A spinal cord injury (SCI) is one of the most devastating of all traumatic events. It results in a loss of some or all of an individual’s sensation and movement. It is common for individuals who are newly injured to have health problems. Plus, it takes the time to build enough strength to be able to fully participate in daily activities. Individuals who are newly injured will likely experience grief. This is a period of mourning that is similar to that following the death of a loved one. The difference is that you are grieving the loss of your sense of touch along with your ability to walk or use your hands. You will likely experience many different thoughts and feelings after injury. Some may seem extreme and others mild. There is no step-by-step grieving process, but some thoughts and feelings are common after injury.
- Denial/Disbelief: Individuals may first react to your injury as if nothing happened. Individuals may refuse to accept that the loss of feeling and movement is permanent. Instead, individuals may view the injury as an illness similar to a cold or flu that will soon pass with time.
- Sadness: Obviously, no one is happy to be injured, no matter what your level of injury. Extreme sadness is common after injury because you have experienced a great personal loss. Sadness is that down, or blue feeling that you have when something bad happens. However, do not confuse sadness with depression. Depression is a medical condition that requires professional treatment. Individuals may be depressed if experiencing symptoms such as extreme sadness, inactivity, difficulty in thinking and concentrating, a significant increase or decrease in your appetite and/or time spent sleeping, and feelings of dejection, hopelessness or worthlessness. Depression may even involve thoughts about suicide.
- Anger: Some people react to their injury with strong feelings of displeasure. Individuals might lash out verbally or want to become physically violent towards others. Individuals may feel angry toward themselves especially if their actions resulted in the injury.
- Bargaining: At some time following the injury, individuals may begin to admit that their injury is a serious condition. However, individuals may still want to hold onto the belief that the injury is not permanent. While individuals may act as though they accept the injury as “the way things are,” acceptance may come with the belief that they will be rewarded for prayers and hard work in therapy and eventually recover from the injury at some point in the foreseeable future.
- Acceptance: Grieving usually ends as the individual comes to accept a realistic view of their current condition and once again find meaning in life. A sign of acceptance is when individuals begin to think about their future as an individual with SCI and set goals to pursue in life.
ADJUSTMENT TO SPINAL CORD INJURY
Adjustment is defined as adapting to a new condition. Everyone makes adjustments during their lifetime. Some of the conditions that individuals are forced to adjust to may be planned and individuals typically have time to think about how they will react to the situation. For example, individuals may have to make adjustments in work hours when starting a new job. Other events may be a surprise in which individuals are forced to adjust to an unplanned event.
Individuals who adjust well to unexpected events generally lead healthy, active, and happy lives after their trauma. Individuals who do not adapt well to unexpected events tend to be less healthy, less active, and unhappier after their injury. Most individuals experience two primary issues of adjustment to spinal cord injury. Immediately after being injured, it takes time to get use to life after injury. Some people grieve longer than others, so the adjustment period is different for everyone. It may take as much as a year for individuals to accept the realities of the injury. Individuals will also experience a continued process of adjusting to the unique issues that occur in their everyday life as a person with SCI.
PROBLEMS ADJUSTING TO SCI
If an individual has been injured for a year or more and has not come to accept the injury and its consequences, it is a good idea to look into other areas to find out whether or not the problems adjusting to SCI can be addressed. You may find it hard to believe upon first thought, but what happens to you is not as important as what you are thinking when something happens to you. Your thinking directly influences how you feel and react to events that occur in your life. This concept is the basis for Rational Emotive Behavior Therapy (REBT). Many counselors and psychologists teach REBT as a way to help people with and without SCI gain a healthy view of their lives.
