Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Patient Hostility and Delivery of Care

The involvement of the husband or wife in an injury is quite a burden. One must go through a spouse in order to deal with the claimant, and the spouse most often is unreasonable, demanding and belligerent.

This conflict is caused by one of three things (which vary among cases):

There are cultural differences, and some societies which are re-created in America bring the old world traditions in which the husband makes all of the decisions. For these same cultures in which the husband is the one who is injured, the wife then takes an uncharacteristic leadership role. The husband (injured worker) resents his loss of power, but he is often quite dependent as well as pain intolerant. The children then defer to the mother for decisions, and the husband feels his masculinity is impugned: the wife and kids think he is less of a man. Yet he dependently clings to both the wife and the kids and perpetuates the problem.

The wife or husband of the injured patient is now getting _pay back_ for years of infidelity, abuse, substance dependence, financial irresponsibility and other domestic problems. This husband or wife then steps in and becomes the controlling demanding person they always wanted to be but could not for fear of retaliation from their mate_who is now disabled.

Most often, however, this is nothing more than _business as usual_ for this couple. The spouse has always made virtually all decisions and plans to do so now.

My approach? I do not attempt to reason with them at all because this irrational behavior is beyond reason. I simply state: _I will see your husband (wife) but not you. You may wish to reschedule if you decide you can accept that._ And I dismiss them both. Almost always, they return before leaving the building.

If your preference is a bit less aggressive, you can use the approach that you want to have him/her help you with their injured wife/husband and that you will get back to them regularly with any new information.

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