Head Cases by Michael Paul Mason

Author:Michael Paul Mason [Mason, Michael Paul]
Language: eng
Format: epub
ISBN: 978-0-374-13452-5
Publisher: Farrar, Straus and Giroux
Published: 2008-04-05T04:00:00+00:00

I haven’t known Marty McMorrow long enough to know whether his subdued and easy demeanor is natural or the result of the twenty-five years he’s spent around violent and aggressive brain injury patients. Either way, in his presence, your shoulders tend to relax a little and you feel a general sense of openness, as though the room just doubled in size. In the nineties McMorrow, a behavior analyst by training, designed a noninvasive neurobehavioral program adopted by over a dozen brain injury rehab centers in America, but this humanistic approach is largely unknown among mental health practitioners. At a hotel in downtown Baltimore, I had the chance to catch up with Marty, and I asked him if he was optimistic about the outlook for brain injury survivors who suffered from behavioral problems.

“Optimism is too strong a word,” he said. “There’s too much social resistance, and there’s too much individual resistance. A lot of people have trouble dealing with aggression, and that’s just human nature.

“When a person swings at you in the face, you’re going to get mad and things can get really out of hand,” he explained. “But if you break down the behavior, what is really your most natural response? It’s surprise, and maybe shock. It isn’t anger. Many of us who work in human services have lost our natural human reaction.”

Marty’s experience among the brain injured is peppered with stories of mistreatment at the hands of medical professionals. On one occasion, he was asked to evaluate a former model who had sustained a brain injury and was currently living on a psychiatric ward. Prior to meeting with the woman, he looked through her medical chart and learned that she had been placed in isolation for seventeen hours a day for the past thirty days in a row. He conducted the evaluation in a seclusion room that contained only a mattress—itself a passively hostile environment for the patient, as she had also lost her legs in the injury. After talking with her at length and scrutinizing the chart for details, McMorrow realized the woman had been secluded simply because she was annoying the staff with her excessive talking and anxiety. Once the woman received the appropriate care in a dignified environment, her behavior changed radically.

After visiting hundreds of patients in various facilities, Marty has witnessed numerous indignities heaped upon brain injury survivors under the aegis of restraint and seclusion. Yes, the patient is violent. Yes, they are agitated and aggressive. But they are human. They always retain that, their humanity.

“It’s absurd what some people come up with when dealing with aggressive patients,” says Marty. “You’re not going to set limits with a six-foot-five, four-hundred-pound brain injury patient! Who are you kidding?”

Since the 1950s, behavioral modification has become an ingrained protocol in many U.S. psychiatric hospitals, and the accompanying mentality has remained largely militaristic. You set boundaries, you reward good behavior, you punish the bad, you take away all privileges, and you slowly return them. The patient will submit, the thinking goes.

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