Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Why Patients Will Lie

Many injured males work in construction. This is obviously physically demanding although they may actually tolerate pain less well than do female production workers.

Actually there are two potential explanations:

First, in general, women are better able to tolerate pain.

But equally as important is the concept of narcissism. Many construction workers have minimal formal education. Many began working in their early teens and terminated their education by the 8th to 10th grade.

Their pride comes in generating very good income without the burden of having to complete high school, much less college. They often own many objects that are of high status in their socioeconomic group, and these objects have become evidence to them of their power, success and even their identity.

They become highly narcissistic – self-involved and self-absorbed.

They are injured, and their status in their community declines very rapidly. Spending power is immediately curtailed, and often they were working more than one job to permit the the status that they had.

Rather than acquire more education, they are alone at home, watching television, going to physical therapy, and sitting in waiting rooms.

Then two things happen: Aside from being angry, bored and restless, they now also believe that they will somehow, by some means, be compensated for their injury at a level that will restore their prior status. Thus, they must be both a victim (their new “career”) and very demanding (which likely characterized their personality before injury).

Their verbal complaints become both a means of expression of frustration but also a means of bolstering what they feel will be their financial future.

It is can feel futile in attempting to motivate such patients since they can readily entrench themselves in the healthcare system and merely allow years to pass. There becomes no “profit” to rapid recovery. However, many can be redirected to see that their struggle to again function is noble and something of which to be proud.

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