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Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
Sport and physical activity in the life of a man with cerebral palsy
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Sport and physical activity in the life of a man with cerebral palsy

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  • 1. Sport and physical activity in the life of a man with cerebral palsy: Compensation for disability with psychosocial benefits and costs Cadeyrn J. Gaskin a , Mark B. Andersen b,*, Tony Morris b a Deakin-Southern Health Nursing Research Centre, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia b School of Sport and Exercise Science and the Centre for Ageing, Rehabilitation, Exercise and Sport, Victoria University, PO Box 14428, Melbourne, Victoria 8001, Australia a r t i c l e i n f o Article history: Received 19 August 2008 Received in revised form 10 December 2009 Accepted 10 December 2009 Available online 23 December 2009 Keywords: Psychodynamic Life history Disability Social isolation Developmental stages Identity a b s t r a c t Objectives: We explored the meanings and experiences of sport and physical activity in the life of a 30- year-old man with cerebral palsy (Ben). Design: Life history. Method: We interviewed Ben about his life, with a particular emphasis on understanding the meanings and experiences of sport and physical activity in his life. We interpreted his stories using Erikson's (1985) model of psychosocial development. Findings: Ben had a strong sense of inferiority, which seemed to have stemmed from social isolation during his early school years. Through participation in sport and physical activity as an adult, Ben was partially able to address these feelings of inferiority. Ben strongly identified with Olympians and Para- lympians, in whom he saw achievement and social connectedness personified. Although Ben became physically fitter, more socially connected, and less stressed through engaging in sport and physical activity, these achievements did not compensate for his feelings of inferiority, and he characteristically set tougher goals for himself after the elation of meeting previous goals had passed. Through devoting substantial time to sport and physical activity, Ben seemed to be avoiding or bypassing some of the psychosocial challenges of young adulthood (e.g., forming strong friendships and romantic relationships). Conclusion: The life history of Ben illustrates the benefits and costs of trying to compensate for disabilities through sport and physical activity. In Ben's life, sport and physical activity both promoted and impeded Ben's psychosocial development. Ó 2009 Elsevier Ltd. All rights reserved. During the last three decades, the maturation of the disability movement has enabled more sporting opportunities to be provided for people with disabilities and a parallel increase in their sporting achievements (DePauw & Gavron, 2005). Organisations, such as the Cerebral Palsy International Sports and Recreation Association, have been active in the support and promotion of sport for people with disabilities, from grass roots levels to the world stage. With greater numbers of people with cerebral palsy performing at elite levels, there is likely to be increasing demands for the services of sport and exercise psychologists. Although reviews of research on people with disabilities (e.g., Hanrahan, 2004; Martin, 2005), along with practical advice on consulting (e.g., Hanrahan, 2007), appear in the sport and exercise psychology literature, there is a dearth of information on the experiences of sports people with cerebral palsy. Studies that focus on the meanings and experiences of sport and physical activity in the lives of people with cerebral palsy would sensitise many sport and exercise psychologists to the issues that athletes with cerebral palsy may raise during counselling or therapy. In the few studies in which the meanings and experiences of sport and physical activity of people with disabilities have been investigated, researchers have tended to focus on the broad, somewhat superficial, themes in their data. From the quotations provided in the papers, however, several deeper intra- and inter- personal issues of social oppression seem to be present, such as: compliance with advice from medical practitioners (Henderson & Bedini, 1995), internalized ableism (the incorporation of prejudices against people who are not able-bodied), identification with people who do not have disabilities (Hutzler, Fliess, Chacham, & Van den Auweele, 2002), poor self-image (Peganoff, 1984), and sexual/ romantic concerns (Guthrie, 1999; Guthrie & Castelnuovo, 2001). Insights into these issues, and how they manifest in the context of sport and physical activity, may be gained through studying the lives of people with disabilities. * Corresponding author. Tel.: þ61 3 9919 5413; fax: þ61 3 9919 4891. E-mail address: mark.andersen@vu.edu.au (M.B. Andersen). Contents lists available at ScienceDirect Psychology of Sport and Exercise journal homepage: www.elsevier.com/locate/psychsport 1469-0292/$ e see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.psychsport.2009.12.003 Psychology of Sport and Exercise 11 (2010) 197e205
  • 2. The use of psychological approaches in the study of people with cerebral palsy could be criticised for positioning them as social deviates in need of treatment from the medical profession (Thomas, 2007). Such approaches can be at odds with the social oppression paradigm that many disability writers have advanced in various forms (e.g., Corker & Shakespeare, 2002; Hughes & Paterson, 1997; Oliver, 1983). Contemporary disability writers have argued, however, that psychology may have much to offer in advancing emancipatory disability studies (e.g., Goodley & Lawthom, 2006; Marks, 1999; Reeve, 2006; Thomas, 1999). Introducing the concept of psycho-emotional disabilism to the disability literature, Thomas (1999) recognised that not only do social barriers place limits on what people with disabilities can do, the imposition of such restrictions shapes their “inner worlds.” Although cerebral palsy is primarily a physical condition, living with such a disability can have a profound influence on an indi- vidual's psychosocial development (Reeve, 2006; Thomas, 1999). Some issues that have emerged during psychotherapy sessions with clients who have cerebral palsy (and their parents) are: anger at themselves, at their cerebral palsy, or at the judgmental and unaccommodating world around them (Blotzer, 1995); depression stemming from their attempts to achieve alongside able-bodied people (Feuerstein, 1995; Lantican, Birdwell, & Harrell, 1994); independence versus dependence, coming from the need to rely on others to perform tasks for them (Blotzer, 1995; Olkin, 1995); parental non-acceptance of disability (Acquarone, 1995; Donovan, 1995); social barriers to sexual intimacy (Joseph,1991); and suicidal ideations (Olkin,1995) and attempts (Jureidini,1988). In these cases of psychotherapy, it was common for people with cerebral palsy to present with one or more of these issues. Because sport and physical activity do not sit apart from a person's life, at least some of these issues may be expected to be present in the study of the meanings and experiences of