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Media- Traumatic realism?

The portrayal of brain injury, from psychologist and patient perspectives

14 April 2007

Traumatic realism?

AT the end of a week where I’d talked to a Canadian radio documentary about the coverage of psychological ideas in the arts, I settled down to watch Recovery (BBC1), a drama ‘focusing on how brain injury can affect someone and their close relationship with their partner’.
Having explained to the listeners how writers can often describe nebulous feelings and concepts in advance of psychological theories on such topics, I now realised I had overlooked another critical function of the arts. I grimaced throughout Recovery. There was a complete absence of any clinical neuropsychologist in the man’s care, and the main character represented an exaggerated pastiche of head injury. But I winced because it made me feel strongly again about the sorts of cases I have long since got used to hearing about.
In the end, I couldn’t say that I felt Recovery was any good, but in talking to my wife afterwards, I was clear it had made me feel. In trying to discuss it back at work, one of my students told me it had made her cry. Whether or not it is an accurate portrayal of head injury and its effect on a relationship, I can’t comment. But whereas the inspection copy of The Brain and its Disorders that I read that week didn’t engage emotionally with the topic, Recovery did. To be honest, that’s why I didn’t like the programme, and yet, that’s why I do like the arts.
So Recovery made me feel angry, guilty, useless… and I felt awkward about having asked Pam, who had a TBI, and Rob, her husband and carer, to watch it. But I’m glad I did, because Rob’s perspective, which we turn to now, clearly carries much more weight than mine.
    Chris Moulin

THE portrayal of brain injury and its consequences in the media is usually far from reality: instantaneous recovery from a coma and the use of amnesia as a cheap plot device are depressingly commonplace and at best unhelpful. Recovery was an attempt to make a realistic drama portraying the effects of traumatic brain injury (TBI) on a family. The main focus was the effect on the wife, Tricia, of dealing with the effects of the TBI on her husband, Alan.
As with any attempt to summarise a long process in a short programme, it’s easy to pick holes in it: rehabilitation after a brain injury is long and complicated, and many aspects of it were not shown or only briefly alluded to. Nonetheless, as an illustration of the problems faced by the close relatives of someone with a serious TBI I felt that it succeeded. In fact, as someone who has been through a similar process to that experienced by the characters in the drama, I found parts of it sufficiently familiar that they were difficult to watch. Small details in the programme resonated with me: for example, the scene where the injured character sets fire to the house because he gets confused by the toaster came straight from my imagination and my own endless worries over safety.
The bigger messages about the effects on the relatives were also recognisable. I could easily understand the sense of isolation experienced by the wife of the injured man, and her difficulty in coming to terms with the change in her husband from a partner in her life to a dependent and difficult stranger. In my case, I had a very supportive family and my employers were flexible. Most importantly, my wife has not only now made a much better recovery than the man in the programme, but she also didn’t exhibit many of the emotional and behavioural problems portrayed in Recovery. Given that the lady in Recovery had little of the family and workplace support that I did, I think that showing her as being on the edge of a breakdown at times was not over-dramatic. Recovery ended on a positive note, with Alan making something of a recovery and Tricia’s final realisation that she has to accept her husband for what he is, and take comfort in those pieces of him that remain: this process of acceptance for her mirrored part of my own acceptance of my circumstances.
Other parts of the drama were less close to my own experience, but nonetheless were believable. The scene where the wife went off the rails and ended up in a drunken one-night-stand is thankfully not matched by my own experience, but I could certainly imagine myself going down the same road if my family had been less supportive or if my wife’s injuries had been different. I thought the conflict over the future of the couple’s teenage son, who was about to go to university but who was also needed at home to help his mother, was realistically handled and usefully illustrated the effects that these injuries have on the family of the victims.
One aspect of the programme that could be criticised, and that I have heard other viewers comment on, was the apparent lack of community support for her. I don’t personally see this as a serious flaw: my experience is that while support for the victim of TBI is available (although even this is variable), community support for the relatives of the victim is less forthcoming. I found it difficult to get any information about my wife’s condition from the doctors dealing with her, perhaps because the culture of not making predictions about recovery has led to a general reluctance to comment at all on the seriousness of a patient’s injuries or on how well the patient is recovering. I certainly felt this was very unhelpful, and I am a professional biologist from a medical family, and better able than most to work things out for myself. Given my experience, and the constraints on time for the programme, I don’t think that the portrayal of Tricia as essentially being abandoned to cope by herself was especially unrealistic.
    Robert Knell