Psychological Aspects of Treatment and Rehabilitation of the Spinal Cord Injured Person

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Abstract
“As you ought not to attempt to cure eyes without head, or head without body, so you ought not to treat body without mind.” Socrates. Ca.400 B.C.** Nowhere in medicine can it be imagined that the Socratic admonition above carries greater validity than in the comprehensive treatment and rehabilitation of spinal cord injured individuals. Reflection on the many problems to which the cord injured person must make an adjustment impresses one with the gravity of the psychological processes which occur following cord injury. Such an individual is confronted with grieving over his loss, coping with pain and phantom sensations, alterations in sexual functioning, loss of bladder and bowel control, the frustrations of immobilization, loss of vocational goals and earning capacity, feelings of uselessness, role reversals in the family and attendant loss in self-esteem, and the social stigma of being “different” in the public's eye. It is an amazing tribute to the flexibility and magnificence of the human spirit that so many people whose lives arc thus devastated survive and function at the level of physical and social independence which most cord injured people achieve. In this chapter we will attempt to cover some of the most frequently encountered problems in psycho-social rehabilitation of the cord injured. First, we will discuss the usual or “normal” reaction to the experienced loss, then some of the reactions observed in people with pre-existing psycho-pathology. Psychological aspects of pain problems, adjustments to altered sexual functions, and the impact of the injury on the family and their role in the rehabilitation process will be mentioned. Finally, the importance of treatment in SCI Centers from a psychological viewpoint will be discussed.

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