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SCI, Scuba Diving and the Art of Cognitive Restructuring

Guest blog post by Bob Vogel

In my pre-SCI (spinal cord injury) days I competed on the professional freestyle snow skiing circuit. Vying for the upper echelon of the sport, I soon discovered the difference between top athletes is as much mental as it is physical. I also had a few hurdles to overcome, not the least of which was that I would be overcome with severe anxiety before the start of a competitive run. I worked with a sports psychologist, and one of the tools she taught to help me overcome this was cognitive restructuring, a technique in which you change negative self talk and turn it into positive self-talk. A technique that worked! After much practice, I was able to convince myself the more nervous I was, the better I would ski. I welcomed the nerves – the tougher the competition, the better I skied.

When I broke my back and was going through SCI rehab, I discovered cognitive restructuring could be a very helpful tool in dealing with the daily routine and rigors required to maintain a healthy body with SCI.

During the acute phase of my SCI, I got hit with a pulmonary embolism (blood clot in the lung). As part of the therapy for the embolism, I had to operate a device that consisted of inhaling through my mouth to keep a little ball raised in a tube as long as I could—long deep breaths—five times every hour, which the time seemed like torture. Even tougher, twice a day the respiratory therapist came in with a torturous machine that with each breath, by mouth, would force saline-misty air into my lungs as I inhaled.  The forced salty air had a horrible taste and would cause me to almost puke. I dreaded every treatment.  However, I also understood the treatments were vital to helping me open and strengthen my lungs to prevent pneumonia.

As awful as the breathing machine felt—there was also something vaguely familiar about it.  Then I figured out the connection—the saline mist was coming from the machine had a similar taste as ocean water, a taste I often encountered when I was scuba diving – a sport I loved!  I used this connection to cognitively restructure my thoughts about the breathing treatments.  Each time I struggled to keep the ball raised on my breathing device I would imagine I was floating on the surface of the water looking down through my dive mask and taking a deep breath on my snorkel before descending as deep as my breath would allow.  During the forced air treatments, I would close my eyes and imagine I was diving in crystal clear water near a colorful coral reef.  Using cognitive restructuring, the previously unbearable treatments became pleasant daydreams.

Transferring from the acute SCI bed to the rehab ward and trying to learn the endless list of daily tasks from when to empty the bladder, how much liquid to take in, bowel training, weight shifts, skin checks, and on and on, with no physical sensation to remind us was daunting to say the least.

I remember having a similar, overwhelming feeling during my first scuba classes thinking of all the things a diver needs to monitor during a dive – depth, amount of air pressure in the tank, length of the dive, decompression status, navigation, buoyancy control, planning a slow controlled ascent and safety stop – seemed just as daunting and there is no physical sensation to help out.  Yet with time and practice it became second nature.  An accomplished diver consistently checks these systems in a relaxed manner and it becomes a source of pride.

Once again, I turned to cognitive restructuring. In rehab, I decided learning how to keep track of the way my body works and learning to manage and monitor all of the systems I could no longer feel, including weight shifts and skin checks would become akin to checking systems in scuba diving.  I worked hard in rehab and got the basics down.  I’ve also found that learning how to keep a body with SCI healthy is a lifelong, ongoing process.  I’m fortunate to have many friends with SCI and we often trade “SCI health and maintenance” ideas. For the friends I roll with, monitoring and taking control of the unique ways our bodies work with SCI is second nature.  We trade stories about keeping ourselves healthy, and dodging (or getting hit with) skin, bladder or shoulder problems the way divers talk about their scuba expeditions.

My cognitive restructuring comparing scuba diving to life with SCI extends to my equipment as well. I take as much pride in my chair and cushion as I do in my scuba gear.  I keep my chair clean and in perfect condition.  Same goes for my ROHO® QUADTRO SELECT® Cushion. As I’ve mentioned in previous blogs, I wash and change my cushion cover every few days and every week or two I take my cushion into the tub and wash it with bath soap and give it a good rinse to make sure my equipment doesn’t acquire odors that I may not be aware of.  For more information on cushion cleaning, see Resources.

 As I’ve also mentioned in previous blogs, people do notice when you take pride in your health and your equipment. The woman I married said one of the things she noticed about me when we first started dating was that I kept my chair clean. She also noticed that I did weight shifts—granted she was a nurse.  To her, taking care of my body and my equipment is a sign of self-confidence and comfort with my disability. She found this attractive!

Stay healthy, my friends!


Cleaning and Disinfecting ROHO DRY FLOATATION Products

How to Keep Your Equipment Clean


Bob VogelBob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog. The views and opinions expressed in this blog post are those of Bob Vogel and do not necessarily reflect the views of The ROHO Group. You can contact Bob Vogel by email at

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