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Measuring the psychological impact of an injury

I have no formal psychological training.  I am not qualified, in a formal sense, to offer opinions regarding the psychological impacts of car crash injuries.  I do have a considerable amount of field experience, though.  It is this field experience that I am drawing on for this posting.

My field experience comes from the active role I play in monitoring my clients’ progress.  I have a goal of meeting with each of my personal injury clients every two months for a comprehensive update.  These meetings typically take between thirty and sixty minutes.  I spend that time getting a complete update of the client’s medical treatment, symptoms, and the impact those symptoms are having on the client’s work, home and recreational lives.

If you have never suffered a chronic injury, you might be surprised by how much impact an injury has on a person.

The most obvious impact is physical pain and discomfort.  We have all suffered some degree of physical pain.  For most of us, thankfully, the pain is short lived.  Having a stress headache once in a while, that goes away with an over the counter pill, is manageable.  The sore muscles you wake up with after shoveling snow for the first time in the season will resolve within a couple days and then you are good for the rest of the season.

Injuries can also impact on what you are capable of doing.  Often, the heavier housekeeping is out.  Shoveling snow is not possible.  Sitting for longer than a few minutes at a time at a computer makes tolerable pain intolerable.  Forget about heading up to Big White for some skiing.

Even if injuries are not disabling, they impact on what you feel like doing.  How many guys have faced the headache excuse?  It’s not just an excuse.  It is not easy to get in the mood for a little hanky panky when there is a headache or lower back pain gnawing at you.

It isn’t only sex.  Pain can often make previously enjoyed activities unenjoyable, if not impossible. Activities that require prolonged sitting, such as knitting, crocheting, scrap booking and reading lose their appeal when holding that posture increases upper back and neck pain.  Gardening is another classic example of an activity that can be stripped of enjoyment by pain.

Often, the price for participating in an activity is not paid until later.  Most of us have learned not to over indulge in alcohol to avoid the day or two hangover that follows.  Similarly, many of my clients have learned not to do certain physical activities so as to avoid the day or two or three of increased pain and stiffness that inevitably follows.

Then there are the financial impacts – the income loss and expense of medical treatment which I have discussed in previous postings.

Consider for a moment how your relationship might be impacted by less money coming in, more expenses to pay, less sharing of household duties, less fun activities, and compromised intimacy.

It doesn’t take a formally trained psychologist to surmise that these impacts might do nasty things to a person’s mood.

In the early stages, the update meetings are optimistic.  Even though the injuries are having all of these impacts, my clients are usually optimistic about their recovery.  The medical system is going to fix them.  The tunnel is not so bad with a bright light shining at the end of it.

As the months go by, there is a gradual, but very tangible, decline in optimism and mood.  It is not uncommon for my clients (both men and women) to get to the point of shedding tears when updating me on how things are going.  That previously bright light is fading.  Recovery is taking longer than expected.  The sprint to the finish has turned into a marathon.

If steps are not taken to deal with the depressed mood, it can transform from being just another impact of the injury, to having its own nasty impacts.  A person with a depressed mood is even less likely to have the energy or inclination to engage in activities, and is far less equipped to maintain the energy required to continue taking an active role in their recovery.  A vicious cycle can play out with the injury causing depression, the depression prolonging recovery, and the prolonged recovery causing a deeper depression.

I am vigilant about the psychological impacts of car crash injuries on my clients, and urge my clients to seek medical help to address the psychological side of things.  Treating the psychological pain is perhaps even more important than treating the physical pain. Whether it is through psychological counseling, a temporary prescription of medication, or other method, it is imperative that the psychological impacts of injury be addressed.

I urge you not to try to deal with the psychological impacts of pain without medical assistance.  Your spouse is not a trained counselor, and your relationship is enduring enough stress as it is because of your injuries.  It is ok to ask for help.

Published February 25, 2007 in the Kelowna Capital News