Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Obstructing Care

There is no case of work injury that does not involve _psych_. All cases do.

_Psychology_ is the science of human behavior. It is what people do, think, feel and believe.

_Psych_ is two things in cases of claimed disability:

a. It is a mental disorder caused, or exacerbated, by injury

b. Or _psych_ are those factors that impede an injured workers_ willingness to return to work.

Mental Disorder frequently arises from injury in the form of mild depression, pain (somatoform) disorders, and/or anxiety disorders (most notably) posttraumatic stress disorder.

In these cases, Psych, if competently treated, psych care can expedite, not impede, the speed of recovery.

The second category, _psych_ factors, is found in virtually all facets of all cases. Psych, in this sense, refers to the patient_s goals, motivations, compliance, honesty, integrity, and ambition.

Psych involves whether the patient is accurately reporting the injury, truly complying with care, honestly reporting symptoms and limitations and is willing to work hard to get back to work.

Without _psych_, we have no idea as to why this patient_s physical complaints are in gross excess of the physical findings_why the MRI (etc) suggests no, or minor, defect, yet the person states that they are immobilized by pain.

It is only with _psych_ that we find out whether the injured worker is being negatively influenced by friends and family or other outside sources, and it is only through _psych_ that we can determine if the patient is capable of (intelligent enough for) understanding their diagnosis and the goals of treatment.

In each and every case, you can either deal pro-actively with _psych_ on behalf of the patient or be blind-sided by it.”

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