Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Anger Is Not a Mental Disorder

An injured worker is seeing Dr. _____ . The notes reflect that the patient is angry, victimized and distrustful. The doctor attributes this to his own perceptions that the care the patient received for his injury has been substandard.

All have reported that the patient eccentric, non-communicative and rarely complies with care. The doctor was initially given eight visits to see him. Then requested 10 more, and now is requesting 10 more.

In this case, the treatment will likely never been ended. The patient suffers from a personality disorder. Such a disorder does not arise from injury but instead arose during the course of his development. Misdirected psychological care will have a negative impact upon such a person.

Such individuals express thoughts and feelings differently than the average person.

They may be very negativistic, suspicious, self-involved, socially isolated, dependent and/or manipulative. They have been this way since early in life, and it has become an ingrained pattern of thinking, feeling and behaving.

Such individuals can remain in psychological care for decades (literally) since they do not change, and they see no reason to change. They attribute their problems to others and/or external events. They do not find themselves responsible in any way for their plight.

While care may financially benefit the psychologist, it will have a counterproductive impact upon the patient.

Injury-related psychological care, some would argue, it actually makes them worse since it reinforces their distortions of their world.

Ideally, the initial diagnostic consultation took this into consideration. If not, then he has been in counter-productive care for an entrenched personality disorder.

The only psychological care for which such patients benefit is the strong/firm redirecting of them away from blamefulness and lack of personal accountability. This requires no more than 2-3 visits.

Since they most often would prefer to stew in their own familiar juices, they do not like such redirection. Care that continues beyond that point is beneficial to the doctor, not the patient.

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