For the first three months after his injury, Elliott recalls, he was told that he was going to walk. “When I first got hurt, I was fed a lot of lies. Maybe they thought I wouldn’t be able to handle it or they were doing me a favor by bringing it on slowly.” But Elliott felt that confronting the reality of his disability was just what he needed so that he could set goals and put his all into rehabilitation. “You need to know the truth, the facts. You’ve got to start dealing with it right away.”
Communicating with your doctor about these issues- what to expect now, what may be available in the distant future, and what you need to function in the immediate future – is probably the best way to develop an attitude of hopefulness combined with realism. This will help you focus on what you need to do now without taking away your motivating vision of a better future. Expressing your feelings and communicating your confusions and questions about your injury is the surest way to avoid a more entrenched denial that could prevent your getting full benefit from the rehabilitation program.
Jim hated using his wheelchair. Throughout his early rehabilitation he struggled with feelings of shame and depression about needing to use it. However, he rather quickly progressed to the use of forearm crutches, and because he had strong arms and was in excellent physical condition before his injury, he soon developed a relatively speedy and efficient gait. Jim’s doctors praised his accomplishment, while telling him that he would probably always need crutches. But Jim would not give up on his dream of walking “normally.” He became obsessed with this goal, spending many hours beyond his allotted therapy time on practicing his walking and exercising his arms, often to the point of exhaustion.
When he was discharged from the rehabilitation hospital, Jim requested a referral for several hours of daily outpatient physical therapy, much more time than most people would want. His doctor worried about lint’s denial of his limitations. He seemed to be spending all his effort on the elusive goal of “normal” walking, leaving little energy for dealing with important vocational and family concerns, Jim’s psychologist was also concerned with his social withdrawal and seeming inability to “lighten up” and enjoy himself during this period.
Working together, his physician and psychologist discovered that, in Jim’s mind, easing up on his physical therapy regimen would mean “accepting that I’m OK like this.” That meant giving up hope, and he still needed the hope of full recovery, or normalcy, in order to carry on both physically and emotionally. And being disciplined and perfectionist by nature, he needed to be absolutely sure that he’d left no stone unturned, that he’d put as much effort into his rehabilitation as was humanly possible.
The doctor agreed to prescribe extra therapy time, as long as Jim was showing progress in strength and efficiency, Jim’s psychologist helped him examine his negative self-image and fears of being rejected socially, and helped him accept the need to change to a less physically demanding career.
Ultimately, Jim gained a great deal of physical strength and confidence. He was able to use a single crutch or cane on occasion. He felt better about himself because of his persistence. As he became involved in other aspects of living and put himself in situations where people responded positively to him as a person, he became less focused on either denying or conquering his limitations. Jim no longer needed to hope for full recovery. He now had hope for living a full and satisfying life with his disability. He began to accept himself, pursue alternative job plans, and go out with friends again.
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