Double bind and disability: the case of traumatic head injury.

This paper presents ethnographic data to support the double bind model of communication most recently described by Alexander. Using traumatic head injury as an example, an interactive view of paradoxical communication was taken focusing on the disabled, the family, and service providers. A brief discussion of head injury in the U.S. is followed by a delineation of the principles of the model. A number of specific binds are described based on perceptions of caregiving, private and public performance of the head injured, the invisibility of the disability, and economic disincentives to employment of the disabled. The paper expands the model based on the disability experience including illustrations of split binds, contextual communication and biological aspects of double bind.