This societal approach makes for attitudinal changes. They require all of us to look out for each other. Parents learn this as they have to watch out for hazards their children might get into. A balance exists between protecting and allowing children to fail and learn. This also applies when dealing with disabled persons.
Finally, our self-images extend beyond each other and the physical world. Here spirituality and religion enter the equation. Writers of many religious texts lived in societies that excluded people with disabilities. They often use disability labels like, “Blind” in pejorative ways. They also associate disability with age. Currently evolving spiritual and religious understandings address these shortcomings.
There are many things that may disable someone. The disabling factor might not be what it seems at first. It could be ability, environment, attitudes (either of self or others) and spiritual/religion. The world we all want to live in requires us to overcome these barriers.
For the purpose of this paper I will define a disability as, “anything that makes someone unable to function like most other people”. Physical and mental differences constitute most of these conditions. However, one needs not look far to find people with similar limitation of their ability functioning as well as most. And seemingly able bodied people unable to perform simple tasks.
I know several people who see nothing but hold down regular jobs and raze families. Many others with some sight struggle to live independently.
A Disability results from interplay of factors that lead to an inability to function as one would like. Thus coaching someone with a disability becomes a full spectrum project. The role of a coach is to help the client explore those factors and find ways to create a full and abundant life.
For a more complete review of the topic of Disability checkout Disability
What is the world of a person with a disability?
Disabilities take many forms and can occur at any time in one’s life. No way exists to list all the things that might cause a disability. One might be well adapted to one’s situation until a need arises.
For example take being a man or woman. You would not consider it a possible disability but part of one’s identity. A Disability can become part of one’s identity too. That is the reality of one born def., blind or any of a long list of possible disabling congenital conditions.
If a man is a sports reporter and gets assigned to cover a woman’s sports team, Most of the action is on the field. Yet interviews with players and coaches often occur in the dressing room after the game. Social norms prevent men in women’s locker rooms. He would be excluded from doing as good a job as a woman because of his gender. This might be called a situational disability, but it makes him unable to perform as well as many others.
A disability might arise from a change in one’s abilities. From birth our abilities increase and improve. When injury or illness suddenly decreases those abilities we find ourselves struggling. We all recall the kid who broke a leg. He would struggle to get up and down stairs at school. Elevators and one floor school designs help, but he is slowed by the need to crutch walk in crowded halls.
A broken leg also causes pain and difficulty sleeping, thus affecting mental capacity. The disability resulting from that broken leg goes beyond a decrease in mobility. Neither the child nor the teacher would anticipate this decreased function.
If the child’s peers all gather and play sports, what should the child do? The broken leg forces him to sit out the games. Other roles exist to help the team. Others might use these roles to participate. A new social cooperation arises. They might be able to exchange roles. A bench warmer now gets playing time.
When the cast comes off there is a period of further rehabilitation. The coach might expect a return to former play. Weakened muscles and reflexes take time to redevelop. Over use can result in injury. Most children would not expect this. Adults need to work with the child to make this part of the injury go smoothly. Coaching can help this process. Then there is fear of doing what caused the injury, a mild form of post-traumatic stress.
Full recovery eludes more serious injuries and many illnesses. A lost limb changes one’s life possibilities. If you expected to be a professional athlete and loos a foot, there goes the mainstream dream. The advent of para-sports created an option for these athletes. The public seems unaware of them and does not celebrate them the same.
Others find themselves at a loss as to what to do. The rehabilitation process leaves them far from where they expected to be. The gaps between expectations and reality exist for most. It is easy to get caught up in blame. A life transition is occurring.
Changes occur all the time. The sun sets; we find ourselves another day older. These are easy to accept. When we can’t accept the changes we are faced with a life transition.
Life transitions proceed thru three phases. First the old will end, and then we will find ourselves at a loss. We can prepare for the losses like graduation. These preparations rarely address all the feelings that will arise. We must grieve for the loss of being a student when we graduate and enter the workforce.