sport and physical activity for adults with cerebral palsy. To gain a deeper understanding of the meanings and experi- ences of sport and physical activity for people with cerebral palsy, as well as the possible relationship between sport, physical activity, and other aspects of their lives, it may be useful to consider unconscious intra- and interpersonal processes. Marks (1999) proposed that psychodynamic theory could contribute to disability studies through facilitating the exploration of the relationships between identity, social location, interpersonal dynamics, and bodily and psychic experiences. People with cerebral palsy face many difficulties and delays in accomplishing developmental tasks (e.g., demonstrating autonomy, identity formation, social and romantic connection), and the most developmentally compre- hensive psychodynamically-oriented theory comes from Erikson (1985). His in-depth life-long developmental formulation of psychodynamic theory, with its emphasis on unconscious processes, family dynamics, and the wider social context across time, may be a suitable lens through which sport and physical activity in the lives of people with cerebral palsy may be examined. Because many of the psychosocial stages outlined in Erikson's model have substantial physical components (e.g., displaying competence at physical tasks, such as walking), meeting the challenges inherent in these stages may be more difficult for people with cerebral palsy than for the general population. Engaging in physical activity, thereby preserving or enhancing physical function, may positively influence their capacity to meet Erikson's psychosocial challenges. Regardless of social factors that may influence physical activity participation, the motor impairments of people with cerebral palsy limit the types of activities they can perform and the extent to which they may be involved in those activities. Although disability researchers working within a social oppression paradigm have typically left impairment unproblematised, some writers have strongly argued that impairment needs to be considered in fully understanding the experience of disability (Crow, 1996; Thomas, 2007). People with disabilities have their own meanings and experiences of impairment, which are not always positive, neutral, or irrelevant (Crow, 1996). Recognition of the importance of people's experiences of impairment is demonstrated through the inclusion of research that focuses on both the experience of impairment and sociocultural issues in the disability studies liter- ature (e.g., Smith & Sparkes, 2004; Zitzelsberger, 2005). To appreciate why some people with cerebral palsy engage in sport and physical activity, it may be useful to consider their past patterns of involvement. Adopting a life history approach (e.g., Denzin, 1989a) would be useful in revealing such patterns and for highlighting the influence of sport and physical activity on psychosocial development. Although the life history approach was conceived in sociology, we have chosen a psychological perspective for our work, which makes our study similar to the case study research found in counselling psychology and more frequently being used in sport and exercise psychology (e.g., Andersen & Fawkner, 2005). The life history approach and Erikson's (1985) formulation of psychodynamic theory are complementary and promote the construction of rich insights into the meanings and experiences of sport and physical activity in the lives of people with cerebral palsy. This paper represents one study in a broader program of research in which we investigated physical activity in the lives of people with cerebral palsy. Another life history from this research program, more centered on exercise than competitive sport, has recently been published (Gaskin, Andersen, & Morris, 2009). In the present study, we explored the life history of an adult with cerebral palsy who was extensively involved in sport and physical activity in Australia. The aim of the study was to understand the meanings and experiences of sport and physical activity in his life. Method Participant The participant (Ben, not his real name) was a 30-year-old Caucasian man with mild cerebral palsy. Ben was competing in swimming at state and national levels at the time we interviewed him for this research. His typical cerebral palsy gait when he walked was the only noticeable sign that he had the condition. Ben's father and mother were 20 and 18 years old, respectively, when he was born. He has one elder brother (by 18 months). His father was a mechanic, and his mother's time was spent raising her two sons as they were growing up. Design We used Denzin's (1989a, 1989b) approach to conducting life history research to guide the present study. The focus of the study was on Ben's experiences of engaging in, or attempting to engage in, sport and physical activity, as well as his perceptions of other people and events in his life that may have contributed to how he handled and interpreted those experiences. The interviewer The first author, who interviewed Ben, has cerebral palsy, which is noticeable in his fine motor control, gait, and speech patterns. At the time that we conducted this research, the first author was completing a doctorate under the supervision of the second and C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205198
  • 3. third authors. He had been involved with various physical activities throughout his life. Procedures The human research ethics committee of Victoria University gave approval for this study to be conducted. After coming across an internet article about our research, Ben emailed us to ask about being involved in our studies. We welcomed his involvement and the first author conducted one interview with Ben. The interview took place at Ben's place of work outside of normal working hours. Ben chose to participate in the interview at his place of work because he felt comfortable there, and it was a convenient place to conduct the interview, for both Ben and the first author. Ben was interviewed about his participation, or attempted involvement, in sport and physical activity throughout his life. During the interview, Erikson's (1985) formulation of psychodynamic theory guided follow-up questions and probes. Although the starting point for the interview was the meanings and experiences of sport and physical activity, follow-up questions and probes often explored other aspects of Ben's life, which appeared related to his involvement, or lack thereof, in physical activity. The interview lasted approxi- mately 4 h and was audio-tape recorded. We used the transcription of the interview and the first author's field notes and impressions as the data for the analysis. Analysis Using Denzin (1989a) as a guide, Ben's life was woven “into and through the researchers' interpretations of that life” (p. 58). We carefully read the interview transcript and extracted patterns of meaning and experience from the text. We then interpreted these patterns using Erikson's (1985) theory of psychosocial develop- ment. Erikson proposed that there are eight stages of psychosocial development. At each stage, there is a nuclear conflict (critical turning point in psychosocial development), which represents an opportunity for the development of new ego qualities. The