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8 Steps to Understanding and Improving Your Emotional Health after Disability-by Jenny Smith

My journey with a C6-7 spinal cord injury began when I was 16 years old. Like most of us, I entered the world of disability without training on how to survive. Yes, we have medical professionals who check in on our physical health, but that’s only the tip of the iceberg. What about our emotional, mental and spiritual well-being after the onset of a disability? After my injury, meeting other women with disabilities in a group setting was what helped me begin to become less ashamed of my disability. I realized I wasn’t the only one who struggled with these things. I learned to work on my own mental and emotional health and have continued to do so since. Last year, after over a decade of using my master’s degree in counseling psychology to support my coworkers who were making the transition to live and work overseas, I shifted my focus to my fellow disabled community. I developed a curriculum to help other disabled people understand and work on their emotional and mental health, and called it The Journey. To test it out, I signed up a diverse group for three eight-week online sessions. From May-December 2023, I had the pleasure of discussing with over 20 participants the ways that we can maintain — or regain — our emotional health after a disability. I adapted the material for the eight sessions from models of cross-cultural transition, with an eye toward creating a curriculum that would help people understand their own emotional health and how to improve it. Each session focused on a step toward emotional understanding. The types of disabilities represented throughout the year included spinal cord injury, stroke, brain injury, multiple sclerosis and others. Not only were people eager to be part of a group, but the participants experienced true community, relationships and growth. The people interviewed in this article all participated in one of the three sessions. Below, they share what they learned in each week’s lesson and how it impacted their overall emotional health.

The Participants

John Branch

Decatur, Texas Age: 52Disability: C6-7 SCI completeYear of onset: 2020John was struggling with depression and drugs when he was paralyzed. A peer mentor gave him hope, and he recently had the opportunity to go to inpatient therapy to become more independent. John looks forward to playing wheelchair sports.

Spencer Keene

Louisville, KentuckyAge: 28Disability: C4-6 SCI completeYear of onset: 2019Spencer is a mechanical engineer who just purchased a patio home with his girlfriend, Katie. He enjoys creating adaptive devices using 3D printing.

Sara Nurrenbern

Evansville, Indiana Age: 42Disability: Neuromuscular disorder and Lyme disease Year of onset: symptoms began in 2018Sara is an avid crafter and board game player who now participates in an online gaming community. She and her husband are the parents of two children.

Nicole Roy

Flushing, Michigan Age: 46Disability: T3 incomplete SCI due to tumor Year of onset: 2022With a full-time job in the healthcare industry, Nicole jumped into the disability world by attending three Abilities Expos during her first year with SCI. Olive is a golden retriever puppy who is training to be a service dog.

Camila Sol Cerrano

Santiago, Chile Age: 35Disability: C6 SCI complete Year of onset: 2006Camila works as an inclusion specialist and helps students prepare for a national exam to enter university. She helps students acquire the accommodations they need to take the entrance exam.

Bree Williams

Louisville, Kentucky Age: 35Disability: C7 incomplete Year of onset: 2020Bree hosts a podcast called The Breezy Way, works out at the Community Fitness & Wellness Center in Louisville and is mom to a French bulldog named Cookie.

1. Take Time to Reflect

Reflecting is an opportunity to process our thoughts and feelings. It’s a chance to look back on events, relationships and emotions with honesty and ask how the current circumstances have changed us. Because we are different. Our physical abilities may be different. Our identity, job and relationships may have changed.Camila appreciated the opportunity to reflect on her injury. “I had my accident in 2006, so it’s been a long time, but I think I needed to revisit my experiences so I could understand the present. I can look back at the events and people to understand — and maybe reconcile — both myself and others,” she said. Camila also learned to name the emotions she felt since her injury. “There are certain emotions that felt forbidden after my injury, so it’s been important to learn to name those emotions. I’ve learned to express them and not push them down,” she said.“Doing a timeline and putting emotions with all the events that have happened was the most eye-opening for me,” Spencer said. For Bree, looking back on the events since her injury was helpful. “It was good to look back and see what I’ve overcome,” she said.

