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The importance of psychological counselling when undergoing an amputation – part 1

 

The loss of a limb is a life-changing situation. However, every individual is unique and how much a person’s life will change largely depends upon the challenges each individual faces. For most people, it can be like moving into another dimension where even the most ordinary daily activities such as walking, may have to be relearnt all over again.

It is not only the amputee who as affected but to a large extent, everyone connected with him or her such as spouse or partner, children, other family members, friends, employers and co-workers.

The psychological impact of an amputation can be as significant as the physical challenges

More often than not, the psychological impact of an amputation can be just as significant as the physical challenges and the perceived loss of ability to engage in leisure activities can play an important role in post-amputation quality of life than the absence of the limb itself. Amputation can negatively influence body image, self-esteem and quality of life. Returning to work can also be difficult. However, the key to successful outcomes lies in making sure that a patient receives appropriate care in terms of their physical and psychosocial needs.

The use of prosthetics is associated with increased quality of life

The use of prosthetics is associated with higher levels of employment, increased quality of life, decreased phantom limb pain and lower levels of psychiatric symptoms. In addition, using prosthetics has been proven to facilitate a reduction in secondary health issues and a greater degree of functional independence and mobility.

Prosthetists and healthcare teams can do a great deal to bring about a successful, fulfilling life for people with amputations while they adjust to the changes in their lives.

Post-traumatic stress disorder (PTSD)

Unlike those who lose limbs due to dysvascular conditions, people with traumatic amputations often suffer post-traumatic stress disorder (PTSD). Fault is often involved with traumatic amputations which causes anger and regret.

The time it takes to heal

One of the main things that people are not prepared for is the reality of the time it takes to heal and what to expect regarding the timeframes for rehabilitation and regaining mobility. Returning to work is influenced by the time it takes to regain mobility.

The number of appointments necessary for medical and prosthetic care, as well as physical or occupational therapy is also dependent on the patient’s own mobility and level of rehabilitation progress. A discussion regarding timeframes is therefore most helpful in reducing anxiety and can help families to plan ahead financially and for periods of absence from work.

An individual with a new amputation often needs to learn new modes of living where it pertains to activities such as cooking, cleaning and bathing. Yet, nothing happens overnight and certain things cannot be planned hence, the key is to recognize that it is all part of the healing process.

Modifications done at home such as the installation of a ramp or the widening of doorways to accommodate a wheelchair may be necessary. For instance, if the bedroom is upstairs, ways need to be found to move around the house easily.

 

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Articles/Case Studies

Subconscious mind heals amputees with residual limb nerve pain

 

Says Roger Wolfson, “Some people often mistakenly refer to nerve pain in the residual limb of an amputee as ‘phantom limb syndrome’.  I would first like to clarify that phantoms or spooks or in fact anything of that nature, have absolutely nothing whatsoever to do with what a patient experiences here.  What is actually happening is that  the source of the pain is the nerve of the residual limb.   It is from here that the pain emanates.  I usually find that once I clearly explain the facts to the patient, this goes a long way towards hastening the healing process.   A positive attitude along with any other methods that work for the individual concerned can only improve the condition.’

Many amputees feel nerve pain in the residual limb as part of their reality.  And part of that reality often involves tremendous discomfort.

What follows is an interesting story involving the use of the subconscious mind to aid the healing process.   Roger’s explanation clearly explains the medical facts.  Yet,  amputees often have the sensation of feeling pain in a limb that is no longer actually there.

The subconscious mind is prone to curious patterns of behaviour

 

Here, we refrain from going into lengthy details and definitions.   In a nutshell, what we can say is that our subconscious mind is prone to rather curious patterns of behaviour. Unlike the conscious mind, whose prime directive is to literally direct and control the will that influences the subconscious mind.   Of itself, the subconscious mind cannot tell the difference between what one perceives as real and what one imagines.

While this at first may appear to be an impediment to the functionality of the subconscious, this is actually not the case. The subconscious mind is purposely designed this way.  This is how it receives ‘patterns’ and it works with these patterns without question.

The subconscious mind is unable to tell the difference between what is real and imagined

This phenomenon has implications that are far reaching when we use a technique such as visualization.  Visualization is a ‘Mind Power’ technique by world renown author and speaker on the topic, John Kehoe.  Using this technique the conscious mind is soberly aware of the fact that visualizations are a creation of the mind.   They are actually not ‘real’ in a physical essence.  Yet, by contrast, the subconscious mind is unable to tell the difference.

