry tends to show when the facilitator does not seem to know what they are doing. Adequate preparation and training for this job would have ensured that I knew where these kinds of supplies were. But I was not being employed for these skills, but because of my knowledge about head injury.

Afterwards, since we were almost in Glenealy, he suggested calling in to T…., ( the previous service coordinator) and D.., her husband.. He had visited them there several times before and this is what he associates Glenealy with. D… was there and we stayed for a chat and a cup of coffee. By the time we got home from this 3-hour expedition Barry was absolutely exhausted and went to bed.

It was noteworthy that the most successful aspect of this whole expedition was the part initiated by Barry. I facilitated the process by making sure that I drove past their door. It was something that happened because both Barry and I were familiar with this place and its people. Familiarity is an important tool when you are working in this approach. Barry, like all of us, knows what to do because he has done the thing before. I could say in relation to his brain injury that he responds to cues, and the only reason that he called in there was because the place provided him with the cue, otherwise he would not have given a thought to this couple. But this is no more true of him than it is of me. I will not make a big trip to call in on someone I do not know very well, but if I happen to be passing their door I am likely to pop in and say hello.

He spent a few days carefully scrubbing the stones with a wire brush before trying to put them in situ. He did this spontaneously and discovered in the process that one of the 'stones' was actually a lump of clay. He very honourably didn't point out that the lump of mud was all my stupid fault!

We got the readimix from Hardware Galore and I tried to remember what I know about mixing cement, which is not a lot. On the day designated to apply the concrete he was very slow and unmotivated. I found it really hard to get him out of bed and it took him nearly 3 hours to get up. I finally got fed up and said in exasperation, 'it's your day, so just get on with it', to which he replied, 'every day is my day and it's boring'.

Getting Barry out of bed has been universally interpreted as a problem by anyone who has attempted to do it. His mother once said, memorably, “all I want for Barry is that he would get out of bed”. The strength of feeling in what his mother said would be echoed by any facilitator who ever worked with him, yet the idea that getting out of bed should be seen as the main issue, or even as the main problem, begs the question of whose problem is it anyway: the young man hiding under his blankets, or the increasingly irritable facilitator who feels that their time is being wasted? There have been many strategies put in place to solve the problem from both sides. For Barry there have been token systems, contracts, various cues in the form of alarm clocks, personable facilitators, phone calls, attempts to decrease fatigue. For the facilitators there have been supervision, training, and changes in the roster (so that he could not 'string them along'). Yet, 'success' in solving this problem is always tentative and precarious. One day he will get up, the next day he will not. Facilitators have resigned over this issue, saying that what he really needs is a work ethic and that all the effort we put into him was spoiling him. The difficulties with 'getting him out of bed' are now considered a rite of passage in the job, you're not 'in' until you have survived one such period. All in all, this is the one area where a problem based approach has been extensively used, with remarkable lack of success, given the amount of energy expended.

There is another way of seeing the issue, reflected by what his father once said, “Barry will get up when he has something to get up for”. This simple shift in focus has resulted in a remarkable success. The 'problem' of getting up, like all the other components of his brain injury, is always there, but it is simply not an issue when there is really something to get up for. In seeing his day as a whole in this way we were able to help him to connect back into a normal rhythm for our society.

I was really fed up with him so I mixed the concrete and left him to get on with it. After about 20 minutes he came and asked me for some trivial advice, which suggested that he wanted my company and was reason enough for reconciliation. And so I stood at his elbow while he got on with the next stage, giving him cues as necessary. He only needs those cues when the task changes, while he can get on with it himself for the rest of the time. After 2 hours there were 2 buckets of concrete used and 3 stones were set in place. He tended to use his fingers to fill in the smaller holes which was effective in terms of doing the job, but which burnt the skin on his fingers. I told him this would happen, but he did not take any particular notice.

We had gone over one of those emotional humps, which I have become all too familiar with. It was much easier to get him out of bed and he managed to disarm me completely the next morning by asking how I was and by making an attempt to remember the children's names.

It is impossible to stay mad with Barry for any length of time. He has a delightful sense of humour and negative feelings blow over very quickly. One can easily and repeatedly get exasperated by his slowness, so his facility to deal lightly with emotions is wonderfully adaptive. It takes patience to stand and be ready to give cues, but not to do the job, which is his work. One of the difficulties of this job is the excruciating boredom which can be inflicted on the facilitators as they wait for him to need a cue from them. This 'problem' has increasingly been alleviated by bringing about a situation where Barry and a workmate work alongside each other on the same project.

He knew what he was doing now and over the next few days completed concreting the stone base by himself, without prompting. He also found a piece of wood to use for a fishing line after trying several when we were rummaging under the house. He sanded this off and tried to plait some fishing line to make it look thicker and hang better. This didn't succeed and eventually he attached a huge hook to the end of some fishing line, which was the perfect accompaniment to the troll. He propped an empty beer can in the other hand and the picture was complete.

The whole project of putting it in place had taken a month in between other tasks. Most people would probably have completed the whole job over the course of a weekend, in between other tasks. He was really proud of this job though; it was something that he had done from start to finish which he could really claim as his own. He had done projects before, such as those when he was at the Ashford Polytechnic, but it was one of the rare moments when he could know that he had really finished something and receive acknowledgement for it. The troll was in a good place to be admired and it was something to be proud of. There is no doubt in my mind that he was proud of it and I felt really good for him and with him. He made the comment that the troll appeared to be leering at the nymph, which was indeed true, and funny.

It's not a bad outcome at all when you are able to make a joke about your work.


Next page: The door





Site Links

Home page
Methods and Ethics

Guestbook (to be enabled soon)

Brain damage stories-
Stories intro
Story 1 - The accident
Story 2 - The OT arrives
Story 3 - The CD rack
Story 4 - The troll
Story 5 - The door
Story 6 - At work
Story 7 - The letterbox
Story 8 - Employment

Occupation in Literature -
Literature intro
Being "well occupied"
The practitioner / OT
The person with brain injury

Discussion -
The need for occupation
Becoming well occupied
Ethical concerns
Occupation and neurology
Future research

Works cited

Brain injury and head injury resources

Occupational Therapy and carer resources

OT jobs

Rehab equipment

Physical rehab

Brain injury web sites

General brain injury resources

Organizations and programs

USA Brain injury association chapters

Headway branches

Brain injury Research

Brain injury support and chat

Brain injury mailing lists

Personal stories

Residential programs and similar services

Home page | Contact us | Copyright © | Privacy