psychosocial stages that are relevant to this study are: latency (childhood), puberty and adolescence, young adulthood, and middle adulthood. In the latency stage, children make their entrances into school life and are confronted with the conflict of industry versus inferi- ority (Erikson, 1985). Children begin to receive systematic instruc- tion in the skills and uses of tools that will assist them in becoming productive members of society. The danger in this stage is that children do not develop their skills and competences for using tools and, instead, end up with a sense of inadequacy and inferiority. These feelings may result in children despairing and regressing to a prior stage of psychosocial development. Socially, this stage can be one of the most decisive. Achieving industry involves doing things alongside or in cooperation with others. Competence (belief in one's ability to perform important tasks) is the ego quality that represents successful completion of this psychosocial stage. Puberty and adolescence mark a period where many of the battles of earlier years are re-fought, with often well-meaning parents as adversaries (Erikson, 1985). This stage encapsulates the nuclear conflict of identity versus role confusion. Adolescents readily and strongly identify with their idols and ideals. They protect their identities by forming strong associations with like- minded people, and through the exclusion of others who are “different.” Adolescents who experience role confusion may have minimal direction as to where their lives are heading (e.g., have difficulty in settling on an occupation). Fidelity (the ability to maintain loyal relationships despite differences in value systems) is the ego quality developed from successful resolution of this stage. For young adults, the identities that they developed in the previous stage are ready to be joined with the identities of others (Erikson,1985). The nuclear conflict, in this stage, is intimacy versus isolation. Intimacy requires abandonment of the ego in situations, such as in close affiliations, in sexual unions, in close friendships, in physical combat, in experiencing inspiration from teachers, and in intuition from self. If young adults fear ego loss through engaging in such situations, isolation and self-absorption may develop. The danger, at this stage, is that the avoidance of contacts that involve commitments to intimacy may lead to isolation. Love is the ego quality that represents the successful passing of the nuclear conflict at this psychosocial stage. In middle adulthood, mature people turn their attention towards guidance of the next generation (Erikson, 1985). Although popular thought focuses on the dependence of the younger generation on those who are older, the mature adult also needs guidance and encouragement from younger people. The nuclear conflict at this stage is generativity versus stagnation. Generativity refers to the establishment and guidance of the next generation. Some people have special gifts and apply them to other directions, rather than to their offspring. The danger of this stage is that stagnation occurs. Care for the new generation is the ego quality that comes from the successful negotiation of this stage. Results We do not have access to material from Ben's challenges in the first three stages of psychosocial development (i.e., oral-sensory, muscular-anal, locomotor-genital). Through conversations with his mother in the months prior to the interview, Ben learned that he was an unwelcome addition to the rural town in which he was born. His mother faced the prejudices of being an unmarried teenager who was having her second child; she and Ben received little assistance from relatives. Support was not forthcoming from medical practitioners, either, who advised that Ben should be institutionalized because of his cerebral palsy e a common practice in the 1970s. His parents were not satisfied with the medical practitioner's advice, however, and choose to raise Ben themselves. Ben's ability to tell his own story starts with the latency period and the challenges of industry versus inferiority. His stories from his primary school years demonstrate that he was struggling to achieve in various facets of his life, especially in the school envi- ronment. Ben was the first child with disability to be fully inte- grated into mainstream classrooms in the rural town in which he lived, and he faced a variety of challenges. The teachers were not trained to accommodate a student with a disability, and did not seem to know how to integrate him into the classroom environ- ment. Academically, Ben struggled to succeed, and recalled receiving report cards with a number of failing grades. Socially, his classmates usually avoided him, and he had no male friends. Boys teased him, he believed, because he was different. Despite many of Ben's classmates not associating with him, he did have two close female friends, who played an integral part in his early life. He fondly recalled how they would spend a lot of their free time together, especially during weekends. They also spent their lunchtimes together, when they would sit, talk, and eat their lunch. At school, Ben had limited involvement in physical activity. His first teacher would carry him around because she feared that he might fall and break a bone. When Ben participated in organized physical activity, he had negative experiences. When he was in the swimming pool, for example, Ben used to stand in the water, beside the pool edge, until he became cold and was taken out of the water. He could not swim, and his teachers did not expect him to perform this activity. Ben could not demonstrate competence in such physical activities and, when he tried to perform them, he said he C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205 199
  • 4. felt inferior to his classmates. He avoided attending sports events, because he perceived that his teachers did not want him to participate in such occasions. In the school playground, boys did not include him in the games they played (typically cricket in the summer and rugby union in the winter). Ben was not competent at competing in these sports, and was not aware of any other forms of physical activity he could pursue. The significant adults in Ben's life did not positively rein- force his attempts at physical activity, and he usually avoided any involvement. Ben also had negative experiences with physical activity outside of the school environment. He attended physiotherapy and was prescribed exercises to improve his walking. For Ben, these exer- cises were unpleasant, because they were painful to perform. This experience further discouraged him from performing physical activity. After school, Ben's two female friends tried to get him involved with physical activity. On separate occasions, his friends encour- aged him to ride a bike and roller skate down a hill, all rather unsuccessfully. The attitudes of Ben's friends towards his involve- ment in physical activity, however, challenged his preconceptions that he was unable to be active. Although Ben remained relatively sedentary, this social support from his friends may have been influential in his decisions to attempt physical activity in later life. Ben stated that his teachers' comments on his report cards showed that