Critical Tensions in Talk About Brain Injury

Abstract

This article presents an introduction to some potential applications of a critical discourse perspective to the field of traumatic brain injury. Critical Discourse Analysis (CDA) examines spoken and written texts as a means to understand the two-way relationship between discourse and cultural context. CDA is particularly interested in how language use reflects and creates power relationships between those involved in the communication. In order to illustrate this perspective, this paper discusses a purposively selected set of written texts about brain injury from a range of institutional contexts: a scholarly journal article, a submission to government from an advocacy group, the home web page of a support group, a newspaper article from the general media, and personal letters written by people with traumatic brain injury. The analysis involved investigation of key linguistic features reflecting the experiential, interpersonal and textual aspects of these texts. Three main lines of tension between competing discourses emerged from an examination. Tension emerged within each text between medical vs. lay terminology, and this was seen as reflecting the widespread power of the scientific paradigm. Tension was apparent between problem talk vs. positive talk. Talk about the problems associated with brain injury forms an essential component when seeking support, and yet talk about positive outcomes forms an essential component when describing the rehabilitation journey. There were also competing discourses in terms of the focus of the talk, between person centredness vs. other centredness. The methodology of CDA is proposed as a tool for reflective clinical practice at both an individual and professional level, as it provides a systematic means to examine health professionals' interactions and promotes the development of a critical understanding of the cultural ideologies and institutions in which practice is located.