Accepting a disability means we have to grieve for the loss of Bing able bodied. No matter how well we function, decrees in ability means we are less able bodied. The stages of grief: depression anger, bargaining, adaptation and acceptance all occur here.
Unfortunately one can’t return to the old script. This leaves the client bewildered, wondering what to do. There are the immediate concerns of getting thru the day. Short term concerns arise of food clothing and shelter. Then you must decide what to do with the rest of your life and how to achieve it. Eventually one must implemented the transition plan to live into a new life script. Will that life script be satisfying?
The rehabilitation process focuses on the future. Grief with its depression impedes this process. A coach can help by focusing upon the grief process. Both anger management and coping with depression require skill. They present an opportunity for growth.
A coach could look at the disability process as two transitions; first, acceptance of the disability, then creating and living into a new life plan. The medical and vocational rehabilitation systems lack this global perspective.
Sometimes we can anticipate the disability. A Chronic illness can decrease one’s ability gradually. Cataracts cloud the lens slowly. Usually an eye exam will detect them before they interfere with function. The eye professionals don’t explore the issue of timing interventions adequately for most. They usually leave the decision of when to do cataract surgery and the criteria for that decision up to the patient.
A coach can help the client/patient explore this decision further. Such questions as how will I know my vision is decreased? How much can I compensate immediately and over time? Could there be unanticipated situations that might require quick action? What if I don’t recover fully from the treatment? Will I risk the worst case outcome? And how would I Live with that?
These coaching questions touch upon self-reliance, planning and acceptance of others support. Thus other avenues for growth open.
These situations force the world one faces with a disability to evolve. The self-identic, skills and abilities, social and spiritual understanding changes and must become an accepted part of life.
What issues might a person see around disability?
What should the scope of your coaching be?
Many issues exist for a person living with a disability. To cover them all would mean recreating a person. The client will have an agenda. As you would do with any other client, I suggest that you start with their agenda. Then as you get to know the client note other issues, and bring them in as they arise.
As one transitions thru a disability they will have to grieve over what they have lost. The things they have lost might not seem obvious. When I stopped driving I replaced the car with a bus and friends. This mint I could get places, but I lost the independence and spontaneity of driving myself places. I gained new interactions with others. I also associate with a different group of people on the bus.
The self-image also changes. As a youth I dreamed of driving a car. Now I must accept that, I have been there and done that, only to never do it again.” The adult task of driving has escaped my options. On long road trips I cannot relieve the driver.
This leads to a fear of letting others down in other ways. I could not help with directions. The advent of GPS technology enabled me again. Yet I had to learn it.
The issue of driving seems like a life regression. Becoming a passive passenger resembles a child. We did not expect to become an adult dependent upon others, at least until advanced age.
We often feel uncertain as to what life stage we belong. Dependency makes us like a child. Having to redefine ourselves keeps us there. As adolescents struggle with this so do recently disabled adults. Unlike youth the limits of what we can learn and time to achieve results are more finite.
A teenager does not worry about retirement savings. He willingly spends to achieve new skills. At 50 the work life left to recoup such an investment becomes an issue. The willingness of others to lend or fund such a life change also differs.
Will our abilities decrease and further shorten the time to recoup that investment? This can lead to more hesitation or hasty action.
What will motivate us now? As a teen we had a life script and peers to judge our progress. While working we could look to the lives of co-workers. Those in rehab centers are non-workers. If they return to work we lose them as role models. It takes some time for them to become secure enough to act as mentors.
Teenagers lack financial security. Financing for those with disabilities is complex. There are potential penalties for earning too much. The Social Security Disability system has a cap over which you lose all the benefit, even if the benefit is more than you are earning. Private disability insurance has unique sets of rules.
Many of those with a disability also find themselves on SSI. This Social Security programs off sets any earnings. The two Social Security programs get confusing.
Private disability insurance has many ways of dealing with a return to work. Some of them make one hesitate to do much of anything. These insurance policies define disability as an inability to do any gainful employment. They would expect a formally highly skilled worker to take unskilled work.
