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How to Keep a Physical Injury from Becoming an Emotional Problem

Tips for keeping bodily injury from becoming a psychological problem.

As a youngster, my husband sprained one ankle repeatedly, first jumping off couches and chairs and later playing basketball and other sports. In adulthood he developed severe arthritis in that ankle and eventually the pain was so bad that he could barely walk. An operation to fuse the bones took care of the discomfort but also nearly ruined our summer - not because he complained (not much, anyway), but because he was physically incapacitated for the three months we usually spent "playing" outside. Walking, biking and even swimming were forbidden for the first six weeks. After that he could get into a pool if he could find a way to do it without taking too many steps (not easy where we live in New York City).

While emergency rooms see more sports injuries in youngsters than in adults, (more than 3.5 million children ages 14 and under receive medical treatment for these injuries each year) adults have a wide variety of sources of physical damage.

Here is just a small sample of concerns brought into therapy by clients in recent weeks. A college athlete tore her knee during practice and was going to have to have it repaired surgically. Not only would she be out of commission for the rest of the season, but to her great disappointment, her vacation plans had to be cancelled. A man in his thirties had developed severe pain in his shoulder and could not play tennis. Another had a bike accident that had landed him in the hospital. And a woman in her forties was suffering from severe pain in her joints and fatigue, and was being tested for Lyme disease (an unpleasant infection spread by deer ticks).

Each of these individuals had their unique responses to their injuries, reflecting both their personalities and life histories. One of them became severely depressed. Another made a minor injury worse by ignoring it initially. Yet another became overwhelmed by feelings of anger.

These reactions made sense in light of what the physical injury meant psychologically to that person. What has become clear to me over the years, however, is that our personal ways of dealing with our bodies can color not only how we heal, but also how we feel about ourselves during and after the healing process. After many summers in which I have observed and dealt with this process both professionally and personally, I have the following suggestions for keeping a bodily injury from becoming an emotional one:

Engage and talk with your family. In a posting on this website, my colleague Alison Bonds Shapiro

talks about the importance of family responses to injuries. Your injury may be affecting your family members more than you realize. They may worry about you and not know how to express it. Or, like happened to me during the summer of my husband's recovery, they may feel that their own suffering is unrecognized and just want some sympathy for themselves. Whatever is going on, if it is out in the open and available for discussion, it can be managed far more easily and with less collateral damage.

Try to understand what the injury means to you. Another colleague on this website, Art Markman writes about a fascinating study revealing that physical pain is far more easily forgotten than emotional pain. But when bodily issues turn into emotional ones, they become stamped in our psyches. For some of us, physical pain represents an inability to take care of ourselves, and injury means we are weak. One pain management technique is to try to focus on other parts of your body than the one that hurts. This can also help when you are feeling overwhelmed by an injury: try to list for yourself some of the ways in which you are functioning well. Recognize what you are proud of in yourself. Remember that you are more than your disability.

Take responsibility without blaming yourself. In a study of sports injury rehabilitation, Martin Hagger, a British social psychologist, and his colleagues found that self-criticism interfered with the healing process, while taking responsibility for rehabilitation helped it.(1) This is, of course, much easier said than done. Self-recrimination is hard to avoid, especially when an injury happens because of something we did or didn't do - like riding a bike without a helmet, or running to catch a bus in high heels - but the truth is, in most cases we don't intentionally hurt ourselves, even unconsciously. And repeatedly reviewing our failures is not likely to help us find a way to move forward.

Similarly, finding a way not to give up power, even when we feel helpless, is extremely difficult but also very important to the healing process. One client complained bitterly that the doctor was not making her better, but failed to seek another opinion until I suggested that maybe this particular physician had reached his limit and someone else might know something more. Suddenly she realized that it was up to her to find out other ways of handling her situation. She spoke with the doctor about other possibilities, then began to do some research on her own - and started to feel better even before a combination of carefully controlled exercise, regular massage, and a different medical approach changed her situation.

Lean on friends and family (but not too much). Getting help, letting people know how vulnerable you feel does not mean that you are becoming a burden or are developing an unhealthy dependency. In fact, genuine strength comes from acknowledging our need for others. If you are worried that your needs will (or already have) become too much for others, open up a dialogue with them. Talk about your worries and your appreciation, and invite them to tell you what they are feeling. And again, look for ways to enhance what you can do for yourself. My husband and I had many arguments during his recuperation, but the conflict was always mediated by ongoing, frank discussions about the situation. It was also helped by the fact that we both knew that he would do the same for me if circumstances ever required it.

Finally, it is important to know that good things can come out of bad experiences. One client put it better than anyone else I know when she said, "who would have thought that out of this awful process I would have discovered valuable parts of myself that I didn't even know existed before?"


(1) Haggar, M. , Chatzisarantis, N., Griffin, M. and Thatcher, J. Injury Representations, Coping, Emotions, and Functional Outcomes in Athletes With Sports-Related Injuries: A Test of Self-Regulation Theory in Journal of Applied Social Psychology, 2005, 35, 11, pp. 2345-2374.

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