In the first few months after spinal cord injury, a high degree of stress or anxiety is common. Some of the anxiety stems from the situation that caused the disability – for example, a car accident, shooting, or war injury. In the heat of a life-threatening emergency, and even during acute hospitalization, the body is stimulated by adrenaline and energy is focused on survival. Anxiety is automatically blocked from mental awareness in an adaptive trick that allows one to cope with the crisis at hand.
Once the immediate danger is over and you are settled into a safe, albeit difficult routine, you may find yourself flooded with anxiety, replaying the trauma in your mind (in flashbacks) or having nightmares with terrifying experiences of helplessness, impending disaster, and loss of control. These symptoms of posttraumatic stress are common after any emotionally overwhelming situation.
Again, talking it out helps. Research on the treatment of people with severe posttraumatic stress reactions suggests that the sooner they talk about the experience and associated fears, and the more detail they are able to give, the less anxiety they are likely to experience in the future.
Patty became paraplegic following a bullet wound to her spine. She was at her niece’s home, their children playing together, when the niece’s estranged boyfriend barged into the house and shot both women. Her niece was killed and Patty was seriously injured.
Patty suffered extreme pain and emotional distress while waiting for emergency assistance to arrive. At the hospital, she was mourning the loss of her niece, confronting her own disability, and worrying about the emotional effects of the event on her child. However, after emergency treatment and medical stabilization, her healing progressed nicely and her spirits were remarkably good.
Once in rehabilitation, Patty surprised the staff by talking frequently and in great detail about the circumstances of her injury, her niece’s bloody death, and her pain and terror while waiting to be rescued. She told the story to anyone who would listen, to the point that some staff questioned the “normalcy” of her preoccupation. Yet Patty seemed immune from the anxiety that many expected of her. She was able to focus on information about her recovery, participate actively in her therapies, and maintain supportive relationships with friends and family. She was eager to learn how to use the wheelchair, to get well, and to get on with her life.
Patty was doing spontaneously what most therapists would encourage any victim of a trauma to do – managing and mastering the anxiety by talking about the trauma and the feelings it evoked. Talking not only “gets it out” but also elicits support and validation from others. Thus Patty, more than many patients, was able to make new friends in the rehabilitation hospital. Fellow patients and staff members saw her as courageous and determined. This reinforced Patty’s sense of self-worth and diminished her anxiety about using a wheelchair, learning bladder care, and becoming independent. She left the hospital with some realistic anxiety about returning to work and parenting with a disability and, indeed, real social and physical challenges lay ahead. But Patty was not overwhelmed or disabled by the anxiety itself.