Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

The Exceptional Patient

Atypical Patient Needs Some would argue that the patient who wants to return to work is the exception. However, the true exception is the highly educated, managerial-executive patient who is unprepared for the nature of the workers-compensation system. Such individuals are not familiar with a health care system in which they have so little input, …

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The Enmeshed Family

Enmeshed Family Creation A distorted perception of the world, society, responsibility and goals can be created and maintained by a family. With injured or ill individuals, the enmeshed family can readily become a subculture which encourages the patient to perceive that he/she is incapable of any productive return to work. The family can encourage the …

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Precious Time Lost

Time Lost: The elimination of all physical causes for a complaint and only then considering the psychological causes is referred to as diagnosis-by-exclusion. We are taught diagnosis-by-inclusion, to examine psychological causation with the same vigor as physical diagnosis, but we rarely do so. If a patient has complaints that are not readily verified, there are …

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Self Medication

It is extremely important to determine to what degree a patient’s self medication and complicates his/her own recovery process In the acute (short term) treatment of pain, aggressive pain management can prevent the patient from developing fear and hopelessness regarding the future and his/her capacity to deal with painful residuals. However, many patients will attempt …

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Clinical versus Administrative Decisions

Clinical Decisions: There are injured workers who appear to languish in care moving from orthopedic care to pain management to psychological care with no end in sight. The concern is whether we are serving these patients when we tie these significant problems to an injury. The problem can arrise when the clinical problem has been …

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satisfaction

Satisfaction

Satisfaction for patient and provider: A survey in 2013 reported that: “An alarming 70% of those surveyed in a recent …
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checkers

Checkers

Checkers vs. Chess: “It may be difficult to trace the origins of healthcare becoming a competitive sport where doctors …
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partial

Partial Malingering

A patient can have a valid disorder yet still be malingering (falsifying complaints for purposes of tangible gain). Malingering …
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