Do you ever see individuals who have it all together, manage life to the optimum, and thrive? There are individuals with paralysis who are doing just that. However, others seem to be permanently fixed in a world of self-doubt and despair. Starting out after the development of neurological disease or injury is a challenge. Individuals are focused on what they must do to maintain their bodies. The number of processes and procedures, time schedules, asking for assistance for private activities is an adjustment as well as overwhelming.

Going from floundering to resilience is a process. Individuals adjusting to a disease process frequently tell me that even though they are constantly adjusting to new challenges, at least they did not have an accident that requires a drastic change overnight. Those that are adjusting after an accident tell me that they have it all dumped on them at once, which is a challenge, but at least they do not have to constantly adjust to new symptoms. This is a first step in adjusting to changes in personal challenges. Each group, disease or injury, looks at the other with the perception that the other cause is more difficult. It is a common coping mechanism to find someone in a worse situation than you. It is a beginning to resilience.

Resilience is an individual’s ability to adapt to a drastic change in life, physically, mentally, or both. It is a process in which individuals strive for positive changes to be able to cope with adversities. When issues arise in life, resilience is a way that individuals adapt. Adversity can cause a feeling of anger, resentment, frustration, pain, and grief. Resilience is a process that is used to learn to deal with adversity both physically and mentally. Note that resilience is a process. It does not occur as a point you reach, making you are forever fine but a collection of skills that you can develop to deal with life's challenges.

Below are some thoughts about developing resilience. There are many ways to develop resilience that are unique to each individual. You may want to try a few of these steps or all of them. Please feel free to comment if you have a resiliency technique that worked for you as your suggestion can help others.

Take an inventory of your abilities. If you are reading this, you are still alive. That is a good starting point. Life gives you opportunities to live to the fullest. Look at your positives. Create a list of your assets. At first, your list might not be too long, but it will grow as your outlook develops.

Develop friendships. Earlier, I pointed to research that indicates friendships with other individuals are helpful to our mental wellbeing. Get out and meet people when it is safe in your area. Even casual relationships boost self-confidence. Say hello to the clerk at the store, volunteer somewhere to interact with others. In this time of COVID, this can be a challenge. You might need to rely on your computer friends and groups for now, but when we all can safely go out, you will be able to meet more people in person.

When you do talk with other people, notice how they cope with adversity. Include individuals with and without paralysis. They might have a strategy that you can use. You can ask outright about their coping skills or gather a lot of information just from how they go about their day. Discriminate what you are told. What another person does might not be the thing for you. On the other hand, listening and applying your own interpretation will create a scenario that matches your own needs.

Set realistic goals for yourself. Make a goal for every day. This can be anything from getting dressed for the day to learning a new fact or whatever you choose for your goal. Decide if your daily goals should be for your personal recovery or something completely different from your recovery. A goal that does not involve your health allows you the opportunity and challenge to think about something besides your health. It can provide an opening to realize you are more than your physical body.

You may have a very large goal that you are striving toward. Break it down into smaller, obtainable goals to reach success. Be realistic about what you can accomplish in one day. Working toward a larger goal can be very satisfying. At the end of the day, you can congratulate yourself on meeting your goal. Whatever your objective is, you can use this as a conversation starter with others. In exploring the issue, you have selected, you might meet others with the same interests.

Make that list of positives about yourself, as discussed last week. This is very important that you see yourself as more than your illness or injury. There are positives about every single individual. You need to recognize yours. The acknowledgment will help you grow as a person in self-confidence. You do not even need to tell others of your discovery. Just your knowing is fine.

Examine your list of self-care tasks. There are a lot of activities that many individuals have to do to maintain their health. These include turning, pressure releases, catheterizing, bowel programs, exercise, and others. A good way to confront these activities is to look at the actual amount of time taken to do them. Once you learn how to do the activity, you will notice that it does not take that much time to accomplish it.

New skills are always slower in the beginning when you figure out how to organize everything and do the activity efficiently. Make the activity a natural part of the day, not the emphasis of the day. Some things, like pressure releases, can be done in the open, just as a part of who you are as a person. Some self-care activities can be combined or adjusted differently into your daily schedule.

Be sure you are looking at your overall health. Eat a healthy diet to get the nutrition your body needs for optimum function. Exercise or have someone move your body to provide the input needed that may not be supplied due to body changes. Your body and your mind need time for exercise either by doing it yourself or having your body moved for you. Both are exercising your body and your mind will help you keep fit. It provides the input your nervous system needs and requires.

There are many activities for all individuals that must be worked into a daily schedule. Be sure to put some ‘me’ time into yours. This can sometimes be when you are alone in a room without a caregiver or another person with you. The caregiver can be in the next room for safety. But plan time to be alone or, if you prefer, time to be with another person, not making any personal care, just conversation. You may choose to be alone to meditate or be with someone else to just talking about general interests.

Recognize your signs of stress. Some individuals get frustrated even as far as lashing out. Others have physical signs of stress, such as clenching teeth or tightening of their muscles. Take a moment at various times of different activities and interactions to find your triggers. Once you can recognize your triggers, you can avoid or curb negative confrontations.

Learn stress reduction techniques. This begins with learning about your triggers. Practice strategies to help you deal with stressful situations. One of the more common techniques for quick stress reduction is deep and measured (slow) breathing to help relax. Some people slowly count to ten before reacting. Other techniques include relaxing your body by focusing on one muscle group at a time, or visualization by thinking about a place, real or imaginary, where you are calm and tranquil. Many individuals picture a beach or a cabin with a roaring fire. Your happy place may be something quite different. You can physically remove yourself from the situation. For longer-acting techniques, meditation can be a help. Keeping your body stress-free can include exercise; remember your body reacts to situations even if you do not sense it. Some people practice yoga or tai chi. Listening to music can also be helpful.

If you feel you are not making progress in dealing with stress, be sure to talk with your healthcare professional, who can direct you with medical management and therapy to help build your resilience. If you need help immediately, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text GO to 741741. This is a free service to speak with a counselor immediately. You can talk with these professionals at any time, not just in the moment of crisis.

Life-changing illness or trauma is a stressful situation. Dealing with such a huge change is all-encompassing. Acknowledge that fact and seek ways to improve your resilience. It is possible. Nurse Linda

Pediatric Consideration:

Children, even teens, do not often recognize stress in their lives. They may not have the words or experiences to relate their feelings to you or others. Their behavior may be the result of stress by crying or temper. Changes in normal behaviors can indicate stress or even depression. Noticing can help provide treatments especially stress reduction techniques.

As parents or caregivers, you might be feeling stress as well. Family counseling is a good start to understanding the dynamics of your family in challenging times. You can begin family counseling before situations spiral out of control. Getting prepared may help avoid challenges in the future as you will be ready to deal with a variety of situations before they spiral. Nurse Linda

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in our Heath & Wellness discussion.