2. Name What We’ve Lost

Loss is at the core of disability, especially during the first several years, and then again as secondary issues and aging occur.“I lost what I thought it meant to be a man, which I thought was physical strength. I experienced a loss of self-confidence, constantly comparing myself to other people and thinking I wasn’t enough,” John said. “I also lost my faith in God,” he added.Spencer said acknowledging his loss was important. “Rearranging my entire house to make it a little accessible was difficult. Then I had to sell my house and move back in with my parents. They sold my vehicle to get a modified van; that was a decision they made, so I’d even lost the ability to make decisions. I lost my job as an engineer since I hadn’t been there long. And my fiance left me,” he said. “I’m an engineer and don’t think about emotions much, so naming emotions for the events after my injury was big for me.”While spending an entire session on loss might sound depressing, Spencer said, “It was interesting to hear other people’s experiences. Even though we had different disabilities, we all had very similar experiences no matter where we were from.”

3. Allow Ourselves to Grieve

Once we can name our losses, we can grieve them. We can experience a variety of emotions with grief, including anger, blame, denial, depression and hopelessness.Camila said, “For a long time I tried to convince myself that I had to be in a good place emotionally for my family. So, I didn’t let myself feel angry or sad since they were taking care of me. But I realized … from the support group that I needed to experience those feelings to grieve.”Sara felt bitter after her diagnosis. “I’ve had to acknowledge my bitterness. But then what? I put myself in uncomfortable situations — like going out when I don’t want to. The more I do that, the less bitterness I feel because I realize I can do this,” she said.While some people experience anger, bitterness and depression after their disability, others avoid grief completely. “I learned that I haven’t truly allowed myself to grieve over my injury. I numbed my feelings, so this is something I’m in the process of tapping into with my therapist,” Bree said. “I’ve also had to grieve the loss of people I thought would never leave my side.”Nicole also realized she hadn’t let herself grieve. She said, “I told everyone who asked how I was doing, ‘I’m OK. My legs just don’t work anymore.’ I was determined to not be like the patients I saw in the hospital rehab unit who hated life and were angry, resentful and difficult to be around. Instead, I was going to be like the people I saw on social media who have it all figured out, and get on with my career and life.” But faking it wasn’t sustainable. “It was a hard dose of reality when I realized I was in complete denial about my paralysis,” she said. “I had convinced myself I was doing great when I hadn’t allowed myself to grieve one of the most difficult events in my life.”For John, grieving involved accepting responsibility. “I chose to put drugs in my body that evening. I did it to myself. In a way, it’s healing to say that because I’m admitting the truth. I’m not blaming God or my family of origin. I made the choices that put me in this chair,” he said. “But I also felt shame. Most people didn’t know about my addictions.”

4. Be Willing to Transition

With a disability, life changes. The question is: Are we willing to adapt to life with a disability? Transition is an intentional decision to be willing to adapt to life with a disability. It’s internal. Emotional. Mental.One way Nicole has mentally transitioned was to allow herself to admit she’s disabled and be OK with it. “Having this mindset of transition has helped me accept what life with an SCI involves and work through the challenges of bowel and bladder instead of suffering in silence and feeling ashamed,” she said. I’m more willing to ask for help rather than act like I can do everything like I did for so long.”Some people transition and adapt to circumstances more naturally — or out of necessity. “I wanted to get back in society,” Spencer said. “It’s frustrating with all the SCI stuff, but I enjoy working and being out and about. But in some parts of life, like personal care, I couldn’t rely on family members to help, so I had to take charge to hire caregivers.”Talking with others in our group helped Camila transition into adulthood. “I was 17 when I was injured and I had to enter adult life when I was dependent on my parents. I started working full time for the first time in 2021, so I felt like I was late in moving into adulthood,” she said. “It wasn’t late; it was the time I needed for me to be ready physically. I finally understood that this year.”


5.Live in the Tension of Paradox

Life with a disability can be crappy. Sometimes literally. It can also be pretty darn great. The thing is, most of us have a hard time seeing that both can be true at the same time. We can learn to live in a state of paradox, where two opposite yet equally true statements can exist at the same time.Sara said the concept of paradox kept coming up in conversation after learning about it. “It’s important to remember both the good and the bad, especially in a situation like ours,” she said. “I think acknowledging the bad helps me stay motivated and set goals. But remembering the good parts of my life helps me reconcile the bad. Not necessarily ‘get over’ the bad, but reconcile with it.”

