Denise G. Tate, Ph.D., ABPP

Professor and Associate Chair for Research

Co-Director, University of Michigan Spinal Cord Injury Model System

The reasons for having to recognize these aspects of incontinence, of bowels function and constipation is because it really has such a major negative influence on people’s quality of life and freedom and the ability to be independent.

So in some cases, for example, patients might experience a very difficult process of adaptation if they don’t – if they are totally dependent, so they have a high level of impairment, and they are unable to perform their own bowel programs.

And they have to then rely on a caregiver who might be maybe a mother or a spouse. So it puts the patient in a very difficult emotional situation where now you’re having some changes in social roles and identity, so the relationship you have with your spouse now might be different because she or he might be someone who is really taking care of you.

Many of my patients have talked to me about the issue of feeling like they are childlike now, that they had to go back after they are 27, 28 years old. They have to go back home, and mother now is the main caregiver. So I think it really is I would like to say almost traumatic for the individual to have to live those stages of life that they have matured and let go of.

It’s going back on time, and what we find with adaptation after a spinal cord injury or after incontinence or bowel dysfunction is that the long you live with your spinal cord injury, the better you are. So you have adapted to some of these changes. You are able to find meaning with other activities in life. So you’re transforming your identity, who you are.

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