It is well-known that risk taking & spinal cord injury are a terrible team, with the top causes being road accidents, falls, violence and sports — often with alcohol in the mix.
The link between risk-taking and SCI is so strong that Dr. James Krause, the director for rehabilitation research in neurological conditions at the Medical University of South Carolina, says “Spinal cord injury is not a random event; SCI occurs most often to young men engaged in high-risk activities.” Despite this, we know very little about risk-taking post-injury, even though it accounts for almost 20 percent of injuries and hospitalizations each year. Here is a look at the intersection of risk-taking and SCI, along with some information to help you figure out if you are taking too many risks or being too careful, and how to find the right balance.
What is Risk-Taking?
Risk-taking is when you are motivated by behaviors that present some level of danger, and yet, provide an opportunity for what you believe to be a positive outcome. Examples include speeding for the adrenaline rush, despite the possibility of crashing, or taking part in extreme wheelchair sports without wearing a helmet. These behaviors might increase the thrill of the activity, but as a risk-taker you often become more vulnerable to a whole host of further injuries. This is why understanding your motivation behind risk-taking is important for getting to the heart of the behavior and reducing your risks. Regardless of whether you see yourself as a risk-taker or not, everyone can benefit from understanding risk-taking. Indeed, research has shown that we all have an innate partiality towards risk-taking due to the feelings of arousal and pleasure that come from achieving something in spite of risk. This “high” is similar to addiction, where the body seeks stimulation, excitement, and satisfaction. We are all prone to risk-taking, but some of us more or less so.
Risk-Taking & Spinal Cord Injury
Research shows a relationship between impulsivity, sensation-seeking and SCI. Therefore, despite misconceptions, people with SCI are just as likely to engage in risk-taking as people without SCI — perhaps more likely. Given the link between risk-taking and sustaining SCI, some of the motivation behind post SCI risk-taking stems from the person’s ability to perform high-intensity activities prior to their injury. This can drive a person to rebel against the disability in an effort to demonstrate their capability, test their limits, and maintain their self-esteem.
Eric Kolar, a C6-7 quadriplegic of 20-years and peer counselor for UroMed’s “Life after SCI” program, has worked with quads and paras with all different affinities for risk-taking. “I’ve noticed that risk-takers who are injured may or may not change their behavior after their accident,” he says. “Much of that is due to their functional level post-injury. If they are a high level quad, they won’t have the ability to engage in much risky behavior. Those who do have more functionality may engage in risky events like contact sports to maintain a sense of independence.”
Perceptions of risk can change after SCI in a way that increases risk-taking because the person feels that they have already experienced the worst. Dave Sadler, who has been living with SCI for seven months, says, “I don’t do anything ‘really’ risky like skiing on a steep slope, but I do like to go down very steep hills in my wheelchair.” As a result, Dave often ends up with scrapes and cuts on his legs from falling off his wheelchair, but this doesn’t concern him because he can’t feel them. He says, “If I’m going to be in a wheelchair, then I’m going to enjoy it!”
Benefits to Risk-Taking?
“Most of the time, when I see people with SCI attempting risky things, I sense that they are trying to build their own sense of independence and improve their social inclusion,”says Kolar. Indeed, while neuro says Kolar. Indeed, while neuro–chemicals and the environment play a role in determining how much risk-taking someone is capable of, intellect also plays a role — risky behavior can help you learn your limitations, give you a sense of competence and, when you take a risk and succeed, empower you. When risk-taking is channelled into sports such as basketball, wheelchair track and field, swimming and water-skiing, it can become a positive and healthy outlet that promotes self-esteem. “I’m a huge proponent of sports for the outlet they give for independence and inclusion,” says Kolar. “Sports are also proven to release endorphins, so engaging in them can help you feel better both physically and mentally.” Supporting this is research showing that as satisfaction in leisure activities increases for people with SCI, occurrence of medical complications decreases.
Finding the Right Balance
When taking risks, be clear on what the risks are by examining and analyzing the consequences. “Everyone who uses a wheelchair says: ‘Oh, what the hell, what’s the worst that can happen — I’ll get paralyzed?’” says Kolar. “It’s more of a joke though — no one wants to go through that ordeal again, no matter what they say in jest. No one wants to do anything to lose any more of the functionality they have left.”
Take advice from peers and professionals and, as long as you show willingness and respect for safety, many thrills are possible. “It’s been 20 years since my injury, but I still ride roller coasters, and I want to skydive one day — in the chair!” says Kolar. “You only live once.” He also points out, however, that “if your behavior is selfdamaging, either subconsciously or intentionally, professional help is necessary.”
On the other side, some people with SCI can end up in a position where they are too scared of the repercussions to do anything more than they have to. Tom Drake has been living with SCI since 2006. “I am way too terrified to take any risks. Just yesterday I had a fall and I wasn’t even doing anything risky,” he says. “I can’t do anything that might make my injury more severe than it already is.”
Research shows that we are much better at assessing other people’s condition or risk than our own. As pointed out by Kolar, “You know, people could say walking my dog is risky. She weighs 90 pounds and can drag me all the way up the hill without breaking a sweat. She’s knocked me out of my chair before without realizing her own strength, but that doesn’t mean I’m going to get rid of my dog, or not take her on a walk.” In such circumstances, having a support group of people who are in the same situation and who understand the conditions, dangers and advantages of taking (or not taking) risks can be extremely helpful. This is especially the case if health professionals, who can explain the pros and cons of taking risky activities, facilitate the group. Indeed, support communities are not just a place to receive advice or share experiences, but they also provide an alternative to self-assessing risks. Rather than approaching a situation on your own, support groups allow you to garner the experience of many to help make more informed decisions. If you thrive off risk, group support can help you make less risky decisions. If you avoid risks to the detriment of quality of life, group support can build your confidence to try new activities.
Risks come in all shapes and forms, and we are all partial to them because they can enhance our lives. While extreme risk-taking can be dangerous, taking some risk is what makes life worth living. Don’t give up on risks, but instead be selective and consider your alternatives. Whether you tend to take too many or too few risks, self-assessing your risk-taking propensity and sharing with others are two ways in which you can work towards achieving some balance.