Investigating the potentials of the subconscious would usually involve ‘gurus’

The subconscious mind accepts such visualizations unquestioningly.   Persistently holding these visualizations in the mind over a period of time causes them to embed within. The discipline of investigating the behavior of the subconscious mind traditionally involves the likes of psychologists or even mystics in order to delve into its depths. Such ‘gurus’ are better qualified to explore these potentials.  As a result, there is no significant body of research based in scientific experimentation investigating the potentials of the subconscious mind.  There is no base upon which to substantiate evidential claims.  Yet, there is, however, an interesting account of an experiment among amputees that demonstrates the wonders of the subconscious mind.

Due to their inability to move or interact with the amputated limb, amputees often report feeling pain in their residual limb.   We refer to this as residual limb nerve pain.

In an attempt to come up with ways and means to help amputees manage residual limb nerve pain, researchers go about constructing a special device.  This contraption enables them to ‘trick’ the subconscious mind.  In this particular case we are dealing with upper limb amputees.

An experiment in ‘reality’

The device is fashioned like a box with openings on each side to accommodate ‘both arms’.  The box is exposed on one side and on the other a mirror is positioned in front of the opening. The patient is asked to position both ‘arms’ in front of each opening and flex their ‘good arm’.  Upon looking in the ‘mirror’ it appears as though the amputated arm is also being flexed whereby in actual fact it is ‘hidden’ behind the mirror .

This exercise gives the ‘appearance’ of the patient flexing the amputated arm.  The conscious mind knows that this is all an act, in that the amputated arm no longer exists.  But, the subconscious mind accepts the ‘mirror image’ of the arm flexing as ‘real’.  After a number of weeks of repeating this exercise, patients report that their pain either diminishes significantly or disappears altogether.

One thing is certain, the facts are plain that  anything which logically promotes the healing process is a case where the end certainly does justify the means.

 

Reference source: Quantum Warrior | The Future of the Mind – by John Kehoe (Zoetic Inc. 2011)

You might also enjoy:  http://rogerwolfsonandassociates.co.za/from-surgery-to-rehabilitation-to-the-fitting-of-your-prosthesis-the-journey-part-1/

http://rogerwolfsonandassociates.co.za/your-prosthetist-may-ask-you-if-your-prosthesis-hurts/

3 important questions you should ask prior to undergoing a lower limb amputation

 

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Articles/Case Studies

Experiment conducted among amputees with residual limb nerve pain demonstrates the wonders of the subconscious mind

Nerve pain in the residual limb is a reality felt by many amputees. And part of that reality often involves tremendous discomfort.  Yet, one needs to bear in mind that the mind has a lot  to do with what is going on.  While we are aware that it is the nerves of the amputated limb through which the pain is felt, amputees often have the sensation of pain being felt in a limb that is no longer actually there.

The subconscious mind is prone to curious patterns of behaviour

In particular, let’s take a look at the subconscious mind. Without going into lengthy details and definitions, in a nutshell, what we can say is that our subconscious mind is prone to rather curious patterns of behaviour. Unlike the conscious mind, whose prime directive is to literally direct and control the will that influences the subconscious mind, of itself, the subconscious mind cannot tell the difference between what is perceived as real and what is imagined.

While this at first may appear to be an impediment to the functionality of the subconscious, this is actually not the case. The subconscious mind has purposely been designed this way in order that it may receive patterns and work with these patterns without question.

The subconscious mind is unable to tell the difference between what is real and imagined

This phenomenon has implications that are far reaching in that when we use a technique such as visualization, one of the ‘Mind Power’ techniques presented by world renown author and speaker on the topic, John Kehoe, the conscious mind is soberly aware of the fact that visualizations are created by the mind and not actually ‘real’ in physical essence, yet, by contrast, the subconscious mind is unable to tell the difference.

Investigating the potentials of the subconscious would usually involve ‘gurus’

The subconscious mind accepts such visualizations unquestioningly and if these visualizations are persistently held in the mind over a period of time they become embedded within. The discipline of investigating the behavior of the subconscious mind would traditionally involve the likes of psychologists or even mystics in order to delve into its depths. Such ‘gurus’ would be better qualified to explore such potentials and as a result, there remains no significant body of research based in scientific experimentation investigating the potentials of the subconscious mind upon which to base substantial evidential claims, yet, there was, however, an experiment conducted among amputees with phantom limb syndrome that demonstrates the wonders of the subconscious mind.