he was not at ease within the classroom environment. The teachers wrote that he was not applying himself to his work, and was being disruptive in class. Ben reported developing feelings of inferiority at primary school, which were compounded when he was held back a year because of poor academic achievement. These feelings of inferiority seemed to pervade other areas of his life. Ben said he had developed a sense of worthlessness that influenced his interactions with family members. In the evening, for example, Ben stopped contributing to family dinnertime discussions, because he felt he had nothing to add to these conversations. His parents intervened by asking him to think of three topics each night that he was willing to discuss. Unfortu- nately, the consistent message Ben received in his school envi- ronment, that his input was not valued, somewhat overwhelmed his parents' efforts to enhance his confidence in contributing to social situations. Ben's other sources of social activities, with children his own age, were camps and a horse-riding program for children with disabilities. At these activities, Ben felt that he had found kindred spirits. At this stage in his life, he did not know what disability he had, but he knew he had a physical condition, and he identified with other children with disabilities. Ben felt they were like him, and they understood what he was experiencing. When Ben was 11, he and his family moved to another small town, which meant that he attended a new school. This move marked a new beginning for him. Academically, he started to excel, receiving A and B grades in many of his subjects. It was not only Ben's grades that changed. His stories about this time seemed to take on a different quality and sounded reflective of a boy who was more at ease in his environment, and with himself. Ben felt that he was treated more as a person at the new school, and he was relieved that he was “normal,” like his classmates. For the first time, Ben had male friends. Having male friends meant that he was involved in physical activity during playtimes and lunchtimes, instead of sitting and conversing, as he had done with his female friends at his previous school. These newfound levels of competence, however, did not extend to his performance during organized physical activity. In physical education classes, he was required to engage in activities that were beyond his capabilities. For example, he was asked to walk on a balance beam in gymnastics and to run cross-country races. Ben, begrudgingly, was involved in these activities (and, in his eyes, failed), and when it came to swimming, he would revert back to his pattern of avoidance, and sit on the side of the pool. Like his perceptions of his teachers from his first school, Ben felt that his physical education teacher did not like him. Here, he may have been projecting his own negative feelings about his involve- ment in physical activity onto his teacher. From Ben's description, it seems that the teacher appeared to treat Ben in the same way as other children. In doing so, however, he was required to participate in activities where he could not show competence, where he had low self-efficacy for the skills involved, and where his inferiority to his classmates was exposed. Although Erikson's (1985) psychosocial stages are loosely con- nected with age, this association does not imply that individuals naturally progress from one stage to the next upon reaching certain ages or milestones, nor that prior stages are completed when individuals reach the next stage. In Ben's case, the challenges of the latency stage are ones that continued to be prominent in the stories from his adolescence and young adulthood. A deep sense of infe- riority, originating in his early school years, seemed to pervade much of his life. At 16, Ben and his family moved again, which meant that Ben had to adapt to yet another school environment. In social terms, Ben reported regressing back to the days of his first primary school. He had only one friend, a female, with whom he spent most of his time. At this time in Ben's life, he became more aware of televised sport. The sports coverage on television was also different from that shown in other regions where he previously lived (e.g., Australian Rules football received more air time than rugby union). In contrast to his avoidance of sport in the past, Ben started following and enjoying sport. Perhaps more important, however, he seemed to begin to identify with the sport people he saw on television. The sports people were what he was not, but what he possibly wanted to become. They were fit, active, successful, and accepted by society. Ben, however, was physically inactive, disliked how his body looked and moved, and had only a small social network. A year later, Ben and his family moved again, which presented him with one more school to attend. Ben was held back a year, because of curriculum requirements in this different state, and so spent 2 years at this school. Ben regarded these years as the best school experience of his life, because he had the most friends he had ever had. He attributed this change in fortune, with regard to the number of friends he had, to the increased maturity of his classmates, as compared to the students in previous years. For Ben, one aspect of normalcy was participating in sporting activities during breaks between classes. As in his second school, when he had male friends, he was involved in lunchtime sporting activities. Playing sport, then, also presented the opportunity for social connectedness. Ben's identification with sports people grew stronger when, in 1992, he saw the Paralympics, for the first time, on television. This event made him aware that people with disabilities could be involved in sport. Even so, seeing these images did not immediately motivate Ben to engage in competitive sport or demanding physical activity. After Ben had finished high school, he and his family returned to live in the area where he went to his third school, and he started seeking employment. Despite going to a region that had high unemployment, Ben was optimistic about the possibility of getting his first job. He did not disclose that he had a disability in his job applications, but perceived that potential employers discriminated against him when they met him in job interviews and realized that he had a disability. He was frequently asked what was wrong with C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205200
