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Inner Strength in Rehabilitation Care

In today’s post, Hielke Bosma explores the role of inner strength in rehabilitation care. Hielke is a spiritual care professional and academic researcher affiliated with the Amsterdam Rehabilitation Research Center  and the University of Humanistic Studies in the Netherlands, whose research focuses on spiritual exercises and chronic pain.

Hielke Bosma


The idea for my research on inner strength began in a rehabilitation centre. I remember two young men of roughly the same age. One was a student; the other worked in construction. Both had sustained a spinal cord injury in an accident and faced the prospect of never walking again. 

Their responses could hardly have been more different. The construction worker felt that his life was over. He believed he could no longer do anything. The student responded: “I was studying before the accident, and now I am studying again. I don’t see the problem.” 

Neither wanted to join a discussion group. For one, talking seemed pointless: it would not change anything. For the other, there was no problem to discuss. Yet both became interested when we began speaking about inner strength—about what makes someone a strong or powerful person. They recognised that such strength might be needed when life becomes difficult. 

This conversation led to the idea of a “gym for the mind.” In a physical gym, we train physical strength through exercise. Good physical training requires a solid foundation, balance, and posture. Could inner strength be developed in a comparable way? This question took me on a journey through different traditions of spiritual exercise: ancient monasteries, Shaolin practice, and spiritual traditions from around the world. My first point of entry was ancient Greek philosophy, especially the work of Pierre Hadot. Hadot showed that ancient philosophy was not merely a collection of theories. It was also a way of life, shaped by exercises that transformed attention, judgment, and conduct. 

Hadot identified two broad movements within these exercises: concentration and expansion. Concentration gathers attention and brings us back to the present. Expansion widens our perspective and places our lives within a larger whole.

In my research, I describe these movements as inner balance and inner posture. Inner balance concerns the work of finding one’s centre when fear, grief, confusion, or uncertainty threaten to overwhelm us. Attention to breathing, bodily awareness, and the present moment may help create this foundation. The goal is not to suppress emotion or pretend that everything is fine. It is to develop enough steadiness to respond rather than simply be swept away. 

Inner posture concerns how we stand inwardly in relation to a changed life. Injury and illness can alter the body, work, relationships, independence, identity, and expectations for the future. Inner posture names the effort to find a viable relation to these changes. It includes questions of meaning, belonging, vulnerability, and hope. It is not the same as forced positivity, and it cannot simply be imposed by caregivers. 

The question that emerged in that rehabilitation centre remains with me: can inner strength be trained? Perhaps not in exactly the same way as a muscle. But through repeated practices of attention, judgment, and perspective, we may become better able to find our centre—and to stand within a changed world.
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