Psychosocial Factors in Spinal Cord Injury
Not only does the physical self change, the psychological
self changes after spinal cord injury.
Body image, self-worth, loss and grief, suicidal ideation, life roles,
family dynamics – these are but a few of the psychosocial factors that must be
addressed after spinal cord injury.
Intensive psychological support is a critical piece of the
rehabilitation process.
The following shows that stages of adjustment in
dealing with spinal cord injury. How an
individual moves through these stages varies.
Some get caught along the way.
On-going support systems need to be identified or developed for
psychosocial adjustment and success.
Stages in Adjustment to Injury
Stage
Response______________________
Shock - Disbelief at what happened
-
Denial
that anything serious or bad
has
actually happened
______________________________________________________
Expectancy
of Recovery - Hope that injury is only temporary
-
Bargaining
as a means of ensuring
a
fast and complete recovery
______________________________________________________
Mourning - Recognition that the injury is
permanent
and that a self-image
based
on previous abilities has been
lost
-
Constriction
of interests
-
Focus
on self-depreciating behavior,
such as self-pity and expressions of
hopelessness and worthlessness
-
Depressive
behavior, including turning
away from the support system of
family and friends
______________________________________________________
Defense - New self-image begins to form
-
New
behavior is tested and tried out,
including angry, aggressive, or
acting-out behavior
-
Dependence-independence
struggle of
adolescence
is repeated
-
Emphasis
is placed on the here and now
_______________________________________________________
Adjustment - New self-image is formed
-
Goals
and plans can be made for the
future
-
Interest
in exploring the quality of life for
him- or herself and significant others
-
Ability
to make decisions and solve
problems
________________________________________________________
Source: Seidel, A.C. (1982). Spinal Cord Injury. In
Logigian, M.K. (Ed.), Adult Rehabilitation: A
Team Approach
for Therapists (pp. 325-346). Little, Brown, & Co.
When attempting to help a person with a spinal cord injury, understanding where they are in the adjustment process is a key piece of information. Accepting help is a new skill to learn. For example, in developing a vocational plan, success will be dependent not only on the physical tasks that have been mastered, but also the psychosocial skills related to adjustment to disability. Adjustment is not just a task, however, but rather a process to be maintained. Optimal health is a combination of physical and mental health.
Now let’s take a closer look at functional deficits related to SCI.