  • 5. him. Ben responded to the repeated rejection of his job applications in two ways: through anger and depression. Anger manifested following his attempts to seek assistance from an employment agency, where he was “enraged” because he was denied help to find work on the grounds that he was insufficiently impaired. The rages that Ben talked about seemed like expressions of frustration with the apparent hopeless circumstances in which he was finding himself, rather than verbal attacks on other people. In the main, however, Ben became depressed through being unable to find work. He questioned why he should have this disability and why he should have to prove himself to society. The rejection by employers seemed to bring to the fore previous rejections by teachers and classmates. Once more, Ben said he felt alone and unwanted. Ben also said he saw his hopes of living independently, like his brother, diminishing, and he faced the undesirable prospect of living with his parents for the rest of his life. In this period of Ben's life, the challenges of the adolescent stage seemed to be overlapping those of the latency period. Ben's feelings of inferiority seemed to have been compounded by his emerging identify as a disabled person who was dependent on others. Ben seemed greatly uncomfortable with this identity, but, faced with the challenges of his social situation, seemed unable to create a different role for himself in society. To gain a sense of normalcy in his life, Ben rekindled his rela- tionship with his female friend from school, and sought refuge with her during most weekends. She emotionally supported him and was someone, other than his parents, with whom he could talk about his difficulties. The emotional support from his parents and friend, however, was not sufficient to compensate for his feelings of inferiority, inability to gain employment, and deepening depres- sion. Such was Ben's despair that he attempted suicide by drinking cleaning fluid e the main effect of which was that it put him to sleep. The liquid appeared to have had minimal consequences for him, apart from him waking up with a sore throat. Ben interpreted his survival as a sign that he was meant to live. He remained depressed after this attempted suicide, but did not have further suicidal attempts or ideations. To improve his vocation skills, Ben completed a bar course, in which his grades were near the top of his class. This extra training, however, did not immediately result in a job. It was not until he was 21, and he and his family moved once more, that he gained employment. Ben's first job was for 3 h per week as a glassier at a lawn bowls club. His job was to pick up drink glasses. Ben said that his desire to prove himself was strong. After the rejections of the past, he was well aware of the perceptions that people typically had in regard to his ability, and he wanted to show people how they were wrong. At this point in Ben's life, his identity seemed to be changing from someone dependent on others to that of a compe- tent worker. Ben divided his life in two temporal phases. That is, pre-23 years of age, and post-23. He referred to the pre-23 phase as psycho- logically damaging, where he believed he erected barriers to his development. These barriers (e.g., difficulties at school, problems finding employment) do not seem as if they were predominantly of his construction. The origins of this turning point (i.e., age 23) probably had roots in his growing awareness of sport during his adolescence. Ben seemed reasonably unaware of these possible connections, however, and was concrete in splitting his life into two phases. As we have described, however, Ben's increasing interest in sport developed at age 16, when he was exposed to a range of different sports on television (e.g., Australian Rules football, rather than rugby union) and intensified at age 19 through watching the Paralympics on television. Four years later, at the age of 23, he said he almost compulsively watched as much of the Olympics and Paralympics from Atlanta as he could. Ben's psychosocial development connected with the adolescent stage of Erikson's (1985) model largely occurred at this time in his life and seemed to be continuing when he was interviewed. He saw sports people (Olympians and Paralympians, in particular) as embodying the ideals that he wanted for himself, and he began to form a strong athletic identity. Following the Paralympics, Ben was interested in finding out all he could about the Games. In essence, he was probably trying to find out how he could participate in sport for people with disabil- ities. For Ben, involvement in physical activity was something he associated with being healthy and normal. It took him 6 months to join the gym, however, because of insecurities about whether a person with cerebral palsy should join the gym, and how other members would react when they saw him exercising. Ben approached the gym methodically, in that he started off with lighter weights and gradually increased the weight he could lift. He also focused on his own progress, rather than on the weights that other people were lifting. Still 23 years old, and training in the gym, Ben decided to learn to swim. The choice of sport in which to participate seemed at odds with his feelings towards, and past experiences with, swimming. Ben said he hated swimming because of bad memories he had from when he was at his first school. When he spoke about swimming, his body image issues were evident. There seemed to be a large incongruence between Ben's amount of physical (body) compe- tence and his internalized ideals regarding well-functioning bodies. Part of the motivation to swim came from a Paralympic swimmer, who had greater physical impairment than Ben. He rationalized that if someone, who was more physically impaired that he was, could swim, then so could he. Learning to swim was confronting for Ben. He was in a class with children, who asked him why he could not swim, or walk, as they did. After six swimming lessons, Ben was able to swim a lap of the 25 m pool unaided. From that point, he was determined to set new benchmarks and to swim further. One of Ben's underlying moti- vations to swim was to change, because he said he did not like who he was. Ben felt that he had erected psychological barriers that prevented him from engaging in new activities (e.g., going to the gym), and he was determined to dismantle such obstacles to his development. Ben felt he gained physically, socially, and psychologically from exercising in the gym and pool. His goals were primarily directed towards getting aerobically fitter and increasing his strength. Ben said he increased his fitness to that of an elite marathon runner, and had dropped his body fat to 5%. This percentage of body fat falls at the lower end of the range of healthy body fat percentages of male national and international level athletes who compete in sports where leanness is desirable (e.g., body building, gymnastics, wrestling; Nieman, 2003). His decisions to be involved with sport (swimming, in particular) seemed to have stemmed from a fixation with childhood traumas (e.g., attempting to swim, social isolation from classmates), rather than his stated (more superficial) goals of becoming physically fitter, more socially connected, and less stressed. Ben's concerns about how other people would perceive his involvement in the gym did not come to fruition. He experienced a socially supportive environment, in which some people openly admired his gym training. He met other gym members and would spend time conversing with them during each workout. The gym and pool became places where he could relieve stress, especially when he experienced difficult days at work. In a short space of time, when Ben was 23 years old, he also met several Olympians and Paralympians who inspired him to keep swimming and to take up the sport competitively. Given his level of identification with these sports people, he did not need much C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205 201
