[by guest writer Dr Anna Logie]

People sometimes view crises such as breakdowns or heart attacks as externally-imposed events. There may often be a period of denial, yearning to return to how it was before. Drinking, drug taking, smoking, eating whatever you want, running up the credit card, watching telly all night, the pub after work… why would one not want to pursue activities that bring pleasure? Who wants to live a boring life? Yet it should be clearly understood that whatever combination of actions were being taken led to this particular point of ill health. Environmental and personal, it is all connected, suggesting that different behaviour is required to avoid a continuation of the symptoms.

It is important to emphasise, with reference to behaviour, that there should be no unnecessary extrapolations of ‘good’ or ‘bad’ behaviour. This kind of polar terminology is likely to exacerbate any stress, worry or symptoms someone may be experiencing. Perhaps it is more sensible to talk of probabilities, in that x behaviour is more likely than y behaviour to cause z action. One can then ask, ‘is z a desirable state?’ It would be perfectly possible to continue behaving in the same ways, but consequently more likely that the same outcomes continue to occur.

From immediate and extended family and friends, support and understanding, rather than judgement or interference, are crucial. Be involved. On a personal basis, people should avoid reacting radically, for example with crash dieting, a new religion or other strenuous activity. With a knee injury, you cannot have a knee-jerk reaction. If one’s body is used to being used in a certain way, shocks of sudden difference or enforced variation may cause further trauma.

Insinuate and instigate lasting change, in physical and mental behaviour. It may be for as little as one hour a week, initially, exercise of some kind, discussion, meditation. However, if someone has serious physical/mental problems, if they survive and overcome crisis, it must change their life.

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