Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Little Motivation


motivationThe healthy individual moves towards pleasure and away from pain.

An individual’s actions are based upon motivation. Motivation refers to a process that starts, controls, and maintain behaviors. Motivation affects the strength of and the persistence of a behavior.

Approach behavior may be based upon the need for achievement, acceptance, fame, fortune and a myriad of other goals. Avoidance behaviors are based upon the need to escape pain, failure, humiliation and similar aversive experiences.

Once a worker is injured, the governing drives are those that motivate the patient to overcome this new obstacle in combination with the need to avoid certain outcomes like financial ruin.

Families attempt to motivate the injured worker through emotional pleas, entreaties and encouragement. Employers may be a bit more heavy handed and remind the patient of impending loss of job or lack of available jobs for the employee.

The course of care for an injury is only passively motivating. The tissue damage is addressed, and the patient is reassured that s/he will be capable of working with no, some or significant limitations. There is no pursuit of understanding that which motivates the patient.

Why was the patient working this particular job? Was the choice based upon positive aspects of the job such as achievement and security or was it based upon avoidance of potentially more difficult agenda such as completing an education, learning new skill sets or even attempts to avoid the confines of an office setting.

There is the assumption that it is unnecessary to know the motivation behind the original job selection or desire to return to productivity. However, if this were true…if motivational factors were irrelevant, then all patients would readily return to work when released MMI.

But they do not.

Some will languish due to a fear of re-injury, fear of ridicule and rejection by former coworkers, belief that a job that was once easy is not perceived as impossible. The underlying motivation is quite often unexplored by those treating the patient.

American Psychosomatic Society

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