Physical activity and fantasies in the life of an adult with cerebral palsy: the motivator, looking for love

Many people with cerebral palsy experience personal and social barriers to engaging in physical activity that may lead to sedentary living. To understand why such inactivity may occur, we examined the meanings and experiences of physical activity in the life of an adult with cerebral palsy (David, aged 27). In this case study, we interviewed David about his life and analysed his stories using psychodynamic theory. Walking was the main physical activity he was interested in performing throughout his life. He received encouragement for his attempts at walking in his childhood. At 12, however, he lost the ability to walk following the surgical lengthening of his hamstrings. David never regained the ability to walk independently, and developed rich compensatory fantasies about how wonderful life would be if he could walk. On rare occasions when David was assisted in performing physical activity, he was able to show some competence and to develop self-esteem from these experiences. Often in his life he was emotionally and physically abandoned by significant others (e.g. his father). His limited physical competence, especially walking, reflected problems in other areas (e.g. education, relationships). As a young adult, David's motivation to perform physical activity was intimately connected to his hope that he would walk again, which was, in turn, associated with fantasies of being a desirable romantic partner, and a motivator for others. David appeared to have internalised the view that sexuality is tied to normative function. For David, it seems that not engaging in physical activity, either by choice or exclusion, was associated with difficulties in psychosocial development.