To Home Page of PHI website to PHI's Secure Shopping Cart
PHI's Education
About PHI Education Advocacy Research Networking to How to Donate to Membership Application

Post-Polio Health (ISSN 1066-5331)

Vol. 18, No. 3, Summer 2002

A Guide for Exploring Polio Memories (pg 2)

Individual Choice and Self-Responsibility

Not all polio survivors are in need of deep intensive healing work, and others have already resolved these issues. Some survivors use psychotherapy to learn better coping skills and to reduce the impact of depression and anxiety. Others choose to make improvements in their lives on their own by exploring self-help resources. Still others cope with what they know and do not want to look at any issues related to the subjects of feelings, distress, or their pasts. Some individuals may choose not to read this article because they do not want to venture into uncomfortable territory or may not possess the energy required.

Each polio survivor has the right to choose what fits with his/her values, priorities, and interests. Each option has its advantages and risks. We encourage survivors to approach these issues with an open mind, and to ask themselves what they need in order to take care of their health and fulfill their goals, regardless of the stage of their lives.

Those survivors who choose psychotherapy will need to:

Not every survivor will want or can afford to deal with these issues in therapy. Individuals who do not have access to adequate mental health services, financial or physical resources, or who do not want to do this work, are advised not to pursue memory work. Instead, we recommend they use available resources to manage the distress of symptoms.

A list of possible resources is in the Fall issue of Polio Network News. (Treatment Approach Options chart)

Goals of Psychotherapy

Depending on an individual's circumstances and what the person wants from therapy, treatment plans and approaches will vary. Goal setting is an essential part of any therapy experience. What does one want to change? What specific and positive results do they want to achieve and experience from investing in therapy? Therapists need to ask their clients these direct questions, gain agreement on treatment goals, and tailor the therapy process to meet the client's needs.

For example, people who have frequent nightmares may identify sleeping soundly as an ultimate goal. Trauma survivors, such as veterans or people who live in war zones, often have related sleep disturbances.

Polio survivors have reported having anxiety attacks before going to medical appointments. These individuals may want to feel calm and confident when dealing with health care issues. Learning how to communicate assertively may help them grow in confidence. However, if their anxiety continues, they may need to consider what causes the anxiety attacks. Unresolved memories may be affecting their unconscious minds.

In successful therapeutic relationships, clients will learn how to express their thoughts and feelings, and how to set healthy limits. Talking about the therapy process and reactions to the therapist typically offers another very useful learning experience (van der Kolk, 1996).

A respectful and nonjudgmental therapist can use these opportunities to build trust and safety with their client. On the other hand, one who does not openly disclose disappointment or anger with a therapist may add to "unresolved issues." These, in turn, may consume mental and emotional energy that can affect a polio survivor's fatigue level.

Another important goal of therapy is to use issues that arise in the therapeutic relationship as a way to uncover unresolved issues. For example, a person who had difficulty speaking up to authority figures expressed disappointment to her therapist and was relieved by the therapist's accepting and validating responses. In talking about her fears, the client uncovered an unconscious belief from her childhood that was limiting her ability to communicate her disappointments and concerns to health care professionals. She came to realize that, as a young child, she had believed that if her doctors became angry at her, they would not take care of her, and she would die.

People who are afraid to talk with a therapist or who find fault with every suggestion a therapist offers, may choose to set a goal of building trust with the therapist. Otherwise, their fear or fault-finding may interfere with their ability to address core issues, such as their feelings about their pasts. Marsha Linehan has created a process known as Dialectical Behavior Therapy (DBT) that can help in reducing "therapy-interfering behaviors" of this nature (Treigle, 2001).

Another goal of therapy is to learn skills that will help the therapeutic process progress towards the client's desired outcomes. For example, one who wants to improve his/her relationship may benefit from learning interpersonal skills. The therapist and client need to identify the particular skills that would help the individual reach his/her goals and make the therapy process productive.

Because working through traumas can trigger thoughts and feelings that may leave one overwhelmed, it is essential that therapists teach their clients skills that will help them learn how to stay focused on the present reality (van der Kolk, 1996). Nancy Napier offers useful techniques that can help clients learn how to cope with the potential distress of working through traumatic memories (Napier, 1993). Normally, treatment programs teach participants how to stay connected to their bodies (rather than being distracted by overwhelming thoughts or feelings), pace the release of feelings and memories, and contain them when they are too overwhelming or inappropriate to deal with at the moment.

Dealing with Feelings

People learn many ways to protect themselves from experiencing their feelings. Since working through memories brings uncomfortable feelings and anxieties to the surface, a person may feel worse before feeling better. Realizing that facing hurt and anger are part of grieving can support a client in recognizing the benefits of committing to the healing process.

In his article, "The Lessons and Legacies of Polio," Lauro Halstead, MD, illustrates how aging adults may need to grieve polio-related losses that they, as younger people, were unable to express emotionally.

"It wasn't until several years after that, when I joined a support group and began talking with other polios about my new loss and new pain, that I began to grieve for the body I had lost thirty years earlier (Halstead, 1995)."

Traumatic events can involve a sense of loss – of safety, childhood activities, career opportunities or trust in self or others. Therapy needs to create safe opportunities for expressing reactions to these events from the past – the "sad, mad, glad, scared" feelings (Glaser, 2001). The healing process requires releasing feelings, understanding the effects of a loss, and discovering ways to find meaning and growth from the experience (Schiraldi, 2000).

Continued ...