The Cocoon Syndrome: A Coping Mechanism of Spinal Cord Injured Persons

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Institutionalized spinal cord injured persons have been noted frequently to spend their bed rest and sleep time with their head covered with bed linens or pillows. A study was conducted to determine the prevalence of this head covering behavior among this disability group and to ascertain the etiology of the behavior. Comparison groups of spinal cord injured and non-spinal cord injured patients at two rehabilitation facilities were periodically observed during sleep and bed rest times for evidence of the behavior. Following the observation periods, the patients who manifested the behavior were interviewed to determine causal factors. The results clearly established a marked prevalence of the behavior in the spinal cord injured population compared to other physical disability types. Interview data suggest that the head covering behavior fulfills a variety of functions related to the coping process, but the reason for its prevalence in the spinal cord injured population remains uncertain.

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