Due to their inability to move or interact with the amputated limb, amputees often report feeling pain in their residual limb.   This is referred to as residual limb nerve pain.

In an attempt to come up with ways and means to help amputees manage this pain, researchers constructed a special device that enabled them to ‘trick’ the subconscious mind. In this particular case we are dealing with upper limb amputees.

An experiment in ‘reality’

The device was constructed like a box with openings on each side to accommodate ‘both arms’. The box was exposed on one side and on the other a mirror was positioned in front of the opening. The patient was then asked to position both ‘arms’ in front of each opening and flex their ‘good arm’ and upon looking in the ‘mirror’ it appeared as though the amputated arm was also being flexed whereby in actual fact it was ‘hidden’ behind the mirror .

This exercise gave the ‘appearance’ of the patient having flexed the amputated arm. While the conscious mind knew that this was all an act, in that the amputated arm was no longer there, the subconscious mind accepted the ‘mirror image’ of the arm flexing as ‘real’. After a number of weeks of repeating this exercise, patients tested reported that their pain had either diminished significantly or disappeared altogether.

 

Reference source: Quantum Warrior | The Future of the Mind – by John Kehoe (Zoetic Inc. 2011)

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The importance of psychological counselling when undergoing an amputation – part 2

 

The importance of communication between the patient and their loved ones cannot be overemphasized. Each individual will naturally have their own unique concerns that need to be addressed. For example, a child might be afraid that peers will make fun of him because his father is missing an arm.

Or, a wife may be anxious about taking on responsibilities that are normally handled by her husband. Alternatively, she may even be afraid that he will be unable to support the family. Family counselling is an absolute must as a tool in the journey towards adjustment.

The time period following surgery may also pose additional stress and challenges to a relationship that is not doing well. Hence, it also makes sense for those in difficult relationships to seek counselling, preferably prior to surgery.

 

A tower of strength in peer support

Other amputees can be a tower of strength in peer support and offer invaluable advice and frequently provide comfort around personal issues such as pregnancy and child care.

Pre-surgery counselling enables a healthier emotional and physical recovery process. It helps the patient to feel supported, validated and to know that they have someone as part of their treatment team who they can lean on in respect of ongoing education, support and guidance. A support group is a safe haven where people can share and feel understood and validated.

 

What your prosthetist can do to help

Some patients may be reluctant to see their prosthetist when things aren’t going too well since they might feel that they are being bothersome or revealing failure. A prosthetist will therefore endeavour to ensure that the patient feels comfortable and will welcome these follow up sessions for any adjustments that may be needed.

It is also common for small problems to become large ones and for such to cause limitations in terms of function and mobility. Hence a prosthetist will endeavour to address such problems before they affect the patient’s quality of life.

 

 

Getting patients more involved in their own decision making and getting them excited and asking questions helps the prosthetist to ensure that a person is more empowered.

A prosthetist will recognize when a patient needs outside help

A prosthetist will recognize when a patient needs outside help beyond the scope of the orthotics and prosthetics practice and will refer the patient to other specialists.

Possible underlying mental health concerns

Telltale signs that may indicate that extra help is needed are such things as fatigue, missed appointments, low energy levels, impaired memory, difficulty in comprehending a task and poor hygiene. Such can point to underlying mental health conditions. If the patient voices suicidal thoughts or intentions, immediate action should be taken to assess mental status and take precautionary measures where necessary. However, it needs to be borne in mind that it is normal for people to experience feelings of sadness, denial, fear and anger in their own unique ways and time periods while others will adjust to their amputations with very few psychological problems.

Knowing a good psychologist

Knowing a good psychologist and being able to recognize at what point a patient may need to be referred are important factors a prosthetist will always bear in mind.   Suicidal thoughts would be an obvious reason for referral to a psychologist and a person who may be struggling with body image, problems, anxiety, depression or other mental illnesses would also benefit. Peer support is also an important factor and a good prosthetist will know when to recommend peer support versus seeing a psychologist.

Give Roger a call now on (011) 640 7198 or send an email to info@rogerwolfsonandassociates.co.za.

 

 

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