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| Scoliosis Treatment Includes Psychology of Patient |
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Few of us will argue the fact that mind and body are interrelated. What exactly does this mean? Well, here are some examples: When we wake up in the morning after a good night’s sleep, we feel rested, energized and ready to face the challenges of the day in front of us. We are both physically and mentally alert. We are able to focus, pay attention, and readily engage in a variety of intellectual and creative tasks. As the day progresses and hours go by we start feeling physically tired, perhaps even sleepy. Our mental abilities slow down. We become less creative, and it takes effort to attend and to accomplish cognitive tasks. As another example, let us suppose that we hear some great news. Suppose a high school student receives an envelope in the mail stating that he has been accepted to the college of his first choice. He is now happy and feels that he is “on top of the world”. He feels physically invigorated and plans to party all night long with his friends. As a third example, let us reflect on our reaction to bad news. A happily married woman finds out that a few minutes ago her husband was involved in a serious car accident, and was taken by ambulance to an emergency room. She becomes worried, anxious, depressed, unable to continue to attend to her daily responsibilities, starts experiencing physical weakness, an upset stomach, and headaches.
Our physical status affects our mental status and vice versa. We all carry mental images of ourselves, and self-appraisals related to our physical appearance, fitness and various abilities. We evaluate ourselves based on social norms. We compare ourselves to others around us with respect to looks, personalities, and achievements. We automatically “rank” ourselves based on such comparisons. Our self worth and self-esteem are based on such rankings and evaluations. But self-worth and self-esteem are not static formulations. They depend on the goals we set for ourselves as we go through life, and on our successes and failures in reaching such goals. Furthermore the goals we set for ourselves are often predicated on our perceived potentials and abilities. Self-efficacy is another important variable. It is our belief in our capacity to perform a specific task. Motivation for success is very much dependent on self-efficacy. Our psychological state influences our self-appraisal, and self-worth can have an effect on our psychological health. Depression for example, often results in low self-esteem; negative self-evaluation may lead to depression. Physical impairments and disabilities often result in low self-evaluation, reduced self-worth, poor self-image and lessened self-respect. Emotional fatigue, hopelessness, helplessness and depression will ensue. As indicated in the introductory examples above, a weakened mental state will down-regulate our general functional abilities. Such is often the case with individuals suffering from scoliosis. This spinal affliction causes discomfort, and sometimes pain. The associated physical deformities are very much known to the patient. These include difference in shoulder height, difference in hip height position, difference in shoulder blade height or position, the head is not centered with the rest of the body. Other irregularities associated with specific body movements are also common. The condition is chronic and progressive if not treated. Repeated physical examinations for many years are warranted in order to monitor the condition. The application of bracing is most often the treatment of choice. As can be expected, this condition has significant psychological implications. As described above, symptoms include underestimated self-evaluation, low self-esteem, depression, and low self-efficacy. Education, or as we call it “success coaching”, is an important component in the treatment of scoliosis. The famous psychologist and personality theorist, Alfred Adler, stated that the primary goal of all human behavior is self-perfection. He further stated that when we face our weaknesses with optimism and courage, we will then make the necessary effort to compensate for such weaknesses. Such efforts often result in superior achievement. Feelings of inferiority and inadequacy must be combated at all cost. Success coaching focuses on self-acceptance with emphasis on the identification of individual strengths and realistic goal setting for high achievement in all aspects of life. Specific aims include the following: 1. Overcoming feelings of inadequacy 2. Overcoming social isolation 3. Overcoming of “feeling different and disabled” 4. Learning psychosocial coping skills 5. Learning realistic goal setting 6. Establishing internal locus of control (self-reliance and motivation for high achievement) 7. Peak performance training (using one’s potentials to the upper limit) 8. Realistic self-appraisal in both cognitive and social domains 9. Elimination of negative and self-defeating behaviors
Success coaching also entails informative lectures on stress management and coping strategies associated with all aspects of daily life (work, school, social and family). Supportive individual and group discussion sessions will be tailored to specific areas of difficulty and adjustment problems.
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GABRIEL G. FELDMAR, PH.D.