Health insurance worries those with disabilities. Receiving the treatments and medications costs much. After two years on Social Security Disability one becomes eligible for Medicare. Insurance paid by the employer ends with the job. During this gap between work and Medicare, one has to purchase Health Insurance in the new Insurance marketplaces. They vary from state to state. Finally, Medicare does not pay like private health insurance. Most people have a Medicare Supplemental Insurance.
There is often a period when one can’t work. Delays in accessing rehabilitation and other supports make one accustomed to not working. During this enforced idleness one often finds other roles. Many partially disabled do child care and other things for family and friends. These obligations might get one active but only so much. Now others depend upon them.
With the prospect of working again come memories of past work. Past work included joys and trauma. Which of these will surface for your client? Being fired or sued results in a major trauma. Will your client admit to them and have they been laid to rest?
When one reenters the workplace you often enter at an entry level. Being 50 among a cohort of 20 year olds creates issues. This might be a good situation for a sitcom. I am unaware of any that have dealt with these age or role reversals.
Social supports shift from work to non-work and then possibly back to work. Most attention to social support deals either with young adults or the elderly. How can a disabled middle aged adult find support? The client will need to reestablish his social support network.
The support of a spouse or life partner gets tested. It takes many years to get these relationships comfortable. Often major strains existed before the onset of disability. Will this become the excuse to move on or work on the relationship?
These are a few of the major issues for a coach to watch for.
What should you strive to achieve in coaching a person with a disability?
As Life Coaches we strive for our clients to feel better about their lives. How can a person with a disability feel better about their life?
With a disability there exists a lot of grief about what the client lost. Unless this is faced a life different from past expectations will not be accepted.
Then want can our client realistically expect from their life? That is the question we always ask. As youths we had heroes. The super heroes never seemed to have overcome any adversity. Normal heroes must face adversity, and overcome it.
In his classic work, The Hero with a thousand faces” Joseph Campbell works us thru this process. The hero sets out on a life adventure only to find challenge within him and others. He must find the resources and mentors to overcome these challenges.
A simpler journey is outlined by William Bridges in his book, “Transitions”. Here he starts by contrasting a transition with a change. Changes happen all the time. We are not the person we were yesterday, or will be tomorrow. We have adapted to these changes, yet in our day to day life we manage to ignore the toll they take. At certain points we reflect upon time and age.
Bridges spends a lot of time on the usual changes that occur in our lives. He references several sets of common changes. One important one for those facing a disability or chronic illness is The Holmes and Raphe, Stress Scale. Use of this scale will help your client understand why he is disabled now. This scale tallies the number of life events in the prior two years. The score predicts the onset of illness. Two forms exist one for adults and another for; children. By reviewing these with your client you can help them see why now; that stress management, relaxing techniques and other coping skills can help them remain well; and address these stresses in your coaching.
According to Bridges a transition occurs when the usual changes prompt an emotional response, requiring growth. Often this is a legacy issue uncompleted small transitions that now converge to force a reevaluation. Such issues might include family systems, work systems, social systems, and organizations. These changes might be among those that precipitated the disability or illness or just resulted from that. Either way identifying them gives you points of insight into your client’s life.
In a social system the role we play fits in with the roles of others. When we change roles others must change roles as well. I think of it as being together in a small boat. When one changes seats, the others must change in complementary ways or the boat sinks. The unanticipated role changes an illness or disability causes a major role change. Thus being aware of the social systems our clients fit into allows us to expand our coaching focus even further.
It might be wise to create a bio, psyche, and social profile of the client. This will give both of you insights into the potential issues. I have outlined such a profile in the resources, below.
Equipped with all these insights we can now help our client journey thru the transition of a disability. First one must grieve over what they have lost. This grief goes thru the classic stages of Keebler Ross, denial, anger/depression, bargaining and acceptance. Unlike the grief of one’s own death we must them make a new life.
