2010 TBI Inventory – Part 1

In conducting a review of the September 2012 and September 2013 TBI inventory data, I have found myself becoming very frustrated. Some of the terms are not understood by me, the response requires self-reporting, and I do not count myself as a reliable witness.

This morning I had the realization that for 12 years I worked in an environment recognized to be among the most stressful of workplaces. All call centre operations are closely monitored and employee performance is constantly checked. Every agent action is subject to scrutiny, all events are timed, each customer interaction is recorded. This recording includes screen grabs of the agent’s computer desktop in addition to a voice recording of all customer interaction. When I worked as a call centre QA assessor, I was able to pull up the agent’s entire record of past calls to determine when a performance deficit had commenced.

In addition to Quality Assurance monitoring of each agent’s work, the call centre technical support staff were required to spend two hours each day monitoring and scoring random agent calls. Each call centre manager was also required to spend two hours each day listening to the work of those agents under his / her supervision.

Each customer was requested to score his / her satisfaction with the agent’s performance at the end of the call. An outside 3rd party was employed to conduct random telephone surveys of recent customers and obtain a detailed response in regard to their satisfaction with call centre agent performance. The outcomes of these various surveys were reviewed with each agent on a regular basis.

Most employees found this work environment extremely stressful. If you were unable to deliver the expected standard of performance, you were subject to dismissal. The agent had no ability to control customer behaviour, or attitude, and was expected to respond in a polite manner to customer hostility and belligerence.

The agent had to accept any request placed by the customer. It did not matter if the issue fell outside the agent’s scope of responsibility, product knowledge, or skills training. I worked for the same global enterprise for over 12 years and, at the end of this time, I was still fielding calls in regard to products, and company operating units, that I had no idea even existed. I was required to handle the caller’s request in a manner satisfactory to the caller even when I had no understanding of the topic raised by the customer.

The IT industry is known for constant, rapid change. Over the course of 12 years with the same firm, I changed physical location more than 8 times. Each move meant a different physical location, often a different province. This movement does not reflect all of the regular internal changes in seating arrangements, in managers, colleagues, contacts, policies, hardware, desktop tools and interfaces. I handled all of these manifold changes without complaint, or problem.

I have encountered case studies in both the management literature, and in occupational psychology, which address call centre employment and describe it as the full realization of Bentham’s Panopticon. A consistent high level of employee stress arises due to the ongoing observation and micro-management of every aspect of employee behaviour and work performance. And within this environment, I delivered performance unequalled by any in my work group.

I have worked in a wide variety of occupational settings. These include the Federal government, the marine industry, creative industry (film), the engineering industry, and the oil industry. I also performed small business consultancy work while in Nova Scotia. In all this experience I have never encountered another work environment that is subject to such extreme constraints on employee task performance, to such narrowly defined productivity and performance requirements, or a workplace subject to such exhaustive monitoring and continual micro management. Yet I performed superlatively in this environment (largely because I did not care about the external monitoring; I was my own harshest critic and taskmaster).

I believe that any survey of the extant scientific literature on workplace environments would support the above description. I know that when I started employment in the call centre it was understood that call centre employment was one of the few occupations that would not result in a refusal of unemployment benefits if the employee were to quit. Even the Federal government recognized the difficult demands of the call centre work place.

In view of the above, I have undertaken to re-score the September 2012 TBI inventory. The scores are based on my memory of my behaviours during a period of employment which commenced in November 1999 and continued until the accident of March 06th 2011 without interruption.

I believe this analysis sheds considerable light on the changes which have become manifest since the accident of March 06th 2011.

 

 

 

 

Section 1 Analysis

I recently searched for a post regarding a text entry metric. In the course of that search, I located the TBI Inventory, Section 1 of which is included here. This event is reported in the post  Blogging and Avoidance  together with links to the other sections of the TBI Inventory. Sections 2 to 6 of the Inventory have been reviewed in prior posts. There was no prior post for Section 1. It appeared to have been completely omitted, or lost, or never created.

