A PSYCHOLOGICAL APPROACH TO TRAUMATIC PARAPLEGIA: USE OF HYPNOSIS

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Abstract
Trauma, whether physical or psychic, may effect the person at all levels of intergration. When a paralysis strikes from the outside as in a traumatic paraplegia, it is assumed that the personality structure is profoundly modified by the disruption of the physiological integration and that a balance is attempted at a new level. Because of the indivisibility of the human organism it becomes theoretically possible again to modify the level of integration by psychological manipulation. We are concerned here with a psychological approach as a means of initiating changes throughout the organism. One of the necessary functions of a rehabilitation program is to ascertain the meaning of the injury to the individual. It is entirely possible that the paralysis itself may serve a purpose in the life of the individual, that conflicts arising from his way of life have been resolved in the injury or in the exaggeration of pathology. Perhaps this may be especially applicable in those cases of complete paraplegia where the diagnosis has been based solely on clinical evidence, and the true extent of the injury not known. A program of exercise to call out all available resources would be oriented to a view which sees personality developing in relation to the demands placed upon it, modified by the willingness or unwillingness to meet such demands. Whole-body exercises, which throw demands on the lower body at the same time that the body-as-a-whole is in action seem to offer particular benefit. The fact that spasticity has been shown to be reduced and contractures released in the hypnotic state, suggests that an emotional component may play a part in the genesis of spasticity. The psychosomatic basis upon which hypnosis rests needs to be explored in detail and such serious organic cases as these offer opportunity for investigation. Although we need to know much more about volitional acts and the attitudes to which they are related before a definite program can be planned, it is safe to assume that will, purpose, desire, play important roles. It is from such broad concepts as these that the psychological approach to paraplegia will come. That the intense wish may have its effect at the organic level is a possibility which cannot be ignored. It does not seem altogether impossible that structural changes may be produced in the body in connection with thought processes. Both may be embedded in a larger context and yet a measure of self-initiation allowed; so that to speak of the creative capacity of the mind in connection with the body processes with which it is so intimately related may not be out of order.

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