Be assertive, not aggressive
when managing SCI care

Managing your care can be an overwhelming situation, especially for a young person who doesn’t have the experience of being in charge. You have to have the ability to tell others what to do, manage different personalities, and balance the line between friend and worker.

When I was in rehabilitation they provided classes for us on different topics related to my spinal cord injury, including care management, which really helped me once I left. The main thing I learned was to be assertive when it comes to my care because nobody knows what I want or need more than me. If I have to live my life with paralysis I need to make sure I stay healthy. But when directing your care, you should make sure to do it in a respectful way. It’s a thin line between being aggressive and being assertive.

Aggressive behavior is standing up for your own rights, but in doing so, other people’s rights are violated. When you are being aggressive toward someone you’re disrespecting them, putting them down, and in some cases hurting their feelings. Examples of being aggressive are:

• Not greeting the worker
• Barking out orders
• Not taking responsibility for your own behavior
• Use “you” statements
• Not thanking him/her for their work
• Having your arms crossed

Assertive behavior is standing up for your own rights, without violating other people’s rights. When you are being assertive you express your thoughts or feelings in an honest, straight-forward way. You’re in control of your emotions and being conscious of their feelings. There are many verbal and non-verbal ways of being assertive. The verbal ways include:

• Show respect and empathy
• Be brief and direct
• Take responsibility for your own behavior
• Use “I” statements
• Listen and reflect back what you hear them say
• Suggest alternatives, not solutions

The non-verbal ways of being assertive include:

• Show that you are confident
• Calm appearance, good posture
• Uncrossed arms
• Make eye contact
• Facial expressions
• Body language

Sometimes situations may occur when being assertive doesn’t work, but that doesn’t mean you should become aggressive and defensive. When all else fails you should take a “time-out” and understand that you both need time to think about the situation. Plan a time to talk so that cooler heads may prevail. When you do talk, acknowledge the other person’s feelings and the importance of the situation.

There is no exact science to managing your care; it takes experience and an understanding of what your needs are. Be assertive when it comes to your health care needs but don’t take advantage of others while doing so.