Then, while opening the WordPress draft of another post, I found a draft version of the Section 1 analysis. The tabular data had been entered and scored but there was no associated discussion, or comment. The original scoring would have been entered at the time of the original draft which WordPress reports as being entered on August 31st 2013. All of my comment was added today, May 19th 2014.

Section 1 Persistent Intellectual Impairments
2012 2013
Unscored 8 0
Scored 0 4 7 Not Present
Scored 1 0 0 Present, no interference
Scored 2 1 3 Mild, not disabling
Scored 3 19 21 Moderate, greatly interferes
Scored 4 0 1 Extremely disabling
Items N/A 2 2
n=34

Section 1 Improvements 2012 2013
Item 1.32 Inappropriate responses to people and things 3 2
Item 1.33 Difficulty taking care of yourself 3 2


Both items in this first section show an improvement between 2012 and 2013. I suspect the 2012 Item 1.32 response is associated with my prior attempts to flee supermarkets due an inability to handle the noise. I now shop in the off hours when I know the store will be quiet.

I experience greater amounts of irritability today than previously. This is relatively new. Since I have training in customer service handling I am able to recognize when I feel an impulse to act out of irritability and I constrain myself.

I have recently been to a dentist. My teeth have sustained much more damage than I was first aware of. They should have been attended to earlier. Part of the reason for not doing so was the belief that I would be covered by the insurance claim. I did not wish to incur significant out of pocket expense while attempting to stretch out my retirement savings.

Section 1 No Change
Item 1.1 Memory problems Score 3
Item 1.2 Difficulty concentrating Score 3
Item 1.3 Attention Difficulties Score 3
Item 1.4 Easily Distracted Score 3
Item 1.5 Misplacing or difficulty tracking things Score 3
Item 1.6 Difficulty making decisions Score 3
Item 1.9 Difficulty understanding written instructions Score 3
Item 1.10 Difficulty finding words Score 3
Item 1.11 Difficulty communicating thoughts & feelings Score 3
Item 1.13 Unintentionally repeating same activities Score 2
Item 1.18 Deficits in processing  information Score 3
Item 1.20 Difficulty executing or doing things Score 3
Item 1.21 Difficulty starting or initiating things Score 3
Item 1.24 Having to check and re-check what you do Score 3
Item 1.25 Disoriented by changes in daily routine Score 3
Item 1.26 Unsure about things that you know well Score 3
Item 1.27 Difficulty learning new things Score 3
Item 1.28 Doing things slowly to insure correctness Score 3


The memory problems continue. See the prior three posts for a description of a recently discovered memory problem. I would today rate this item as a 3.5, or even as a 4.0 due to its potential impact.

Difficulty finding words appears to have improved since 31 August 2013, the date on which I entered the 2013 data. I remember having particular problems with compound words: I would remember the Ernest but not the Hemingway. I still experience this problem but my sense is that it is less of an obstacle than it once was. The work on the blog may take the credit for the improvement.

I feel I am better able to communicate thoughts and feelings. If I read posts from the start of the blog and compare them to recent posts I believe there is a noticeable positive improvement. I believe I have become more self-aware and the blog is a vehicle that has assisted with this progress.

I do tend to repeat the same activities. In a prior post, I postulated that 90% of my activities involve cooking, photography, walking, and blogging. When I become upset I will retreat into these activities. There is less of the repetitive performance of the same action which was noted immediately after the accident.

I continue to have difficulty executing or doing things. I can get things done but I take an inordinate amount of time. I have the hope that the constant application of effort will result in a speed improvement but any such improvement appears to be very slow, if not glacial. I have an entire range of projects and activities that I have not engaged in since the accident and I am now proceeding to throw these things out as it appears very unlikely that I will ever reconnect with them. I am uncomfortable doing new things or extending outside my normal range. I need to constantly recheck what I do and then double check to make sure that I checked; I do not trust myself. I seek to avoid change in my daily routine. Any trip to a new dentist, or other new location, becomes an expedition project. I spent a day planning and preparing for a day trip to Montréal. I become very uncomfortable if I travel on new routes in the city and avoid this if at all possible. I refuse to park in other than my pre-established standard stops. I have 30 years of programming and PC experience, including 12 years in advanced tech support, but get flustered making changes to my own equipment. There are things that need to get fixed but I just defer this due less to complexity than a recognition of my own inadequacies. I have tried to brush up on my html, css3 and js skills. These are relatively simple programming languages  (I used to program in x86 Assembly which is a beast)  but I have difficulty in simply updating my skills. Everything I do is done slowly. If I attempt to operate at normal speed, I either become frustrated to the point I want to throw things, or I make so many errors I may not have bothered to start. In just this post I have made multiple errors and have entirely omitted chunks of text (an error I just found and corrected.)

