JOB VACANCY WITHIN THE REHABILITATION AND MEDICAL MODEL.

There is a piece missing from the pie that has been put together to rehabilitate someone with a serious injury. After an injury, we receive treatment to make us as medically stable. We are given physiotherapy which strengthens our bodies to achieve maximum independence, an occupational therapist is there to guide us with decisions regarding equipment and housing needs, and social workers are there to smooth the ADL (activities of daily living) tasks such as financial management.

We emerge from spinal units or rehabilitation facilities with shiny wheelchairs, a medically stable body and other aids that help with ‘independence’. Yet at no point do we address what makes us uniquely human – our broken minds. A spinal injury is one of the most psychologically damaging events that can happen to a human being, yet little thought is given from a holistic perspective to help heal those broken minds.

Cast out into the world with little to no coping mechanisms we are expected to get back to work, get back to families and friends and achieve a sense of normalcy in spite of what mayhem is going on deep inside of us. Some experience guilt, some anger, some despair, some relief, we are all different in how we cope, yet those inner feelings are often buried or ignored and sometimes they manifest into unhealthy practices with devastating consequences.

As ‘patients’ we are told to act happy, be obedient, comply with rules, take instruction and do as we are told. Not complying is met with disapproval and sometimes punishment. The rehabilitation facility has more in common with a penitentiary; rules, disciplinary procedures, schedules, and most importantly, a loss of autonomy. The setting is one of oppression. Clinical, sterile, one where dignity is ‘left at the door’. There is nothing warm, hopeful or homely about a rehabilitation facility such as a publicly run spinal unit.

In New Zealand, we have a prevailing ethos whereby people are expected to pick up their own pieces and ‘get on with it’. We are expected to get back to productive work or study, and by doing so, our reward is a ‘normal life’. But how can life be normal when our minds are struggling with a whole new world, a new environment that is 2 dimensional?

And when is it ok to grieve? Is it even ok? Do we wait till we get home, or pour out our feelings to the counsellor who writes a report stating we have a mental illness to add to our list of ‘failings’ as individuals? How can we, as humans, be so blind in our refusal to acknowledge the enormity of what has happened to us?

Once out of the clutches of the rehabilitation facility, we are cast into the ‘insurance system’, where we are told what we can have, how we can have it and what is best for us. Yet even these decisions can affect us negatively as they work on a system based on power and driven by neoliberal economic values. You don’t get what you want, you get what you need… they tell us. But is a need more important than what we want? Often those needs are marred by the sense of a loss of autonomy. And all of these little incidents and the loss of autonomy get clocked up in our broken minds.

What we need is to heal. Heal our minds, empower our mental state and get back some of the dignity that was taken during our moments of helplessness and disbelief at our situation.

I propose another genre of occupation is needed for those with a serious injury. We need to address the grief, we need to feel autonomy with the other disciplines, we need to feel like we have been listened to. We need to know we are not alone, yet we are also individuals. We need to know that sometimes although physically able, pushing oneself to get back to a ‘normal’ life may be detrimental to the health of our minds. We need sleep, good food, life management skills, we need to relearn what our capabilities might be, and when to say no. We need to grieve, even if that grief is through humour, or artwork, or poetry, or screaming, or crying, because we are all different, and our needs are all different, and that’s ok because we are human and that’s what makes us unique in this world.

To heal a broken mind, we need help, and it’s something we don’t get; from the medical system, from our insurance system, from the existing support structures that prop us up and spit us out. Too much time is spent negotiating what our requirements are, amidst a suspicious cohort of professionals who get told of the ‘naughty ones, the ones who ‘rip-off the system’ so we all regarded with suspicion and apathy.

Someone needs to help us as we 'don’t know what we don’t know'. Our bodies are looked after yet addressing our mental state isn’t even on the list. Our minds usually want to be happy again, so perhaps a new profession should be started, a holistic one that addresses our needs in relation to our mental health. After all, a body is useless if it doesn’t have a mind that knows the importance of its job.

We need to feel listened to, we need hope and we need autonomy. We need to nourish our broken minds but that nourishment should come from a discipline designed to cater to that specific need. If we don’t, then what is the point of having a body that’s been carefully manipulated to maximise it’s potential, when the brain is all but forgotten?