6. Learn Coping Strategies for Stress and Trauma

Life with a disability is full of stressors: health complications, time and energy constraints, and financial responsibilities. We need to learn how to have healthy coping strategies to manage stress.“I’m learning to cope with stressors,” Sara said. “It’s an ongoing process because I’ve had anxiety my whole life. In therapy, I’m learning how to practice mindfulness. I’m trying to remember that I can only control myself. I can’t control anybody else,” she said. “I’m learning to just kind of breathe through and exhale that negativity in those hard situations.”Bree has learned she needed help to cope with the stress of disability and the trauma she experienced from her car accident. “I’m now seeing a therapist. And I love it!” she said. “She’s the only one to get me to cry and I never knew how much of a relief that could be.”John knew he needed to find positive coping strategies, especially with his past addictions. “I needed to change from how I was living pre-injury. For me, the most important strategy is going back to my relationship with God. If I don’t, I will return to my addictive behaviors,” he said. “I’m also in a 12-step program. I need to work with people who understand disability and addiction, and [I need to] have a sponsor.”

7. Refill Your Emotional and Mental Resources

We often hear proverbs or sayings about the importance of “filling your cup.” With all the stressors we experience with disability — along with the losses — we need to find new ways to refill our emotional, mental, physical and spiritual cups.“I have found little things that bring me joy like washing my face and doing what I call my minifacial helps me relax before bed,” Nicole said. “Also, I have begun decluttering my home, which sounds like work, but I found it’s helping me to feel better.”Sara learned that to refill her emotional and social resources, she needed to try something new. “Going to Gen-Con [the largest tabletop game convention in North America] was a huge deal for me. That was completely outside my comfort zone,” she said, laughing. “I traveled with a friend. I was without my husband and kids for the first time in years, and I spent an entire day by myself at the convention, taking care of my own needs, and doing my own thing. I went up on a stage in front of thousands of people in a costume we created. I still think about that weekend and am encouraged.” Sara said, “On a smaller scale, just trying to make lunch or coffee dates and getting outside of the house is a big help for me.”“I refill my cup by doing crafts,” Bree said. “I also started reading again and joined a book club. And I’m going to church again.”

8. Find Meaning and Purpose

To thrive in this world of disability, we need to find purpose and meaning in life. We can find meaning when we set goals and try new things, help others, and find meaning in our circumstances.John is finding his meaning and purpose in helping people with disabilities who struggle with addiction. “I know a lot about addiction, mental health and disability and I think there are many addicts who are disabled, and they are hopeless,” he said. “I want to be a voice of hope to others. My goal is to take this wherever God wants to take it.”“I am still figuring out what my purpose is,” Nicole admitted. “I honestly thought being an independent, driven career-woman in the field of health care was my purpose. I realize none of that is important and it’s not what I want people to remember me for when I’m gone. I want to help people navigate the challenges of health care. I am not sure what that looks like yet, but I’m praying for God to lead me.”

The Benefits of a Group

The feedback from the participants after they completed the sessions suggests that the process had helped people understand their emotional health and, in many cases, take positive steps to improve it. “It was important to be with other people with disabilities,” Camila said. “There’s a loneliness that comes with our disabilities. So, to learn and grow within a community was the most powerful part of the experience. It gave me a sense of belonging.” “In the group, I knew I was with people who could relate,” Spencer said. “A therapist can’t really relate in the same way,” he said. “In every session, we learned from each other. And since we had all spinal cord injuries, we always ended up talking about poop and pee. ”For John, the group put a face to disability. “I got to hear the life experiences of people who’d been injured longer than me. I heard about their challenges and where they experienced success. I knew that I wasn’t alone,” he said. Nicole finds that she’s still processing everything she learned in the group. “There was so much I had not thought of or dealt with. That being said, I feel much more equipped to deal with the emotions and times when my mental health is not so great,” she said. “I also realize I have nothing to be ashamed of, and it’s OK to not have it all figured out. I met some amazing people who I know I can reach out to for genuine support or a kick in the bum if I need it.”

Author Jenny Smith has adapted the eight-week experience into The Journey, a workbook that allows readers to tackle the eight stages on their own. The Journey is available wherever you buy books. A Spanish edition will be released soon. Find out more at

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