Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Resistance to Recovery: Resentment of the Cause and Outcome of Disability

“More often than not, lost time injury cases “F.E.S.T.E.R – feat, education, secondary gain, threat, expectancy and resentment.

The retaliatory drive that frequently governs society is often difficult to fully comprehend. Seeking of revenge/justice/restitution is a central component in many societies.

The concept of self as victim and the corollary perception that someone else must always be at fault, gives rise to the resentment that often obscures the recovery process.

If a patient perceives that someone must emotionally and/or financially suffer as a result of their limiting or disabling experience, the patient will maintain this level of resentment until resolution can occur. The question remains as to whether society fosters this resentment or, as would be the preference, seeks to assist the individual in resolving it.

In either case, resentment can maintain the patient’s disability presentation for extended periods. The psychophysiological aspects of continual anger and frustration and the need to portray oneself as a victim for financial compensation does little to promote healthy resolution of the limitations which the patient confronts.

Several of the perceptions that need to be addressed include:
a. Do you feel that someone is to blame for the problems you now have?
b. Are there periods during most days when you think of little else but your resentment of person(s) involved in the problems you now confront?
c. Do you believe that you cannot resolve this situation until someone compensates you for what you have experienced?
d. Would your problem be easier to manage if you were assured that someone else paid or suffered for the problem?

Summary and Conclusion
Far too often, the concept of the patient is that of a passive-dependent organism. Patient complaints are seen as factors which should readily yield to diagnostic studies. Symptoms are perceived as events in which response to treatment can be reliably predicted without recourse to psychological understanding of the factors which impact the context and aftermath of injury or illness.

In reality, early detection of these psychological factors can foreshorten the timeframe of disability, and when limitation comprises a permanent and partial disability, the delineation and early action upon these psychological factors can insure that physiological treatment is maximally effective even when it cannot be completely restorative. Ultimately, our goal is to insure that maximum recover occurs and that complaints do not fester.”

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