HEALTHY ADJUSTMENT TO SCI
No matter what the event, you know that it triggers self-talk. These ideas, thoughts, and/or beliefs lead to your feelings. Your behavior and the results of your behavior are guided by your feelings. One of the biggest keys to adjusting to spinal cord injury is personal motivation. Individuals who are newly injured are often motivated to attend therapy sessions out of a desire to gain strength and function. You probably have a strong belief that your paralysis is only temporary, and you will soon return to your old, “normal” self. This hope is a common reaction after an injury. Unfortunately, it is far more likely for individuals to recover function based on their level and completeness of injury. In fact, only a few people actually fully recover from their injury. This does not mean that all hope is lost for a full or partial recovery. Almost all individuals with SCI continue to hope that they will walk again one day. However, a cure for paralysis may or may not come in your lifetime. A healthy approach to this reality is to move forward with your life after injury with the continued hope that advances in medicine will one day lead to a cure. In other words, do not wait on a cure to proceed with your life!
People who adjust well to life after injury are usually motivated to meet personal goals. These goals are different for everyone and often change throughout life. For example, your goal today may be to get a job, and you may want to have children in the future. Research from the University of Alabama at Birmingham (UAB) shows that people with SCI who are goal-oriented are less likely to be depressed and more likely to obtain some acceptance of their disability than persons who are not goal-oriented. However, it is up to you to find purpose in your life and the motivation to achieve your goals. It may help to think about what you wanted out of your life before you were injured. For example, you may have once strived for good health, an enjoyable job, and a loving family. There is no reason that you cannot continue to strive for the same things now that you have a spinal cord injury.
It is important for individuals with SCI to recognize that the injury also has a tremendous impact on the family. Although they may not have to adjust to losing the use of their hands or ability to walk, family may experience a loss of the way their life was before your injury. For example, they may have to adjust to the role of caregiver. They may need to work to help with family finances. All of the changes that they face can lead to added stress and anxiety.
Family members also grieve. They may ask questions to try and understand the full impact of the injury and to help ease their feelings of sadness and fear. As your family comes to accept the injury, they face issues of adjustment similar to those you may experience. Children are naturally curious and adjust to events by asking questions. They ask questions because they make few assumptions about how the injury impacts their life. Therefore, children adjust rather quickly to an injury if their questions are answered in a clear, honest manner.
PROBLEMS IN FAMILY ADJUSTMENT TO SCI
As an adult family member, you may have difficulty with adjustment if you have your own irrational beliefs about life after injury. For example, you may hold the false assumption that individuals with SCI cannot work. You may hold the unrealistic idea that “no one” with SCI can or “should” have children. You may hold the irrational belief that you “must” do everything for your loved one who is injured.
Your actions as a family member are reflected in what you say and do around your loved one. If your actions are based on irrational beliefs, you may be unknowingly acting with less than supportive behavior. For example, if you continue to do things for your loved one that he/ she can do, your actions may be encouraging your loved one to be overly dependent on others.You may also be reinforcing your loved one’s false assumptions that individuals with SCI should be pitied or felt sorry for because life has treated them unfairly.
You may be enabling your loved one to engage in self-destructive behavior if you ignore or deny the possibility of a problem with substance abuse. Plus, it is also likely that your irrational beliefs will influence your own feelings, which may then lead to unhealthy behavior and unhealthy results. If you experience prolonged feelings of stress and anxiety, you may be putting yourself at risk for serious health problems such as disease or stroke if you do not adjust your views of life after injury
HEALTHY FAMILY ADJUSTMENT TO SCI
If you are a family member, healthy family adjustment is, essentially, taking care of you. For example, you can take time away from your loved one to do those things that you enjoy. You can help minimize your stress and anxiety by working to replace your own false assumptions, unrealistic ideas, and irrational beliefs. You can start by learning the facts about SCI. Then, challenge your irrational beliefs with evidence to dispute your beliefs. Finally, replace your false information with facts. Hopefully, you will soon discover that you too are living a healthier, happier, and more satisfying life.
No matter if you have a spinal cord injury or not, you have control over what you feel by choosing how you want to think about your situation. You can be happy and more hopeful about your life, but it will only happen when you work to make it happen. Your thoughts, feelings, and behavior do not change overnight. It takes time to grieve your loss and come to accept the realities of the injury. Then, you face a continued process of adjusting to everyday issues of living with SCI. If you avoid false assumptions, unrealistic ideas, and irrational beliefs, you will give yourself more opportunities to reach your goals and have the life that you desire.