Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

The Last Minute Bail Out

As they proceed toward settlement, an injured worker, at the very last moment, suddenly asks for another opinion, a change of providers or some other obstacle toward closure. Why do they consistently do this, and can it be predicted?_

I am tempted to reply with _what else are they supposed to do?_ What I mean is that very often these individuals have nothing to do once their _case_ settles. They know that the money will not last, and they have established no future plans. After 1-3 years of living as a workers_ comp patient, they have little other meaning or direction to their lives.

As anyone approaches a goal, the closer you get, the more anxiety you experience. This is why people fail to show for their own weddings, or why they back out of closing on the purchase of a home.

Closure implies a commitment and acceptance of its long term implications. Closure is frightening for some individuals.

Yes, it can, indeed, be predicted. An examination of the patient_s concept of future goal and direction is what is needed. While for you, closure seems logical and appropriate, the patient may perceive it as an empty conclusion, one without a future. Patients are able to verbalize this. Unless someone assists them in determining not only what to do with their money but what would constitute a viable future path, they are likely to balk as settlement approaches.

At the end, patients realize that they are quite alone, all accounts are financially settled but not emotionally resolved. Many patients need brief assistance with an emotional resolution as things come to a financial ending.

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