This has translated into a psychotherapy style bent on encouraging ill and disabled male clients to get back into the game. When 77-year-old Bill suffered a major stroke, severely weakening the entire right side of his body, he was an inconsolable lump, lying motionlessly in his hospital bed. He'd been a vital, powerful man throughout his adulthood, but now he was in shock about having to depend on others for such needs as grooming, dressing, and toileting. I told him I knew he felt devastated, but he must rise up and get moving. I said that sitting on life's sidelines is enervating, in and of itself. Disability is only compounded, I argued, when men avoid trying to resume cherished activities for fear of humiliating themselves through facing what they can no longer do. Playing a diminished role, in contrast, is psychologically better than having no role at all. Swing the bat, I said. Take the shot. Find out what contribution you can still make.

Bill gazed up at me with an incredulous look. He told me he was afraid there wasn't any game left. He said he didn't believe he could play any role that related to the person he'd been. His three daughters voiced support for his viewpoint, carefully explaining to me that it was better now for their father to sit out than to flounder.

When I returned to his room the next day, I found him still staring at the ceiling. His daughters still sat silently around his bed as if on some deathwatch. I started off talking gently to him about seeing the scope of his life as its own well-worn playing-field, upon which he could still hustle and strive, regardless of the deterioration of his skills. I described for him the hoary picture of the 70-year-old basketball player, broken down but proud. I talked about stroke-hobbled men I've known who struggled to get back on their feet. I worked myself into the fervor of a fourth-quarter pep talk, imploring him to have hope, grasp purpose, and take action. To the daughters, I urged a different approach—creating the means by which their father could still be an active, if limited, player.

Bill looked at me blankly as if I were daft; the daughters looked away. I left the room unsure of the impact of my visit. Later that day, though, I wandered into the physical therapy gym and saw him standing in the parallel bars with the help of three physical therapists. He was shaky but upright, with severe strain on his face. When he eyed me across the room, he at first glanced away in embarrassment, but then he looked back steadily with a grin that showed pride and a bit of defiance. It wasn't the time or place for me to go slap him on the back. I bowed my head toward him to convey my sincere respect.

Barry J. Jacobs, Psy.D., is the director of behavioral sciences for the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania, and the author of The Emotional Survival Guide for Caregivers. Contact: barryjjacobs@ gmail.com. Tell us what you think about this article by e-mail at letters@psychnet worker.org, or at www.psychotherapynet worker.org. Log in and you'll find the comment section on every page of the online Magazine section.

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reitz.randall@gmail.com  - Great article   |Registered |2010-06-02 01:18:16 Barry, What a great personal/professional narrative. As a father of a "High School Musical" loving 6 year-old, I've learned the need to "getcha head in the game." I also use sports metaphors with clients frequently. As just about every sports movie ever produced extols the virtues of suspended disbelief, I find them very effective at helping clients take a difficult next step. Also, as my residents will tell you, no patient gets out of my exam room without some sort of exercise prescription. Granted, sports and exercise bring different values, but both lead to many improved outcomes. Randall

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