Amputee Perspectives: Fear

Written by Beth Hudson LBKA

According to the Oxford English Dictionary, fear can be defined as either a noun or a verb. As a noun, it means, “an unpleasant emotion caused by the belief that someone or something is dangerous, likely to cause pain, or a threat.” As a verb, it means, “be afraid of (someone or something) as likely to be dangerous, painful, or threatening.” Regardless of what part of speech it is, fear triggers a response in two parts of the brain, the amygdala and the hypothalamus. ”The fear response starts in a region of the brain called the amygdala. This almond-shaped set of nuclei in the temporal lobe of the brain is dedicated to detecting the emotional salience of the stimuli – how much something stands out to us… A part of the brain called the hippocampus is closely connected with the amygdala. The hippocampus and prefrontal cortex help the brain interpret the perceived threat. They are involved in a higher-level processing of context, which helps a person know whether a perceived threat is real. (Arash Javanbakht and Linda Saab, The Conversation, What Happens in the Brain When We Feel Fear | Science| Smithsonian Magazine, 10/27/2017).

So the science lesson tells us that we need to differentiate between real fear and perceived fear, and then deal with it accordingly. Some fear is good for us; it keeps us from doing stupid things. But fear can also paralyze us and keep us from doing something because of our perceived experiences. Some of these fears are very rational, and others are irrational. And some we can put to rest by confronting them and processing how we feel and how we respond the next time. Seeing a professional therapist is a good place to start if a fear is holding you back.

The context of fear is very important. If you like scary movies, you know the fear isn’t real. That allows you to enjoy movies like “Alien” or “Silence of the Lambs.” But the fear that the bombers invoked during the Boston Marathon bombing in 2013 had a totally different context; one set in reality, where real people were hurt and killed.

How does fear relate to the amputee community? Several ways. Fear of the unknown. Fear of rejection. Fear of the ability to be independent. Fear of not being able to function. For lower extremity amputees, the fear of falling. For upper extremity amputees, the fear of not being able to manipulate objects as basic as a fork or spoon. The fear of rejection from friends and/or family. The fear of not being able to work or be a contributing member of society. The fear of being a burden. Those are just off the top of my head, and I’m sure all of you could add to the list.

Personally, my biggest fear was falling; I was terrified. Notice that I used the past tense in that last sentence. Walking with crutches and being an MIA (Multiple Injury Amputee) made me much more susceptible not only to further injury, but also to not being able to get up. I became overly cautious about walking in the rain, in the wind, and on uneven surfaces to the point that it was debilitating. And, I knew that for all lower limb amputees it wasn’t a matter of IF I fell, but WHEN. It’s the same as when your parents or driving instructor gave you the “not if, but when” speech about accidents when you were learning to drive.

Luckily, I had an excellent PT who regularly asked me not only about my physical struggles but also about my psychological struggles. When I mentioned falling, her response was, “I can fix that.” First she showed me several ways to get up from the ground depending on my environment and what elements I could use to my advantage, and how to get up if I had to rely solely on myself and my crutches. As luck would have it, that same day at PT I actually did fall. I don’t think I’ll ever know if she caused me to fall on purpose or not. All she said was, “Get up.” And that’s exactly what I did. Once I learned the skills I needed to get up, my fear dissipated. Good thing, too, because in the next twelve months I fell five times. I got a little scraped up and bruised, but I didn’t break in half. I only needed assistance during one of those falls – 80% success rate – I’ll take it!.

As amputees, much of what we fear, especially early on, is fear of the unknown. Once we face the unknown and make it known, the fear diminishes. Sometimes the best response IS flight, but we can fight through our fears too. Not alone, mind you – help from professionals is important – from the medical community, the therapeutic community, the O&P community, and our inner circle of friends and family. Living with fear or feeling fear is normal. Holding onto that fear is unhealthy. If we face a fear head on, voice it, get help understanding where it is coming from, and have a tangible way of dealing with it, we will be healthier for it. Rational or irrational, it doesn’t matter. What does matter is how you deal with it. Find resources to help you.

Face your fears, and “eat them for breakfast.” (Alfred A. Montapert)

And remember: You don’t know how much strength you have until you are called upon to use it.