  • 6. encouragement to dedicate more time to swimming. At the pool where Ben swam, an Australian Olympian was also training. Ben spoke with him one day and found out that the Olympian was covering a far greater distance in his training than he was. This conversation inspired Ben to increase the distance that he swam from 50 to 100 laps per day. To be like an Olympian or Paralympian, Ben reasoned that he had to begin training like one. As a member of the Olympic Club for Sydney 2000 (a marketing initiative that aimed to encourage Australians to be involved in the Olympics through providing members with opportunities to attend exclusive lead-up events, meet Olympic athletes, and purchase tickets to events), he took the opportunity to travel to Brisbane to meet another Olympic swimmer. On the train ride to Brisbane, Ben was greatly affected by a chance meeting with a Paralympic soccer player. The reason that this meeting was profound for Ben was that he interpreted it to mean that he was on the right path through life. The experience seemed to be quite spiritual for him. Although Ben described himself as agnostic, he believed there was something or someone who was looking out for him. About 2 months after meeting the Paralympic soccer player, a new manager was appointed to the gym where Ben trained. The new manager was a Paralympic gold medalist in swimming. Meeting this Paralympian was another profound moment for Ben, and further evidence that he was experiencing something extraordinary and seemed to help confirm that he was on the right path. Ben and the Paralympian, however, did not speak with each other for a while. He felt too embarrassed and awed to approach one of his idols. He would sometimes see the Paralympian watching him swim, but nothing was said until he approached Ben. During their conversation, the Paralympian told him that he thought he was talented and should start competing. To receive coaching for his technique, Ben joined a swim squad. His inclusion in this squad, however, presented him with a further concern. He knew that the other swimmers were children, and he was uncertain as to how they would react to him being in the squad. Given that he had difficulties making friends with children when he was a child, he was unsure whether the children would accept him. His concerns, however, were not realized. The children in the squad were enthusiastically supportive of his inclusion; they welcomed him into the team and were friendly towards him. Ben initially did not want to swim competitively, but exactly 6 months after joining the squad he went to Sydney to get his disability classified, so that he could compete. The trip to Sydney gave Ben an opportunity to see the Olympic Village and Olympic Park. More important, however, was that he was able to attend the Australian National Athletics (track and field) Championships. It was at this competition where Ben first saw live events that included athletes with disabilities. He experienced both anger and relief when seeing these athletes. The anger was directed towards himself for building so many psychological barriers that restricted his development, as well as towards others (e.g., school teachers) for not advising him about ways in which he could ach- ieve through sport. Ben seemed to be relieved that he had discov- ered how he could participate in sport for people with disabilities and that he had made it this far. From the age of 23, Ben experienced positive development in many facets of his life. Not only was Ben demonstrating compe- tence in the gym and pool, he also took opportunities to extend his hours of work at a lawn bowls club, and to learn other operational aspects of the organization (e.g., bar work, cellar duties, managing staff). Earning his own money meant that he had the resources to leave home and live independently of his parents. He now could fulfill his wish of independence that he had had since finishing school. At this stage of his life, Ben said he had everything he wanted. He had a place of his own, a job, and a full life with his gym training and swimming. Two years later, however, the relationships between staff and management at the lawn bowls club became strained. Management reacted by changing the hours that staff worked, and Ben's hours were halved. Another of his profound moments occurred at his first swim- ming competition in March 2000, which was at the new Olympic pool in Sydney. For Ben, being at the Olympic pool and seeing his name on the main scoreboard was a huge moment. He may have been overawed and stressed by the personal significance of the occasion, and he was disqualified from his first race for not touching the wall when he was performing the tumble turns. He sorted out his technique, and went on to win his next four races. After he had finished racing, he rang his parents to tell them of his achievements. Apart from the competence that Ben demonstrated through swimming, he benefited from the friendliness that other swim- mers, officials, and supporters showed towards him at the swim- ming competition, and from seeing the confidence that other swimmers with disabilities exuded. Ben felt at ease around other people with disabilities, which was reminiscent of how he felt when he participated, as a child, in a horse-riding program for people with disabilities. Being a person with a disability seemed to be an important part of his identity. In contrast to the rather limited view of what people with disabilities can achieve that various people in authority (e.g., potential employers, teachers) seemed to have projected onto him, Ben was coming into contact with many successful people with disabilities who were acting as positive role models for him. He identified strongly with these people. Ben received his first trophy at his swimming club's annual awards evening. This moment held substantial meaning for him. He had recently won four competitive races, but up to this point in his life, he had never won a trophy for his involvement in sport. Ben received a small trophy from his coach, which was for the swimmer who had put in the most effort for the year. Winning this trophy caused him to reflect on how, at his first school, the teacher had handed out awards for those students who had swum specific distances (e.g., 50 m, 100 m, 200 m). Ben did not receive a certifi- cate, because he could not swim. This trophy represented public recognition that he had displayed competence in a physical activity setting, and had accomplished something other people did not think him capable of doing. At 27 years of age, Ben had become frustrated with his job. He was not getting opportunities to perform other roles, which was restricting his development. Finally, Ben quit his job, which was a relief for him. The day after Ben quit his job, he received a letter from the Sydney Olympic Games Organising Committee inviting him to work in the Athlete's Village at the Sydney 2000 Olympics. This invitation was a dream come true for Ben, and it provided him with the opportunity to be around the athletes with whom he identified so deeply. He regarded receiving this invitation as another profound, and almost spiritual, moment, in that he believed someone was looking out for him. Going to Sydney for the Games was also a decisive stage in Ben's life for another reason. He had decided to continue to live in Sydney following the Games. To him, this move represented the biggest risk he had taken in his life. Ben had 10 weeks of work guaranteed, during the Games, and was determined to find a job after the Games had concluded. Ben was extremely proud of his involvement in the Games. His description of his journey to the Games seemed to resonate with an account that an Olympic or Paralympic athlete might give. These times were extremely emotional for Ben, because he began to realize how much he had achieved in his life and that his efforts were worthwhile. C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205202