Section 1 Increases
Item 1.7 Difficulty solving problems From blank to 3
Item 1.8 Difficulty understanding spoken instructions From 0 to 3
Item 1.16 Impaired abstraction or literalness From blank to 3
Item 1.17 Mental Rigidity From blank to 3
Item 1.21 Difficulty handling work requirements From blank to 4


This is awkward as I am tending to re-rate my 2013 responses based on my current response. On Item 1.17 Difficulty solving problems I would today rate that as a 2. I have the ability to solve problems; I am just much slower than I was. I have also come to rely on the fact that if I attempt a problem and am unable to resolve it, that it is likely that my mind will eventually present a full, or partial solution. This was first noted with the quiz puzzles presented by Dr L.

The prior three posts all address  Item 1.18 Difficulty understanding spoken instructions. This may be influenced by my hearing loss since the accident and an inability to discriminate spoken words from background noise. It may also be due to a failure to remember just what was said.

I also believe that I am showing improvement in abstraction. I believe the blogging activity is helping me in handling conceptual problems. Today I would rate this as a 2.5.

Mental rigidity remains a sticking point. In the real world I continue to follow the same set of routines and travel the same routes. With photography I appear to have forgotten my prior routines and this has led to an improvement in image making. With blogging I experience my writing as being more playful. Today I would rate this as 2.5.

I am not sure on what basis I scored Item 1.21 Difficulty handling work requirements. I am fairly certain that were I to attempt to perform my prior work for the computer company, I would have great difficulty in doing so. That job required the ability to multi-task which I no longer have, it required an ability to control frustration and irritation which I now have difficulty with, it required an ability to recall informal data from months previously, a skill I no longer have, it required an ability to engage in constant learning which is something I continue to have trouble with. I would leave this item scored at 4.

Section 1 Not Observed
Item 1.12 Unintentionally repeating the same remarks
Item 1.14 Stuttering or stammering
Item 1.15 Difficulties doing simple math
Item 1.19 Deficits in sequencing information
Item 1.29 Decreased capacity for reality testing
Item 1.30 Impaired ability to appreciate details
Item 1.31 Impaired ability to benefit from experience


On Item 1.15 Difficulties doing simple math, it is noted that the first attempt to total the scores associated with this inventory was attempted manually and it was incorrect. All later scores have been tabulated using built in spreadsheet functions. I use a calculator at all times.

I am not sure I understand what is meant by Item 1.19 Deficits in sequencing information or by Item 1.29 Decreased capacity for reality testing.

I know that I had some problem with speech when I first saw Dr H. I cannot remember where I encountered the note on this. I suspect it was in the Accident Log. Today I would score Item 1.14 as not observed.

Section 1 Not Applicable
Item 1.23 Difficulty handling school requirements
Item 1.34 Difficulty taking care of children


There is no change in the items in this section.

 

 

 

 

Clouseau and the Maggots

This is the third Groundhog Day. Like the preceding two, it opened with sun in chill morning air. Unlike the others, I woke at six and immediately went back to bed.

My recent discovery is having a big impact on me. It had been my intention to devote most of the weekend to continued spring cleaning. Instead, I have spent the time investigating my own mind.

Last night I had a horrible dream sequence. It was an image of white maggots teeming inside my own brain, deep in the centre, gnawing away at all they could reach. From the outside their presence was hidden and invisible. Their activity was only made evident by continued deterioration in the mental functions of me, their unwitting host.

