The importance of self-esteem after a stroke

A stroke often robs the stroke victims of their self-esteem, confidence, and functional independence. Functional independence of a stroke victim is hampered by loss of mobility, vision or difficulty in communicating.

Various neurological and psychosocial factors resulting from stroke make it difficult upon the stroke victim to regain his freedom of movement. In order to restore his mobility, the stroke victim undergoes rehabilitation. In the process of trying to improve the stroke victim’s neurological functions, the psychosocial factors that affect the mental ability of the stroke victim after stroke may get neglected. Low self-esteem in the stroke victims may occur due to such neglect of psychosocial factors. It is very pertinent to restore the stroke victim’s self-esteem to improve his participation in and the eventual outcome of rehabilitation treatments.

Attending to the Psychosocial factors of the Stroke Victim

It is suggested that neglecting the stroke victim’s psychosocial attributes not only prolongs the period of recovery, but ultimately tends to hamper the stroke victim’s physical disability even more. Stroke victims suffering from aggravated psychosocial problems incur greater rehabilitation costs for staying in the hospital. While a lot of studies have looked at post-stroke depression, few looked at the level of self-esteem. Behavioural care in stroke patients is influenced by social support and self-esteem. Self worth is often established after reaching adulthood, but critical events or situations, like suffering a stroke, may alter or erode self-esteem. Such alteration in self esteem has to be corrected to avoid falling into a state of emotional disorder, such as depression or anxiety, of which stroke victims to begin with are already prone to experiencing from the stroke itself.

A previously employed productive provider of the family who suddenly becomes unemployed and unable to contribute to the family’s financial stability due to a stroke may have his ego threatened and see himself as a burden.  A previously active person who suddenly loses motor function and balance after a stroke may lose confidence and become anxious about doing activities independently.  The resulting loss in drive to try one’s best may indeed lead to sub-optimal recovery during the rehabilitation phase.  Community reintegration, likewise, becomes difficult.

Correlating Self esteem with Physical illness

Loss of self-esteem and physical illness appears to be a catch-22 that tends to go into a cycle that has to be stopped to prevent a downward spiral.  As a stroke victim realizes his physical limitations, his self esteem becomes affected.  Yet, the low self-esteem that develops may lead to even poorer recovery and either persistent or worsening physical condition.  It is important that family and friends understand the situation and remain patient despite seeming irrationality of the stroke victim.  Some self-help techniques that the stroke victim and/or the family and friends can are the following:

1)   Suppressing the negativity within:

After a stroke, the victim should be helped in silencing the“negative voice” within.Even while still in the hospital, family members must instill confidence in him, by way of making him do certain things which might help him regain his self esteem. Generally, stroke patients lose determination because of a feeling of being deprived.  Constant encouragement and belief in the patient’s ability would be very valuable.

2)   Realizing one’s self-worth

The stroke victim’s family and friends are very important in enabling the stroke victim to appraise his self-worth. The stroke victim needs affection and care. Making the victim realize that he remains the same person and is just as loved and wanted and important as how he was before the stroke can certainly help restore his sense of worthiness.

3)   Asking help from family members

Often, people who suffer from low self esteem find it extremely hard to digest that they cannot do certain things independently. Such feelings ought to be discarded immediately, with family members and friends showing that helping the stroke victim is not a bother at all..This avoids the stroke victim from feeling of being a burden.  However, at the same time, family and friends should avoid doing for the stroke victim things that he could do himself.  Such family members and friends may mean well, but are often themselves anxious, and may transmit that same anxiety to the stroke victim.  Occasionally, it may also become an easy way out for stroke victims to intentionally remain inactive.  It is a balance that sometimes may be difficult to achieve.

References

http://www.strokeassociation.org

http://stroke.ahajournals.org

The Inspiring Story of Ingrid Clarfield: A Celebration of the Human Spirit

The following is a guest post by Lu Leslan 

“You don’t give up. You just keep looking for new and different ways to improve.”

- Ingrid Clarfield, Piano Professor and Stroke Survivor

On June 2009, I attended the Washington State Music Teacher Conference at Yakima, Washington, representing the Eastside Chapter as President. I was looking forward to spending a few days catching up with fellow teachers, taking time to listen and learn from workshops and performances.

