Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Finding Case Focus

The longer a case goes unresolved, the less likely it is to do so.

There are actually three sources for this ; some of which we cannot directly influence:

1. The patient’s source of the patient’s complaints are slow to be diagnosed since there is that tendency to dismiss everything as a minor problem until so much time has passed, complaints have built and providers changed that there is no choice but to look at, and for, more serious problems. In this process “the simple back strain” winds up, in actuality, being multiple bulged discs.

2. The input from family, friends, coworkers and others who encourage the patient to dwell upon the concept of preventability of the injury, unsupportive response of the employer and suggesting that the complaints have a financial/numerical value.

3. The response of the insurer who declines to approve diagnostic tests, recommended therapy and prescribed medications.

The latter is a significant concern because the patient will become increasingly futile feeling and blameful. If he/she is provided a target for that blame, the patient’s attention is focused away from the injury and self-accountability for rehabilitation to retaliating against the employer/insurer. While the patient’s perceptions of what the employer/insurer has done, and is doing, may be entirely accurate, the focus upon these misdeeds becomes a distraction and displacement from a healthier focus.

If you want a patient to assume individual responsibility for the process of recovery, you must be certain that you do not provide them with a convenient distraction that justifies their inactivity.

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