Bridges states that we must do the grieving before we can inter thee neutral zone. The neutral zone is the period where one no longer can rely on the old and has not yet found the new. One feels lost and without direction. Here is when a client is apt to seek a coach. If the coach can reassure the client that this is normal, a new direction will emerge from the current chaos of their life. This will give them hope.
Unfortunately one wishes to stand again on solid ground. That solid ground will not emerge until the ties with the old have either been severed or strengthened. Some judgement will be needed here. Severing ties plunges the client further into the neutral zone. Strengthened ties might prevent advancement.
What is the process of working through a disability?
The process of working thru a disability resembles a spiral. One cycles thru grief, wilderness and insight. This cycling eventually leads to enough insight to go forward. For those who a have lost an ability they will always be confronted with the fact of their loss.
When one recalls their past ability anger arises. This anger might become a major emotion and stop one in their tracks or just be a fleeting feeling. Other factors contribute to the height of the wave of anger. When the client gets caught in a wave of anger looking for other triggers of anger can help to get over the anger.
Likewise the feeling of depression caused by the disability and other factors can stop your client. To address the disability related losses, we can recall the abilities now possessed and how they came about. In those situations where the disabling condition progresses, a return to rehabilitation can help.
This might be recalling and trying again skills that seemed unnecessary or learning new ones. In my rehabilitation training I learned to use a white cane. For several years, I did not use it regularly. Then I took a couple of flying leaps off unseen stairs, and realized that I would be safer using the cane. Now I have found other reasons to carry it.
Doing or reviewing the bio, psycho, social and spiritual profile of the client can help to cover the bases of this anger/depression and set the stage for the future.
The uncertainty of where to go from here has several reasons to trap your client. The disability safety net means that if one is willing to accept less than what the client expected he will be OK. This acceptance is often part depression and defeat. Thus we should not coach intending for the client to accept this. They need hope and happiness no matter the life style. They might not return to the former job or social roles. Ultimately achieving the spiritual understanding that they are Loved and Valued no matter what will give your client peace. This love and acceptance comes not from others but from the Universe itself. Such acceptance is a mystical spirituality which many find foreign. Thus it will have to be approached in small bits.
During your reassessment of the losses you reviewed the skills your client still possesses. Thus you are prepared to match skills with the needs and roles open. Refreshing the negotiation skills originally used to fit into a social setting is important. The client is no longer who he was and he will need to seek out and accept other social roles.
When making plans for the future, preparation for future cycles might come up. The first few times that might be depressing. Remembering that the client overcame prior trials will give hope. Learning to look for signs that abilities are changing and developing strategies to address these helps prevent new bought of depression.
The realization that I might not always be able to do something partially sighted gives me the opportunity to “practice” blind skills. One day I found myself blindly stabbing a knife into the knife block. When I asked myself how I could do it blind, I found a new way; drag the knife tip across the holder until it found the slot. Then raised the knife until it slid in. this seemed so neat and simple that it became my preferred way. How might your client “play” at being more disabled than they are and find a better way?
As your client moves into a new phase of functioning be sure to celebrate and review. Showing off the new skills gives pride. I just learned to use the Apple I-phone tool Siri to get directions. Getting directions and help a driver find the way to a new destination made me feel great. Now I can help my drivers and be confident that I will not be just cargo.
I learned to use Siri by riding with a totally blind friend and observing her use of Siri. Her phone battery wen dead. I had an I-phone, so I tried it. My command was wrong. I let her try. She added a word and I could see how to use it. Thus I learned by a round of show and tell with someone more disabled. It also showed me that all I need to do when struggling is ask others.
What are the traps you can fall into when coaching those with disabilities?
There are many traps one can get into when working with people with disability or chronic illness. For those like doctors or nurses the first trap they face is seeing themselves as ill. Most medical students think they have at least one illness that they are studding. Then they realize that if they really had that illness they would be suffering a lot more or even dead by now. They must learn to empathize without sympathizing.