I never expected to be completely energized by our guest speaker: Professor Ingrid Clarfield. What struck me was her sense of humor and delivery of teaching demonstrations that was both colorful and entertaining. It surely was a rare quality for someone to be spontaneous and demanding at the same time. However, mesmerized as I was with Ingrid, I noticed the left side of her body was paralyzed due to a devastating stroke in 2007. She presented her workshop with a left-hand pianist accompanying her right hand. She won the hearts of everyone in the auditorium in spite of her debilitating condition. Thus it became clear to me that what drives her was the love for teaching, music, and life.

Apparently Ingrid had suffered a hemorrhagic stroke that resulted in paralysis of the left side of her body. She immediately had to start physical therapy and ended up spending the next seven-and-a-half weeks at the St. Lawrence Rehabilitation Center in New Jersey. To help her combat severe depression and anxiety, Ingrid turned to acupuncture. In 2010, she started Biofeedback sessions to improve her movement and coordination. Currently, Ingrid does physical therapy twice a week. She has made tremendous improvement since the stroke. She still does what she loves best- traveling the country showcasing teaching workshops and musical performances, driving around town, even playing golf on a regular basis.

Forever the teacher, Ingrid has been posting comprehensive updates on her website: http://ingridclarfield.com/news_flash.asp. The last five years has taught Ingrid an important lesson that she wants to impart to others facing the same physical and emotional challenges she went through - that no matter what, never give up!

As an aspiring filmmaker, I approached Ingrid with the idea of a documentary. She was very appreciative of the opportunity to tell her story and, perhaps, motivate others to face their own challenges. “If I inspire just one person with a serious illness to not give up hope and keep trying to find ways to create the best life for themselves, I’ve accomplished my goal.” Acknowledging that life was certainly different after the stroke, she added, “Your life might not be exactly as it was before, but you may find new and sometimes even better ways to achieve the same results.”

I asked Ingrid what seemed like an ironic question, “Did the stroke make you feel more complete?” she replied, “The stroke taught me to be more creative and more compassionate. I feel blessed for the opportunity to do what I love everyday.”

On March 2012, The Music Teachers National Association will bestow Ingrid with the highly prestigious 2012 Teacher of the Year Award for her exemplary role in music education.

Ingrid’s incredible spirit despite seemingly insurmountable odds has proven to be a very special gift. The gift inspired me to embark on a different yet important journey – “TAKE A BOW – The Ingrid Clarfield Story”, a full-length documentary on the nationally recognized piano teacher and stroke survivor.

To learn more about the powerful, compelling and well-reviewed documentary, go to www.takeabowingrid.com

Family And Loved Ones: Their Role In The Road To Stroke Recovery

When a person suffers an ischemic stroke, the brain is damaged. An ischemic stroke is a condition where the brain doesn’t get enough oxygen because of a blockage (called a blood clot) in the blood vessel, When the brain doesn’t get the oxygen it needs, permanent damage can occur.

The stroke victim can suffer from paralysis, speech defects, and vision problems. Ischemic strokes can also impair the person’s ability to be cognitive as well as affect one’s moods and emotions.

Changes in Personality Caused by a Stroke
When a person suffers a stroke, a part of the brain that affects mood and behavior is impacted. It can cause several changes in the personality of a stroke victim. Some of the changes a person who suffered from a stroke may be the following:

• Depressed – After a stroke, a significant change in the behavioral personality of a stroke victim is depression. This is caused by biochemical changes that happened in the brain cause by the stroke.  A depressed stroke victim often feels hopeless, are fatigued, sleep poorly and do not eat well.
• Apathetic – A person after having a stroke can be apathetic. Apathy is when a person is indifferent and unmindful of the surroundings and is content with not doing anything.
• Impulsive – Another personality change a stroke victim may experience is impulsiveness. This is when the person does not think ahead and often does something too quickly, on impulse. The normal brain pattern of deciding whether to do or not to do something is impaired and the resulting behavior is impulsiveness.

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