Type “A” Behavior and Polio Survivors
When polio survivors first came to us more than 35 years ago, we discovered that polio had had a profound effect on learning and earning. The subjects in our first post-polio research study made clear that polio survivors were very unusual. The subjects used power wheelchairs and had, not just bachelors, but also graduate degrees. It became apparent that polio survivors were unique, not only among individuals who had disabilities of equal severity, but also among non-disabled peers. Polio survivors had risen to high levels in their professions. More than the expected percentages of polio survivors are corporate executives, members of both houses of Congress and professionals of all types -- teachers, lawyers, doctors and nurses. This level of achievement points out a startling fact: Polio survivors, who were told that they would never go to college or even get a job, became America's “best and brightest.”
Polio survivors apparently shared a personality type that first had been described in those who developed heart disease: The hard-driving, time-conscious, competitive, self-denying, perfectionist, overachieving “Type A” personality. We weren’t surprised when our 1985 National Post-Polio Survey found that polio survivors reported 50% more Type A behavior than people without disabilities, even more than in those who'd had heart attacks. We also discovered that the more Type A behavior polio survivors reported, the more new fatigue and muscle pain they had.
The polio experience provided the ideal environment for becoming Type A. Lack of social support, low self-esteem, loss of control and fear of punishment have been found to teach Type A behavior. Our 1995 International Post-Polio Survey found that polio survivors reported 34% more physical abuse and 94% more emotional abuse than in those without disabilities.
The Survey included a questionnaire measuring sensitivity to criticism and failure that found polio survivors were 15% more sensitive to the criticism of others and thinking of themselves as failures than were non-disabled respondents. Not surprisingly, the more abuse polio survivors experienced the more sensitive they were to criticism and failure and the more Type A they had become. So, polio survivors became Type A to prevent criticism and abuse by others and to protect against feelings of failure. That’s why so many survivors discarded in childhood any evidence of polio – crutches, canes, braces, wheelchairs – and refuse to accept them now when they develop PPS. Polio survivors want to both act and appear “normal.”
Our 1995 Survey also found that protecting against criticism and failure was more important than polio survivors own emotional or physical well-being. Nearly three-quarters answered "yes" to the question "I often do what others expect, regardless of how I feel emotionally or physically." Said one of our Post-Polio Institute patients, "Polio survivors aren't just Type A, we're Type ‘E: We do everything for everybody every minute of every day!" For most polio survivors, it is more important appear "normal" and take care of others than it is to physically or emotionally care for themselves. Unfortunately, the ultimate price polio survivors have paid for being Type A -- and “Type E” -- is PostPolio Sequelae.
The sad paradox is that, in spite of survivors cheating death by polio, conquering disability and dealing with years of severe physical and emotional abuse and pain to become “the best and the brightest,” many polio survivors believe that they have no ability to survive PPS. This paradox is why psychotherapy for polio survivors is so important: To help them deal with the terrible things that have happened in the past, to stop them from expecting more abuse and to help them accept that they are competent adults whose emotional and physical future is in their own hands.
It is exactly because of everything polio survivors have already experienced that they will survive in spite of PPS. To do this, polio survivors need to read these words again and again and take in the full depth and breadth of their meaning:
“I am a polio SURVIVOR !”
If polio survivors can acknowledge the truth to their suffering they have survived, there is no question that they can cope with the past and make the physical and emotional changes necessary to survive and thrive with PPS.