SPINAL CORD INJURY AND AMBIGUOUS LOSS
Spinal cord injury (SCI) can happen through trauma, such as a road traffic collision, fall or sporting injury, or through illness, infection, tumours, medical negligence, other conditions, or disruption to the blood supply by bulging discs over time. Injury can occur at different levels of the spinal cord and may be complete or incomplete, and can include tetraplegia/quadriplegia and paraplegia, as well as conditions affecting the bundle of lower spinal nerves and cause Cauda Equina Syndrome (CES).
CES is rare but a serious condition, affecting approximately 6-10 people per million (British Association of Spine Surgeons). If symptoms develop, it is considered a medical emergency. Prompt treatment is essential, as early surgical decompression of the affected nerves can help minimise the risk of permanent damage. More information about the red flags is on the Spinal Injuries Association website.
Depending on the level and severity of the SCI, it can cause changes to movement and muscle strength, coordination and balance, sensation and the ability to feel touch, pressure, pain, heat and cold. It can cause neuropathic pain, muscle spasms and spasticity, changes to bladder, bowel and sexual function. Higher-level spinal injuries can affect breathing and coughing, can disrupt blood pressure, heart rate, sweating and regulating temperature.
The physical symptoms is only part of what someone may be dealing with. An SCI can dramatically affect mental health and bring a series of secondary losses that are less visible. These might include changes to independence, employment, finances, relationships, parenting, hobbies, social life, physical activity, future plans and the ability to do things that once felt ordinary.
There may also be loss of privacy, spontaneity, confidence or a sense of safety within your own body. For some people, the biggest loss is a change in identity - you no longer recognise who you are now. The roles you had, the things you valued and the way you understood yourself may have been built around abilities that have changed.
You may find yourself grieving the person you were, the life you expected to have, or the future you had imagined. Ambiguous loss describes situations where there is a significant loss but no ending, resolution or sense of being able to move on. The losses can be hard to define, difficult for others to see, and challenging to grieve. It's likely you will not feel understood by people around you.
There can also be uncertainty about what recovery will look like. Function may change over time, and hopes can sit alongside fear, frustration and adjustment. This can create a sense of being in limbo - caught between what was, what is now, and what might still be possible. Some difficulties may look invisible to others and may not feel validated.
Therapy can provide space to recognise these losses without reducing your experience to the physical injury. It can help you make sense of the changes, acknowledge the complex grief that may not have been recognised by others, and find ways of adapting to a life that may look very different from the one you had planned.
CES is rare but a serious condition, affecting approximately 6-10 people per million (British Association of Spine Surgeons). If symptoms develop, it is considered a medical emergency. Prompt treatment is essential, as early surgical decompression of the affected nerves can help minimise the risk of permanent damage. More information about the red flags is on the Spinal Injuries Association website.
Depending on the level and severity of the SCI, it can cause changes to movement and muscle strength, coordination and balance, sensation and the ability to feel touch, pressure, pain, heat and cold. It can cause neuropathic pain, muscle spasms and spasticity, changes to bladder, bowel and sexual function. Higher-level spinal injuries can affect breathing and coughing, can disrupt blood pressure, heart rate, sweating and regulating temperature.
The physical symptoms is only part of what someone may be dealing with. An SCI can dramatically affect mental health and bring a series of secondary losses that are less visible. These might include changes to independence, employment, finances, relationships, parenting, hobbies, social life, physical activity, future plans and the ability to do things that once felt ordinary.
There may also be loss of privacy, spontaneity, confidence or a sense of safety within your own body. For some people, the biggest loss is a change in identity - you no longer recognise who you are now. The roles you had, the things you valued and the way you understood yourself may have been built around abilities that have changed.
You may find yourself grieving the person you were, the life you expected to have, or the future you had imagined. Ambiguous loss describes situations where there is a significant loss but no ending, resolution or sense of being able to move on. The losses can be hard to define, difficult for others to see, and challenging to grieve. It's likely you will not feel understood by people around you.
There can also be uncertainty about what recovery will look like. Function may change over time, and hopes can sit alongside fear, frustration and adjustment. This can create a sense of being in limbo - caught between what was, what is now, and what might still be possible. Some difficulties may look invisible to others and may not feel validated.
Therapy can provide space to recognise these losses without reducing your experience to the physical injury. It can help you make sense of the changes, acknowledge the complex grief that may not have been recognised by others, and find ways of adapting to a life that may look very different from the one you had planned.
