Representations of Values in Britain and America
The concept of malingering resulted from nineteenth-century social and economic contexts in Britain and America. Suspicions of poverty were high. Relations between employer and employee were changing. Industrial accidents that caused traumatic injuries fell into a grey area of jurisprudence as new workers compensation laws took shape in statutes, torts, and contract negotiations.
Reference Friedman and Ladinsky 16 Lawyers for plaintiffs brought actions in the nineteenth century. Employers resorted to a common defense that emphasized the “contributory negligence of the employee, assumption of risk, and common employment.”
Reference Epstein 17 Was the victim blameless, a question which meant that the plaintiff’s character, associations, and legitimacy deserved investigation.
18 Whether the injured patient was a hereditary defective was also considered a legitimate question. Malingering filled these special rabbit holes. As historian Roger Cooter has shown, malingering became a medical and psychological problem during the First World War,
Reference Cooter, Cooter, Harrison and Sturdy 19 yet the malingerer emerged as a category of social existence from the mid-nineteenth century.
Normative pressures should be understood in this essay as commonly accepted traditions and behaviors that structure behavior and that are difficult to challenge without critical reflection. In the conclusion, this paper calls for a reflexive turn in TBI research to make these axiological and economic structures radically visible and introduces one remedy.
“The malinger, the author stated, was a beggar, a corpulent fellow likely surviving on the labor “of his daughters — a pair of weak-looking girls, seamstresses”, an indolent, and indeed the tendency ran “in the blood” for “hereditary paupers” formed a class in the workhouse populations “all of them inveterate malingers.”
24
Perhaps the most singular form of malingering — which takes almost every form — is that which puts on the appearance of insanity. I have seen one such instance — that of a soldier charged with a serious offense — who, taking a hint from a comrade, assumed the mask of a lunatic, and wore it so naturally as to escape all the consequences of his misdeed. I have good reason to believe that the same sort of thing is much more frequent than most people would be inclined to suspect. I know that a good many people designedly work for the reputation of being “a little cracked,” because it is an admirable excuse for all sorts of follies and most vices. I know, too, that a good many look upon the lunatic asylum as rather a pleasant sort of retreat, whence all care for the morrow is excluded.
25
The source shows a whole worldview manufactured in an instance. It displays resentments typifying class relations in British and American industrialization, a time when with hindsight it should be recalled that: “Social insurance was unknown. Local poor relief was cruel, sporadic, and pinchpenny. Institutions for the helpless were indescribably filthy and heartless … the whole system was shot through with … an inordinate fear of the spread of idleness and a perverse notion that pauperism generally arose out of the moral failings of the poor.”
Reference Friedman and Ladinsky 26 But the argument I am offering is that these representations would be as familiar now as they would become in that period, and that far from being accurate, they signal prejudices that shape structures determining clinical and legal encounters. Laziness, poverty, obesity, sinful licentiousness, mentally illness, and cowardice — all pointed to the conclusion that it was easy to feign sickness for monetary reward.
Women TBI patients experienced these matters in similar ways.
Reference Oppenheim 27 Consider this second source. In 1886 a case history in the United States appeared in the
Boston Medical and Surgical Journal. The source points to the way normative attitudes could result in self-injurious behaviors. The author Arthur H. Nicols recounted how in 1884 a freight train flipped over tracks and tumbling over brought up against this house, knocking a hole in the side-wall of the kitchen where Louisa Russell “was at the time engaged in her ordinary housework.”
Reference Nichols 28 The box car did not destroy the house. Nicols noted that Russell had “not been thrown down, rendered unconscious, or even nauseated” which indicated that “the blow received was not of great severity.” Indeed “there was no satisfactory evidence to show whether she was in reality struck on the head.”
For the period of about a fortnight after the accident she appears to have been dressed and about the house each day. Though doing no house-work, she was able to attend to the adjustment of the award for damage to the house … It will thus be understood that when at a subsequent date, having in the meantime felt aggrieved at the same sum awarded by the referees on account of damage to the house, she preferred a claim for personal injury, it was not unnatural that her allegation should be viewed by the corporation with suspicion and held to be an after-thought.
29
Nicols explained that the chief symptom complained of and seen by her personal physician “sixty-five” times was headache. The suspicions of others are certainly noteworthy. Nichols wrote: “The exercise involved in hanging out clothes must be pronounced at least injudicious, if there existed, as it assumed, any lesion of the brain. To interpret, however, this indiscretion as evidence of fraud or exaggeration, would indicate an imperfect knowledge of the eccentricities of the patient.”
30 Nicols explained that the case appeared to be “concussion of the brain.” The cause of the patient’s long term problems was that “the real nature of the trouble was not for a time suspected, and consequently absolute rest, the essential element in the treatment of such lesions, was not enjoined.” It would be impossible, Nicols said, “to assume this to be a case of malingering” because “stimulation of organic brain trouble is not admitted as within the range of possibility by any treatise on malingering.”
Reference Nichols 31
Órlaithí Flynn Sinn Féin 
