Experiences of change and adjustment within couple relationships following spinal cord injury

Mair, Luned 2021. Experiences of change and adjustment within couple relationships following spinal cord injury. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Preface All relationships negotiate changes and challenges over time. However, relationships may be especially challenged where one partner has faced a significant, life-changing spinal cord injury (SCI). The two papers composing this thesis focus on the experience of individuals living with SCI and address how romantic relationships may have to change and adjust to enable their maintenance post-injury. Perhaps because SCI commonly affects sexual functioning, there are many research papers that examine the sexual aspects of relationships following SCI as a component of disability. However, the aim of this thesis is to establish a broader, psychologically-informed perspective of how individuals’ experiences of SCI may affect their relationships more broadly. It is hoped that constructing a deeper understanding will inform development of appropriate support for those with SCI and their partners, aiding them to positively adjust and maintain their relationships following injury. Paper one The first paper considers the adjustments that may be required within relationships following SCI and how this may impact upon intimacy and adult dyadic attachment. Despite a growing body of literature researching the experiences of individuals and their partners following SCI and focusing on how injury may affect their relationship, including emotional and physical intimacy, there is a lack of synthesis of their findings. This paper looks at how individuals living with SCI, and some couples, have experienced changes and associated adaptations to their relationships post-injury. A meta-ethnographic approach was used to synthesise 15 qualitative papers. The results revealed three master themes and six related super-ordinate themes that reflected the processes and changes within relationships, adult attachments and both emotional and physical intimacy following SCI. 7 The review findings showed that many aspects of their relationships required adaptation from both partners. Communication was of great importance as couples negotiated new roles, determined boundaries around caregiving and experimented to discover new ways of being intimate. The SCI and associated need for adjustment meant that some couples felt that their relationships became stronger as they faced challenges deriving from the injury as an entity rather than as individuals. However, other dyads had greater difficulty adapting. For many, the SCI seemed to threaten their attachment, bringing a constant danger of relationship breakdown. It seems that the experiences of many individuals were strongly situated within the way their culture viewed and defined disability, gender and relationships. In some cases, this appeared to make the adjustment process more complex and challenging. The clinical implications of the synthesis suggest that both partners should be offered culturally-sensitive, person-centred support, both immediately after the injury and in the years that follow. It is hoped that this will aid them to develop successful, relational processes of coping that focus on both partners’ experiences, needs, hopes and abilities. This support should focus on all elements of romantic relationships, not just sexual functioning and physical intimacy. Paper two The second paper also adopts a qualitative approach to gather a rich understanding of the experiences of individuals who live with SCI. This paper considers the changes couples faced when one partner is living with SCI, as well as how relationships are maintained after injury. It looks at both the processes that may have helped adaptation and relationship maintenance and those that may have made this more difficult. This paper consists of semi-structured interviews with nine people living with SCI, all of whom had partners. Four participants were female and five male. Some had been with their current partner at the time of injury whilst others had started their relationship post-SCI. Interpretative phenomenological analysis was used to analyse the data and four super-ordinate themes emerged. 8 These themes included the way in which relationships continue to develop and adapt following injury and how couples have to negotiate changes to roles and boundaries within their relationships. Another theme concerned how partners, faced with sexual function changes following SCI, need to experiment and adapt in order to maintain both physical and emotional intimacy. The final theme summarised some of the factors that those interviewed felt were most important for relationship maintenance. The clinical implications of paper two included the need for both partners to be made aware of the support that is available to them after SCI. It is suggested that the focus of this support should be on guiding couples to develop greater flexibility and understanding within their partnership to enable them to better communicate, solve difficulties and approach and adjust to new roles and ways of being intimate following injury. It is hoped that this would support the maintenance of relationships after a member of a couple has experienced SCI

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2021
Last Modified:	22 Sep 2022 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/144328

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