  • 7. Two weeks after the Olympics had concluded, Ben was back at the Olympic Village for the Paralympics. He became angry, however, when he was told that he only had five shifts during these Games. Ben's name, however, was put on a list of workers who could cover shifts if other people could not work, and he ended up working the entirety of the Games. His anger, at originally being given a small number of shifts, manifested because he was being prevented from attending the Games for the sports people with whom he strongly identified. Ben felt that these were his Games, and he was determined to be a part of them. Ben benefited from his identification with Paralympic athletes with regard to the support the Paralympics received from the Australian public. Many people, who did not go to a large number of Olympic events, because of the cost of tickets, went to the Para- lympics to watch sport at the elite level. The Australian public's support and acceptance of Paralympic sport seemed to translate as approval of Ben and his swimming. He, vicariously through the Paralympians, possibly received some of the acceptance from people outside of his family that he had been looking for as a child and adolescent. With the Olympics and Paralympics over, he set about finding a new job. Ben was unemployed for about a year when an employment agency, which specialized in finding jobs for people with disabilities, found him a job performing a variety of admin- istrative tasks within a large organization. His days were occupied with full-time work and training, either in the gym or pool. Through gaining employment, he continued to see himself as a person with ability, rather than a person with a disability. At the time of the interview, his manager was also encouraging him to undertake study at university to increase his skills and to gain the knowledge to perform a greater number of roles in the future. In this job, Ben seemed to have broadened his identity from a prime focus on sport and disability to viewing himself as a person who also had a career. Ben's swimming developed strongly, and at the time he was interviewed he had won many state titles and had swum times that placed him within the top 50 in the world (taking his disability classification into account). Although he was achieving at a high level through sport, his successes did not seem to bring a lasting sense of competence. In Ben's life post-23, there was a distinctive pattern of setting goals, achievement, elation with his display of competence, recognition of the ever-present feelings of inferiority, and setting more demanding goals. This pattern was most evident in his sport participation. Ben was severely critical of himself for not achieving more in his sporting career. Although he identified many social barriers to sporting participation throughout his life (e.g., children when he was at school, teachers), Ben seemed to blame himself more than the social contexts in which he developed for his perceived underachievement. At the time of the interview, partic- ipation in the next Paralympics was his major goal. Following his long-standing pattern, however, it is doubtful that even performing at international level would allay his feelings of inferiority. The year before the interview, he went back to the area in which he first lived for a swimming competition. He said he had some unfinished business with his first school, and wished to swim in the area once in his life. Ben wanted to demonstrate his competence to those people who had made him feel inferior. Although the people who contributed to his sense of inferiority as a child probably were not at the competition, swimming in the area and medalling in races was enough for him. While in the area, Ben also went and visited his first school. Being at this school again was emotional for him; he had a deep resentment of the staff and students who were at the school when he was young. Ben described how he stood at the pool's edge and screamed, “You didn't think I had the ability, and now I've done it, despite what you thought.” The pool was significant as a place where Ben could not display competence when he was a child. He had received little tangible support and encouragement from the teachers, who were supposedly there to guide his development. Yet, as a young adult, Ben demonstrated his competence at swimming in emphatic fashion, by winning numerous medals at state championships. On that day, the pool represented those people who had restricted his development and expressed doubt over his potential to achieve. Ben seemed to be indirectly confronting his first teachers. More broadly, his release of frustration also seemed to be directed at the doctors and extended family members who had negatively appraised his future when he was young. During the interview, Ben's interest in the politics of disability came through. His dissatisfaction with some elements of govern- ment policy, with reference to people with disabilities, was obvious. He had strong views on the unfairness he perceived there to be in some policies, such as employment and funding of Paralympic athletes. Ben's interest in advocating for disability issues seems to have its origins in helping himself through assisting others. Through his involvement in swimming, Ben met many children and young people with disabilities. He did not want to see these people exposed to the same injustices that he had experienced while growing up. By advocating for others, especially young people, Ben appeared to be helping himself mend his own past. He perceived that there was a potential role for him in advocating for people with disabilities, but he wished to obtain a university degree first. As with the adolescent stage of Erikson's (1985) model, the young adult stage of psychosocial development (with the conflict of intimacy versus isolation) seemed also to have been delayed. As an adult, Ben appeared to be displaying behaviors that were more consistent with the latency and adolescent stages of psychosocial development. At a chronological age when Erikson suggested individuals typically form close bonds with others (e.g., friends, romantic partners, work colleagues), he seemed to be avoiding such involvements. He seemed consumed with his sporting endeavors, which were important in his identity formation. Ben's most intimate relationship was with his mother, rather than with friends, romantic partners, or workmates. A significant reason for the lack of a romantic relationship was his avoidance of intimacy for fear of getting hurt. This fear had been present in previous attempts at engaging with others (e.g., joining the gym). Ben was aware of how this fear prevented him from becoming close to others. Erikson