Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

The Drama of Being on Stage

Some patients behave as though their injuries are some form of melodrama_as though they are performing_ This seems to be a contradiction, either they hurt or are suffering or they are not and are enjoying their role.

Histrionic individuals can be injured. Injured individuals may become histrionic. The dramatics, theatrics, rapidly shifting and shallow moods, the need to be the center of attention, the continual use of complaints to draw attention to themselves, and exaggerated emotionality can become a hallmark of post-injury behavior.

These individuals derive secondary gain in the form of attention, affection, special considerations in their family/social group and are financially remunerated for their complaints.

From a clinical perspective, they can also be quite suggestible, and respond in the affirmative when asked about even obscure/unlikely symptoms.

They are frequently provocative if not outright seductive in behavior which would seemingly be in contrast to someone suffering.

Rather than attempting to be courageous, stoic and strong, they dramatically emphasize their symptoms with grimaces, groans and outcries of pain and discomfort.

Rather than being annoyed with such patients, whose behavior admittedly can be grating, it is important to identify them, their sources of secondary gain and whether they can (and how to) redirect the melodrama of their injury into a more appropriate _courage to recover._

Thus, if their goal is to be the center of attention, psychological care would ideally have that attention derived from their strength in the recovery process.

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