Rehabilitation Psychology: learning to mow a quarter of the lawn

People often ask me what the main treatment areas I work with are. I often say I deal in adjustment. I step in when all previous coping strategies are no longer working, when life feels unfamiliar and overwhelming.

A Personal Story

For most of my adult life, jogging has been my therapy. It’s what I do to get activated, to feel better, to feel in control.

I had felt like it was something always accessible to me. One morning, in my early 20s, during a time of extraordinary personal challenges, I went out to start jogging and I began hyperventilating. Any attempt to get my heart rate up resulted in pure panic. I stopped to walk, tried again, but I couldn’t.

I felt so lost. Jogging was my anchor, my coping mechanism. And suddenly, it wasn’t working.

When I describe this to people, this feeling of no longer having access to normal coping mechanisms, they nod knowingly. This often happens following an injury, illness diagnosis, or any extraordinary life event.

Our whole body reacts and needs to reorganize. I often refer to it as a "snow globe moment" where everything is shaken up and we don't know what the picture is yet.

Our physiology often changes faster than our thoughts, our self-perception, values, and worldview. We can often expect to manage as we had previously, with a much more limited capacity. We might think we are able to wash our car, cook dinner, attend a party or play with our kids just as we always did, but this might not be possible, or if we do it might set us back.

Why Adjustment Is So Hard

When major events (health and otherwise) disrupt life, the suffering can feel amplified and overwhelming. The strategies that worked before, the routines, the beliefs about who we are and what we do, may no longer serve us during the rehabilitation process.

I often say to clients: “One of the most frustrating parts of rehabilitation is learning to mow a quarter of the lawn.”

This is my metaphor for learning to do something differently, in the service of sustainable recovery (or in some cases we are actually problem solving how to deal with an overgrown lawn).

The lawn is the example I use to demonstrate how helpful it can be to approach a common task differently, to get out of autopilot and choose a behaviour that will assist with rehabilitation. Matching rehab with someone's current capacity, not their tightly held belief about what they "should" be able to do.

This involves gently challenging the thought that "if we start something, we have to finish it". There is nothing inherently wrong with that thought, it probably served them really well as a healthy person, but treating it as gospel doesn't help during rehabilitation.

That process is psychological. This reorganisation. The above is just one example.

Hard working, tough, resilient people just want to push through. Sustainable recovery comes from strategies like pacing, that can require understanding beliefs and values to assist with challenging those existing rules and ideas.

The Role of Psychological Support

There may or may not be an underlying mental health condition contributing to these challenges and the associated psychological distress. Either way, psychological support during this time can be the difference between a timely, sustainable recovery and long-term chronicity.

Final Thoughts

If you’re navigating rehabilitation, know this: often what you are going through requires a brand new skill set. You don’t have to do it alone.

- Sarah.

Have you experienced a moment when your usual coping strategies stopped working? Reach out if you’d like to learn more about psychological support during rehabilitation.