While it is common for individuals to seek privacy in order to sort out problems, work on tasks or simply relax, it is uncommon for individuals to live in isolation. Indeed, the use of isolation, as in solitary confinement, is used as a form of punishment. An individual, who is so confined, becomes depressed and confused. Some individuals emerge from solitary confinement with an impaired ability to test reality, to relate to others or to emotion stability.
For many, a work injury results in isolation. Isolation from coworkers is the first and most obvious experience, but this is also accompanied by isolation from society. Society is arising, going to work, producing throughout the day and journeying home to discuss the daily events, both good and bad.
By contrast, the injured worker often arises at an unspecified time, with no agenda, no sense of accomplishment and in isolation from others. The day is spent nonproductively with television and radio, often stewing over events in the outside world over which they have no control or influence. They complete minimal tasks, have no tales to share at the end of the day and both envy and resent those who have real lives.
Additionally, they have time for maladaptive health behaviors such as smoking, drinking, recreational drug use and over eating. They may nap away segments of the day and then be unable to sleep at night. Due to both their injury and their decreased motivation, they engage in no physical activity. For some, such activity was only associated with demands on the job site.
They also have “time for pain.” They watch their bodies and register minute changes in the experience of pain. They note, track, schedule and count their medications. If they are on a fixed schedule of narcotic intake, they become obsessed with the time spans between permitted dosages, and not surprisingly, they almost universally feel that they are not sufficiently medicated. And, without question, they are at home for the bills to accumulate, statements to arrive in the mail and the seemingly endless calls from creditors.
The isolation of the injured worker is largely noted by only their family. Their friends have less contact and those involved in their care rarely register that this is arguably the most difficult aspect of the post-injury process.
It is, therefore, imperative to know how an injured worker is spending his/her day. If these daily schedules are a marked departure from the pre-injury life, then an attempt must be made to help the patient create a more sense of purpose and meaning to each day.