Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression


grievingGrieving: “A routine part of a psychological exam, at least my own, is to determine if the patient’s problems may be compounded by other and similar events.  One such event is the concept of loss.

It is obvious that an injury results in loss of income, loss of mobility, loss of daily productive activities and loss of daily comfort.   However, there are other losses such as the loss of relationships, both at work and in the community.  Sometimes the losses include support from loved ones.

In the case of amputation injuries, there is a clear and demonstrable physical loss, as well as the loss of concept of one’s body and its integrity.

When I examine a patient, I inquire as to whether there has been other, often non-injury losses, at or near the time of injury.   If these have occurred during the course of the preceding year, the patient may have already been in a state of grief. Grief then becomes compounded but also can be obscured by the focus upon the injury.

Grief involves sorrow, longing and yearning.  There is a mournful sense of loss and a yearning to have things as they once were.  This is similar to the presentation of depression after injury.  For many years, bereavement (grief) was felt to be somehow different from depression, but that belief is no longer held as valid. A grieving person is depressed.

Importantly, the grieving process can complicate the recovery from an unrelated injury. Some would even argue that a person who is grieving may be more prone to be distracted and inattentive, leading to vulnerability for injury.  In either case, while grief may complicate injury recovery, and grief may make the worker vulnerable to injury, injury can also complicate an unrelated and ongoing grief process.

It is therefore, imperative, that the post-injury 

patient be asked if there had been any recent losses with which they were attempting to cope.


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