I am the Clouseau of psychological investigations, bumbling about, completely unable to see what is taking place around me. I am attempting to be reserved, and practical, and intelligent, about these matters. I cling to the keyboard as the single piece of flotsam in a broad and desolate ocean that reaches out to the ends of the earth. And, like Conrad’s Kurtz, I am left muttering some variation of “the horror, the horror.”

So much for mixed metaphors as a start to the morning. First, the bad news.

I have been seeing a dentist and periodontist. After the accident I had night seizures and nipped my tongue and ground down, crushed, or fragmented my teeth. Dr B advises that I have teeth that have been fractured below the gum line. They will have to be removed. There is much work to be done, a considerable degree of conferring between me, and the specialists. Dr A has taken an active role and has been very helpful, acting as the “lead manager” running point, guiding and explaining events to me. I missed undertaking actions, or failed to understand what I was to do; this was the reason Dr A stepped in and I am very grateful to him.

I now suspect that the communications problems were due to the fact that almost all of the communications were verbal and I failed to remember elements of our interaction. I now have a very strong preference for email and feel uncomfortable with phone communications. I suspect this is due to the deficit.

There was an episode of a year ago when I was driving with a former girlfriend and she requested we take a certain route. I agreed with the change and then reneged and failed to make the turn when it was required. She accused me of bad hearing and there is evidence to support that interpretation. It is also possible that I simply forgot her request and my own agreement to it. I am still confused over what happened.

In the post  Austerity and Disability  I described my attendance at a seminar on disability cuts in the UK. This was primarily a verbal event. I only retained one significant fact – people in wheelchairs being tipped out of them and accused of being charlatans to gain access to benefits. Since my notes were unintelligible (my handwriting is a bad scrawl), I had to search the web for a printed document in order to gather more information. My recollection of that event was as poor as my recollection of my last visit to Dr D.

I may be painting a picture of this deficit that is worse than it is in actuality. The past hour has been spent in silent review of whatever problematic social interactions I am able to remember. I am starting to blame all of the world’s failed communications, bad speech, confused directions, and unintelligible comment, on my deficit. This is unreasonable; I think the world should accept its share of the blame.

I am also conscious of the fact that this self-flagellation is amplified and supported by my history of childhood trauma. After an abusive encounter, I would blame myself for what had taken place. I saw the event as being my fault, my responsibility. There would follow an extensive investigation and self-review to identify the actions which had triggered the attack. The outcome of this was two fold:  1) reinforcement of a negative self-image in which I am at fault, or incapable in some way. I am falling into the same psychological trap with this query into my cognitive deficit;  2) a strong urge toward post-event rationality, an investigative review of all actions in an attempt to gain understanding. This is the germ of my affinity for intellectualization and reason. These blog posts are evidence of the same behavioural traits at work.

Clouseau and the Maggots  –  Conclusions

  1. This is a real phenomenon. If my assumptions are correct than it has the potential to truly play havoc with all interaction. I don’t think it possible to go through life with everything reduced to the transfer of text notes between individuals ( of course the world is headed in that direction anyway which implies the presence of assistive technology to re-mediate the problem ).
  2. To a degree, I am making a mountain out of a molehill. This is primarily due to the shock of discovery. The first encounter of any kind is always slightly traumatic.
  3. It cannot be due to any tumour, or other form of brain degeneration. This would have been picked up by the MRI testing. The maggots exist only in my dreams.
  4. It is possible for me to have successful verbal interaction. I have conferred with Dr H and Dr D for several years now; my sense is that those conversations went well. This is not a case of sudden abrupt senility. I need to have confidence in my ability to conduct my affairs.
  5. I cannot rule out the possibility that this is a framing issue. I have acknowledged having similar deficits and memory lapses in the past, and have recorded those events without experiencing any great concern. Those prior lapses did not significantly impact my daily life. I only noted the lapse when it was too late to do anything about it. In the current case, I experienced a memory lapse and this memory lapse was noticeable and significant as it did impair my ability to perform an activity. My response has been due to:  1) the immediate impact;  2) the experienced limit to my action. The implied severity derives from this framing not from the event itself.
  6. There is a problem with a subject attempting to assess him / herself. I need to address this issue with Dr H and Dr D and obtain their opinion.