warned that the avoidance of intimate relationships could result in isolation and self-absorption. During the interview, Ben spoke about being obsessed with himself and considered himself a loner. Ben's mother was the only person with whom he had a long-term intimate relationship. She appeared to be the first, and sometimes only, person he would call to share his joys and sorrows (e.g., winning events at his first swimming competition). Although Ben mentioned the names of friends at times, there seemed to be no longevity and regularity in communication with these people. His self-absorption was clearly reflected in the stories he told and in the scheduling of his time. Swimming and work were central parts of his life. There was, however, a glimmer of hope in Ben's stories. He was aware of how he closed himself off to other people, and wished to become more open in his relationships with them. There was a sense that Ben may achieve greater levels of intimacy with others in the years to come. Ben also seemed to be preparing himself for the psychosocial stage of middle adulthood, in which attention is turned to the establishment and guidance of the next generation. Through his focus on helping others with disabilities (through advocacy and speaking with young people who have disabilities), Ben seemed to be avoiding or bypassing the challenges of the psychosocial stage of young adulthood (intimacy versus isolation). C.J. Gaskin et al. / Psychology of Sport and Exercise 11 (2010) 197e205 203
  • 8. Discussion In the stories that Ben told, there is strong evidence that sport and physical activity can promote psychosocial development in a person with mild cerebral palsy. Through his involvement in sport and physical activity as an adult, Ben seemed to be addressing the challenges of the Eriksonian stages of latency and adolescence. Ben's early struggles to show competence alongside able-bodied people and his reactions to these experiences are reflective of the issues discussed in psychotherapy with people who have cerebral palsy, such as anger (Blotzer, 1995), depression (Feuerstein, 1995; Lantican et al., 1994), and suicide attempts (Jureidini, 1988). In contrast to many of his experiences throughout his early life (pre-23 years), in which he struggled to show competence, swim- ming was a task at which Ben could show industry. For Ben, sport and physical activity was a way in which he could meet some of the challenges of the latency period. Ben used sport and physical activity to meet the challenges of the adolescent stage of psychosocial development. His develop- ment in this stage seemed to begin in his late teenage years and may have been still progressing when he was interviewed. He used sport and physical activity to improve his body image and he installed sports people as his idols. His use of physical activity as a way to improve his body image is reminiscent of one of the outcomes of a brief swimming program for a 14-year-old girl with a disability (Peganoff, 1984). In both cases, self-esteem seems to have increased through improving physical function. The findings from our research and Peganoff's case study provide strong support for arguments that impairment needs to be included when devel- oping understandings of the experience of disability (Crow, 1996; Thomas, 2007). Sport and physical activity may not be the panacea to the challenges of living with a disability that Ben may have imagined. His extensive involvement in sport and physical activity, along with working regular hours, meant that the time he had available to cultivate strong relationships was limited. Although it can be difficult for people with cerebral palsy to develop intimate rela- tionships (especially romantic ones; Joseph, 1991), Ben seemed to be largely avoiding being close to others. His deep sense of inferi- ority saw him become self-absorbed in the hope of addressing these feelings. Involvement in sport and physical activity, then, was a way he could avoid attempting some of the challenges of the young adult psychosocial stage. Using Ben's life history, we have shown that not only do social forces magnify the psychosocial challenges for people with disabilities, their internalization of others' prejudices about people with disabilities may also limit their development. This finding is consistent with Thomas's (1999) concept of psycho-emotional disabilism. Ben was aware that the perceptions he had of himself, especially during adolescence and early adulthood, had restricted his development. Although Ben's past experiences seemed to be still limiting his psychosocial growth, our impression was that he tended to blame himself too much for not having achieved more in life and too readily discounted the influence of the environments in which he was raised. When working with people who have disabilities, sport and exercise psychologists need to appreciate that sometimes their clients may have distorted perceptions of the extent to which the environment has shaped their lives. After reflecting on Ben's life, we feel slightly ambivalent about his involvement in sport and physical activity. Swimming and gym training seem to have resulted in many positive changes, such as delayed onset of functional decline, improved ways of handling stress, greater fitness, improved body image, increased competence and self-esteem, and more social connections. The extent of Ben's physical activity participation, however, meant that he remained isolated and did not form intimate relationships, because he perceived himself as too busy with swimming. His sport and physical activity had a dependency quality. His fitness was never enough; his accomplishments through his sport were never enough. Paradoxically, sport and physical activity have helped Ben grow and prosper, and at the same time they seem to have helped arrest his development and keep him stuck in isolation and perpetual longing for an elusive happiness with himself. One issue that was dominant during the interview was the influence of sport and physical activity in shaping Ben's identity. In many Western societies, such as Australia, sport has a dominant role in defining hegemonic forms of masculinity in the mass culture (Burgess, Edwards, & Skinner, 2003; Connell & Messerschmidt, 2005; Light & Kirk, 2000). The sporting images that Ben viewed on television were greatly influential in his development. Based on this finding, sociological investigations into the influence of sport and physical activity on the construction of the gender identities of males with milder forms of cerebral palsy appear warranted. Another area for research that emanates from this study is the potential influence of positive physical activity experiences on the psychosocial development of children and adolescents with cere- bral palsy. Since Ben was born, there has been a sizable growth in opportunities for people with disabilities to be involved in sport and physical activity (DePauw & Gavron, 2005). Such activities may be of immense value in promoting the psychosocial development of children and adolescents with cerebral palsy. We speculate that the effect of the interviewer (the first author) having the same disability as Ben, and also being male, was positive in eliciting rich material. 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